Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.
The aim of this study is to evaluate clinical usefulness of Korean red ginseng (RG) on various postmenopausal syndromes. Total plasminogen inhibitor-l (tPAI-l) in peripheral blood from 9 postmenopausal women with climacteric syndromes (CS) was measured before and 3 months after treatment with daily oral administration of 6 g RG and that from 8 postmenopausal women without any CS was also measured as healthy controls. Blood samples were collected in the early morning on the bed-rest. Psychological conditions of postmenopausal women with CS were measured before and 3 months after treatment with RG using simplified menopausal index (SMI). In addition, OKETSU (blood stagnation) syndrome scores and KI deficiency (generalized energy stagnation) scores proposed by Terasawa et al., were recorded before and 3 months after treatment with RG in postmenopausal women with CS and in healthy postmenopausal women. OKETSU syndrome scores and tPAI-l levels in postmenopausal patients with CS were significantly (P<0.001 and P<0.01) higher than those in healthy postmenopausal women without CS. Similarly, SMI scores and KI deficiency scores in postmenopausal patients with CS were about three-fold higher than those without any CS. When RG was administered for 3 months, KI deficiency scores and OKETSU scores as well as SMI scores declined around the levels of healthy postmenopausal women. Although tPAI-1 levels significantly (P<0.05) decreased after treatment with RG, those did not reach the levels of healthy postmenopausal women. Clinical usefulness of administration of RG to postmenopausal women with CS was confirmed from evaluation not only by modem medicine but also by traditional KAMPO medicine.
Purpose: The purpose of this study was to examine the effects of position change from supine to Fowler's on back pain and discomfort in patients who remained on bed rest after undergoing PCIs with a vascular closure device. Methods: Data was collected from 35 inpatients who were hospitalized in coronary-care unit to perform PCIs with a vascular closure device at S hospital in Seoul from December, 2006 to May, 2007. Back pain, discomfort, presence and grade of bleeding and hematoma from femoral arterial puncture site and blood pressure/pulse rate were measured prior to, 10 minutes, 1 hour and 2 hours after position change. Data was analyzed with descriptive statistics, $x^2$ tests and t-tests using SPSS/WIN 12.0 for Windows program. The level of significance (${\alpha}$) was set at 0.05 for this study. Results: We found that there was no significant difference in back pain and discomfort in 10 minutes after position change between the two groups. However, the experimental group reported significantly less back pain and discomfort than the control group in 1 hour (p<.01, respectively) and 2 hour (p<.01, respectively) after position change. There was no significant difference in the presence and grade of bleeding and hematoma at the puncture site, blood pressure, and pulse rate in 10 minutes, 1hour and 2hours after position change between the two groups. Conclusion: Fowler's position change after PCIs in, therefore, safe and effective method of reducing back pain and physical discomfort without causing additional bleeding and changes in blood pressure and pulse rate.
A long-term bed rest results in an inevitable foot drop. Yet preventive device such as a foot board and high-neck tennis shoes, are not widely used. This study was conducted to compare the effects of a pillow-type foot board with that of the band-type device. The band-type device of a resonable price is designed for an effective prevention of foot drop, and the convenience for it use. Among the non-equivalent control group design, foot drop preventive effects, usefulness of the device, as well as its cost effectiveness were examined. The study was carried out for four months from December 1999, and its subject had been patients and nurses of two intensive care units at K medical center in Seoul. According to the study purpose, the data collected were analyzed by $x^2-test$ and t-test. The results are as follow : 1. The ROM of ankle joint is promoted in the experimental group with a band-type device comparing the control group with a pillow type one. Dorsiflexion is particularly increased in the experimental group as compared with the control group, while planterflexion hardly shows any change. 2. The usefulness score of the experimental group nurses using the band-type device (23.97) is higher than that of the control group nurses (18.88). 3. In an aspect of the unit production cost, band-type devices are low-priced compare with pillow-type or other foot board (wooden) or high-neck tennis shoes. In summary, the newly developed band-type device is both useful and preventive for a foot drop. It is also desirable regarding to the production cost and the cost effectiveness. This fact proves that the new anti-foot drop device could be practical both for clinical care and home care. Yet the results were obtained by some subjects, it should be used after a further examination. More effective nursing intervention could be observed throughout general studies, including proper positioning and foot and ankle exercises which are the important variables of the foot drop prevention.
Cardiac cathererization has become a routine diagnostic procedure indicated for evaluation of a wide varity of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients report feeling uncomfortable in the CCU, but no studies have been done on the effects of bed rest, sand bags on the femoral puncture site and restricted mobility for 4 to 12 hours or longer postprocedure. The main objective of this thesis is to provide basic data to nursing on interventions which de-crease the uncomfortableness experienced by patients in the CCU following cardiac catheterization. In this phenomenological study, the various discomforts felt by the patients were collected and classified. The study subjects were a convenience sample of 29 patients who were admitted to the CCU of a general hospital in Inchon following cardiac catheterization. They were conscious, so they were able to communicate without difficulty. The data were collected over an U days period from July 21, to October 14, 1994. The subjects were interviewed using unstructured open questions and the interviews were tape recorded with the patient's permission The data were analyzed using the Van Kaams phenomenological method. Reliability and validity were exammed by two professor of nursing science, one head nurse, one staff nurse and one cardiologist. The results of the study are summarized as follows ; 1. The 129 descriptive statements by the postcardiac catheterization patients of discomfort were organized into 19 themes. 2. The 19 themes were divided into 3 categories ; physical, psychological, and environmental aspects. 3. The problems concerning the physical aspect were the discomfort of restriction of movement, dysuria, medical devices, pain in the puncture site, symptom is related to the procedure of cardiac catheterization, headache and dizziness, leg painand tingling sensation, and chest pain. The problems concerning the psychological aspect were regret resulting from dependency, economic burden, dissatisfaction with medical personnel, dissatisfaction with medical service system, anxiety about the result of the procedure, concern about the prognosis, loneliness, and concern over treatment procedure. The problems concerning the environmental aspect were influence from neighboring patients, noise, and maladaptation to environmental change. The necessity for holistic care which satisfies physical, psychological, and environmental need must be emphasized in order to solve these discomforts.
Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.
The Korean society is recently becoming the aging society at an unprecedentedly rapid speed. Following the increase of the older population, their needs for special care is also rocketing. However, due to the increase of working women, nuclear-families, and old persons living alone, new facilities for the elderly such as nursing home are urgently needed. Thus, many nursing homes for the elderly are also rapidly providing. It is needed to examine if such nursing homes are properly designed for the dependent elderly to live. This study was carried out by the field observation using a checking sheet with measuring and taking photograph. The subjects were 12 nursing homes which gave positive responses for walking through their facilities. The items for observing and measuring were made based on the regulation on improving the facilities for the disabled, the elderly, and the pregnant. Whether each item fits the regulation or not was examined. The 9 areas in each nursing home were examined : entrance, hallway and corridor, stair, elevator, ramp, bed room, shower and locker room, bathroom, and rest room. It was founded that many accessible-related items were met. However, many supportive-related items such as ones for the visual disabled, and many supportive-related and accessible-related ones for bathroom, shower room, and restroom were unmet. In the process of this research, it was founded that the tool for evaluating the design of nursing home in terms of universal design should be developed.
Objectives : Skeletal muscle atrophy occurs in response to a variety of conditions. The unloading to muscle occurs clinically in limb immobilization, bed rest, spinal cord injury and peripheral nerve damage, resulting in significant loss of muscle mass and force production. Muscle disuse is accompanied by an increase in apoptotic signaling, which mediates some of the responses to unloading in the muscle. In this study we tested the hypothesis that Daeyeoung-jeon extract would improve muscle recovery after reloading following disuse. Method : Twenty young male Sprague-Dawley rats were used for the studies. The hindlimb immobilization was performed with casting tape to keep the left ankle joint in a fully extended position. No intervention was performed on the right leg and used as intact region. The Rats in Daeyeoung-jeon treated group (DYJ) were orally administrated Daeyeoung-jeon water extract, and rats of Control group were given with saline only. After 2 weeks of immobilization, all animals were sacrificed, and the whole gastrocnemius muscles were dissected from both legs. The morphology of right and left gastrocnemius muscles in both DYJ and Control groups were assessed by hematoxylin and eosin staining. Moreover, to investigate the immobilization-induced muscular apoptosis, the immunohistochemical analysis of Bax and Bcl-2 was carried out. Results : Daeyeoung-jeon represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. The treatment with Daeyeoung-jeon extract significantly reduced the immunoreactivity of BAX and increased the immunoreactivity of Bcl-2 in gastrocnemius muscle compared with Control group. Conclusion : Daeyeoung-jeon has protective effects against immobilization-induced muscle atrophy by regulating the activities of apoptosis-associated BAX/Bcl-2 proteins in gastrocnemius muscle.
본실험은 상족기에 집중적으로 소요되는 노동력을 절감하기 위하여 숙잠의 자연등족을 촉진시키는 보조수단의 1종인 기피제에 대해서 연구하였는바 다음과 같은 결과를 얻었다. 1. 기피효과가 가장 현저한 것은 참나무계통이며 약쑥 개여뀌의 순으로 나타났다. 그 이외의 처리구도 기성등족제 シ ル ク ア ツ プ 처리구보다 등광률이 높은 것으로 미루어 보아 실용화가 기대된다. 2. 기선제의 조제방법은 증류액, 탕액 및 즙액의 형태로 조제하여 조강에 흡수시켜 시용하는 것이 등족효과가 우수하였다. 이 중에서도 가장 손쉬운 방법은 탕액이 라고 생각된다. 3. 기피제처리가 누에 생리에는 거의 영향이 없는듯하며 견질과 사질에도 별로 영향을 미치지 않는 것으로 보인다. 4. 본기피제를 잠좌에 처리했을 때 미숙잠도 등족하는 경향이 있으므로 기피제를 이용할 때는 숙화정도를 재일하게 해야만 더욱 효과적일 것으로 살펴진다.
Objectives : The aim of this clinical experiment was to investigate the effect of KamiWooseul-tang on low back pain and kidney function. Methods: We investigated 64 low back pain patients. We treated the patients with acupuncture, bed rest, herbal medicine, physical therapy. The patients were divided into two groups as follows, 32 patients (with normal renal function) were treated with only KamiWooseul-tang. Another 32 patients were treated with a commonly used herbal medicine. Results : The obtained results are summarized as follows. The patients were 43.8% male and 56.2% female. Their age were 20s 15.6%, 30s 25%, 40s 17.2%, 50s 9.3%, 60s 18.8% 70s 12.5% and 80s1.6%. Duration is most common in the most acute stage (< 1 week), next was chronic stage ( >6 months ), acute stage (1 week ~ 1 month) and subacute stage(l months ~ 6 months) in turn. Cure rate increased step by step after herb-medicine administration. Duration of patients had no relation with cure rate(P>0.05). The KamiWooseul-tang was more effective than the commonly used herbal medicine after 3 weeks therapy (P<0.05). Serum BUN and Creatinine level in KamiWooseul-tang group changed from $14.69{\pm}4.0,{\;}0.76{\pm}0.19(mg/dl)$ before adminstration to $13.64{\pm}3.92{\;}0.77{\pm}0.19,{\;}13.48{\pm}3.00{\;}0.82{\pm}0.21,{\;}13.26{\pm}3.73{\;}0.87{\pm}0.21(mg/dl)$ at 7th, 14th, and 21st days of administration respectively. Urinalysis showed no specific change in the KamiWooseul-tang group. During medication serum-electrolyte was within normal range. Conclusion : Therefore KamiWooseul-tang was more effective than the commonly used herbal medicine and there was no clinically remarkable difference in the serum BUN, Creatinine level, urinalysis and serum electrolyte between pre-medication and post-medication in the KamiWooseul-tang group.
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