• Journal of Acupuncture Research
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• v.27 no.2
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• pp.43-49
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• 2010

Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

• Journal of Acupuncture Research
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• v.34 no.2
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• pp.113-125
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• 2017

Objectives : Cervical herniated intervertebral disc (HIVD) are common diseases. They can be managed with acupuncture, but the evidence for effectiveness is uncertain. This review analyzed the acupuncture studies of domestic neck pain and cervical HIVD; the purpose of this study was to provide basic data useful for future research. Methods : We investigated acupuncture treatments for neck pain and cervical HIVD by searching 5 Korean Internet databases. The keywords used were "neck pain", "HIVD-cervical spine", and "nuchal pain". A total of 53 research papers (17 case reports, 16 clinical data analyses, 11 randomized controlled trials, and 9 non-randomized controlled trials) were found and analyzed according to the publication year, type of study, treatment, use of filiform needles, and type of pharmacopuncture used acupoint. The effectiveness of acupuncture treatment was determined. Results : 1. Filiform needles have been primarily used in domestic research and were used in at least half of published pharmacopuncture studies. 2. In 51 papers using filiform needles, many studies used only local acupoints; few studies used only distant acupoints. 3. All studies using pharmacopuncture were performed using local acupoints. In particular, the studies based on A-shi point, trigger point, and radiologic lesion sites were useful for multiple purposes. Conclusion : In this study, we analyzed the acupuncture contents of the domestic neck pain and HIVD-cervical spine clinical studies. This study considers the assessment of the quality and efficacy of each study, which is likely to require research that reflects the future.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.495-502
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• 2021

This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.

• PNF and Movement
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• v.17 no.1
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• pp.41-46
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• 2019

Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.210-221
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• 2020

Spinal block procedures are useful methods that reduce the need for surgical treatment. In addition to their therapeutic aspects of pain relief, in many patients, they are also used for diagnostic purposes to distinguish from symptoms originating from extra-spinal areas. Therefore, these procedures are the most basic technique for orthopedic surgeons dealing with diseases from limbs and spine. On the other hand, despite the simplicity of the instruments and drugs used, the overall understanding of them and the lack of knowledge of the possible side effects and complications can cause serious harm to the patient at the beginning of the trial. Therefore, it is necessary to understand the types of drugs used in the spinal block procedures, pharmacokinetic properties, and the side effects of each drug. In addition, efforts should be made to identify their indications, as well as advantages and disadvantages of each procedure to avoid possible complications. The purpose of this review was to provide basic knowledge and skills necessary for lumbar spinal block procedures as well as provide the reader with the ability to perform themselves.

• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.505-512
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• 2022

In this study, a 3D printed assistive device was applied to X-ray examinations to diagnose human diseases. Based on the results of evaluating the device, statistical and regression analyses were conducted to evaluate its clinical utility and purchase intention, respectively. In the experiment, 90 radiologists performed X-ray examinations on patients who agreed with the use of the assistive device in oblique view X-rays of the lumbar spine, and then statistical analyses were undertaken with a traditional aid and factor analysis. The non-standardized coefficient values of the multiple regression analysis performed by setting the purchase intention of the 3D printed device as the dependent variable and the 3D printed device and traditional aid calculated by factor analysis as independent variables were 0.893 (p<0.001) and 0.269 (p<0.001), indicating statistically significant results. The results show that the 3D printed assistive device proposed in this study has higher clinical utility than traditional aids used in oblique view X-rays of the lumbar spine.

• Korean Journal of Radiology
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• v.1 no.1
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• pp.11-18
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• 2000

Objective: To evaluate the hydrodynamic changes occurring in cerebrospinal fluid (CSF) flow in cervical spinal stenosis using the spatial modulation of magnetization (SPAMM) technique. Materials and Methods: Using the SPAMM technique, 44 patients with cervical spinal stenosis and ten healthy volunteers were investigated. The degree of cervical spinal stenosis was rated as low-, intermediate-, or high-grade. Low-grade stenosis was defined as involving no effacement of the subarachnoid space, intermediate-grade as involving effacement of this space, and high-grade as involving effacement of this space, together with compressive myelopathy. The patterns of SPAMM stripes and CSF velocity were evaluated and compared between each type of spinal stenosis and normal spine. Results: Low-grade stenosis (n = 23) revealed displacement or discontinuity of stripes, while intermediate- (n = 10) and high-grade (n = 11) showed a continuous straight band at the stenotic segment. Among low-grade cases, 12 showed wave separation during the systolic phase. Peak systolic CSF velocity at C4-5 level in these cases was lower than in volunteers (p < .05), but jet-like CSF propulsion was maintained. Among intermediate-grade cases, peak systolic velocity at C1-2 level was lower than in the volunteer group, but the difference was not significant (p > .05). In high-grade stenosis, both diastolic and systolic velocities were significantly lower (p < .05). Conclusion: Various hydrodynamic changes occurring in CSF flow in cervical spinal stenosis were demonstrated by the SPAMM technique, and this may be a useful method for evaluating CSF hydrodynamic change in cervical spinal stenosis.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.281-286
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• 2017

Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015. All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine.

• The Journal of the Korea Contents Association
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• v.14 no.11
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• pp.362-369
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• 2014

This study aimed to propose an accurate diagnostic method for osteoporosis by realizing a computer-aided diagnosis system with the application of the statistical analysis of texture features using digital images of lateral lumbar spine of patients with osteoporosis and providing reliable supplementary diagnostic information by model experimental research for early diagnosis of diseases. For these purposes, digital images of lateral lumbar spine of normal individuals and patients with osteoporosis were used in the experiments, and the values of statistical texture features on the set ROI were expressed in six parameters. Among the texture feature values of the six parameters of osteoporosis, the highest and lowest recognition rates of 95 and 80% were shown in average gray level and uniformity, respectively. Moreover, all the six parameters showed recognition rates of over 80% for osteoporosis: 82.5% in average contrast, 90% in smoothness, 87.5% in skewness, and 87.5% in entropy. Therefore, if a program developing into a computer-aided diagnosis system for medical images is coded based on the results of this study, it is considered possible to be applied to preliminary diagnostic data for automatic detection of lesions and disease diagnosis using medical images, to provide information for definite diagnosis of diseases, to diagnose by limited device, and to be used to shorten the time to analyze medical images.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.65-72
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• 2016

Objectives : While neck pain is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for neck pain. Methods : A preliminary questionnaire was developed to investigate current practice patterns of neck pain and cervical intervertebral disc displacement (IDD) treatment, and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results : The response rate was 3.34 %. Most participants replied that they received multiple Korean medicine interventions for neck pain treatment consisting of such methods as acupuncture, wet cupping, interferential current therapy and electroacupuncture. A total of 378 respondents acknowledged that diagnostic testing was needed for neck pain treatment. The most commonly used Korean Standard Classification of Diseases (KCD) principal diagnosis code for neck pain was M542, and for cervical IDD was M501. Conclusion : This survey study helps determine current practice patterns of neck pain, and recognizes the need for use of diagnostic devices in neck pain treatment. These results are further anticipated to provide basic data for clinical practice guidelines (CPGs) and future studies using Korean National Health Insurance and Health Insurance Review & Assessment Service data.