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Case Report of Syringomyelia with Herniated Intervertebral Disc of Cervical Spine Treated by Korean Medicine Therapy (척수공동증과 경추 추간판 탈출증을 진단받은 환자에 대한 한방치료의 치험 1례 보고)

  • Jung, Bum-Hwan;Jo, Joo-Hyun;Choi, Seung-Peom;Na, Hyun-Wook;Kim, Kyung-Woon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.97-104
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    • 2013
  • Objectives : The purpose of this clinical case is to evaluate the efficacy of Korean Medicine treatment on Syringomyelia with Herniated Intervertebral Disc(HIVD) of C-SPINE. Methods : We used Acupunture, herbal acupuncture, herbal medicine for this patient. This patient received hospital treatment for 15 days. Results : Patient's chief complain were neck pain and trapezius pain. NRS of chief complaint decreased from 6 to 2 and Patient's NDI decreased from 46 to 14. Conclusions : We experienced improvement of symptoms in this case by acupuncture stimulation, herbal medicine. and we hope this study is helpful for the treatment of Syringomyelia with HIVD of C-SPINE.

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A Case Report of Korean Medicine Treatment for a Patient with Cervical Dystonia (경부 근긴장이상증 환자에 대한 한방치료 증례보고 1례)

  • Hyo-won Jin;Jeong-rim Bak;Jeong-rim Bak;Jong-min Yun;Byung-soon Moon
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.948-956
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    • 2023
  • The purpose of this study is to report a case of cervical dystonia and the effects of a series of traditional Korean medicine treatments applied to the patient. The patient was treated with conventional treatment and traditional Korean medicine consisting of acupuncture, moxa, chuna therapy, and herbal medicine (Hoesu-san-gami) for 48 days. Progress was measured by Tsui's score, the Toronto Western Spasmodic Torticollis Rating Scale, and the Neck Disability Index. We observed some improvements in the patient's symptoms: Tsui's score of 15 to 11, TWSTRS of 63.3 to 47.8, and NDI of 24 to 17. These findings indicate that the application of traditional Korean medicine to cervical dystonia can yield decent clinical outcomes.

Cross-Cultural Adaptation of Korean Language Versions on Neck Pain and Disability Questionnaires and Their Psychometric Testing (한글 경추 통증 및 기능장애 측정 도구의 개발과 타당도 및 신뢰도 검사)

  • Lee, Hae-Jung
    • Korean Journal of Acupuncture
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    • v.24 no.2
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    • pp.99-112
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    • 2007
  • Objectives : It was to translate three neck and spinal pain disability questionnaires - the Neck Disability Index (NDI), the Neck Pain and Disability Scale (NPDS), and the Functional Rating Index (FRI) - into Korean language, and evaluate the psychometric properties of Korean versions of questionnaires to achieve a good cross-cultural adaptation. Methods : Forty (23 males, 17 females) subjects aged from 15 to 64 years old, participated to examine test-retest reliability. One hundred and eighty (76 males, 104 females) subjects with a primary diagnosis of non-specific neck pain and 81 healthy volunteers were undertaken to examine internal consistemcy, discriminative validity and longitudinal construct validity. Versions of each questionnaire in idiomatic modern Korean were developed using a procedure proposed by Beaton et al. (2000). To assess reliability, the Intraclass Correlation Coefficient (ICC $_{(2,1)}$) was calculated. Internal consistency was evaluated by Cronbach's alpha. Discriminative validity was examined with independent-group t-tests. Responsiveness was tested by calculating the effect size and standardized response mean for each questionnaire and using Pearson' s r and the area under the receiver operating characteristic curve analysis. Results : Test-retest reliability ofthe translated versions of the three disability questionnaires was excellent (ICC $_{(2,1)$ = 0.86-0.90). High internal consistency was found in the three disability questionnaires (Cronbach's alpha ranged from ${\alpha}=0.88$ for the FRI to ${\alpha}=0.96$ for the NPDS and 0.82 for the Short Form McGill Pain Questionnaire(SFMPQ)). the VAS subscale of the SFMPQ was found to be the most responsive of the subscales (ES=1.44, SRM=1.37). The VAS was also the most responsive pain and disability index in internal responsiveness analysis, although disability indices showed marginally better responsiveness when compared with external standards. No floor or ceiling effects were observed. Conclusions : It is concluded that the questionnaires were successfully translated and exhibit acceptable measurement properties, and may suggest that they are suitable for use in clinical and research application.

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Clinical evaluation of 3.0-mm narrow-diameter implants: a retrospective study with up to 5 years of observation

  • InKyung Hwang;Tae-Il Kim;Young-Dan Cho
    • Journal of Periodontal and Implant Science
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    • v.54 no.1
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    • pp.44-52
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    • 2024
  • Purpose: This study aimed to evaluate the clinical outcomes of a single type of narrow-diameter implant (NDI) by investigating its survival rate and peri-implant marginal bone loss (MBL). In addition, variables possibly related to implant survival and MBL were investigated to identify potential risk factors. Methods: The study was conducted as a retrospective study involving 49 patients who had received 3.0-mm diameter TSIII implants (Osstem Implant Co.) at Seoul National University Dental Hospital. In total, 64 implants were included, and dental records and radiographic data were collected from 2017 to 2022. Kaplan-Meier survival curves and a Cox proportional hazard model were used to estimate the implant survival rate and to investigate the effects of age, sex, jaw, implant location, implant length, the stage of surgery, guided bone regeneration, type of implant placement, and the surgeon's proficiency (resident or professor) on implant survival. The MBL of the NDIs was measured, and the factors influencing MBL were evaluated. Results: The mean observation period was 30.5 months (interquartile range, 26.75-45 months), and 6 out of 64 implants failed. The survival rate of the NDIs was 90.6%, and the multivariate Cox regression analysis showed that age was associated with implant failure (hazard ratio, 1.17; 95% confidence interval, 1.04-1.31, P=0.01). The mean MBL was 0.44±0.75 mm, and no factors showed statistically significant associations with greater MBL. Conclusions: NDIs can be considered a primary alternative when standard-diameter implants are unsuitable. However, further studies are required to confirm their long-term stability.

Comparison of the Morphometric Changes in the Cervical Foramen: Anterior Cervical Discectomy and Fusion versus Posterior Foraminotomy (전방 경유 디스크 절제술 및 유합술과 후방 추간공 절제술에서의 경추 추간공의 형태학적 변화 비교)

  • Chung, Sung-Soo;Sun, Woo-Sung;Chung, Jong-Chul;Heo, Ki-Sung;Kim, Hyun-Min
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.512-518
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    • 2021
  • Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

Reliability Improvement of Offshore Structural Steel F690 Using Surface Crack Nondamaging Technology

  • Lee, Weon-Gu;Gu, Kyoung-Hee;Kim, Cheol-Su;Nam, Ki-Woo
    • Journal of Ocean Engineering and Technology
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    • v.35 no.5
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    • pp.327-335
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    • 2021
  • Microcracks can rapidly grow and develop in high-strength steels used in offshore structures. It is important to render these microcracks harmless to ensure the safety and reliability of offshore structures. Here, the dependence of the aspect ratio (As) of the maximum depth of harmless crack (ahlm) was evaluated under three different conditions considering the threshold stress intensity factor (Δkth) and residual stress of offshore structural steel F690. The threshold stress intensity factor and fatigue limit of fatigue crack propagation, dependent on crack dimensions, were evaluated using Ando's equation, which considers the plastic behavior of fatigue and the stress ratio. ahlm by peening was analyzed using the relationship between Δkth obtained by Ando's equation and Δkth obtained by the sum of applied stress and residual stress. The plate specimen had a width 2W = 12 mm and thickness t = 20 mm, and four value of As were considered: 1.0, 0.6, 0.3, and 0.1. The ahlm was larger as the compressive residual stress distribution increased. Additionally, an increase in the values of As and Δkth(l) led to a larger ahlm. With a safety factor (N) of 2.0, the long-term safety and reliability of structures constructed using F690 can be secured with needle peening. It is necessary to apply a more sensitive non-destructive inspection technique as a non-destructive inspection method for crack detection could not be used to observe fatigue cracks that reduced the fatigue limit of smooth specimens by 50% in the three types of residual stresses considered. The usefulness of non-destructive inspection and non-damaging techniques was reviewed based on the relationship between ahlm, aNDI (minimum crack depth detectable in non-destructive inspection), acr N (crack depth that reduces the fatigue limit to 1/N), and As.

The Domestic Trend of Chuna Manual Therapy on Cervical Spinal Disorders (경추부 질환에 적용하는 추나 치료에 대한 국내 연구 동향)

  • Jeong, Yun-Gyu;Kim, Min-Young;Kim, Jin-Soo;Ro, Hae-Rin;Choi, Young-Il;Choi, Hee-Seung;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.1-13
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    • 2013
  • Objectives: The present study examines the domestic trend of Chuna manual therapy on cervical spinal disorders in Korea. Methods: We investigated the studies on Chuna manual therapy for cervical spinal disorders via searching 6 Korean web databases. As a result, 51 research papers were found to be analyzed according to their published year, published institution, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of cervical spinal disorders and ethical approvals. Results: The number of the research papers published tended to increase every year. The studies on Chuna manual therapy for cervical spinal disorders were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Chuna spine manipulation therapy - cervical spine technique. Visual analogue scale (VAS), neck disability index(NDI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusions: Reviewing the domestic trend of studies on Chuna manual therapy for cervical spinal disorders and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

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The Effects of Neck Stabilization Exercise and Proprioceptive Neuromuscular Facilitation on Neck Alignment, NDI, and Static Balance in Adults with Forward-head Posture in a Sitting Position (앉은 자세에서의 목안정화운동과 PNF 목 패턴이 거북목증후군 성인의 목 정렬, 목 장애지수 및 정적균형에 미치는 영향)

  • Song, Gui-Bin;Kim, Jwa-Jun;Kim, Kyu-Ryeong;Kim, Geun-Young
    • PNF and Movement
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    • v.18 no.1
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    • pp.11-22
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    • 2020
  • Purpose: The purpose of this study was to investigate the effects of neck stabilization exercise with PNF for neck alignment, neck disability index, and sitting balance in adults with forward-head posture. Methods: Forty participants were randomly assigned to two groups. Patients in the neck stabilization exercise group (NSG, n = 20) and the proprioceptive neuromuscular facilitation neck pattern exercise group (PNFG, n = 20) were studied 30 minutes a day three times a week for four weeks. Outcomes were measured using cranial vertical angle (CVA), the Korean version of the neck disability index (KNDI), anterior limit of stability (ALOS), and posterior limit of stability (PLOS) before and after the intervention period. Results: There were significant effects in the CVA and the KNDI of both groups pre- and post-intervention. There were significant effects in ALOS and PLOS in the PNFG pre- and post-intervention compared with the NSG. Conclusion: The results of this study suggest that PNF with neck exercise could be beneficial to the static balance of adults with forward-head posture.

Effects of Cervical Instability on Function of Deep Neck Flexor Muscle and Muscle Tonus of Neck Muscles (목 불안정성이 깊은목굽힘근의 기능과 목 근육들의 긴장도에 미치는 영향)

  • Lee, Sung-Hyun;Seo, Dong-Kwon
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.1
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    • pp.123-131
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    • 2021
  • Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.