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

• The Journal of the Korea Contents Association
• /
• v.11 no.6
• /
• pp.270-278
• /
• 2011

The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.1
• /
• pp.29-37
• /
• 2020

Manual therapy has undergone parallel development throughout many parts of the world dating back to ancient times for at least 2,500 years. The earliest historical reference to the practice of manual therapy in Greece, dates back to 400 B.C. Over the centuries, manual medicines have fallen in and out of favor with the medical profession. To truly understand the principle, it is important to know that manual therapy was initially the mainstay of the three leading alternative health care systems, osteopathy, chiropractic, and most notably physical therapy. These were all founded in the latter part of the 19th century in response to the shortcomings in allopathic medicine. Although it has been around for a long time and has been used all over the world, there are a few reports on manual therapy treatment, and most papers provided a low level of evidence. Despite the controversies over manual therapy, its use appears to be increasing gradually. This article reviews the history of manual therapy from ancient times to the present including Korean history, discusses the current state of knowledge on manual therapy, and informs physicians who manage musculoskeletal pain.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.2 no.2
• /
• pp.17-32
• /
• 2007

Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.5
• /
• pp.39-46
• /
• 2020

Graham Greene's The Quiet American is a war novel set in Vietnam. Thus, although war-related political stories are mainly unfolded, this novel presumes that Westerners are basically superior to the colored Vietnamese. In addition to racial issues, it describes the dual discrimination and inequality that women face. Phung, a Vietnamese woman who wishes to live a rich and comfortable life through marriage to a Western man, is a gender underdog oppressed by the capital and males. She is discriminated against by selfish views created by men, such as being expressed as an ignorant woman who can feel physical pain but not mental pain and being described as a partner to satisfy men's pleasure. Fowler and Pyle, the male lead characters who are gender strong, treat the Asian woman as a low-status person who is qualitatively different from Westerner and use and exploit the woman simply to satisfy their selfish needs. Therefore, it is hard to say that this story involves true love, as it is based on an unequal relationship. Eventually, Pyle's death brings Phung back to Fowler, confirming that Asian women are unable to escape from the gender underdog of Western men.

• Journal of Acupuncture Research
• /
• v.21 no.5
• /
• pp.79-99
• /
• 2004

Objective : This study was designed to find out the effect of scolopendrid aquacupuncture classified by the type of HIVD(Herniation of Inter-Vertebral Disc) in lumbar spine. Methods : The 50 patients who had a diagnosis of HIVD by lumbar-CT or lumbar-MRI and admitted to Gwangju oriental medical hospital in wonkwang university from June 2003 to March 2004 were observed. The symptom of inpatients is low back pain with or without sciatica. We treated 50 patients by scolopendrid aquacupuncture besides the general consevative treatment of oriental medicine. Results and Conclusion : The scolopendrid aquacupuncture treatment led to improvement in the pain and symptom of HIVD as determined by all efficacy measures. After scolopendrid aquacupuncture treatment, there was improvement in VAS, oswestry disability index, ROM and SLRT. The improvement index of scolopendrid aquacupuncture treatment classified by the type of HIVD showed that the effects of scolopendrid aquacupuncture had correlation with the type of HIVD. The more the herniation of intervertebral disc decreased, the more the effect of scolopendrid aquacupuncture increased. This results suggest that scolopendrid aquacupuncture is good method for treatment of HIVD but we have to consider the clinical correlation with the degree of herniation.

• Journal of Oral Medicine and Pain
• /
• v.25 no.4
• /
• pp.415-425
• /
• 2000

In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

• Korean Journal of Adult Nursing
• /
• v.12 no.4
• /
• pp.517-532
• /
• 2000

The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

• Journal of Acupuncture Research
• /
• v.25 no.6
• /
• pp.135-143
• /
• 2008

Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

• Journal of Korean Medicine Rehabilitation
• /
• v.23 no.3
• /
• pp.177-186
• /
• 2013

Objectives This study is to evaluate the current situation of Russian tourists for medical tourism of Spine Specialty Korean Medicine Hospital. Methods 133 Russian tourists visiting Spine Specialty Korean Medicine Hospital from January 1, 2012 to December 31, 2012, were analysed in the statistics. Their data was sourced from the computerized medical records. And 87 of them answer a questionnaire about reasons for selection of Spine Specialty Korean Medicine Hospital and satisfactory for medical service. Results A total of 133 Russian visited Spine Specialty Korean Medicine Hospital for medical service, consisting of 73 females (54.8%), the fourties to fifties 58.9% by age. They avoided visiting in the winter. The average number of visiting was 7.1 times. The average treatment period was 9.9days. Majority of the elapsed time from the onset to the arrival was more than 1 year (56.6%). Low back pain (56.4%) is the most in musculoskeletal disorders and obesity (21.7%) and gynecological diseases (30.4%) were the most in a non-musculoskeletal disorders. Medication and acupuncture was the major treatment. 89.2% of the prescribed medication was the efficacy of musculoskeletal. Russian medical tourists most visited by support of travel agent (58.6%). The main reason of their visiting was non-surgical treatment for spinal disorder (31%). 96.6% of them were satisfied because rapid pain relief and kindness. Conclusions For this study, we confirmed a possibility for the Korean medical treatment of Russian tourists for medical tourism. Still, more research and goverment support for the expansion of Korean medical tourism is needed.