• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.719-729
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• 2022

Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.45-51
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• 2015

Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention and treatment. Materials and Methods: Patients with different stages of esophageal/gastric cardia lesions completed two QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1, 6 and 12 months after treatment. Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer, and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancer reported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores before treatment and at 1 month after treatment were $71{\pm}9$ versus $69{\pm}9$ (p>0.01), $71{\pm}8$ versus $61{\pm}11$ (p<0.01), $67{\pm}11$ versus $62{\pm}9$ (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recovered gradually in precursor lesion and early cancer patients, while some continuously deteriorated in advanced cancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions (p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior to corresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patients with early stage cancer, those with advanced cancer showed worse QoL with all function and most symptom measures (p<0.01). Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancer show better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatment may improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling should be given by health care providers during treatment and follow-up to facilitate QoL improvement.

• Journal of Acupuncture Research
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• v.24 no.3
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• pp.63-79
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• 2007

Objectives : Korean traditional acupuncture Theory, Sa-am's 5 phases acupuncture method was originated in 1644-1742, in the middle of the Cho Sun dynasty. This study was to verify the effect of Sa-am Acupuncture Treatment on dysmenorrhea of Women. Methods : The subjects were 49 volunteers who were suffering for dysmenorrhea, employed using Measure of Menstrual Pain (MMP) questionnaire. Subjects were divided into two groups including Sa-am acupuncture treatment group(n=23) and minimal acupuncture treatment group(n=26). They had agreed to take part in tIris experiment, with didn't take any anodyne drugs. In the acupuncture group, subjects were stimulated at $GB_{41}$, $SI_3$, $GL_{66}$, $SI_2$(Small intestine jung-guk) and $SP_6$. In the control group, subjects were needled at $L_{10}$, $S_{40}$, $P_5$, $G_{40}$ points have any effect on dysmenorrhea. A total of 5 acupuncture sessions were performed for each patient depending on the individual menstruation cycle. The MMP score by using 7 questions and the Menstrual Symptom Severity List(MSSL-D) were measured before and after menstruation cycle. Collected data were analyzed as frequency, percentage, paired t-test, independent t-test using SPSS 10.0 WIN Program. Results : Acupuncture treatment produced a significant improvement on dysmenorrhea in two groups, but a statistically significant difference was not shown in the acupuncture group compare to control group. Conclusions : Based on the above results, it was verified that Acupuncture Treatment was effective in decreasing the symptom of Dysmenorrhea.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.126-130
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• 2016

Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

• Journal of Technologic Dentistry
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• v.34 no.3
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• pp.291-302
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• 2012

Purpose: It is to survey old men's utilization status of dental clinic and temporary-binding dentures and then to provide basic data to make a program for manufacturing old men's dentures and their teeth health education. Methods: Random selection was made on old men living in Daejeon and Chungnam, and a survey was conducted from April 15 to May 20, 2011. 500 questionnaires were distributed and 420 questionnaires were collected. Using spss 18.0 program, final analysis was made on 363 questionnaires except for 57 questionnaires which had missing value or showed some doubts about the unreliability. Results: 1. With respect to number of natural teeth as per the age, the upper/lower jaws had meaningful differences (P<.001), which means that the older the person is, the smaller number of natural teeth is. In the meantime, there was no meaningful difference according to sex. 2. With respect to kind of prosthetics installed in a mouth as per the age, there was meaningful difference in the upper jaws (P<.05) but there was no meaningful difference in the lower jaws. It was found out that the older the persons are, the more they use removable dentures while the younger the persons are, the more they use fixed partial dentures. 3. With respect to mouth health condition recognized by oneself, it showed bad (44.4%) and good (10.3%),which means recognition as bad is greater, and the age when prosthetics were first used is dispersed variously from below 40 to over 70. 4. Dental care institutions which they mainly used are hospital and clinics (91.5%), and 66.4% of them visited dental clinics lately. Preferential treatment if they go to dentists is as follows in the order of prosthetics (33.9%), gum treatment (24.2%) and pain treatment (14.9%). 5. 68.4% of them revisited dentists after installation of dentures and the reason for revisit is as follows in the order of poorly fitted dentures (35.1%), painful gum 25.9%, regular check-up 25.4% and difficult chewing 9.6%. Conclusion: As our country enters into an aging society, mouth health problem of old men has come to a serious issue, and therefore, a survey was conducted on some old men with respect to their utilization status of dental clinic and removable dentures in order to provide basic data for improvement of quality of their life, maintenance and enhancement of their mouth health. The study result shows that the older they are, the higher the loss rate of teeth as well as needs for prosthetics are, and thus it is thought the study will help to develop mouth health education program which may improve quality of old men's life by recovery of mouth functions declined due to loss of teeth and by regular check-up, education for mouth health control and following-up control of dentures.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.6
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• pp.1762-1768
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• 2004

The Korean formula medicine, Gami-Yukmi-Jihwang-Tang (GYJT) has been used for growing slowly, short of stature, incomplete development, fatigue, weak child, growing pain of child. However, it is still unclear how GYJT has an effect on experimental models. In the present study, the author investigated the immune-enhancing effect of GYJT. Forced swimming test (FST) was performed as a model of activity test in mice and measured blood urea nitrogen (BUN), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactic dehydrogenase (LDH), glucose (Glc) and total protein (TP) in the serum. GYJT (1, 0.1 and 0.01 g/㎏) were orally administered to mice, once per day for 7 days using a feeding atraumatic needle. After 3 days, on FST, the immobility time was significantly decreased in the GYJT (0.01g/㎏/day)-fed group (120.75±5.71s) in comparison with the saline-fed group (153.80±10.74s). After 7 days, the immobility time was significantly decreased in the GYJT (0.1 and 0.01g/㎏/day)-fed group (125.67±5.36s and 107.67±3.71s) in comparison with the saline-fed group (167.67±12.99s). In addition, the contents of BUN and Glc in the blood serum were significantly decreased and the contents of AST, ALT and LDH were also decreased in the GYJT (1g/㎏/day)-fed group. However, the content of TP was not changed. The present results suggest that GYJT may be useful for the anti-fatigue and immune-enhancing agent. Also, the author investigated the effect of GYJT on the production of cytokines in human T-cell line, MOLT-4 cells. However, GYJT has not affected the production of IFN­γ, IL-2, IL-4. These results suggest that GYJT has immune-enhancing effect but does not affect T cell-mediated production of cytokines in the immune function improvement.

• Women's Health Nursing
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• v.2 no.2
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• pp.284-297
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• 1996

A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review. The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care. The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care. The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows. 1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001). 2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001). 3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001). 4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows. 1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done. 2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge. 3. We suggest general hospitals to establish a phone-counseling system.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.413-425
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• 2011

Purpose: This study conducted a survey on the elderly with physical debilities, who are in a medically vulnerable social class, to examine closely their demo-sociological characteristics, unmet needs, dental states, and living qualities and satisfaction levels relating to oral health and social supports to them, and also to prepare the basis for effective public medical policies and health improvement programs aimed at improving the quality of life for the elderly with physical debilities. Methods: Twenty-two elderly care facilities within Jeju Special Self-Government Province participated in the survey. Between 11 January and 5 March 2010, a total of 250 elderly persons(65 and over) with physical debilities were interviewed and their dental health was checked. Results: The results of the survey are as follows. The need for social support for dental care of the elderly with physical debilities was high in the medical institution-supported service (49.6%). The unmet needs for physical care were high in bathing (49.6%) and using public transportation (71.6%). More than half of these surveyed had ten or fewer teeth. The survey found that 31.6% of the participants experienced problems eating, due to poor dental health. Concerning quality of life, 30.5% of those surveyed experienced physical pain. Conclusion: In summary, the ages of the survey participants directly relates to the degree of behavioral debility experienced. The more debility a participant exhibits, the greater is the need for social support and dental care. The dental health of a participant directly relates to a higher quality of life. Good dental health of a participant translate to better quality of life. In light of the fact that the elderly with physical debilities suffer from a lack of accessibility to medical care and worse oral health than do other elderly persons, it is essential to increase accessibility to medical institutions that can provide such services as door to door dental care. Current insurance policies, funding for denture insurance, and free denture and denture-upgrade programs desperately need to be expanded. Therefore, to improve effectively the quality of life for the elderly with physical debilities civil dental medical resources should be encouraged to provide inclusive and prevention-focused medical care. In the public domain, door to door dental care services and cooperation with civil dental care resources need to be improved to increase impartial accessibility to dental medical institutions.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.3
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• pp.141-147
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• 2021

This study's purpose is to report the effectiveness of Korean medicine treatment to posterior cruciate ligament tear patients due to traffic accident. 2 patients were treated with Korean medicine by acupuncture, pharmacopuncture and herbal medication. We assessed the knee pain and functional improvement by using numeric rating scale (NRS), Western Ontario and McMaster Universities arthritis (WOMAC) index and EuroQol-5 dimension (EQ-5D) index. After treatment, NRS decreased from 6 to 2 in case 1 and from 5 to 3 in case 2. EQ-5D index chaged from 0.465 to 0.72 in case 1 and from 0.719 to -0.171 in case 2. WOMAC index decreased from 82 to 13 in case 1 and from 55 to 54 in case 2. NRS improved in both cases, but WOMAC index and EQ-5D index improved in only one case. Korean medicine treatment could be helpful for posterior cruciate ligament tear traffic accident patients. However, further clinical studies are needed to clarify the effectiveness to the patients with old age, degeneration and accompanying injury.