ntradiscal electrothermal therapy (IDET), which is a minimally invasive treatment, was performed to treat cervical HNP. Although IDET has a relatively short recovery time and lower cost compared to surgical treatment, it can still cause complications, such as nerve injury due to improper insertion of the catheter and temperature of the heating coil. This paper reports a rare case of dysphagia following IDET in Korea. A 71-year-old male complained of hoarseness and dysphagia after IDET on the C6-7 level. A Video Fluoroscopic Swallowing Study revealed vallecula and a pyriform sinus remnant, as well as incomplete vocal cord adduction. Subglottic aspiration was observed in the entire examination. The main cause of the dysphagia was attributed to recurrent laryngeal nerve injury during IDET through the right anterior approach at the C6-7 level. In conclusion, even in the case of minimally invasive procedures, the anterior approach may cause neurological damage, such as the recurrent laryngeal nerve. A fter the procedure, it is necessary to observe the patient’s symptoms, consider further evaluations, and perform rehabilitation treatment.

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate.The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate.The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.

Objective: To investigate changes in blood glucose level after steroid injection in patients with type 2 diabetes mellitus (DM) and factors affecting those changes. Methods: We retrospectively studied 51 patients with type 2 DM who underwent steroid injection for shoulder and back pain. Mean fasting blood sugar (FBS) levels for 7 days before steroid injection was used as the baseline blood glucose level, which was compared with FBS levels for 14 days after steroid injection. We compared the differences in blood glucose changes between HbA1c >7% and HbA1c ≤7% groups and those between insulin and non-insulin treated groups. Demographic data, injection site, and steroid dose were analyzed. Results: Compared to baseline, blood glucose significantly (p=0.012) elevated 1 day after steroid injection but not 2 days after injection. In the HbA1c >7% and insulin groups, blood glucose was significantly increased 1 day after injection compared to that in the HbA1c ≤7% (p=0.011) and non-insulin (p=0.024) groups, respectively. Higher HbA1c level before injection was significantly (p=0.003) associated with the degree of blood glucose increase 1 day after injection. No significant differences were noted in the degree of blood glucose increase according to injection site or steroid dose. Conclusion Higher HbA1c level was associated with greater elevation in blood glucose 1 day after steroid injection. Careful monitoring of blood glucose is required on the first day after steroid injection in patients with poorly controlled DM.

Objective: To investigate the effect of low frequency cerebellar repetitive transcranial magnetic stimulation (rTMS) on balance impairment in patients with cerebral infarction. Methods: Thirty-two patients were randomly divided into two groups: rTMS group (n=16) and control (n=16). In the rTMS group, treatment was performed five times per week for 2 weeks (10 sessions), and in the control group, a sham coil was used with the sound and sensation of scalp similar to the rTMS coil. Patients in both groups underwent a conventional rehabilitation program. Berg Balance Scale (BBS) was used as the primary outcome measurement. Timed Up and Go test (TUG), 10-m walk test (10mWT), and Activity-specific Balance Confidence scale (ABC) were used as the secondary outcome measurement. All scales were measured at baseline (T0), after 10 sessions of rTMS (T1), and at 4 weeks after treatment completion (T2) by therapists with over 5 years of clinical experience. Results: There were significant improvements between T0 and T1, and between T0 and T2, for all assessed items in the rTMS group. Whereas there were significant improvements between T0 and T1, and between T0 and T2, for the BBS and 10mWT in the control group. TUG (-4.87±5.05 vs. -0.50±2.97 seconds) and ABC score (8.10±8.33 vs. 0.16±0.97) were observed significant differences in comparison of the changes from T0 to T1 between the two group. BBS score (4.40±3.66 vs. 1.88±3.14), TUG (-4.87±4.56 vs. -0.62±2.96 seconds) and ABC score (8.22±7.70 vs. -0.09±0.86) differed significantly from T0 to T2 between the two groups. Conclusion Our findings suggest that low-frequency cerebellar rTMS is helpful for improving balance in patients with cerebral infarction, and maybe a beneficial treatment for these patients.

OBJECTIVE: To evaluate the influence of atrial fibrillation (Af) on the clinical characteristics and rehabilitation outcomes of patients with cerebral infarction. METHODS: We evaluated 87 of 101 consecutive patients with cerebral infarction admitted to the department of physical medicine and rehabilitation during their rehabilitation period. The patients were divided into two groups, Af and non-Af groups. We estimated characteristics of patient demographic features, disease duration, length of hospital stay, other comorbidities and risk factors for stroke, and functional status at admission and at discharge and compared those in patients with and without Af. Functional Independence Measure (FIM), the Modified Barthel Index (MBI), and the PULSES profile (PULSES) were used to evaluate functional status. RESULTS: The number in the Af group was 20 (22.9%) and that of the non-Af group was 67 (77.1%). Demographic features, other comorbidities, motor function, cognitive function, neurological scales, and brain lesions did not differ significantly between the groups. The incidence of coronary artery disease and valvular heart disease were significantly correlated with the incidence of Af in multivariate analysis. Based on FIM, MBI, and PULSES scores, functional improvement in the Af group after rehabilitation was significantly less than that of the non-Af group. CONCLUSION: Af was shown to be associated with a markedly negative result in rehabilitation in patients with cerebral infarction. Thus, early recognition and proper treatment of Af may help patients achieve more effective rehabilitation.
Atrial Fibrillation* ; Brain ; Cerebral Infarction* ; Comorbidity ; Coronary Artery Disease ; Heart Valve Diseases ; Humans ; Incidence ; Length of Stay ; Multivariate Analysis ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Risk Factors ; Stroke ; Weights and Measures

OBJECTIVE: To examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for plantar fasciitis. METHODS: Sixty patients with plantar fasciitis despite conservative treatment were enrolled. The patients were divided into a low-energy group (group L: n=30, 1,000 shocks/session, energy flux density [EFD] per shock 0.08 mJ/mm2) and a medium-energy group (group M: n=30, 1,000 shocks/session, EFD 0.16 mJ/mm2). The main outcome measures were visual analogue scale (VAS), Roles and Maudsley (RM) score, and thickness of plantar fascia (PF). To compare the effects between each group, follow-up was carried out 1 week after 3 and 6 sessions, and 1 and 3 months after ESWT. RESULTS: Significant VAS and RM score improvement, and PF thickness reduction were observed in both groups (p<0.01). After 3 sessions of ESWT, group M showed significant improvement in the VAS and RM score than group L, whereas after 3 additional sessions applied in group L, the main outcomes were no longer significantly different in both groups (p>0.05). CONCLUSION: Therapeutic effect might disclose a dose-related relationship; therefore, EFD and the times of the session are considerable factors when treating with ESWT.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Shock

Purpose: Few studies have assessed the prevalence of temporomandibular disorders (TMD) in the Korean population. Methods: We used cohort data from the Korean National Health Insurance Service between 2012 and 2020. The data consisted of main diagnoses related to TMD (International Classification of Diseases 10th Revision [ICD-10] code: K07.6 and K07.6x). The age-standardized prevalence of TMD was calculated using the estimated Korean population in 2020 as a reference. Results: The age-standardized prevalence of TMD increased from 604 persons per 100,000 persons in 2012 to 869 persons in 2020. In 2020, the overall age-standardized prevalence was 1,355 persons in the 10 to 19 years age group, 1,809 persons in the 20 to 29 years age group, and 979 persons in the 30 to 39 years age group. The age-standardized prevalence was approximately 1.5 times higher in females than in males (698 persons in males vs. 1,040 persons in females). Among the specific TMD subtypes, the age-standardized prevalence of internal derangement of the temporomandibular joint and pain in the temporomandibular joint, not classified elsewhere, was higher than that of other specific TMDs. Conclusion The overall age-standardized prevalence of TMD was higher in the 10s, 20s, and 30s age groups and in females between 2012 and 2020. The age-standardized prevalence of internal derangement of temporomandibular joint was the highest among specific TMD subtypes.

Objective: To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). Methods: The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. Results: The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. Conclusion AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.

Purpose: Few studies have assessed the prevalence of temporomandibular disorders (TMD) in the Korean population. Methods: We used cohort data from the Korean National Health Insurance Service between 2012 and 2020. The data consisted of main diagnoses related to TMD (International Classification of Diseases 10th Revision [ICD-10] code: K07.6 and K07.6x). The age-standardized prevalence of TMD was calculated using the estimated Korean population in 2020 as a reference. Results: The age-standardized prevalence of TMD increased from 604 persons per 100,000 persons in 2012 to 869 persons in 2020. In 2020, the overall age-standardized prevalence was 1,355 persons in the 10 to 19 years age group, 1,809 persons in the 20 to 29 years age group, and 979 persons in the 30 to 39 years age group. The age-standardized prevalence was approximately 1.5 times higher in females than in males (698 persons in males vs. 1,040 persons in females). Among the specific TMD subtypes, the age-standardized prevalence of internal derangement of the temporomandibular joint and pain in the temporomandibular joint, not classified elsewhere, was higher than that of other specific TMDs. Conclusion The overall age-standardized prevalence of TMD was higher in the 10s, 20s, and 30s age groups and in females between 2012 and 2020. The age-standardized prevalence of internal derangement of temporomandibular joint was the highest among specific TMD subtypes.