• The Korean Journal of Pain
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• 제14권2호
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• pp.199-206
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• 2001

Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

• Journal of Nutrition and Health
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• 제34권6호
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• pp.645-655
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• 2001

The purpose of this study is to investigate the dietary intake and bone mineral density(BMDs) in college women(n = 10), female swimmers(n = 10), and female weight lifters(n = 10). BMDs of lumbar spine(L2-L4), femoral neck, ward's triangle, and trochanter were measured with dual-energy X-ray absorptiometry. The results are summarized as follows. In swimmers and weight lifters, mean daily intakes of energy, protein, and fat were higher than those of college women and the intake of carbohydrate was significantly high in weight lifters. Also in swimmers and weight litters, mean daily intakes of animal flood, phosphorus, vitamin A, vitamin B$_1$, vitamin B$_2$, niacin, vitamin C, and cholesterol were found higher than those of college women but there was difference among the types of exercise. According to correlation analysis between nutrient intake and BMDs, intakes of energy, protein, carbohydrate, and vitamin B$_1$ were positively associated with BMDs of lumbar spines. According to stepwise multiple recession analysis, BMDs of lumbar spines were affected by intakes of protein, Fe, phosphorus, and vitamin B$_2$, also BMDs of femur were affected by each of vegetable protein, dietary fiber, and fe. from the above explanation, the nutrient intakes can be independent factor besides exercise. In conclusion, the weight lifting, resistant exercise, resulted in increase of both BMDs of lumbar spines and femur specially in growing and adult period of female. Whereas swimming lead to increase of BMDs of lumbar spine and decrease of BMDs of femur in female.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.408-416
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• 2001

Objectives : To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. Methods : Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. Results : Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. Conclusions : These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.

• 보건행정학회지
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• 제11권3호
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• pp.71-88
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• 2001

The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991ｇ/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834ｇ/$cm^2$, respectively.

• 척추신경추나의학회지
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• 제1권2호
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• pp.93-100
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• 2006

Objectives: To invesgate correlation between the scoliotic curve and BMI, cervical lordosis, lumbar lordosis and Ferguson angle in spinal scoliotic patient. Methods: The study was composed of 14 scoliosis patients beyond cobb'a angle $10^{\circ}$ (sample I group) and 15 scoliosis patients over cobb'a angle $10^{\circ}$ (sample II group). The patients were evaluated with X-ray findings of full spine AP and lateral views and statistically analyzed. Results: 1. Sample II group showed a significant decrease in BMI as compared with Sample I group(P<0.05). 2. Scoliotic curve had s negative relationship with $BMI({\gamma}=0.406)$ 3. Scolotic patients had a lower cervical angle than normal man. Conclusion: 1. The larger the scoliotic angle, the lower BMI 2. There are no concemed scoliotic curve and cervical lordosis, lumbar lordosis and Ferguson angle.

• 보건교육건강증진학회지
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• 제25권5호
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• pp.53-64
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• 2008

목적. 본 연구의 목적은 골다공증의 유병률을 확인하고 건강증진 프로그램의 우선적 대상을 확인하고자 실시되었다. 방법. 연구대상자는 Ansan Health Study센터를 방문한 18-84세의 성인 남녀 1,269명이었다. 위험요인을 평가하기 위한 질문지를 이용하였고 DEXA(Dual Energy X-ray Absorptiometry)를 이용하여 2번 요추와 대퇴의 골밀도를 측정하였다. 수집된 자료는 SPSS12.0프로그램을 이용하여 분석하였다. 결과. 골밀도는 50대와 60대 여성에게서 급격히 감소하였으며, 골다공증 유병률은 대퇴와 요추를 기준으로 남성은 각각 0.8%, 6.3%, 여성은 0.9%와 7.1%로 나타났다. 골다공증 지식 정도는 골밀도와 유의한 순상관관계가 있는 것으로 나타났다. 결론. 본 연구의 결과는 골다공증 예방 프로그램을 위한 효과적이고 실제적인 중재전략을 위한 기초자료를 제공하였다.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.204-209
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• 2012

Objective : The authors performed a retrospective study to assess the accuracy and clinical benefits of a navigation coupled with O-arm$^{(R)}$ system guided method in the thoracic and lumbar spines by comparing with a C-arm fluoroscopy-guided method. Methods : Under the navigation guidance, 106 pedicle screws inserted from T7 to S1 in 24 patients, and using the fluoroscopy guidance, 204 pedicle screws from T5 to S1 in 45 patients. The position of screws within the pedicle was classified into four groups, from grade 0 (no violation cortex) to 3 (more than 4 mm violation). The location of violated pedicle cortex was also assessed. Intra-operative parameters including time required for preparation of screwing procedure, times for screwing and the number of X-ray shot were assessed in each group. Results : Grade 0 was observed in 186 (91.2%) screws of the fluoroscopy-guided group, and 99 (93.4%) of the navigation-guided group. Mean time required for inserting a screw was 3.8 minutes in the fluoroscopy-guided group, and 4.5 minutes in the navigation-guided group. Mean time required for preparation of screw placement was 4 minutes in the fluoroscopy-guided group, and 19 minutes in the navigation-guided group. The fluoroscopy-guided group required mean 8.9 times of X-ray shot for each screw placement. Conclusion : The screw placement under the navigation-guidance coupled with O-arm$^{(R)}$ system appears to be more accurate and safer than that under the fluoroscopy guidance, although the preparation and screwing time for the navigation-guided surgery is longer than that for the fluoroscopy-guided surgery.

• Journal of Nutrition and Health
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• 제29권9호
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• pp.991-1002
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• 1996

The objectives of this study were to obtain normative data for 45 mother-daughter pairs on spine, femur(neck, ward's triangle, trochanter) and total body BMD (bone mineral density) measured by dual energy X-ray absorptiometry, anthropometric measurement, body composition, biochemical markers, nutrient intakes and energy expenditure, to determin the interrelations of these factors within each group, to measure familial resemblance for each variable. We observed significantly positive correlations between height, weight, head, hip and calf circumferences, tricep, femur and calf skinfold thickness, total lean body mass(=weight-total fat body mass-bone mineral content), protein and fat intakes, Ca index, serum total protein and albumin of monter-daughter pairs(p<.05-p<.001). Among mothers, age, osteocalcin, higher, weight, Ca and energy intakes were predictors of BMDs. Among daughters, weight and energy intake were predictors of BMDs. The BMD in lumbar spine(r=.48, p<.01), femoral neck(r=.38, p<.05), ward's triangle(r=.36, p<.05) of the mothers were significantly correlated with those of the daughters, after adjustment for mother's age, hight, weight, osteocalcin, Ca and energy intakes and daughter's weight, energy intake. In regression analyses, mother's BMD also were positively associated with daughter's BMD in lumbar spine, femoral neck, ward's triangle. Our findings support that mothers with low BMD tended to have daughters with low BMD. In the age groups studied, as well genetic factors as environmental factors may have an important role in determining BMD. This study suggests that women may successfully enhance their genetically determined BMD through adequate nutrient intakes and weight bearing exercise.

• 한국직업건강간호학회지
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• 제12권2호
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• pp.146-155
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• 2003

This study was conducted for investigating the status of management of preemployment health examination and to have an effect on the worker's employment. Health managers of 103 companies in Incheon metropolitan city and Gyeonggi were interviewed by telephone. Of 103 companies, 67(65.1%) said they don't hire the applicants who have an active pulmonary tuberculosis, 80(77.7%) companies said they health HBV carrier is acceptable but active HBV carrier is not 29(28.2%) companies said they don't hire the applicants who have a hypertension or diabetes mellitus, 42(40.8%) companies said they don't hire the applicants who have a hearing disturbance. If HIVD is suspicious in X-ray lumbar-sacral region, 37(78.7% of 47 companies) said they do not hire the applicants. 29(35% of 83 companies) said they cancel the employment of the applicants who are suspicious of noise induced hearing loss on preplacement health examination. From our survey, preemployment health examination was utilizing mainly as a tool for the selection of health employees who don't have a disease. Furthermore, in many companies, additional test items are being included and getting more strict the selection criteria for preemployment health examination. For the right use of preemployment health examination, author suggested that further studies were needed to select the adequate test items and establish the reasonable criteria for preemployment health examination.

• 대한약침학회지
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• 제19권4호
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• pp.359-362
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• 2016

Objectives: Loss of lumbar lordosis causing pain and curvature of the vertebral skeleton to one side is a relatively uncommon disease. To our knowledge, successful treatment of loss of lumbar lordosis with any potentized homeopathic drug diluted above Avogadro's limit (that is, above a potency of 12C) has not been documented so far. In this communication, we intend to document a relatively rare case of loss of lumbar lordosis with osteophytic lippings, disc desiccation, and protrusion, causing a narrowing of secondary spinal canal and a bilateral neural foramina, leading to vertebral column curvature with acute pain in an adolescent boy. Methods: The patient had undergone treatment with orthodox Western medicines, but did not get any relief from, or cure of, the ailment; finally, surgery was recommended. The patient's family brought the patient to the Khuda-Bukhsh Homeopathic Benevolent Foundation where a charitable clinic is run every Friday with the active participation of four qualified homeopathic doctors. A holistic method of homeopathic treatment was adopted by taking into consideration all symptoms and selecting the proper remedy by consulting the homeopathic repertory, mainly of Kent. Results: The symptoms were effectively treated with different potencies of a single homeopathic drug, Calcarea phos. X-ray and magnetic resonance imaging (MRI) supported recovery and a change in the skeletal curvature that was accompanied by removal of pain and other acute symptoms of the ailment. Conclusion: Homeopathy can be a safe, much less expensive, non-invasive, and viable alternative for the treatment of such cases.