• 한방재활의학과학회지
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• 제30권4호
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• pp.143-154
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• 2020

Objectives To analyze the prognosis of patients with low back pain according to the severity of abnormal lumbar lordotic angle and Ferguson's angle. Methods Data from electronic medical record of a total of 199 patients hospitalized in Korean medicine hospital were analyzed. With the sagittal view of lumbar spine X-ray, lumbar lordotic angle was defined as the angle between the superior endplate of L1 with the inferior endplate of L5. Ferguson's angle was defined as the angle between the superior surfaces of the sacral with a horizontal line. 'Measure Cobb's Angle Tool' of 'INFINITT PACS' was used to measure both angles. Lumbar lordotic angle and Ferguson's angle were subdivided into five sections. The number of days from onset and the duration of hospitalization were analyzed in each section. Results Severe hypolordotic lumbar lordotic angle group were found to have longer medical history and hospitalization duration than the control group. The ratio of long-term hospitalization (over 15 days) and chronic medical history (over 180 days) of patients with severe hypolordotic Ferguson's angle were significantly higher than the control group. The ratio of patients with chronic medical history (over 180 days) was significantly higher in severe hyperlordotic Ferguson's angle group than the control group. Conclusions Severe hypolordotic lumbar lordotic angle was related to patient's prognosis. Both severe hyperlordotic and severe hypolordotic Ferguson's angle were found to be related to patient's prognosis. However, a moderate loss of lumbar lordotic angle and Ferguson's angle was not related to prognosis of low back pain patients.

• Korean Journal of Acupuncture
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• 제36권1호
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• pp.1-18
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• 2019

Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

• 한국엔터테인먼트산업학회논문지
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• 제13권8호
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• pp.583-593
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• 2019

본 연구는 만성허리통증자의 특징적과거력의 존재수와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 간의 상관성을 조사하였다. 40명의 만성허리통증자들에게 4가지 특징적과거력의 존재 유무를 조사 한 후, 존재 수에 따라 5개 그룹으로 분류 하였다[그룹 1 (0) : n = 8, 그룹 2 (1) : n = 8, 그룹 3 (2) : n = 8, 그룹 4 (3) : n = 8, 그룹 5 (4) : n = 8]. 불안정성과 관련한 주관적 통증 양상 16개 항목의 양성반응을 조사하고, 7개의 이학적 불안정성 검사를 수행하여 그 결과를 점수화 하였다. 특징적과거력의 존재 수에 따른 주관적 불안정성 통증 양상, 이학적 불안정성 검사 점수를 비교하고 상관 분석을 하였다. 그 결과, 그룹 간 비교에서 유의한 차이가 있었다(p<.05). 또한 특징적과거력의 존재 수와 주관적 불안정성 통증 양상(r = .819, p = .000), 이학적 불안정성 검사(r = .606, p = .000) 사이에는 높은 양의 상관성을 나타내었고, 주관적 불안정성 통증 양상과 이학적 불안정성 검사(r = .571, p = .000) 사이에도 양의 상관성을 나타냈다. 본 연구 결과에 따라 3개 이상의 특징적과거력의 존재는 만성허리통증자의 허리부위 불안정성 진단에 유용한 변수가 될 수 있다. 또한 특징적과거력 정보와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 결과의 조합은 불안정성 진단의 정확도를 높일 수 있다.

• 대한정형외과학회지
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• 제55권2호
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• pp.135-142
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• 2020

목적: 본 연구에서는 봉합 불가능한 광범위 회전근 개 파열에 있어서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 임상적 유용성 및 장기 추시 결과를 발표하고자 한다. 대상 및 방법: 봉합 불가능한 광범위 회전근 개 파열 환자 중 상완 이두근 건 장두에 50% 미만의 파열이 있는 41명의 환자를 대상으로 상완 이두근 건 장두를 이용하여 관절경하 부분 봉합술을 시행받은 1군과 파열되지 않은 상완 이두근 건 장두가 있으나 자가 이식건을 이용하지 않고 관절경하 부분 봉합술만을 시행한 2군으로 나누었다. 임상 점수는 시각통증점수(visual analogue pain scale, VAS), 운동범위(range of motion, ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES) 및 Korean Shoulder Scoring System (KSS) 점수로 측정하였으며 최종 추시에 측정된 점수가 사용되었다. 수술 전과 최종 추시에 촬영한 단순 방사선 사진을 이용하여 견봉상완거리(acromiohumeral interval, AHI)를 측정하였고 최종 추시에 시행한 초음파 또는 자기공명영상 검사를 이용하여 재파열 여부를 평가하였다. 결과: 환자의 평균 연령은 62.1±12.7세였으며, 평균 추시 기간은 90.3±16.8개월이었다. 1군과 2군 간에 VAS와 ROM (전방 거상, 외회전, 내회전)의 유의한 차이는 없었다(p=0.179, p=0.129, p=0.098, p=0.155). UCLA, ASES 및 KSS 점수는 2군과 비교해 1군에서 기능적 개선을 보였다(p=0.041, p=0.023, p=0.019). 최종 추시 시 AHI는 1군 9.46±0.41 mm, 2군 6.86±0.64 mm로 측정되었다(p=0.032). 재파열은 1군 21예 중 6예(28.6%), 2군 20예 중 9예(45.0%)에서 발견되었다. 1군의 경우 2군에 비하여 유의하게 낮은 재파열률을 보였다(p=0.011). 결론: 본 연구에서는 봉합이 불가능한 광범위 회전근 개 파열이 있는 환자들에게 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술을 시행하여 장기 추시한 결과, 상완 이두근 건 장두를 사용하지 않은 군에 비하여 기능적 향상 및 낮은 재파열률을 보인다. 따라서 이는 봉합 불가능한 광범위 회전근 개 파열이 있는 환자에서 좋은 수술적 방법으로 생각된다.

• 동의신경정신과학회지
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• 제12권2호
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• pp.103-122
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• 2001

The clinical study was carried out the 58 patients with Headache who were treated in Department of Neuropsychiatry, College of Oriental Medicine, Dae Jeon University from 14 October 1999 to 15 October 2001. The results were summarized as follows. 1. The ratio of male and female was 15:43, 40s(36.2%) was frequent, the ratio of Tension headache and Migraine was 43:12, hypernoia and overwork oneself were the most inducing factor. 2. In distribution of the period of the clinical history, Tension headache was comparatively short term within 1 month(62.8%) and Migraine was comparatively long term over 1 year(91.7%), Tension headache was frequent at whole portion(41.3%) and occipital portion(26.1%), Migraine was frequent at temporal portion(76.9%). 3. In pain type, Tension headache has many vandlike discomport type, Migraine has many pulsatile type, neck-stiffness-pain and dizziness were mainly coexited. 4. Toung aspect has many SULDAMHONGTAEBAEKHOO(舌淡紅苔白厚), GINMAEK(緊脈) and HEUNMAEK(弦脈) were frequent in Pulse type, the GAEDAMSUNKIJEETONG(祛淡順氣止痛) prescription drugs were frequent such as GEYNTONGA(肩痛A), GEYNTONGDODAMTANG(?通導淡湯), Tension headache patients were well treated(90.7%). 5. In Tension headache and Migraine, the Curve has many SL except Tension headache‘s 2th SANGHAN(상한), in Regulation RR was frequent at 1th, 2th, 3th, 4th, 7th SANGHAN and RL was frequent at 5th, 6th SANGHAN, the result of Graph, Activity and Reactivity have many low response at the whole. 6. The Curve was within normal limit at whole portion and frequent SL at temporal portion, the whole and temporal portion s Regulation also have many RR at 1th, 2th, 3th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity and Reactivity have many low response at the whole. 7. The occipital and frontal portion‘s Curve have many SL at 1th SANGHAN, the occipital portion’s Regulation has many RR at 1th, 2th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity has many low response at the whole, Reactivity has many low response at 1th, 4th, 5th, 6th SANGHAN and high response 2th, 3th SANGHAN, the frontal portion s Regulation has many RL at 1th, 3th, 5th, 6th, 7th SANGHAN and RR at 4th SANGHAN, Activity and Reactivity also have many low response at the whole except 6th, 7th SANGHAN respectively.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.637-642
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• 2016

Objective : Although many treatment modalities have been introduced for trigeminal neuralgia (TN), the long-term clinical results remain unsatisfactory. It has been particularly challenging to determine an appropriate treatment strategy for patients who have responded poorly to initial therapies. We analyzed the surgical outcomes in TN patients who failed prior treatments. Methods : We performed a retrospective analysis of 37 patients with recurrent or persistent TN symptoms who underwent surgery at our hospital between January 2010 and December 2014. Patients with follow-up data of at least one year were included. The prior treatment modalities of the 37 patients included microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and percutaneous procedures such as radiofrequency rhizotomy (RFR), balloon compression, and glycerol rhizotomy (GR). The mean follow-up period was 69.9 months (range : 16-173). The mean interval between the prior treatment and second surgery was 26 months (range : 7-123). We evaluated the surgical outcomes using the Barrow Neurological Institute (BNI) pain intensity scale. Results : Among the 37 recurrent or persistent TN patients, 22 underwent MVD with partial sensory rhizotomy (PSR), 8 received MVD alone, and 7 had PSR alone. Monitoring of the surgical treatment outcomes via the BNI pain intensity scale revealed 8 (21.6%) patients with a score of I, 13 (35.1%) scoring II, 13 (35.1%) scoring III, and 3 (8.2%) scoring IV at the end of the follow-up period. Overall, 91.8% of patients had good surgical outcomes. With regard to postoperative complications, 1 patient had transient cerebrospinal fluid rhinorrhea (2.7%), another had a subdural hematoma (2.7%), and facial sensory changes were noted in 8 (21.1%) patients after surgery. Conclusion : Surgical interventions, such as MVD and PSR, are safe and very effective treatment modalities in TN patients who failed initial or prior treatments. We presume that the combination of MVD with PSR enabled us to obtain good short- and long-term surgical outcomes. Therefore, aggressive surgical treatment should be considered in patients with recurrent TN despite failure of various treatment modalities.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.363-366
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• 2012

Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

• 대한한방부인과학회지
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• 제31권3호
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• pp.61-78
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• 2018

Objectives: The purpose of this study was to analyze the current characteristics of outpatients with postpartum disease and provide a treatment instruction in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, We searched medical records from January 1, 2015 to December 31, 2017 using Z34 (Supervision of normal pregnancy), O94 (Sequelae of complication of pregnancy), U327 (産後風) and 388 postpartum patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $33.73{\pm}3.62$ years old, 356 (91.75%) patients are full term pregnancy, 201 (51.81%) patients are first delivery, 79 (20.36%) patients had past history of abortion and 63 (16.24%) patients had past history of gynecologic disease. 2. The most subjects visited in April (10.31%). The mean duration from delivery date to visiting date was $131.5{\pm}214.6$ days. The mean number of visits after the initial visit was $1.91{\pm}1.7$. 3. The characteristics related with pregnancy and delivery are as follows. The number of subjects taken assisted reproductive technology was 19 (4.9%) and suffering from gestational disease was 28 (7.22%). The mean body weight difference between full term pregnancy and visiting date was $-8.24{\pm}3.57kg$. The number of subjects discharging lochia on visiting date was 167 (43.04%) and breastfeeding was 262 (67.53%). 4. The most chief complaint was arthralgia in 217 (55.93%) followed by general weakness, cold sensation, edema, sweating disorder, dizziness, lower abdominal pain, digestion disorder, heat sensation, defecation disorder and urination disorder. 5. The most accompanied symptom was arthralgia in 322 (82.99%), followed by sleep disorder, cold sensation, general weakness, sweating disorder, defecation disorder, edema, dizziness, digestion disorder, urination disorder, lower abdominal pain and heat sensation. 6. A total of 356 subjects were taken herbal medicine. The most prescribed herbal medicine to subjects was Gungguijohyeol-eum-gamibang (29.59%). Conclusions: These results could be helpful to diagnose and treat postpartum patients in Korean gynecologic clinical fields.

• 대한간호학회지
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• 제28권1호
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• pp.171-183
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• 1998

The purpose of this study was to identify the incidence of urinary incontinence in adult women and to identify factors related to life style and sexual intercourse that were related to incontinence. The sample consisted of 1,065 women living in Seoul or one of five provinces. Data for this study were collected from January 16 to June 23 using structured questionnaires. The Urinary Symptom Questionnaire developed by Jackson and a demographic questionnaire were used to collect the data. The data were analyzed using frequency, percentage with an SPSS/PC$^{+}$ program. The major finding are as follows : 1. The distribution of age of subjects was as follows : 20-29(10.1%), 20-39(17.8%), 40-49(27.3%). 50-59(22.3%), 60-69(12.9%), 70-79(6.1%). 80-89(2.8%), more than 90(0.6%). The frequency of normal delivery, 0(155%), 1-2(36.0%), 3-4(29.2%), 5-6(13.0%). more than 7(6.3%). The rate of subjects with menopause was 40.8%. 2. It was reported that 50.7% of the subjects experienced urinary incontinence with stress, mixed. and urgency incontinence being 49.8%, 43.4%, 6.8% respectively. 3. The lower urinary symptoms and incidence with urinary incontinence were as follows : Daily frequency. 22.3%, nocturia. 40.8%, urgency, 71.2%, bladder pain 47.8%, unexplainned incontinence, 32.4%, noctural incontinence, 16.1%, and frequency of incontinence, 37.7%. In term of quantity of incontinence, drop/pants damp, 29.5%, dribble/pants wet, 20.5%, flood or soaking through to outer clothing, 1.7%, and flood or running down legs or onto floor, 0.2%. 4. The symptoms related to sexual intercourse and incidence of urinary incontinence were as follows : dry vagina, 39.1%, sex life trouble, 10.8%, pain during sexual intercourse, 27.4%, and urine leakage during sexual intercourse. 8.8%. 5. Life style problems related to urinary incontinence were as follows : fluid intake restriction, 20.0%, affected daily task, 24.5%. avoidance of placess and situations, 35.0%, interference in physical activities, 30.6%, interference in relationships with other people. 19.0%. interference in relationships with husband/companion, 8.1%, and time after attack of urinary symptoms, 76.9%. In term of the feeling about the rest of their lifves the women reported : perfectly happy, 11.3%. pleased, 16.9%. mostly satisfied, 20.2%, mixed feelings, 21.0%, mostly dissatisfied, 21.0%, very unhappy 8.5%, and desperate. 1.0%. In conclusion. this study was a preliminary study to provide nursing practices guidelines for incontinence in adult women. Nurse working with adult women should develop and provide adequate care for these women.n.

• Clinics in Shoulder and Elbow
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• 제17권2호
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• pp.68-76
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• 2014

Background: Recently, reverse total shoulder arthroplasty (RTSA) has been accepted as a main treatment option in irreparable massive rotator cuff tear with cuff arthropathy. The purpose of this study was to evaluate the early complication incidence and the preliminary clinical results of RTSAs performed in single institute. Methods: Fifty-seven RTSAs (56 patients) were performed between April 2011 and March 2013. The indications for RTSA were cuff tear arthropathy and irreparable massive rotator cuff tear with or without pseudoparalysis. Exclusion criteria were revision, preoperative infections and fractures. At final follow-up, 45 shoulders were enrolled. Mean follow-up duration was 12.5 months (range, 6-27 months). The mean age at the time of surgery was 73.6 years (range, 58-87 years). All the patients were functionally accessed via Constant score, American Shoulder and Elbow Surgeons (ASES) score, pain and functional visual analogue scale (VAS) scores and active range of motion. Complications were documented as major and minor. Major complications include fractures, infections, dislocations, nerve palsies, aseptic loosening of humeral or glenoid components, or glenoid screw problems. Minor complications include radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid. Results: The mean Constant score increased from 31.4 to 53.8 (p < 0.001). The pain and functional VAS scores improved (5.2 to 2.7, p < 0.001, 4.0 to 6.7, p < 0.001) and active forward flexion improved from $96.9^{\circ}$ to $125.6^{\circ}$ (p = 0.011). One or more complications occurred in 16 (35.6%) of 45 shoulders, with one failure (2.2%) resulting in the removal of implants by late infection. The single most common complication was scapular notching (9 [20%]). There were 4 (8.9%) axillary nerve palsies postoperatively (n=3: transient n. palsy, n=1: Symptom existed at 11 months postoperatively but improving). Conclusions: In a sort term follow-up, RTSA provided substantial gain in overall function. Most common early complications were scapular notching and postoperative neuropathy. Although overall early complication rate was as high as reported by several authors, most of the complications can be observable without compromise to patients' clinical outcome. Long term follow-up is required to clarify the clinical result and overall complication rate.