• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.67-75
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• 2005

Objectives : Straight leg raising test(SLR) is useful clinical test to diagnose herniated lumbar intervertebral disc. The purpose of this study is to analyse diagnostic value of straight leg raising test between traffic accident patients group and non-traffic accident patients group. Methods : The study involved 26 traffic accident patients group and 45 non-traffic accident patients group with low back pain or radiating pain into the leg. All had a result of straight leg raising test and lumbar computed tomography(CT) or magnetic resonance imaging(MRI). The associations between straight leg raising test and herniated lumbar intervertebral disc were analysed. Results and Conclusions : 1. There is not significant associations between straight leg raising test and herniated lumbar intervertebral disc in traffic accident patients group. 2. There is significant associations between straight leg raising test and herniated lumbar intervertebral disc in non-traffic accident patients group. 3. In traffic accident patients group, and negative predictive value are higher than non-traffic accident patients group. 4. In non-traffic accident patients group, sensitivity, positive predictive value and odds ratios are higher than traffic accident patients-group.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.109-117
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• 2016

Objectives The purpose of this study was to investigate the correlation between walking ability of lumbar spinal stenosis patients and the cross-sectional area (CSA) of lumbar paraspinal muscles. Methods This study was carried out on 62 lumbar spinal stenosis patients who had limited walking abilities because of neurogenic claudication (NC). All patients received more than 2 weeks of complex treatment at Mokhuri Neck&Back Hospital. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of adjacent vertebral body to avoid influence of body statues (RCSA-Relative CSA). Pain Free Walking Distance and Numerical Rating Scale (NRS) was measured before and after treatment. Results The Pain Free Walking Distance had significantly increased in patients who had bigger RCSA of psoas muscle (r=0.313, p<0.05). Conclusions The psoas muscle can be a predictive factor for restoring walking ability of lumbar spinal stenosis patients who have limitations walking.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.131-143
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• 2011

Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.1
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• pp.15-26
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• 2014

Objectives : The purpose of this study was to evaluate the effect of Korean medicicine treatment in patients with Spondylolisthesis and Lumbar Herniated Intervertebral Disc(HIVD). Methods : This clinical study was carried out on 62 patients who were diagnosed as spondylolisthesis and lumbar herniated intervertebral disc(HIVD) on L-spine X-ray and L-spine magnetic resonance imaging(MRI), who had been admitted from Feb. 2013 to Apr. 2014. All of 62 patients were treated with acupuncture, chuna treatment and herbal medicine during the whole admission period. Numerical rating scale(NRS) was used to evaluated the effectiveness of the oriental medical treatment. Results : 1. Distribution showed female predominance in general. 2. Degenerative type is the most common in this study. 3. In the duration of symptoms, the largest group was" Subacute"(32.26%). 4. Almost of patients had radiation pain, but in SLR test and valsalva test, more patients had no significant sign. 5. Spondylolytic type involved the 5th lumbar vertebra in 80% and degenerative type involved the 4th lumbar vertebra in 53.84%. 6. Most of case were grade 1(93.54%) in degree of slipping. 7. By the oriental medical treatment, NRS reduction in spondylolytic spondylolisthesis, was better than degenerative spondylolisthesis. Conclusions : The result of treatment by Korean medical is satisfactory for the tretment of spondylolisthesis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Korean Journal of Acupuncture
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• v.25 no.4
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• pp.175-185
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• 2008

Objective : Acupuncture (from the Latin acus, "needle," and pungere, "to prick") is a technique of inserting and manipulating fine needles at specific points on the body. As a placebo acupuncture needle device was developed based on the visual impact of needling, it has been raised that it is useful only when acupuncture points and needling are visible to subjects. To examine the visual factor of the placebo acupuncture, the present study was aimed to compare the blinding index of the verum and placebo acupuncture between masked and unmasked situation. Methods : Thirty-six patients were randomly alloted to be stimulated with a verum or placebo acupuncture in a cross-over design. They were asked to guess a right answer whether they were stimulated with the verum or placebo acupuncture at LI4 in an unmasked or masked situation. The penetrating, pain, and deqi sensations were also measured after the stimulation using modified visual analogue scale. Results : The correct answer rate of the placebo acupuncture was 22.2% and 16.7% in an unmasked and masked situation, respectively (P>0.767). The blinding index of the placebo acupuncture was -0.56 (95%CI -0.84 to -0.27) and -0.67 (95%CI -0.91 to -0.42) in an unmasked and masked situation, respectively. The penetrating and deqi sensation of the verum acupuncture were significantly higher than those of the placebo acupuncture in both unmasked and masked situation. The pain sensation of the verum acupuncture was significantly higher than that of the placebo acupuncture in masked situation, but not in unmasked situation. Conclusion : Blinding of the placebo acupuncture was successful both in the unmasked and masked situation. These finding indicate that visual factor might not play a critical role in blinding of the placebo needle. We suggest that placebo needle would be also useful in a functional magnetic resonance imaging scan even when the subject could not see the placebo needle.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.111-115
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• 2007

Background: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an altemative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. Methods: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process, We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). Results: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. Conclusions: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.

• The Korean Journal of Pain
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• v.25 no.2
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• pp.81-88
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• 2012

Background: In discography performed during percutaneous endoscopic lumbar discectomy (PELD) via the posterolateral approach, it is difficult to create a fluoroscopic tunnel view because a long needle is required for discography and the guide-wire used for consecutive PELD interrupts rotation of fluoroscope. A stereotactic system was designed to facilitate the determination of the needle entry point, and the feasibility of this system was evaluated during interventional spine procedures. Methods: A newly designed stereotactic guidance system underwent a field test application for PELD. Sixty patients who underwent single-level PELD at L4-L5 were randomly divided into conventional or stereotactic groups. PELD was performed via the posterolateral approach using the entry point on the skin determined by premeasured distance from the midline and angles according to preoperative magnetic resonance imaging (MRI) findings. Needle entry accuracy provided by the two groups was determined by comparing the distance and angle measured by postoperative computed tomography with those measured by preoperative MRI. The duration and radiation exposure for determining the entry point were measured in the groups. Results: The new stereotactic guidance system and the conventional method provided similarly accurate entry points for discography and consecutive PELD. However, the new stereotactic guidance system lowered the duration and radiation exposure for determining the entry point. Conclusions: The new stereotactic guidance system under fluoroscopy provided a reliable needle entry point for discography and consecutive PELD. Furthermore, it reduced the duration and radiation exposure associated with determining needle entry.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.36-43
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• 2011

Background: Nucleoplasty is a minimally invasive spinal surgery using a $Coblation^{(R)}$ technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. Methods: Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the $Perc^{TM}$ DC Spine $Wand^{TM}$. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. Results: Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. Conclusions: Percutaneous decompression with a nucleoplasty using a $Coblation^{(R)}$ technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.