• 제목/요약/키워드: Musculoskeletal conditions

검색결과 254건 처리시간 0.036초

Missed Skeletal Trauma Detected by Whole Body Bone Scan in Patients with Traumatic Brain Injury

  • Seo, Yongsik;Whang, Kum;Pyen, Jinsu;Choi, Jongwook;Kim, Joneyeon;Oh, Jiwoong
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.649-656
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    • 2020
  • Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

항암제 함유 골시멘트에서 유리되는 아드리아마이신의 세포 독성 (Cellular Toxicity of Adriamycin Eluted from Adriamycin-impregnated Bone Cement)

  • 장동욱;이동신;최선실;최승준;어수익;김병석
    • 대한골관절종양학회지
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    • 제7권1호
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    • pp.1-12
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    • 2001
  • 목적 : 아드리아마이신 함유 골시멘트의 국소 항암제 치료로서의 가능성을 알아보고자 실험을 실시하였다. 대상 및 방법 : Palcos R, LVC, CMW 3, Simplex P의 4종류 골시멘트에 아드리아마이신 2.5mg, 5mg, 25mg의 각각 다른 농도로 균일하게 섞은 후, 원주형 또는 납작한 형의 모양에 따른 아드리아마이신 용출 차이, ddH2O, 0.45% 식염수, 0.9% 식염수, 3% 식염수 등의 주위 환경에 따른 아드리아마이신 용출 차이를 연구하였다. 또한 용출된 아드리아마이신의 세포 독성을 알아보고자, 골육종 세포주 Saos-2를 골시멘트 단독, 각기 다른 3종류의 아드리아마이신 농도를 함유한 골시멘트와 같이 37 C, 5% $CO_2$ 조건하에서 가습 배양기내에서 배양을 실시하여, MTT assay 방법으로 세포 생존율을 확인하였다. 결과 : 납작한 모양이 원주형보다 아드리아마이신 용출이 많았고, 3%, 0.9%, 0.45%의 식염수 순으로 아드리아마이신 용출이 줄어 들었으며, CMW 3, Simplex P가 Palacos R, LVC보다 아드리아마이신 용출이 많았으며, 아드리아마이신 농도가 2.5mg, 5mg, 25mg 순으로 세포 독성은 각각 95%, 98%, 99%이었다. 결론 : 적절한 용량의 아드리아마이신을 골시멘트에 섞는다면, 용출된 아드리아마이신이 세포 독성을 가져 국소 항암제 치료 수단으로 이용 가능성을 확인하였다.

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트라이애슬론의 과사용 부상과 의학적 위험요인에 대한 고찰 (Triathlon-Related Overuse Injury and Medical Issues)

  • 박찬호;곽이섭;김태운
    • 생명과학회지
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    • 제20권2호
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    • pp.314-320
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    • 2010
  • 트라이애슬론은 수영, 사이클, 달리기로 구성된 스포츠로 단일종목의 스포츠에 참가할 때 보다 잠재적인 의학적 위험요인을 더 많이 포함하고 있다. 과사용은 스트레스의 증가와 뼈, 관절, 근육, 건 또는 신경의 손상을 일으키며, 지금까지 트라이애슬론 훈련과 경기 중에 발생될 수 있는 과사용 부상은 목통증, 요통, 근육과 건 부상, 인대부상, 만성적인 통증 등이며, 대부분의 과사용 부상은 달리기 훈련시 가장 많이 발생된다. 또한 트라이애슬론 참가자들은 다양한 자연환경과 경기거리에서 완주해야 하는 만큼 부상 이외의 의학적 문제에 직면할 수 있으며, 현재까지 트라이애슬론과 관련하여 보고되고 있는 의학적 위험요인들은 저체온증, 저나트륨혈증, 일사병, 자외선에 과도한 노출, 면역억압, 심리적인 탈진현상, 용혈증 등을 포함하고 있다. ID 경기 중에 발생 할 수 있는 의학적 문제들 가운데 가장 빈번하게 발생하는 증상은 탈진과 탈수현상이며, 그 다음으로 나타나는 문제점들은 저나트륨혈증, 열부상, 저혈압, 화상과 물집, 근육경련 등이다. 그러나 SD와 OD 경기 중에는 달리기 속도가 빠르고 더 높은 강도에서 경기가 진행되기 때문에 일사병의 발생 위험이 더 높고, 경기 시간이 짧은 관계로 저나트륨혈증은 발생하지 않는다. 본 연구는 트라이애슬론 훈련과 경기 중에 발생 될 수 있는 과사용 부상과 의학적 위험 요인에 대한 연구문헌들을 고찰하여 스포츠 활동에 직접 참여하는 엘리트 선수 및 동호인 그리고 스포츠 현장에서 선수들을 지도하는 코치와 대회를 주최하는 관계자들에게 트라이애슬론과 관련된 과사용 부상과 의학적 위험요인에 대한 기초자료를 제공하여 이러한 위험요인들을 미연에 예방하거나 감소시키는데 도움을 줄 수 있는 기초자료를 제시하고자 한다.

The Effects of Simulated Mild Leg Length Discrepancy on Gait Parameters and Trunk Acceleration

  • Jung, Soo-jung;An, Duk-hyun;Shin, Sun-shil
    • 한국전문물리치료학회지
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    • 제25권4호
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    • pp.9-18
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    • 2018
  • Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.

궁귀조혈음가미방(芎歸調血飮加味方)을 복용한 여성의 산욕 초기 증상과 어혈 변화에 대한 연구 (A Study on the Changes of Early Puerperium Symptoms and Blood Stasis Index of Women Taking Gungguijohyeol-eum-gamibang)

  • 최석영;김찬우;김남훈;박경선;황덕상;이진무;이창훈;장준복
    • 대한한방부인과학회지
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    • 제31권1호
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    • pp.1-19
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    • 2018
  • Objectives: The purpose of this study was to investigate the changes of early puerperium symptoms and Blood Stasis Index in women during the first two weeks after childbirth. Methods: 38 women staying at Korean postpartum management facilities were studied. Questionnaires were filled out on the date of arrival and departure. Changes in overall physical conditions including neuropsychiatric, circulatory, digestive, musculoskeletal, and urogenital and breast symptoms as well as Blood Stasis Pattern were studied. Results: 1. Neuropsychiatric symptoms were shown in order of Depressed Feeling, Insomnia, Dizziness, Headache, and Easy to Anger and Nervous on arrival. All symptoms showed improvement after two weeks, without significance. 2. Circulatory symptoms were shown in order of Excessive Sweating, Edema, Fatigue, Hot Flash, Anemic Feeling, Alternating Chills and Fever, Cold Hypersensitivity, Chills, Oppression in the Chest, and Palpitation on arrival. Hot Flash, Excessive Sweating, and Edema showed significant improvement after two weeks. 3. Digestive symptoms were shown in order of Dyspepsia, Dry Mouth, Constipation, and Loss of Appetite. All symptoms showed improvement after two weeks, without significance. 4. Pain of Muscles & Joints showed improvement after two weeks, without significance. Pain of Teeth & Gingiva showed slight worsening after two weeks, without significance. 5. Urogenital and Breast symptoms were shown in order of Wound Pain, Fever and Distending Pain in the Breast, and Lower Abdominal Pain on arrival. All symptoms showed significant improvement after two weeks. 6. Blood Stasis Index showed significant improvement after two weeks. Conclusion: Most symptoms were improved in women staying at Korean postpartum management facilities for two weeks. Hot Flash, Excessive Sweating, Edema, Wound Pain, Lower Abdominal Pain, Fever and Distending Pain in the Breast and Blood Stasis Index showed significant improvement.

Fermented ginseng extract, BST204, disturbs adipogenesis of mesenchymal stem cells through inhibition of S6 kinase 1 signaling

  • Yi, Sang Ah;Lee, Jieun;Park, Sun Kyu;Kim, Jeom Yong;Park, Jong Woo;Lee, Min Gyu;Nam, Ki Hong;Park, Jee Hun;Oh, Hwamok;Kim, Saetbyul;Han, Jihoon;Kim, Bo Kyung;Jo, Dong-Gyu;Han, Jeung-Whan
    • Journal of Ginseng Research
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    • 제44권1호
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    • pp.58-66
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    • 2020
  • Background: The biological and pharmacological effects of BST204, a fermented ginseng extract, have been reported in various disease conditions. However, its molecular action in metabolic disease remains poorly understood. In this study, we identified the antiadipogenic activity of BST204 resulting from its inhibition of the S6 kinase 1 (S6K1) signaling pathway. Methods: The inhibitory effects of BST204 on S6K1 signaling were investigated by immunoblot, nuclear fractionation, immunoprecipitation analyses. The antiadipogenic effect of BST204 was evaluated by measuring mRNA levels of adipogenic genes and by chromatin immunoprecipitation and quantitative real-time polymerase chain reaction analysis. Results: Treatment with BST204 inhibited activation and nuclear translocation of S6K1, further decreasing the interaction between S6K1 and histone H2B in 10T1/2 mesenchymal stem cells. Subsequently, phosphorylation of H2B at serine 36 (H2BS36p) by S6K1 was reduced by BST204, inducing an increase in the mRNA expression of Wnt6, Wnt10a, and Wnt10b, which disturbed adipogenic differentiation and promoted myogenic and early osteogenic gene expression. Consistently, BST204 treatment during adipogenic commitment suppressed the expression of adipogenic marker genes and lipid drop formation. Conclusion: Our results indicate that BST204 blocks adipogenesis of mesenchymal stem cells through the inhibition of S6K1-mediated histone phosphorylation. This study suggests the potential therapeutic strategy using BST204 to combat obesity and musculoskeletal diseases.

심리외상 이후의 신체증상 (Somatic Symptoms after Psychological Trauma)

  • 박주언;안현의;김원형
    • 정신신체의학
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    • 제24권1호
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    • pp.43-53
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    • 2016
  • 연구목적 심리외상에 노출된 이후 신체증상이 매우 빈번히 발생하곤 한다. 이러한 신체증상은 사회기능과 직업기능 및 환자-의사 관계와 종종 연관되지만 외상후스트레스장애 진단 범주에 포함되지 않은 상태이다. 본 논문에서는 이러한 신체증상의 기전, 흔한 임상양상, 그리고 치료에 대해 고찰하고자 한다. 방 법 PubMed, Scopus, Google Scholar, KoreaMed, KISS와 같은 학술검색엔진을 사용하여 2016년 3월 31일까지 검색된 심리외상 노출 이후 신체증상에 관한 자료를 바탕으로 연구하였다. 결 과 심리외상 노출 이후의 신체증상의 발생 기전은 심리적인 측면과 생리적인 측면으로 구분될 수 있었다. 심리기전은 정신역동이론, 인지행동이론, 그리고 다른 이론들이 포함되었다. 생리기전은 신경내분비 및 면역계, 자율신경계, 중추 신경계의 변화로 설명되었다. 심리외상과 연관된 신체증상은 두경부, 흉부, 복부, 기타 근골격계, 피부 및 면역계에서 나타나는 다양한 건강문제로 표현되었다. 이러한 신체증상의 표준화된 치료에 대한 연구는 매우 부족하였다. 결 론 임상의와 재난정신건강지원 실무자는 심리외상에 대한 개입이나 PTSD 치료 동안 동반된 신체증상에 대해 항상 염두에 두어야 한다. 심리외상과 PTSD에서 보이는 이러한 신체증상에 대해 더 많은 연구가 진행될 필요가 있다.

경남지역 물리치료사의 직무만족도 및 자립개설에 대한 조사연구 (The Study about the Job Satisfaction and Independent Establishment of Physical Therapy of Working Physical Therapist in Gyeongnam Region)

  • 이준철
    • 문화기술의 융합
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    • 제4권4호
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    • pp.123-133
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    • 2018
  • 본 연구는 물리치료 인식도 개선에 필요한 기초자료를 제시하고, 자립개설에 관한 의식도를 알아보기 위하여 경남지역 물리치료사 175명을 대상으로 실시되었다. 수집된 자료는 SPSS 10.0 통계 프로그램을 이용하여 일반적 특성, 현재의 근무처 및 소속여건, 직무만족도에 대한 연구는 카이제곱검정의 빈도분석을, 자립개설에 관한 연구는 EXCEL 프로그램을 사용하였다. 통계적 유의순준 a는 0.05로 선정하였다. 성별에 따른 물리치료에 대한 흥미도는 남자가 52.2%로 여자보다 높게 나타났고, 자기능력 발전에 대해 종합병원이 32.8%로 의원보다 만족하는 것으로 나타났다. 자립개설에 대한 찬반의견은 83.4%가 찬성하였고, 자립개설 시 가장 먼저 해야 할 일은 전문적인 이론 및 임상 치료기술 습득이 57.5%로 가장 높게 나타났다. 개설 분야는 근골격계 물리치료가 45.2%, 자립개설 시 가장 걸림돌로 작용하는 것은 의사의 의식 39.7%로 나타났다. 자립개설이 이루어지기 위해서는 물리치료사들의 전문적인 이론 및 임상치료기술을 습득하고, 물리치료사와 의사간의 의식 개선이 필요할 것으로 생각된다. 또한 물리치료 관련학과를 4년제로 일원화해야 할 것이며, 물리치료사의 자립개설에 대한 법제화가 반드시 필요할 것으로 사료된다.

The Effect of Shoe Heel Types and Gait Speeds on Knee Joint Angle in Healthy Young Women - A Preliminary Study

  • Chhoeum, Vantha;Wang, Changwon;Jang, Seungwan;Min, Se Dong;Kim, Young;Choi, Min-Hyung
    • 인터넷정보학회논문지
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    • 제21권6호
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    • pp.41-50
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    • 2020
  • The consequences of wearing high heels can be different according to the heel height, gait speed, shoe design, heel base area, and shoe size. This study aimed to focus on the knee extension and flexion range of motion (ROM) during gait, which were challenged by wearing five different shoe heel types and two different self-selected gait speeds (comfortable and fast) as experimental conditions. Measurement standards of knee extension and flexion ROM were individually calibrated at the time of heel strike, mid-stance, toe-off, and stance phase based on the 2-minute video recordings of each gait condition. Seven healthy young women (20.7 ± 0.8 years) participated and they were asked to walk on a treadmill wearing the five given shoes at a self-selected comfortable speed (average of 2.4 ± 0.3 km/h) and a fast speed (average of 5.1 ± 0.2 km/h) in a random order. All of the shoes were in size 23.5 cm. Three of the given shoes were 9.0 cm in height, the other two were flat shoes and sneakers. A motion capture software (Kinovea 0.8.27) was used to measure the kinematic data; changes in the knee angles during each gait. During fast speed gait, the knee extension angles at heel strike and mid-stance were significantly decreased in all of the 3 high heels (p<0.05). The results revealed that fast gait speed causes knee flexion angle to significantly increase at toe-off in all five types of shoes. However, there was a significant difference in both the knee flexion and extension angles when the gait in stiletto heels and flat shoes were compared in fast gait condition (p<0.05). This showed that walking fast in high heels leads to abnormal knee ROM and thus can cause damages to the knee joints. The findings in this preliminary study can be a basis for future studies on the kinematic changes in the lower extremity during gait and for the analysis of causes and preventive methods for musculoskeletal injuries related to wearing high heels.

Importance of an Integrated Assessment of Functional Disability and Work Ability in Workers Affected by Low Back Pain

  • Fabrizio Russo;Cristina Di Tecco;Simone Russo;Giorgia Petrucci;Gianluca Vadala;Vincenzo Denaro;Sergio Iavicoli
    • Safety and Health at Work
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    • 제15권1호
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    • pp.66-72
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    • 2024
  • Background: This study examines the relationship between functional disability and work ability in workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data were collected during the first medical examination using anamnestic and clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the high school degree, 45.6% married. Results: WAI and ODI reported a negative and fair correlation (r = -0.454; p = .000). Workers with acute LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms. White collars without depressive symptoms reported higher work ability - even in chronic disability conditions-than those with depressive symptoms. Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study's findings highlight the importance of using a multidisciplinary approach to manage and prevent disability due to LBP.