• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.33-38
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• 2014

Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.193-203
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• 2001

The purpose of this study was to identify the relationship between depression and physical health of the elderly and to provide fundamental data for programs which improve the health of this population. The subjects were 168 elderly people(55 years and older) who resided at home in Taegu. They were surveyed by interview using a closed- ended questionnaire. The survey was done from September 16 to October 16 in 2000. The instruments used in this study were general characteristics, Short form Geriatric Depression Scale(SGDS), Barthel Index, Muscular skeletal symptoms scale, Northern Illinois University's Health Self Rating Scale. The data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, multiple regression with SPSS PC 10.0 version for Windows. The findings were as follows: 1. As compared 65-74 years elderly group, 75-84 years group was significantly higher score for depression(F=3.17, p=.026). As compared elderly group who has own spouse, the group who has no own spouse was significantly higher score for depression(t=- 2.44, p=.016). 2. The aged who have more limitation of Activities of Daily Living(ADL)(t=3.93, p=.000), pain of muscular skeletal symptoms(F=5.33, p=.002) and poor perceived health state(F=17.04, p=.000) showed the higher severity of depression than the aged who have not. 3. ADL correlated negatively with depression(r=- .293, p=.000), pain of muscular skeletal symptoms correlated positively(r=.251, p=.001), perceived health status correlated negatively(r=-.522, p=.000). 4. The combination of perceived health status and ADL explained 29.1% of the varience of depression. On the basis of the above findings the following recommendations are made; 1. Developing health programs is needed considering ADL, pain of muscular skeletal symptoms, perceived health status, demographic variables (age, spouse status) which have an significant effects on depression of the elderly. 2. In the following study, the use of the various scale is needed which reflects physical status of the elderly in home.

• Therapeutic Science for Rehabilitation
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• v.7 no.4
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• pp.19-30
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• 2018

Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.129-135
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• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.672-677
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• 2007

Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.134-148
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• 1995

Dysmenorrhea is probably the most common of all Gynecologic disorders. In the oriental medicine the etiology of Dysmenorrhea is very various, but its mechanism is just that the block of the flow makes the pain. So its treatment is removing the pain by promoting menstrual flow, promoting the flow of qi and by warming channel and activating blood flow. In the various treatments of dysmenorrhea, the method of applying drug at the acupoints which could be combined with feeding herb-medicine by oral was studied. The results obtained here were as follows; 1. In the treatments of dysmenorrhea, the method of applying drug at the acupoints was mainly applied to the type dued to stagnancy of qi and blood stasis, menorrhalgia dued to to cold and dampness, and primary dysmenorrhea. 2. The acupoint used in this treatment was Shin-gwol$(CV_8)$, the umbilicus. 3. The drugs used in this treatment were almost same as oral herb-medicine mainly to activate the blood flow and remove the blood stasis and to promote the flow of qi by warming the channel and remove the pain. 4. The duration of the treatment is, from 3 days before menstration till its period or a few days after it., usually concentrated on fore-postmenstration. 5. The effect of this treatment was reported as excellent. It is more effective to the type of stagnancy of qi and blood stasis, cold and dampness than dued to deficiency of both qi and blood, and dued to the impaired liver-kidney essence. 6. The method of applying drug at the acupoint was as an external treatment, easy, economical, and had no pain and side effect. 7. In the treatments of dysmenorrhea, the method of applying drug at the acupoint could be used as emergency treatment and symptomatic treatment in fore-postmenstration.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.150-156
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• 2021

Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.598-604
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• 2008

Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

• Proceedings of the Materials Research Society of Korea Conference
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• 2003.11a
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• pp.54-54
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• 2003

최근 새로운 개념에 물성 구현을 위한 강유전체 산화물 인공격자의 연구가 활발히 진행되고 있다. 본 연구에서는 펄스레이져 증착법을 이용하여 산소분압 100 mTorr와 증착온도 50$0^{\circ}C$에서 LSCO/MgO 기판 위에 PbTiO$_3$(PTO) 와 PbZrO$_3$(PZO)을 주기적으로 적층하여 강유전체 산화물 인공격자를 형성하였다. 인공격자의 주기는 1~100 unitcell 까지 변화시켰다. 적층주기와 두께 변화에 따른 PZO/PTO 인공격자의 성장과 전기적 특성에 대하여 관찰하였다. X선 회절분석을 통하여 PZO/PTO 인공격자는 주기가 25 unit cell 이하의 적층구조에서 초격자의 형성으로 인한 위성피크가 관찰되었으며, 그 이하의 낮은 주기(1~10 unitcell)에서는 위성피크와 강한 (100)과 (200) 성장거동을 보였다. 높은 주기에서는 c축 성장된 PTO와 a축 성장된 PZO 각각의 성장거동을 보였다. 적층 주기가 감소함에 따라 a축 성장된 PTO와 c축 성장된 PZO가 초격자를 형성하였다. 적층주기가 감소함에 따라 유전상수와 잔류분극값이 향상되었다. 유전상수는 1 unitcell 주기에서 800정도의 값을 보였고, 잔류분극값은 2 unitcell 주기에서 2Pr=38.7 $\mu$C/$\textrm{cm}^2$ 정도의 가장 큰 값을 나타냈다. 적층주기가 2 unitcell에서 두께가 감소함에 따라 유전상수가 감소하였고, 20 nm 까지 분극반전에 의한 capacitance-voltage 특성곡선의 이력 현상(강유전성)을 관찰하였다. 이러한 산화물 인공초격자에서의 유전상수와 잔류분극값의 향상에 대하여 논의 할 것이며, 임계크기효과 관점에서 나노사이즈(50 nm~5 nm)에서 인공초격자의 전기적 분극의 안정성에 대하여 또한 논의 할 것이다.소수성 가스의 경우70% 이상 향상되었음을 알 수 있었으며, 본 연구를 통해 광분해를 이용한 스크러버가 기존설비의 장.단점을 충분히 보완 가능한 환경 설비임을 확인할 수 있었다. duty로 구동하였으며, duty비 증가에 따라 pulse의 on-time을 고정하고 frequency를 변화시켰다. dc까지 duty비가 증가됨에 따라 방출전류의 양이 선형적으로 증가하였다. 전압을 일정하게 고정시키고 각 duty비에서 시간에 따라 방출전류를 측정한 결과 duty비가 높을수록 방출전류가 시간에 따라 급격히 감소하였다. 각 duty비에서 방출전류의 양이 1/2로 감소하는 시점을 에미터의 수명으로 볼 때 duty비 대 에미터 수명관계를 구해 높은 duty비에서 전계방출을 시킴으로써 실제의 구동조건인 낮은 duty비에서의 수명을 단시간에 예측할 수 있었다. 단속적으로 일어난 것으로 생각된다.리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.187-198
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• 1999

Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.