Cervical disc herniation is one of the most common causes of neck, shoulder and arm pain. There are many treatments for a cervical disc herniation, such as rest, physical therapy, medication, epidural steroid injection and surgery. However, conservative treatments sometimes have limited effectiveness, and a surgical discectomy is often associated with numerous complications. Nowadays, a percutaneous discectomy, using a Dekompressor(R) , has been used in herniated disc patients, but a posterolateral extruded disc is not an indication. Herein, our experience using a 19 G Dekompressor(R) , on a 52 year-old male patient with a left C6 7 posterolateral extruded disc, is reported. Decompression was successfully performed, and the pain and range of motion was immediately improved.
Arm ; Decompression ; Diskectomy* ; Diskectomy, Percutaneous ; Humans ; Intervertebral Disc Displacement ; Male ; Middle Aged ; Neck ; Range of Motion, Articular ; Shoulder

BACKGROUND: Prolotherapy is an effective treatment for pain due to ligament or tendon laxity. The purpose of this study was to determine the effects of prolotherapy on the relief of shoulder pain. METHODS: Twenty-nine patients who complained of shoulder pain were investigated using a pain score system. Prolotherapy was performed using 15% dextrose to regions according to Hemwall's pattern. We recorded numeric rating scale (NRS) pain scores just before prolotherapy and 1, 2, 4 and 8 weeks later. RESULTS: For the 29 patients, prolotherapy proved to be effective and satisfactory in 83% (NRS; 7.2 +/- 0.8 before, 2.0 +/- 1.3 after prolotherapy). CONCLUSIONS: Prolotherapy with 15% dextrose resulted in a clinically significant improvement of shoulder pain due to ligamentopathy.
Glucose ; Humans ; Ligaments ; Shoulder Pain* ; Shoulder* ; Tendons

Smoking can be changed by health behavior education on the fact that unhealthy behaviors can cause chronic diseases and cancer and that it is important to identify health behaviors in smoking. We try to compare the health behaviors of combustible cigarette (CC), heated tobacco (HT) users, and quitters. Smoking behaviors were divided into three groups (CC, HT users, and quitters). The HT user group (n = 100) was selected among those who underwent a health examination in 2021-2022. CC smokers cohort group (n = 100) and quitters cohort (n = 100) were randomly selected from the same groups (age ± 2) who underwent a health examination in the same period. Sleep-related problems (snoring and sleep apnea), alcohol consumption, and exercise were compared in the CC group, HT group, and quitters group, respectively. Snoring was more common in the quitters group (27%) than in the CC users group (19%) and HT users group (18%). It can be related to weight gain during quitting tobacco use. Nondrinkers were more common in the CC users group (21%) than the HT users group (8%) and quitters group (10%). CC users seem to be more concerned about the health effects of drinking compared to HT users and quitters. Anaerobic exercise was different among groups, and aerobic exercise was not. HT users group did more aerobic exercise than CC users and quitters group. Differences in healthy behaviors among CC and HC users and quitters can be useful information for health education to smokers. Understanding smokers’ health behavior is important to smoking cessation counseling in clinical practice.

People who recover from the novel coronavirus diseases 2019 (COVID-19) complain of psychological symptoms such as stress, anxiety, and depression by psycho-stress due to social stigma in the early stage of the epidemic. To assess the psychological stigma of early and late epidemic periods, stigma scale was compared between the first epidemic period (February-May 2020, n = 20) and the fifth epidemic period (February-May 2022, n = 21) post-recovery COVID-19 patients in outpatient clinic. The average total stigma score was significantly higher (79.6 ± 18.16) in post-recovery COVID-19 patients of the early (first) epidemic period compared to late (5th) epidemic period patients (37.5 ±10.99). Four subscales were significantly higher in early epidemic period compared to late epidemic period (enacted stigma 27.5 ± 7.25 vs. 13.0±4.18, disclosure concerns 19.5 ± 9.38 vs. 9.4 ± 2.99, negative self-image 16.2 ± 8.10 vs. 8.1±2.47, concern with public attitudes 16.6 ± 6.95 vs. 7.0 ± 2.01). In those who recovered from the early COVID-19 epidemic period, patients experienced significantly higher social stigma stress compared to the late epidemic period. In the early period of novel virus epidemics, the risk of personal stigmatization and stress should be prevented in public policy. Socio-psychological assessment and treatment should be considered for the patient in addition to physical symptoms.

COVID-19, the first pandemic experienced in the current generation, results various physical and mental stress and stigma. Stress (Korean version of the stress perception scale), anxiety and depression (hospital anxiety depression scale) and stigma was evaluated from the 20 patients recovered from the initial pandemic period, during February to March 2020. The average age was 51.3 (± 8.26) years old. The average hospital and therapeutic living center admission period was 26.8 (± 5.24) days, and the average period after discharge was 19.4 (± 4.33) days. The severity of the symptoms was 3 (15%) asymptomatic, 13 (65%) mild, and 4 (20%) severe (pneumonia). The average score on the perceive stress scale was 19.6 (± 6.52) and 65% (13/20) perceived moderate or severe stress status. The average score for hospital anxiety depression was 15.0 (± 5.45) points, the average score for anxiety was 6.6 ± 3.25 points, and the average score for depression was 8.4 (± 3.86). The average stigma score was 79.6 (± 16.16) points. Post-recovery patients from COVID-19 was perceived significant stress, experiencing anxiety, depression, and stigma in early pandemic period.

Long coronavirus disease (COVID) syndrome is persistent symptoms and complications that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 infections. Symptoms associated with long COVID can vary widely from person to person but commonly include: fatigue, shortness of breath, chest pain or discomfort, joint pain, difficulty concentrating (brain fog), headache, loss of taste or smell, sleep disturbances, palpitations, persistent cough. Possible pathophysiologic theories are viral persistence, dysregulated immune response, autoimmune response, endothelial dysfunction, gut dysbiosis, damage to organs and tissues, neurological involvement, post-viral syndrome. Although current diagnostic and treatment options are insufficient, the management aim to alleviate symptoms, improve quality of life, and support recovery. The possible therapies and interventions that may be considered are symptomatic management, rehabilitation and exercise, respiratory support, cognitive and psychological support, sleep management, nutritional support, support groups and patient education, anti-inflammatory drugs, immuno-modulatory therapies. For patients enduring prolonged suffering from this long COVID syndrome, a multidisciplinary approach is essential for comprehensive management.

The use of complementary alternative therapies in cancer patients are increasing with the increase in cancer incidence and treatment rates. Studies were conducted to find out about cancer patients’ knowledge and attitudes (treatment effect, intention to use) towards complementary and alternative therapies. 10 complementary alternative therapies (hyperthermia, ascorbate, thymosin, mistletoe, immunocyanin, selenium, Phellinus linteus, cholecalciferol, glutathione, herb remedies) were selected from evidence review. 100 patients who visited cancer care hospitals were surveyed about their knowledge and attitudes (effectiveness, treatment choices) by self-questionnaire. The total score for knowledge/attitude (effectiveness/intent to use) towards complementary and alternative therapies was 25.4 points (26.7 points/24.7 points, out of 40). Knowledge and attitude scores for hyperthermia were the highest, and knowledge and attitude scores for immunocyanin and glutathione were the lowest. Herbal remedies scored higher on knowledge but lower on attitude (effectiveness and choice). Vitamin C had moderate knowledge and effectiveness scores, but the highest intention-to-use score. There was a negative correlation between the effectiveness of complementary and alternative therapies and the choice of treatment regimen with lower scores as people aged. The use of complementary alternative therapies is increasing although the evidence has not been proven for the cancer cure rate or survival. It is necessary to recognize the effectiveness and limitations of complementary alternative therapies and educate patients so that they can choose the appropriate treatment. Further research is needed on the effects and side effects of various complementary alternative therapies used in addition to standard treatments.

BACKGROUND: The presence of pain during interventional pain management such as prolotherapy and intramuscular stimulation is stressful to patients and can affect the treatment outcome. We studied the safety and efficacy of two drug regimens: midazolam alone and midazolam/alfentanil for sedation anesthesia during prolotherapy and intramuscular stimulation. METHODS: Fifty three patients received either midazolam 0.04-0.08 mg/kg (Group M) or midazolam 0.01-0.02 mg/kg with alfentanil 4-8microgram/kg (Group A) for prolotherapy or intramuscular stimulation. We recorded the pain response, sedation score and side effects during the procedure, as well as amnesia, satisfaction and time to discharge after the procedure. RESULTS: Both drug regimens had significant sedation scores, amnesia and overall provided patient satisfaction. The treatment of pain was superior in Group A. Respiratory depression of three patients occurred in Group A. The time to discharge was longer in Group M. CONCLUSIONS: Midazolam and midazolam/alfentanil used for sedation anesthesia during prolotherapy and intramuscular stimulation were both effective; however, midazolam alone was the safer approach.
Alfentanil ; Amnesia ; Anesthesia* ; Humans ; Midazolam* ; Pain Management ; Patient Satisfaction ; Respiratory Insufficiency ; Treatment Outcome

OBJECTIVE: Laparoscopic vaginal vault closure with conventional straight instruments is the final barrier to single-port access total laparoscopic hysterectomy (SPA-TLH). The aim of this study is to find out the safer, easier, simpler, faster, and even cheaper way to overcome it. METHODS: Vaginal vault suturing techniques of 152 consecutive single-port access total laparoscopic hysterectomy cases performed by the author in Gangnam CHA Hospital, CHA University from October 1, 2003 to June 30, 2012, were retrospectively analysed with medical records and DVDs. RESULTS: Of 152 patients who were attempted SPA-TLH, 119 patients (78%) were finished their operations without conversion to multi-port laparoscopy or laparotomy. Of women with successful SPA-TLH, 8 cases (7%) were closed their vaginal vaults vaginally (median, 20 minutes; range, 15-44 minutes), and 111 cases (93%) laparoscopically (median, 44 minutes; range, 13-56 minutes). Laparoscopic vault closure techniques were continuous suture (4 cases, 3%; median, 36 minutes; range, 30-45 minutes), interrupted sutures using knot-pusher (7 cases, 6%; median, 52 minutes; range, 48-56 minutes) Endo Stitch suture (2 cases, 2%; median, 32 minutes; range, 13-50 minutes), continuous vault closure using percutaneous sling sutures (PCSS) (92 cases, 77%; median, 40 minutes; range, 19-56 minutes), and continuous vault closure without PCSS (6 cases, 5%; median, 23 minutes; range, 16-31 minutes). CONCLUSION: Laparoscopic vault closure using PCSS in SPA-TLH only with conventional straight instruments is the best way to overcome the barrier and the short-cut to shorten the learning curve to date.
Female ; Humans ; Hysterectomy* ; Laparoscopy* ; Retrospective Studies ; Suture Techniques* ; Sutures