• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.410-415
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• 2005

Objective: The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique. Methods: Thirty-four patients over 65years of age who underwent unilateral partial laminectomy for bilateral decompression from January 2000 to October 2003 were analyzed. These patients were studied for preoperative co-morbid condition and physical status according to the American Society of Anesthesiologists(ASA) classification, postoperative morphometrical change, and clinical outcomes, including visual analogue scale(VAS) score. The mean follow-up was 23months (range 6 - 48months). Results: A patient's physical status was recorded as class I, II, or III by ASA classification, which correlated to 41.2%, 44.1%, and 14.7% of patients, respectively. The cross-sectional area of the pre- and postoperative dural sac at the level of the stenosis was $52.5{\pm}19.9mm^2$ and $110.6{\pm}18.2mm^2$, respectively. The outcome was excellent in 8.8%, good in 58.8%, fair in 23.6%, and poor in 8.8% of the patients. The VAS was changed postoperatively to $3.1{\pm}1.2$. There was no operation-related transfusion yet there was no evidence of postoperative instability at the follow-up examination. Conclusion: Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.392-395
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• 2011

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

• Journal of Acupuncture Research
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• v.22 no.6
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• pp.75-84
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• 2005

Objectives : Research on the effect and satisfaction between Acupuncture Treatment, Physical Treatment and contemporary Treatments of Acupuncture and Physical of lumbago patients Methods : We separated lumbago patients into three groups. A group with only Acupuncture Treatment and a group with only Physical Treatment and a group with contemporary treatments of Acupuncture and Physical. Questionnaire survey and score of Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) were examined for comparison. Results & Conclusion : 1. Of the 54 patients Acupuncture Teatment group had 17 patients with similar ratio of gender and the average age was 39.5 years old. For the Physical Treatment group the ratio of male was 75% of the 8 patients and had the youngest average age which was 29.1 years old and the group with contemporary Treatments the ratio of female was 62% of 29 patients and had the oldest average age which was 46.7 years old. 2. The Acupuncture Treatment group had the shortest treatment period because of many acute stage caused by lumber sprain and the improvement score was the best. The group of contemporary treatments had the longest history day and treatment period by serious disease like HIVD and spinal stenosis but the improvement score of VAS and ODI was good similar to the Acupuncture Treatment group. For the Physical Treatment group there was many patients with degenerative change but not severe pain. The VAS, ODI and the improvement score was the lowest before and after the treatment.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.69-73
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• 2005

Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

• Journal of the Korean Home Economics Association
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• v.32 no.1
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• pp.165-180
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• 1994

The change in the police concerning food and dietary life were analyzed in order to provide bases of establishing policy of food and dietary life properly. The last half one century was divided into six periods as follows ; The period since liberlation from Japanese rule(1945-1949) the 1950's (1950-1959) 1960's (1960-1969) 1970's (1970-1979) 1980's (1980-1989) 1990's (1990-1992). Dietary life by 1960's were a life of distress and policies coducted by government took on an relief supply of food at this period. Movement about 'intake of mixed rice with barley and foods from flour' to supress rice consumption were encouraged by government. And Korean recommended dietary allowance was made and the national nutritional survey was practived in the first place by the Ministry of Health and Social Affairs. Dietary life of the country begin to improve sharply along with rice self-sufficiency since 1975 With the growth of food and eating out industry intake of instant food processed food and fast food has increased at the 1980's To ministry of Health and Social Affairs drove campaign of 'Joo-Moon Sik Dahn Je' for dietary life improvement at 1981 The Ministry of Education made and announced a 'School Feeding Law' at 1981 The government that is the Office of Permier and the Ministry of Health and Social Affairs developed compaign for improvement of dietary life and drove 'Jo Eun Sik Dahan Je' with Association of restaurant jointly. Policy on food and dietary life conducted by government up to data were planned mainly dependent on food production supply and demand of food. Infectious diseases continue to decrease with increasing of degenerative diseases which will be required proper management of dietary life. In the future more aggressive intergrated food policy are needed to maintain the public health. Aoso dietary improvement movement should be drived actively.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.637-644
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• 2008

Purpose: The survival of bone marrow derived stem cell was reported several times. But the survival of adipose tissue derived stem cells(hASCs) was not mentioned on. We studied the adipose tissue derived stem cell's survival and effect on articular cartilage in rabbits. Methods: Osteoarthritis was induced in twenty New Zealand white rabbits by intraarticular injection of monosodium iodoacetate(MIA). After four weeks, hASCs were also injected into the knee joints space without any vehicle, but the control group received phosphate buffered saline only. The histologic grade of articular cartilage was measured in 4 and 8 weeks after the transplantation of hASC and the viability of injected stem cells measured by Fluorescent in situ Hybridization (FISH) examination. Results: After 4 and 8 weeks from hASCs transplantation, histologic grade was not significantly difference between two groups(p>0.05), and the Y chromosome of the transplanted hASCs was not detected in articular cartilage. Conclusion: We found that direct injection of hASC in joint space didn't work on damaged articular cartilage repair.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.293-308
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• 1996

Recently, dental laser have been applied for removal of soft tissues, hemostasis and blood coagulation, removal of benign and malignant tumor, treatment of leukoplakia, aphthous ulcer and herpetic lesion, implant second surgery, removal of granulation tissue, frenectomy, clinical crown lengthening, gingivectomy, gingivoplasty, and treatment of dentin hypersensitivity. Even though the frequency of laser treatment is increasing, the research on the healing process after gingivectomy using pulsed Nd : YAG laser is very rare. The purpose of this study was to observe and compare the wound healing after gingivectomy using scalpel and pulsed Nd : YAG laser in the rat. Gingivectomy was performed using pulsed Nd : YAG laser(SUNRISE Technologies, U.S.A., 1.5 Watts, 10 pps) on the buccal gingiva of right maxillary first molar and using scalpel(No.12) on the contralateral side. Those sites treated by surgical scalpel were designated as the control, and by pulsed Nd : YAG laser as the experimental group. Animals were sacrificed at 1, 2, 3, 5, 7, 11 and 14 days postoperatively, and specimens were histologically observed under light microscope. The results were as follows : 1. Clinical observation Normal color and shape were observed at the 5th day ill the control group and the 7th day in the experimental group. 2. Histologic findings 1) In the control group, denser inflammatory infiltration was observed. 2) Epithelialization started at the 2nd day in the control group, similar to the experimental group, and completed at the 11th to the 14th day postoperatively. 3) In the experimental group, connective tissue showed the vacuole formation and degenerative change during early healing period. Healing of connective tissue was slower in the experimental group than in the control group by 2 days. 4) In the both groups, wound healing was completed at the 2nd week. From this study, gingivectomy using pulsed Nd : YAG laser seems to result in a little delayed wound healing process, compared to the gingivectomy using scalpel. Considering the clinical advantages of laser surgery, pulsed Nd : YAG laser might be useful device for gingivectomy.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.34-37
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• 2013

Objective : The purposes of this study were to evaluate the prevalence, types, and locations of Modic changes (MCs) in the thoracic spine in a large number of subjects, and to investigate the relation between the distributions of MCs and disc herniations (DHs) in the thoracic spine. Methods : Two experienced musculoskeletal radiologists assessed the presence of MCs and DHs by consensus in the thoracic MRIs of 144 patients with non-specific back pain. Patient ages ranged from 22 to 88 years (mean=$53.3{\pm}14.66$ years), and 72 were female (50%). The prevalence, distribution, relation of MCs and DHs was recorded. Results : MC was observed in 8 of the 144 patients (5.6%) and 10 of 1728 segments (0.58%). The most common MC was type II. Of the 8 patients exhibiting MC, 6 had type II (75.0%), and 2 had mixed MCs (type I/II or type II/III). MCs were distributed mainly at the mid-thoracic level (from T5/6 to T9/10). DH was detected in 18 patients (12.5%), 36 of 1728 segments (2.1%). Of the 10 segments exhibiting MC, 5 had DHs at the same level (50.0%). Accordingly, DH was strongly associated with MC (p=0.000). Conclusion : A low prevalence of MC was observed in the thoracic spine, and type II MC predominated. The low prevalence of MC in the thoracic spine suggests that it was caused by a relative lack of mobility as compared with the cervical and lumbar spines. And DHs were found to be strongly associated with MCs even in the thoracic spine.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.191-196
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• 2000

Purpose This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. Patients and Methods The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. Results The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. Conclusion The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.