• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.370-374
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• 2014

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.23-37
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• 2004

Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

• The Journal of Pediatrics of Korean Medicine
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• v.29 no.4
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• pp.67-76
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• 2015

Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.161-168
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• 2016

Purpose: Patients who suffer from rheumatic arthritis, fibromyalgia, other various inflammatory diseases and musculoskeletal disorders, which are all similar to temporomandibular disorders (TMD), have been complaining about changes in the level and type of pain in response to changes in weather conditions for a long time. Through an investigation about pain perception in TMD patients in response to weather conditions, our primary objective was to develop base materials for future studies on change in pain in response to meteorological factors. Methods: Among patients who presented with TMD to Department of Oral Medicine, Pusan National University Dental Hospital from August to October 2016, one hundred consecutive TMD patients diagnosed with TMDs according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were recruited for the study and 28 patients were excluded according to exclusion criteria. Survey was done with the questionnaire and investigated whether there was any difference in incidence and level of pain in TMD patients between non-rainy and rainy days. Results: Among a total of 72 samples, 4 patients reported change in pain on rainy days rather than non-rainy days. Two patients from chronic group (joint and complex subgroup) reported increased pain on rainy days rather than non-rainy days but it was not statistically significant (p>0.05). One patient from chronic/muscle group reported the change in pain characteristics while pain intensity remained unchanged. One patient from acute/complex group reported decreased pain intensity. In comparison of the patients who reported increased pain on rainy days between acute and chronic groups, there were two reported cases and were both from chronic group only. There was a significantly higher chance of reporting increased pain on rainy days in chronic group than acute group (p<0.001). Conclusions: It is considered that TMD patients couldn't perceive the change in pain well in response to weather change on rainy days but some chronic patients could perceive the increase in pain in rainy days.

• Journal of muscle and joint health
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• v.2 no.2
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• pp.197-208
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• 1995

The purpose of this study is to describe specific system manifestations and suggested nursing interventions in patients with lupus. Lupus is a chronic, inflammatory, multisystemic disorder of the immune system. Antibodies are formed which react against the person's own normal tissue. This abnormal response can be very damaging and leads to the many manifestations of the lupus. Lupus can affect any part of the body, and patients experience symptoms in organs involved. So lupus patients have integumentary, blood, central nervous system, eye, gastrointestinal, musculoskeletal, kidney, heart and lining membranes, reproductive system involvement. The courses are unpredictable and very individualized. Lupus varies greatly in severity from mild cases requiring minimal interventions to those in which significant damage occurs to vital organs such as the lungs, heart, kidney and brain which ultimately can be fatal. In addition to direct physical care, the nursing professional has an excellent position from which to support the lupus patient. Patients need assistance with receiving current, accurate information about the disease process and also to be helped in developing realistic expectations and goals. Nursing interventions for the patient with lupus is challenge drawing on at the resources, knowledge and strengths the nursing teams have to offer. Because of the unpredictable, highly individualized and frequently changing the nature of the disease itself as well as the intricacy of the patient's needs. The nurse has a key role in its management. The patient and nurse, working together, have much to offer each other. These are of inestimable value to the patient. As the nurse listens to the patient and learns what problems the patient perceives, can guide the patient in a self-help program that allows to adapt to living with a chronic illness.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.96-104
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• 2022

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.1
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• pp.124-129
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• 2013

Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.

• The Korean journal of sports medicine
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• v.36 no.4
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• pp.197-206
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• 2018

Purpose: This study analyzed the muscle activity changes induced by motions of reaching forward and chest expansion that were examined from the bilateral muscles with rectus abdominis, external oblique, multifidus, and longissimus thoracic using Pilates cadillac instrument. Methods: Nine young adult women, who have no musculoskeletal disorder and any of chronic diseases, were participated. Surface electromyography system was used for recording of all signals produced by muscles, and then normalized as percentage of maximum voluntary isometric contraction (%MVIC). The paired t-test and repeated measures of analysis of variance was performed. Results: Reaching-forward motion showed a higher muscle activity from non-dominant external oblique muscle than that of the chest-expansion motion. During both reaching-forward motion and chest-expansion motion, MVIC values collected from dominant side of external oblique muscle were shown a significantly lower than the values obtained from non-dominant side (p<0.05). Conversely, %MVIC values in external oblique muscle collected from dominant side showed a significantly higher than the values obtained from non-dominant side of the same oblique muscle (p<0.05). Reaching-forward motion was caused a higher %MVIC on non-dominant external oblique muscle than that of the chest-expansion motion (p<0.05). Regardless of dominant or non-dominant sides, external oblique muscle was shown the highest activation rate of all the other muscles during reaching forward action, and longissimus thoracic muscle was shown the highest activation rate of all the other muscles during chest expansion action. Conclusion: Reaching-forward motion is suitable for activating an external oblique muscle, and chest-expansion motion is an effective enough in activating of longissimus thoracic muscle.

• Journal of the Ergonomics Society of Korea
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• v.34 no.4
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• pp.313-326
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• 2015

Objective: The objective of this research is to quantitatively analyze muscle activities of arm and shoulder, according to direction in various types of one-handed manual material handling, based on surface electromyography. Background: Workers in industrial sites frequently carry out one-handed manual material handling using arm and shoulder muscles. Therefore, chronic load and accumulated fatigue occur to arm and shoulder muscles, which becomes a main cause of upper arm and shoulder musculoskeletal disorders. The shoulder muscles have widely range of motion, and complex interactions take place among various muscles including rotator cuff muscles. In this regard, research on interactions among should muscles, according to such various dynamic motions, is required. Method: Ten male subjects in their 20s participated in this research. This research considered upward, downward, leftward, rightward, forward and backward directions and fourteen muscles around arm and shoulder (biceps brachii and trapezius, etc.) as independent variables. The mean muscle activity was set as the dependent variable. This research extracted $4^{th}{\sim}7^{th}$ repetition signals according to ten times of repetitive muscle contraction, and analyzed the muscle activity concerned using the envelope detection technique. Results: The mean muscle activity of upward direction was analyzed highly statistically significant. The reason is that the effect of gravity works to arm and shoulder muscles. Also, it is conjectured that deformation of coracoacromial ligament was caused, and its contact pressure increased, due mainly to the shoulder flexion, and therefore load was analyzed high. Muscle activity was analyzed significantly low, according to concentric ballistic motion used in the concentric contraction phase by storing elastic energy in the eccentric contraction phase with a motion to bring the weight to the front of subject's body as to downward, leftward and backward directions. Because, elbow joint's flexion-extension motions mainly occurred, biceps brachii was analyzed high muscle activity as the prime mover. Conclusion: The information on the quantitative load of muscles can be applied to ergonomic work design for one-handed manual material handling to minimize muscle load. Application: This research has effectively identified muscle activity according to dynamic contraction by applying an envelope detection technique. The results can be used for ergonomic work design to minimize muscle load during the one-handed manual material handling, according to each direction. The research results are expected to be used for musculoskeletal disorder prevention and physiotherapy in the rehabilitation medical field, based on the muscle load of arm and shoulder in various directions.

• Journal of the Korean Applied Science and Technology
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• v.40 no.2
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• pp.290-300
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• 2023

This study was understood the risk mechanism of falls in the elderly and reviewed previous research data to see if the principle of Pilates rehabilitation exercise could have a positive effect on balance ability and postural stabilization in the elderly, and the purpose of this study is to present literature-based data on the fall prevention effect of rehabilitation Pilates exercise. First, the rehabilitation Pilates exercise makes it available for strengthening the center of the body to stabilize the spine and pelvis and stimulates the nerve root, thereby having an effect on the balance and the joint stabilization. Second, a proprioceptive sensory impairment and a musculoskeletal degenerative disease due to aging increase the loss of balance ability and the instability in posture maintenance, thereby coming to raise the risk of a fall damage caused by the difficulty in performing motor functions and by the gait disturbance. Third, the rehabilitation Pilates exercise leads to improving the core muscle strength in older adults, resulting in being capable of expecting the betterment in the balance and the reaction time motor function. And there is a positive impact on the improvement in body imbalance and on the stability in movement involved in the fall prevention, resulting in being able to suggest the possibility of likely contributing to a reduction in a fall risk rate. In conclusion, the rehabilitation Pilates as the elderly exercise program showed effects on the improvement in the body's muscular strength, on the upgrade in a sense of balance, and on the stabilization of core. Thus, it was considered to diminish the risk factors for a fall damage caused by musculoskeletal degeneration and to be capable of preventing a serious disorder of activity due to a chronic senile disease.