• 대한정형외과학회지
• /
• 제54권6호
• /
• pp.528-536
• /
• 2019

목적: 저에너지 손상에 인한 척추체 압박골절이 발생한 골다공증 환자들에서 척추체 압박률의 변화, 요추부 동통 및 척추체 골절 치유에 테리파라타이드가 미치는 영향을 알아보고자 하였다. 대상 및 방법: 2016년 1월부터 2017년 12월까지 골밀도 검사상 T 점수가 -3.5 이하인 심한 골다공증성 척추 압박골절 환자 57명을 대상으로 하였다. 최소 6개월간 척추체 압박률의 변화, 시각통증지수(visual analogue scale, VAS) 및 Oswestry disability index(ODI)를 조사하였고 수상 후 자기공명영상에서 손상된 척추체의 골수 부종의 형태, 최종 추시 방사선 사진에서 추체내열의 유무, osteocalcin, N-terminal telopeptide (NTx) 등 골 형성 표지자의 변화 및 실험군 및 대조군에서 인구통계적 차이를 조사하였다. 결과: 실험군(테리파라타이드군)에서 3개월 후 평균 압박률은 20%, 대조군에서 38%였고 시간에 따른 척추체 압박률 변화에서 유의한 차이가 있었다(p<0.05; t-test). 각 군 내에서 추시 기간에 따른 척추체 압박률의 변화 정도를 비교하였을 때 실험군에서는 척추체 압박률이 유의하게 증가하지 않았으며(p=0.063), 대조군에서는 유의하게 증가하였다(p<0.05). 척추체의 평균 압박률이 변화하지 않는 평형기에 도달하는 시기는 실험군에서 1개월, 대조군에서 3개월이었다. 실험군에서 VAS가 0.39점, 대조군에서 1.07점으로 실험군에서 VAS의 호전 정도가 우수하였다. 실험군에서 ODI가 33.72점, 대조군에서 39.52점으로 실험군에서 ODI가 우수하였다. 최종 추시 방사선 사진에서 추체내열이 있는 증례가 실험군에서는 없었고(0%), 대조군에서는 1명이었다(2.2%). 실험군에서 osteocalcin 평균은 수상 직후 17.15 ng/ml, 6개월 후 24.20 ng/ml로 유의한 차이가 있었으며(p=0.003), NTx 평균은 수상직후 49.54 nMBCE/mMCr, 6개월 후 49.98 nMBCE/mMCr로 유의한 차이가 없었다(p=0.960). 결론: 심한 골다공증 환자에서 발생한 척추체 압박골절의 치료 약제로서 주 단위 테리파라타이드는 골절의 유합을 촉진하여 척추체 붕괴를 방지하며 요추부 동통을 더 빠르게 경감시킨다.

• 대한족부족관절학회지
• /
• 제22권2호
• /
• pp.68-73
• /
• 2018

Purpose: This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications. Results: No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2. Conclusion: Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

• Journal of Acupuncture Research
• /
• 제35권3호
• /
• pp.129-137
• /
• 2018

Background: The purpose of this study was to determine the effect of Postural Yinyang correction of the temporomandibular joint (functional cerebrospinal therapy) on temporomandibular disorder. Methods: Medical records of 21 outpatients were reviewed who were diagnosed with temporomandibular joint disorder, unspecified (K0769) and treated at the Department of Acupuncture & Moxibustion, Dong-Eui University Korean Medicine Hospital from May $1^{st}$, 2017 to April $30^{th}$, 2018. Patients received more than 10 treatments of upper cervical manipulation and performed self-exercise therapy more than 3 times a day and wore an accurate balancing appliance in the oral cavity for more than 8 hours per day. To estimate the efficacy, visual analogue scale (VAS), numerical rating scale (NRS), maximum mouth opening (MMO), symptom intensity scale (SIS), max SIS (MSIS), symptom frequency scale (SFS), mandibular function impairment questionnaire (MFIQ) and 5-point Likert scale were used. Results: NRS and MSIS were significantly improved during each period. VAS, MMO, SIS, and SFS were significantly improved during each period, except the period from the $8^{th}$ to $10^{th}$ visit. MFIQ score was significantly improved during the period from the $1^{st}$ to $10^{th}$ visit. In the 5-point Likert scale, the results showed a high patient satisfaction with the treatment. Conclusion: These results showed that functional cerebrospinal therapy using an accurate balancing appliance, may be useful for reducing the symptoms of temporomandibular disorder.

• 대한한방체열의학회지
• /
• 제2권1호
• /
• pp.17-23
• /
• 2003

Purpose The cold hypersensitivity is a subjective symptom and it is very difficult to evaluate the severity. It is possible to detect cold hypersensitivity by measuring the skin temperature on DITI, but there is limitation only using DITI to find the objective grade of the symptom. To set a new objective standard for the diagnosis of cold hypersensitivity, we examined the relationship between the Visual Analogue Scale (VAS) score for the cold hypersensitivity and the change of skin temperature on hands by cold stress test Method 23 patients with symptom of cold hypersensitivity were participated as subjects who visited the women medical center of Kangnam Kyunghee Korean Hospital, Kyung Hee Univ. from May 1, 2002 to August 31, 2002. There were all carefully examined to rule out other disease such as obesity, skin diseases, spinal nerve lesions and external wounds. Thermographic observations for this study were made using DITI. We performed cold stress test three times to compare with the results from thermographic observations by DITI: first, after 15 minutes-resting, second, right after 1 minutes soak in $20^{\circ}C$ water, the third for last, 10 minutes after the soak. VAS score was chosen to determine the severity of cold hypersensitivity. Result 1 male and 22 female patients were participated ranging in age from 22.17 to 45.21. There was a significant negative correlation between the recovery rate of finger skin temperature after cold stress test and the VAS score. And there was a significant positive correlation between the difference of finger skin temperature and the back and palm of hands after cold stress test and the VAS score. Conclusion In cold hypersensitivity patients, the cold stress test combined with DITI could be a accurate method for the objective evaluation of cold hypersensitivity, especially good at deciding the severity by numeric values. Using a more strict criterion, as diagnosing of cold hypersensitivity, and longer follow-up may improve the validity of the results attained in clinical trials.

• Clinics in Shoulder and Elbow
• /
• 제14권2호
• /
• pp.222-228
• /
• 2011

서론: 회전근 개 대 파열 및 광범위 파열에 대한 관절경적 봉합술 군과 개방적 봉합술 군 간의 중기 임상적 결과를 비교 분석하였다. 대상 및 방법: 회전근 개 대 파열 및 광범위 파열에 대해 봉합술을 실시한 48예 를 후향적으로 분석하였다. 관절경적 봉합술을 시행한 군은 28예, 개방적 봉합술을 시행한 군은 20예 였다. 임상적 결과는 관절운동 범위, 통증과 기능에 대한 VAS, ASES 점수 및 KSS 점수를 평가하였다. 결과: 관절운동 범위, 통증에 대한 VAS 점수, 기능에 대한 VAS 점수 및ASES 점수는 두 군 모두 술 전에 비해 최종 추시상 의미있는 향상을 보였으나 최종 추시상 두 군간에 통계학적으로 유의한 차이는 없었다 (p>0.05). KSS 점수도 최종 추시상 두 군간에 통계학적으로 유의한 차이는 없었다 (p>0.05). 결론: 관절경적 봉합술과 개방적 봉합술 모두 향상된 중기 임상 결과를 얻을 수 있었으며 두 군간에 의미있는 차이는 없었다.

• Journal of Korean Neurosurgical Society
• /
• 제42권5호
• /
• pp.371-376
• /
• 2007

Objective : Balloon kyphoplasty can effectively relieve the symptomatic pain and correct the segmental deformity of osteoporotic vertebral compression fractures. While many articles have reported on the effectiveness of the procedure, there has not been any research on the factors affecting the deformity correction. Here, we evaluated both the relationship between postoperative pain relief and restoration of the vertebral height, and segmental kyphosis, as well as the various factors affecting segmental deformity correction after balloon kyphoplasty. Methods : Between January 2004 and December 2006, 137 patients (158 vertebral levels) underwent balloon kyphoplasty. We analyzed various factors such as the age and sex of the patient, preoperative compression ratio, kyphotic angle of compressed segment, injected PMMA volume, configuration of compression, preoperative bone mineral density (BMD) score, time interval between onset of symptom and the procedure, visual analogue scale (VAS) score for pain rating and surgery-related complications. Results : The mean postoperative VAS score improvement was $4.93{\pm}0.17$. The mean postoperative height restoration rate was $17.8{\pm}1.57%$ and the kyphotic angle reduction was $1.94{\pm}0.38^{\circ}$. However, there were no significant statistical correlations among VAS score improvement, height restoration rate, and kyphotic angle reduction. Among the various factors, the configuration of the compressed vertebral body (p=0.002) was related to the height restoration rate and the direction of the compression (p=0.006) was related with the kyphotic angle reduction. The preoperative compression ratio (p=0.023, p=0.006) and injected PMMA volume (p<0.001, p=0.035) affected both the height restoration and kyphotic angle reduction. Only the preoperative compression ratio was found to be as an independent affecting factor (95% CI : 1.064-5.068). Conclusion : The two major benefits of balloon kyphoplasty are immediate pain relief and local deformity correction, but segmental deformity correction achieved by balloon kyphoplasty does not result in additional pain relief. Among the factors that were shown to affect the segmental deformity correction, configuration of the compressed vertebral body, direction of the most compressed area, and preoperative compression ratio were not modifiable. However, careful preoperative consideration about the modifiable factor, the PMMA volume to inject, may contribute to the dynamic correction of the segmental deformity.

• 대한정형외과 초음파학회지
• /
• 제3권1호
• /
• pp.21-25
• /
• 2010

목적: 회전근 개 봉합 수술 후 증상이 지속되는 환자에서 초음파를 활용한 증식 주사술의 유용성에 대해서 분석하였다. 대상 및 방법: 2008년 1~12월까지 회전근 개 손상 중 극상근 파열을 보인 환자에서 수술을 시행하고, 4주 후 평가에서 동통이 지속된 환자 중 초음파를 이용한 증식 요법을 시행한 90명을 대상으로 하였다. 평균연령은 55.2세였다. 시술 전 후 통증에 대한 시각 점수 척도(Visual analog scale, VAS)와 관절 운동 범위 및 시술 시 발생하는 문제점 및 합병증을 비교 분석하였다. 결과: 통증에 대한 시각 척도 검사(VAS)는 시술 전, 시술 후 4주에서 각각 $6.3{\pm}1.25$, $2.5{\pm}2.304$로 감소하여 의미 있는 통증의 감소를 보였고(P<0.001), 관절 운동 범위 (Forward flexion)는 $106{\pm}21.64$도, $143{\pm}26.63$도 증가하여 의미 있는 운동 범위의 호전을 보였다(P<0.001). 시술 4주 후 재 평가된 통증 및 관절 운동 범위는 74예(82%)에서 호전을, 13예(14%)에서는 2~5일 사이의 단기간의 호전을 보였으며 3예(4%)에서는 증식 치료 후 증상의 변화가 없었다. 결론: 회전근 개 파열의 환자에서 시행한 증식 주사 요법은 이론적으로 치유의 가능성을 증대시킬 수 있으며 실제 환자의 증상을 완화함으로써 재활의 효과를 높일 수 있는 방법의 하나로 생각된다.

• 척추신경추나의학회지
• /
• 제2권2호
• /
• pp.41-48
• /
• 2007

Objectives : These studies are designed to make a survey of the effectiveness of the non surgical decompression treatment. Methods : These studies 15 cases of L-spine herniated lumbar intervertebral disc(HIVD) which was treated with non surgical spinal decompression and other medicine treatment(acupuncture, cupping, interferential current therapy, ultra-sound therapy and hot poultice). Each patient has been treated with spine decompression and other medicine treatment. And degree of improvement has been evaluated by Visual Analogue Scale and the Roland-Morris Disability Questionnaire score for low back pain. Results and Conclusions : Through the results, the medical treatment proved to have valid effect for L-spine HIDV. And further clinical studies comparing non surgical spinal decompression treatment and other medicine treatment is necessary.

• Journal of Periodontal and Implant Science
• /
• 제45권6호
• /
• pp.229-237
• /
• 2015

Purpose: The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). Methods: Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. Results: Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. Conclusions: These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.

• 한방재활의학과학회지
• /
• 제20권4호
• /
• pp.231-239
• /
• 2010

Objectives : This study was performed to report the effect and safety of oriental medical treatment in the pregnant woman diagnosed to herniation of nuclues pulposus(HNP) at L5-S1 with central protrusion and left S1 nerve root. Methods : A 32-year old pregnant woman diagnosed HNP at L5-S1 at local hospital was admitted with low back pain and left leg rad pain. We treated her by acupuncture, a herbal medicine, cupping treatment and measured visual analogue scale(VAS), Oswestry disability index(ODI) and Roland-Morris disability qustionnaire(RMDQ) from 5th March 2010 to 26th March 2010. Results : After treatment, most symptoms decreased, VAS score changed 10 to 2, ODI changed 388, RMDQ changed 13 to 6. Conclusions : In this study, oriental medical treatment was effective and safe in pregnant woman with HNP at L-spine. But the rigorous studies will be needed to define clearly that oriental medical treatment is effective and safe in pregnant women with HNP at L-spine.