Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

BACKGROUND: Despite the many advantages of recombinant subunit vaccines, they have critical weaknesses that include a low efficacy for promoting cellular and humoral immune responses against antigens because of their poor immunogenicity, and a rapidly cleared properties as a result of proteolytic enzymes in the body. To circumvent these problems, we developed mannan-decorated inulin acetate microparticles (M-IA MPs) that functioned as carriers and adjuvants for immunization with the recombinant foot-and-mouth disease multi-epitope subunit vaccine (M5BT). METHODS: The M5BT-loaded M-IA MPs were obtained by a double-emulsion solvent-evaporation method. Their properties including morphology, size and release ability were determined by field emission scanning electron microscope, dynamic light-scattering spectrophotometer and spectrophotometer. To assess the immunization efficacy of the MPs, mice were immunized with MPs and their sera were analyzed by ELISA. RESULTS: The M-IA MPs obtained by a double-emulsion solvent-evaporation method were spherical and approximately 2–3 µm, and M5BT was encapsulated in the M-IA MPs. The M5BT-loaded M-IA MPs showed higher antigen-specific IgG, IgG1, IgG2a and anti-FMDV antibodies than the M5BT-loaded IA MPs and the Freund’s adjuvant as a control. CONCLUSION The M-IA MPs showed a powerful and multifunctional polymeric system that combined two toll-like receptor agonists compared to the conventional adjuvant.

BACKGROUND: Despite the many advantages of recombinant subunit vaccines, they have critical weaknesses that include a low efficacy for promoting cellular and humoral immune responses against antigens because of their poor immunogenicity, and a rapidly cleared properties as a result of proteolytic enzymes in the body. To circumvent these problems, we developed mannan-decorated inulin acetate microparticles (M-IA MPs) that functioned as carriers and adjuvants for immunization with the recombinant foot-and-mouth disease multi-epitope subunit vaccine (M5BT). METHODS: The M5BT-loaded M-IA MPs were obtained by a double-emulsion solvent-evaporation method. Their properties including morphology, size and release ability were determined by field emission scanning electron microscope, dynamic light-scattering spectrophotometer and spectrophotometer. To assess the immunization efficacy of the MPs, mice were immunized with MPs and their sera were analyzed by ELISA. RESULTS: The M-IA MPs obtained by a double-emulsion solvent-evaporation method were spherical and approximately 2–3 µm, and M5BT was encapsulated in the M-IA MPs. The M5BT-loaded M-IA MPs showed higher antigen-specific IgG, IgG1, IgG2a and anti-FMDV antibodies than the M5BT-loaded IA MPs and the Freund’s adjuvant as a control. CONCLUSION The M-IA MPs showed a powerful and multifunctional polymeric system that combined two toll-like receptor agonists compared to the conventional adjuvant.

As the request of the authors, one paragraph has been changed.

Anti-inflammatory effects of Houttuynia cordata supercritical extract (HSE) were investigated in rat carrageenan-air pouch model. Oral administration of HSE (50-200 mg/kg) suppressed carrageenan-induced exudation and albumin leakage, as well as inflammatory cell infiltration at a high dose (200 mg/kg). Intraperitoneal injection of dexamethasone (2 mg/kg) only decreased exudation and cell infiltration, while indomethacin (2 mg/kg, i.p.) reduced exudate volume and albumin content without influence on the cell number. HSE lowered tumor-necrosis factor-alpha (TNF-alpha) and nitric oxide (NO), as well as prostaglandin E2 (PGE2). Dexamethasone only reduced TNF-alpha and NO, while indomethacin decreased PGE2. The results indicate that HSE exhibits anti-inflammatory effects by inhibiting both TNF-alpha-NO and cyclooxygenase-2-PGE2 pathways.
Administration, Oral ; Animals ; Carrageenan ; Cell Count ; Dexamethasone ; Dinoprostone ; Exudates and Transudates ; Houttuynia ; Indomethacin ; Inflammation ; Injections, Intraperitoneal ; Nitric Oxide ; Rats ; Tumor Necrosis Factor-alpha

The anti-inflammatory effects of fuciodan and Cistanche tubulosa (CT) extract were investigated in vitro macrophage culture system and in vivo carrageenan-induced air pouch inflammation model. CT extract inhibited nitric oxide production from activated RAW 264.7 macrophage cells, while fucoidan was inactive. In vivo air pouch inflammation model, carrageenan-induced vascular exudation and increased nitric oxide and prostaglandin E2 concentrations in the exudates were synergistically suppressed by co-administration of fucoidan or CT extract. Moreover, tissue inflammation was substantially attenuated by the combinational therapy. However, there was no synergistic effect against the inflammatory cell infiltration, although fucoidan and CT extract each markedly reduced the cell numbers. Therefore, it is suggested that fucoidan blocks infiltration of inflammatory cells, while CT extract inhibits activation of the cells, and that their combinational treatment could be a promising candidate for the relief of various types of inflammation.
Carrageenan ; Cell Count ; Cistanche ; Dinoprostone ; Exudates and Transudates ; Inflammation ; Laminaria ; Macrophages ; Nitric Oxide ; Polysaccharides

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care

PURPOSE: The advent of laparoscopic abdominal surgery made it possible to perform a laparoscopic adrenalectomy (LA). We have successfully performed 10 such operations since November 21, 1995. We retrospectively compared the effectiveness and the safety of a laparoscopic adrenalectomy with the effectiveness and the safety of an open adrenalectomy (OA). METHODS: The 45 patients with adrenal diseases who underwent an adrenalectomy from March 1990 to January 1998 were included in this study. Ten (10) laparoscopic cases comprised the study group, and 17 of the 32 open adrenalectomy cases, performed by anterior approach, comprised the control group. RESULTS: No one died from an adrenalectomy. Nine cases (45%) from the OA group needed transfusions (average: 661 ml), but one patient from the LA group, who had required a conversion to a celiotomy, required a transfusion (400 ml). The operating times were, on average, 191 minutes in the OA group and 230 minutes in the LA group (p=0.0384). The average size of the masses was 6.5 cm. The first days of walking after the operation was 3.4 days for the OA group and 1.3 days for the LA group (p=0.0002). The patients' former regular diets were started on days 6.9 and 3.2 for the OA and LA groups, respectively (p=0.0001). Postoperative in-hospital days were 17.5 for the OA group and 7.9 for the LA group (p=0.0001). CONCLUSION: In comparison with an open adrenalectomy, a laparoscopic adrenalectomy showed better convalescent features: that is, less chance of transfusion, earlier recovery, faster resumption of the former diet, shorter postoperative hospital stays, and cosmesis. We think and suggest that a laparoscopic adrenalectomy is a safe and effective procedure, and hopefully it will become the standard choice of operation for various adrenal diseases.
Adrenalectomy* ; Diet ; Humans ; Laparoscopy ; Length of Stay ; Retrospective Studies ; Walking