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Clinical Observation on The Left and Right Facial Palsy (${\cdot}$右側 口眼와斜 患者에 對한 臨床的 考察)

  • Lim, Jin-Ki;Lim, Gyu-Sang;Hwang, Choong-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.10 no.1
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    • pp.383-402
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    • 1997
  • The author analyzed 155 cases of Facial Palsy, excluding lesions caused by cerebrovascular attacks, who were treated in the Kwang-ju Oriental Medical Hospital of Wonkwang University from March 1996 to September 1996. I've examined the 155 cases in the view of the etiologic distributions, the age, the relationship of the sex and paralytic side, attended symptoms and analyzed 95 cases who were treated over ten times in the view of the ratio of recovery according to the age, anatomic focus, the relations of sex and paralytic side. The following results are obtained. 1. The ratio of punghan(風寒) was $20.64\%$(32 cases), overwork was $18.70\%$(29 cases), stress was $6.44\%$(10 cases), excessive drinking was $3.23\%$(5 cases), teeth pain was $1.93\%$(3 cases), and idiopathy was $38.05\%$(59) and etc. 2. The ratio of stylomastoid pain was $15.48\%$(24 cases), auricular pain was $10.32\%$(16 cases), headache was $4.51\%$(7 cases), eyedried was $4.51\%$(7 cases), taste paralysis was $2.57\%$(4 cases), tinnitus was $2.57\%$(4 cases) and non-significant symptoms was $50.97\%$(79) and etc. 3. The ratio of 2th and 5th decade were $20.00\%$(31 cases), 4th decade was $18.71\%$(29 cases), 3th decade was $16.71\%$(26 cases), 6th decade was $11.61\%$(18 cases), teenagers in $5.81\%$(9 cases), over seventy and under teenagers were $3.23\%$(5 cases), and infant was $0.65\%$(1 case). 4. The ratio of the male-right was $28.39\%$(44 cases), female-right was $25.82\%$(40 cases), male-left was $23.23\%$(36 cases), female-left was $20.65\%$(32 cases) and male-both side was $1.94\%$(3 cases) in order. 5. Topographically, The ratio of the infrachordal lesion was $72.90\%$(113 cases), transgeniculate lesion was $16.13\%$(25 cases), suprageniculate lesion was $5.81\%$(9 cases), infrastapedial lesion was $3.87\%$(6 cases) and suprastapedial lesion was $1.29\%$(2 cases) in order. 6. When we examined the degree of recovery about the 95 patients who were treated over ten times after on attack, normal improvement was seen in $46.32\%$(44 cases), excellent in $7.37\%$(7 cases), good in $12.63\%$(12 cases), fair in $13.68\%$(13 cases), poor in $20.00\%$(19 cases). The total remedial value of the 95 patients who were treated over ten times was revealed $61.58\%$. 7. When we examined the 95 patients who were treated over ten times, the remedial value of the infant was $50.00\%$, under teenagers $43.75\%$, teenagers $37.50\%$, 2th decade $56.82\%$, 3th decade $64.06\%$, 4th decade $55.00\%$, 5th decade $73.53\%$, 6th decade $77.50\%$, over seventieth $68.75\%$. The remedial value of 3th decade, 5th decade, 6th decade, 7th decade and over seventieth were higher than the total remedial value($61.58\%$) 8. In the point of topographical lesion, when we examined the 95 patients who were treated over ten times, the remedial value of infrachordal lesion was $66.78\%$, infrastapedial lesion $58.33\%$, suprastapedial lesion $50.00\%$, transgeniculate lesion $48.44\%$, suprageniculate lesion $31.25\%$, in order. Only the remedial value of Infrachordal($66.78\%$) was higher than the total remedial value($61.58\%$). 9. In the point of the relationship of the sex and the paralytic side, when we examined the 95 patients who were treated over ten times, the remedial value of male-left was $57.29\%$, male-right $61.54\%$, male-both side $58.33\$%, female-left $57.81\%$ and female-right $68.27\%$. Only the remedial value of female-right($68.27\%$) was higher than the total remedial value($61.58\%$). These results demonstrated that in the point of prognostic view there was more concerned with the topographical lesion, body condition than the traditional rule of sex-paralytic relationship that man is awed left paralysis and woman right paralysis.

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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

The Effects of Ginseng Saponin on Relaxation of Smooth Muscle in the Lower Urinary Tract and the Corpus Cavernosum (인삼 사포닌이 하부요로와 음경해면체 평활근의 이완작용에 미치는 효과)

  • Jung, Hee-Chang;Oh, Tae-Hee
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.52-61
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    • 2006
  • Background: Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. Materials and methods: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. Results: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from $9.0{\pm}2.9$ to $33.7{\pm}4.8%$ in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from $5.8{\pm}2.1$ to $36.7{\pm}5.8%$, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was $37.5{\pm}8.5$ mmHg at $52.1{\pm}7.0$ sec. during isovolumetric bladder contraction, showing no significant differences from $35.7{\pm}7.8mmHg$ and $50.7{\pm}7.2$ sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was $6.9{\pm}0.5mmHg$ at $62{\pm}7.5$ sec, which was significantly higher compared to $4.6{\pm}1.1mmHg$ at $45{\pm}10$ sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (${\Delta}ICP$) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased ${\Delta}ICP$ from $1.3{\pm}0.5$ to $21.3{\pm}7.8mmHg$ in a dose-dependent manner (p<0.05). The duration of tumescence was from $0.3{\pm}0.1$ to $5.2{\pm}0.2$ min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. Conclusion: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.

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A Study on the Relationship between Musculoskeletal Symptoms and Health Promoting Life Style among Some Workers (일부 직업인들의 근골격계 자각증상과 강증진생활양식간의 연관성에 관한 연구)

  • Kang Hong-Gu;Lee Eun-Kyoung;Jun Sun-Young;Kim Sang-Deok;Jeoung Jae-Yeal;Lee Yong-Gil;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.2
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    • pp.40-68
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    • 2001
  • In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

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The Risk of Onset of the Illnesses Based on Gender, Age, and Monthly Income;Focusing on cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders (성별, 연령별, 월소득차이에 따른 질병발생의 위험성 차이연구;암, 고혈압, 중풍, 당뇨병, 관절염, 심장병을 중심으로)

  • Lee, Jun-Oh;Kim, Se-Jin;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.1
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    • pp.19-48
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    • 2008
  • In order to verify the risk of onset of the illnesses based on gender, age, and monthly income 1,739 subjects from Hongcheon county, Gangwon province were selected. Questionnaire on demographic sociology, health condition, existence of illnesses(cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders), and usage of public health services was surveyed from October 1, 2006 to October 20, 2006. Following conclusions were reached on the basis of the questionnaire : - For demographic sociological peculiarities, gender, age, occupation, and education level were evenly distributed. Most were under normal marriage(67.38%), health insurance(86.39%), 494(36.0%) individuals with less than monthly income of 1 million won, 494(36.0%) individuals with monthly income between 1 and 2 million won, 219(16.0%) with monthly income between 2 and 3 million won, and 164(12.0%) individuals with more than 3 million won, thus showing relatively low income. - For health status, 1,199(70.28%) individuals are non-smokers, 209(45.63%) individuals smoke $10{\sim}20$ cigarettes a day, 754(44.02%) individuals exercise less than twice a week are the major sector of the population. 1,518(88.10%) individuals have regular checkup more than once and 1,131(65.49%) stated their health condition less than average. - For comparison of existence of illnesses between genders, there was no statistical significance on cancer, stroke, and diabetes. But statistical significance was shown on hypertension(P value 0.025), arthritis(P value 0.000), and cardiac disorders(P value 0.016). Statistical significance was seen in the age comparison, and OR(confidence interval) drastically increased with increase in age. - There was no difference between the primary health clinic(P value 0.000), most visited clinic(P value 0.000), selection criteria(P value 0.000), and satisfaction on efficacy(P value 0.000). There was a tendency preferring hospital than public health center with increase in income. - For correlation between the existence of illnesses among different income levels, except for cancer(P value 0.172), statistical significance was seen in hypertension(P value 0.000), stroke(P value 0.003), diabetes (P value 0.001), arthritis(P value 0.000), and cardiac disorders(P value 0.000). The number of individuals suffering from illnesses and ratio all decreased for all illnesses with increase in income. - After adjusting confounding factors(gender, age, income, marriage, occupation, education) and male (1) as the standard, OR (confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 0.47(0.11${\sim}$2.05), 1.27(0.89${\sim}$1.81), 0.58(0.21${\sim}$1.59), 0.71(0.41${\sim}$1.23), 1.79(1.34${\sim}$2.39, P<0.01), and 1.46(0.72${\sim}$2.96), respectively. Risk of arthritis is significantly high in female and 20's (1) as the standard, OR(confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 1.01(0.96${\sim}$1.07), 1.06(1.04${\sim}$1.07, P<0.01), 1.05(1.01${\sim}$1.10, P<0.01), 1.06(1.03${\sim}$1.08, P<0.01), 1.05(1.03${\sim}$1.06, P<0.01), and 1.06(1.04${\sim}$1.09, P<0.01), respectively. Risk of onset for illnesses significantly increased with yearly aging except for cancer. - For comparison between monthly income after adjusting confounding factors(gender, age, income, marriage, occupation, education), with less than 1 million won (1) as the standard, OR(confidence interval) of cancer for 1 to 2 million won, 2 to 3 million won, and more than 3 million won were 0.23(0.03${\sim}$2.16), 2.53(0.41${\sim}$15.43), and 1.73(0.15${\sim}$19.50), respectively. OR(confidence interval) of hypertension were 1.12(0.76 ${\sim}$1.66), 0.68(0.34${\sim}$1.34), and 2.04(1.08${\sim}$3.86, P<0.01), respectively. OR(confidence interval) of stroke were 0.96(0.30${\sim}$3.08) for 1 to 2 million won, and 0.80(0.08${\sim}$8.46) for 2 to 3 million won. OR(confidence interval) of diabetes were 0.73(0.38${\sim}$1.38), 0.65(0.24${\sim}$1.71), and 0.69(0.24${\sim}$2.01), respectively. The values were 0.76(0.55${\sim}$1.03), 1.14(0.75${\sim}$1.73), and 0.90(0.56${\sim}$1.46), respectively for arthritis. OR(confidence interval) of cardiac disorders were 1.15(0.53${\sim}$2.48), 0.63(0.13${\sim}$3.12), and 1.20(0.28${\sim}$5.14), respectively. Risks of cancer, hypertension, stroke, diabetes, arthritis, and cardiac disorders were dependent of monthly income, and stroke and diabetes decreased with increase in income. Summarizing above data, arthritis was significantly higher in women and increase in age by each year brought significant increase in the chance of onset in hypertension, stroke, diabetes, arthritis, and cardiac disorders except for cancer. Stroke and diabetes decreased with increase in income. Above findings can be applied and reflected in public health policies at the national level, and it can also be applied at the personal level for individual health maintenance and prevention.

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The Change of The Effect on The Subcutaneous Fat Area and Visceral Fat Area by The Functional Electrical Stimulation and Aerobic Exercise (기능적 전기 자극과 유산소 운동이 복부비만의 피하지방과 내장지방에 미치는 효과)

  • Oh Sung-tae;Lee Mun-hwan;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.85-123
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    • 2004
  • Back ground : Subcutaneous fat area is the main factor involved in replacement disease and arteriosclerosis. Simple weight control is the appropriate medical treatment. It's understood that weight reduction does not only reduce the fat concentrations in blood but also reduces blood pressure, improves glucose levels in diabetes patients and reduces incidents of heart disease. there are several methods for reducing fat in the abdominal region but their effectiveness is not folly understood. one method is electrical stimulation of the problem areas. Method : From May 1st 2002 to October 31st. The 15 subjects who received medical examination were aged between 25 and 53 and were of mixed gender. The subjects were divided into two groups one to received functional electrical stimulation and the other a control group. Using Broca's criterion for judging fat grades. I analysed the differences between the two groups before and after the treatment. Subjects received functional electrical stimulation on the abdominal muscle intensity 50Hz. They received this treatment 4 days a week for 40 minutes a day. In the case of aerobic exercise, at the Treadmill, we used it with the intensity of $75\%$ maximum heart rate (220-age). Result 1)After functional electrical stimulation in the case of male subjects, the weight was reduced 1.93kg, obesity $2.60\%$, fat mass 2.73kg, Percent body fat $4.40\%$, waist circumference 6.53cm, circumference of hips 5.53cm. On the other side, the quality of muscle was increased at the rate of 1.03kg, but it's not attentional level. The subcutaneous fat area was reduced by $26.63cm^2$, the visceral fat area was reduced by $43.00cm^2$, In the female subjects, we can see the reduction of fat grade by $26.63cm^2$, the quantity of body fat by 1.5kg, percent body fat by $1.77\%$, circumference of waist by 4.02cm, circumference of hips by 3.67cm, weight by 1.40kg but was increased 0.72kg at the quantity of muscles. We can see the reduction also in the subcutaneous fat area $24.03cm^2$, the visceral fat area by $25.36cm^2$. 2)After aerobic exercise, on the male subjects, we can see reduction of weight by 3.36kg, obesity by $4.00\%$, fat mass by 2.83kg and we can see increase at the soft lean mass by 2.96kg, but we can see reduction, the percent body fat by $3.03\%$, fat distribution by $0.023\%$, circumference of waist by 3.10cm, circumference of hips by 2.23cm. The female subjects show a reduction in the weight by 2.48kg, percent body fat by $2.20\%$, show an increase in the soft lean mass by 1.54kg. We can see a reduction in the quantity of fat mass by 2.32kg, the percent body fat by $2.80\%$, the circumference of waist by 2.16cm, the circumference of hips by 2.68cm, the fat distribution by $0.016\%$, the subcutaneous fat area by $15.25cm^2$ the visceral fat area by $11.52cm^2$. After aerobic exercise, we can't see the attentional change at the total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. 3)After the application of functional electrical stimulation and aerobic exercise, in result of measurement on the body ingredient, we could see the weight reduction and increase the quantity of muscle with the male group who exercised aerobic. We can see the attentional rate on the electrical stimulation about abdominal fat rate, circumference of waist, circumference of hips. The other hand, I couldn't see the attentional differences between the two groups in the rate of fatness and quantity of body fat and the rate of body fat. There isn't any attentional difference in the area of fat under skin, on the contrary, There is attentional difference in the fat in the internal organs area at the electrical stimulation site. We can't see the attentional change of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol between electrical stimulation and aerobic exercise. 4)After execution of functional electrical stimulation and aerobic exercise, in result of measurement on change of body ingredient among female objects, We could see weight reduction, increase at muscle quantity in the aerobic exercise group. We could see the attentional differences in the rate of fatness, the rate of abdominal region, the circumference which received electrical stimulation. But, we couldn't see the attentional differences between two groups in the quantity of body fatness, the circumference of hips. The subcutaneous fat area doesn't show the attentional differences. On the Contrary, we could see lots of differences in the visceral fat area of the electrical stimulation group. Conclusion The results show that functional electrical stimulation and aerobic exercise have insignificant differences when if comes to total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. Though there is affirmative change in body ingredient after both electrical stimulation and aerobic exercise. Functional electrical stimulation is more effective on the subcutaneous fat area and in changing visceral fat area. There fore. It is concluded that the physical therapy is more effective in the treatment of abdominal fatness.

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