• 제목/요약/키워드: carpal tunnel

검색결과 178건 처리시간 0.02초

작업관련 근골격계질환의 요양재해 추이 분석 및 위험요인과 유병률에 관한 고찰 (Analysis of Trends in Patients with Work-related Musculoskeletal Disorders and Literature Review of Risk Factors and Prevalence)

  • 김남수;김용배
    • 한국산업보건학회지
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    • 제33권3호
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    • pp.298-307
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    • 2023
  • Objectives: The purpose of this study is to analyze the recent trends in patients with work-related musculoskeletal disorders in South Korea and to check the major results by reviewing the literature on the risk factors and prevalence of musculoskeletal diseases related to work. Methods: Industrial disaster data from the Ministry of Employment and Labor from 2012 to 2021 were used, and the literature was reviewed regarding risk factors for musculoskeletal diseases related to work using PubMed and RISS. Results: The trend of patients with work-related musculoskeletal disorders has increased overall since 2017 after declining until 2016, with a particularly notable increase in the average annual number of patients with physical burden work. The average annual rate per ten thousand people for patients with body burden work, non-accidental lower back pain, and carpal tunnel syndrome among work-related diseases was high in the mining industry. The average annual rate per ten thousand people for patients with accidental lower back pain was the highest in the fishing industry. Within the manufacturing field, it was the highest in the shipbuilding and ship repair industry. As a result of the literature review, the search rate for work-related musculoskeletal disease papers in unstructured work was high. In addition, physical stress factors were high among risk factors, and pain areas showed a high rate for the waist. Conclusion: Even after the institutional implementation of a hazard investigation system related to musculoskeletal diseases is implemented, the number of patients with occupational musculoskeletal disorders continues to increase. Therefore, it is necessary to conduct regular surveys and implement effective improvement activities for vulnerable industries or occupations.

지방섬유성 과오종 : 증례보고 (Two Cases of Lipofibromatous Hamartoma)

  • 김남중;박은수;최환준;신호성;정성균;이영만
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.356-360
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    • 2009
  • Purpose: Lipofibromatous Hamartoma(LFH) of nerve is a tumor - like lipomatous process principally involving the young persons. This is rare disease characterized by a soft slowly growing mass surrounding and infiltrating major nerves and their branches of the palm and digits. LFH of nerve usually affects the median nerve, with the most common sites of presentation being the distal forearm and hand in the wrist or palm. It may cause symptoms of compression neuropathy and is associated with macrodactyly. Recently, MRI plays a major role in confirming the diagnosis of LFH. Therefore, we present two cases of LFH in the hand with MRI features and surgical management. Methods: One is 6 - years - old female who presented with macrodactyly involving both the soft tissue and bony parts of the second, third and forth digits of her right hand. The other one is 16 - years - old man who presented involving the soft tissue of the second and third digits of his right hand, with pain and numbness, along with motor and sensory deficits in the median nerve distribution. To evaluation about LFH, we enforced preoperative MRI and physical examination. After confirming the diagnosis of LFH, we proposed decompression of all compromised peripheral nerve to help alleviate pain and paresthesia to reduce the likelihood of permanent motor and sensory sequelae. Results: A characteristic feature on MRI is the appearance of serpentiform nerve fascicle surrounded by fibro - fatty tissue within the expended nerve sheet. Distribution of fat between fascicles is asymmetric. Two cases were treated by limited debulking of the redundant tumor tissue and excision of epineurial fatty tissue. These cases were performed with relief of symptom. Conclusion: MRI not only confirms the diagnosis, it also provides a detailed assessment of nerve involvement preoperatively. Especially, on coronal images, the nerve has a spagetti - like appearance that is pathognomonic of LFH. Recommendations for early treatment include decompression of the carpal tunnel, debulking of the fibro - fatty sheath, microsurgical dissection of the neural elements and excision of involve nerve with or without grafting.

상지의 단일신경병증에 대한 수기치료의 국내외 동향 (Literature Review of Manual Therapy for Mononeuropathies of Upper Limb)

  • 김형석;신우철;전준영;박재현;배준형;김세윤;박혜성;윤예지;윤정민;조재흥;정원석
    • 한방재활의학과학회지
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    • 제27권4호
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    • pp.21-31
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    • 2017
  • Objectives This study aimed to review manual therapies for mononeuropathies of upper limb through domestic and foreign studies designed for human body. Methods We searched databases (KMbase, OASIS, RISS, NDSL, KISS, KoreaMed, MEDLINE/Pubmed, CENTRAL, EMBASE) on the 1st to 31th of July 2017 to find related literatures that published after 2000. Results Twenty-eight studies were finally included. Of these, 13 articles were published after 2010. Twenty-two studies were clinical trials and 6 were observational studies. Carpal tunnel syndrome were the most researched type of diseases (85.7%). Most frequently used method of manual therapies was neurodynamic mobilization (35.7%). Pain scales and questionnaires were generally employed for evaluation. Significantly effective studies were 72.2% in controlled trials and 90% in the studies without control group. Conclusions In this study, we reviewed literatures concerning manual therapies on mononeuropathies of upper limb. Further studies are needed on the various diseases of mononeuropathies of upper limb to retain the evidence for the effectiveness of manual therapies.

국내 데이터 베이스 검색을 통한 오공 약침 시술에 대한 임상 논문고찰 (Narrative Review of Clinical Trial on Scolopendrid Pharmacopuncture in Korean Literature)

  • 조동찬;이진현;김창곤;정우석;문수정;박태용;이정한
    • 한방재활의학과학회지
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    • 제23권4호
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    • pp.73-82
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    • 2013
  • Objectives The purpose of this review is to investigate studies of Scolopendrid pharmacopuncture and the evidence of it's effects in order to suggest a better research method in the future. Methods We retrieved numbers of clinical studies about Scolopendrid pharmacopuncture from 7 Korean web databases, using key words such as 'Scolopendrid', 'Scolopendrid AND Pharmacopuncture'. This study had been conducted from 1st May 2013 to 31th July 2013. Controlled studies and case studies were only used for this study. Clinical studies that we picked from the databases were classified according to the diseases that those studies are about, and from these clinical studies, we are to research what has to be improved generally in clinical researches. Results 18 case studies, 4 controlled studies had been under research. Scolopendrid pharmacopuncture has a therapeutic effect mainly in musculoskeletal and neurological diseases such as herniated intervertebral disc, carpal tunnel syndrome, swollen leg, feeling of cold on legs, wrist ganglion, lateral epicondylitis, radial nerve palsy, cervical myelopathy, cauda equina syndrome, postauricular pain; as an early symptom of Bell's palsy, pain of popliteal part, gout, plantar fasciitis, cellulitis, frozen shoulder, pain of hip adductors. However objectivity and reliability of the Scolopendrid pharmacopuncture studies still remains controversial. Conclusions It has been suggested that there are positive effects of Scolopendrid pharmacopuncture therapy in treating specific diseases (especially neuromusculoskeletal diseases). However, this narrative review can't conclude and prove that the Scolopendrid pharmacopuncture has positive effectiveness on these diseases unlike systematic review. So, in order to put Scolopendrid pharmacopuncture therapy to use for many kinds of diseases in more reasonable ways, it is essential to build well-designed clinical research tools. In the future, abundant case studies, more follow-up trials and randomized controlled trials based on the korean medicine should be done to use Scolopendrid pharmacopuncture for a clinical purpose.

손목관증후군에 관한 인간공학적 연구 (An Ergonomic Study on Carpal Tunnel Syndrome)

  • 김철홍
    • 대한인간공학회:학술대회논문집
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    • 대한인간공학회 1993년도 추계학술대회논문집
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    • pp.3-14
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    • 1993
  • 손목관증후군(CTS)이란 장기간에 걸쳐 여러가지 의학적, 생리학적, 직업적 요인들에 기인 하여 발생하는 누적외상병(Cumulative Trauma Disorders: CTD)의 대표적인 한 형태이다. 이 증 후근은 1960년에 국제노동기구(ILO)에 의해 직업병으로 인정되었으며 미국을 비롯한 구미각국에 서는 산업체에서 발생하는 작업손실시간및 산업재해보상으로 인한 경비손실에 중요한 요인의 하 나로 규정되어 이에 대한 예방책의 연구가 정부기관, 대학, 연구소, 그리고 산업체를 중심으로 활 발히 이루어지고 있으나, 우리나라에서는 아직 이에 대한 인식및 예방책에 관한 연구가 미흡한 실정이다. 본 논문에서는 직업적 요인을 중심으로 손목관증후군(CTS)의 발병가능성이 높은 직업 및 그 작업조건들을 고찰하고 이의 예방을 위한 연구방안을 다음과 같이 모색하였다. 첫째, 손목 관증후군에 관련된 문헌조사를 통하여 어떠한 직업들이 보다 높은 발병위험에 직면하고 있으며 어 떤 작업조건및 환경적 요인들이 손목관증후군(CTS)을 발병시킬수 있는가에 대하여 고찰하였다. 둘째, 미국등의 대학및 연구소에서 여러가지 작업조건들을 통제한 실험을 통하여 얻어진 이 증후군 의 발병율을 감소시키기 위한 여러가지 안전한 작업기준들을 검토하고 정부기관(NIOSH, OSHA)의 정책방향을 검토하였다. 세째, 미국의 연구소및 경영자문회사등에서 산업체를 대상으로 시행하고 종합적인 누적외상병(CTD)의 예방프로그램을 검토하였다. 마지막으로, 현재 우리나라의 손목관증 후군(CTS)을 중심으로한 누적외상병의 현실을 검토하고 앞으로의 예방을 위한 연구방향및 방법과 정책적 대응방안등에 대하여 연구검토하였다. 결론을 제시하고자 한다.기서 사용된 아이콘에 대해서만 타당한 것으로 이것을 모든 아이콘에 대해 일반화시키기는 어려우나 이후에 행해질 Icon-based User Interface 분야의 많은 연구들의 기초가 될 것이다. 더불어 아이콘과 관련된 많은 요인들(문화적 영향, 아이콘 색깔, 크기, 아이콘의 위치등이 인식에 미치는 영향)에 대해서도 연구가 행해져야 할 것이다. 확인하고 각각의 기능을 분명히 했다.가 수월하게 하였고 메모리를 동적으로 관리할 수 있게 하였다. 또한 기존의 smpl에 디버깅용 함수 및 설비(facility) 제어용 함수를 추가하여 시뮬레이션 프로그램 작성을 용이하게 하였다. 예를 들면 who_server(), who_queue(), pop_Q(), push_Q(), pop_server(), push_server(), we(), wf(), printfct() 같은 함수들이다. 또한 동시에 발생되는 사건들의 순서를 조종하기 위해, 동시에 발생할 수 있는 각각의 사건에 우선순위를 두어 이 우선 순위에 의하여 사건 리스트(event list)에서 자동적으로 사건들의 순서가 결정되도록 확장하였으며, 설비 제어방식에 있어서도 FIFO, LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation ener

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기욘씨관 압박 증후군에서의 척골 동맥의 폐색 (Ulnar Artery Obstruction in Guyon Canal Compression Syndrome)

  • 안희창;김종도;이장현;최승석
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.783-787
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    • 2010
  • Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

일부 치위생과 재학생의 치면세마실습 자세와 근골격계 질환 인식도 (Oral prophylaxis practice and awareness of musculoskeletal diseases in dental hygiene students)

  • 문희정;신명숙
    • 대한치위생과학회지
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    • 제1권2호
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    • pp.41-52
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    • 2018
  • The purpose of this study was to examine the state of oral prophylaxis practice among dental hygiene students and their awareness of musculoskeletal diseases in an effort to provide some information on how to strengthen education on treatment posture to manage musculoskeletal diseases and how to raise awareness of musculoskeletal diseases. From November 2 to 13, 2016, a self-administered survey was conducted on 653 sophomores, juniors and seniors with an experience of oral prophylaxis practice. SPSS version 20.0 for Windows was employed to analyze the collected data. The findings of the study were as follows: 1. The largest group that accounted for 37.4% responded that the total number of students undergoing oral prophylaxis practice during a semester was four to six. The biggest group that represented 65.4% answered that the required practice time per student was one to fewer than three hours. 76.0% continued to be in the repeated same posture. 2. As for the posture of patients, supine position was most common for the maxillary sinus, which accounted for 82.2%. And semi-upright position was most common for the mandibular sinus, which represented 49.6%. 3. In regard to the burden of oral prophylaxis practice, 33.9% considered the required for the practice appropriate. 42.3% took the repeated long-lasting posture, and 53.5% were under physical pressure. 55.4% suffered from mental pressure and stress. 4. The most dominant musculoskeletal area that they experienced pain after oral prophylaxis practice was neck with 52.5%; waist with 48.2, shoulders/wrists/hands with 45.5, back with 10.3, buttocks with 4.1, elbows with 2.3, legs with 2.1, ankles/feet with 0.8 and knees with 0.6%. 5. Concerning the maintenance of repeated treatment postures and pain experience, the students who continued to be in the repeated same position underwent more pain than the others who didn't on the shoulders(2.92±1.05), in the waist(3.02±1.01), buttocks(1.75±0.92), elbows(1.55±0.79) and ankles/foot(2.52±1.25). The differences were statistically significant(p<.05, p<.01). 6. As to educational experience on treatment posture and musculoskeletal diseases, 88.8% received education on treatment posture; 87.9%, on what position should be taken in times of cooperation; 46.9%, on musculoskeletal diseases; 51.9%, on carpal tunnel syndrome; 42.3%, on varicose vein. The students who replied education on occupational diseases was necessary accounted for 89.6%. 7. The students who experienced treatment posture education were better aware of the causes of musculoskeletal diseases(3.23±3.00), ways for preventing the diseases(3.33±.834) and how to stretch the body(3.63±.858). The differences were statistically significant(p<.05, p<.001). 8. The students who experienced education on occupational diseases heard more about musculoskeletal diseases(3.27±.965), were better cognizant of the causes of the diseases(3.45±.847), were better aware of how to prevent them(3.55±.805) and found themselves to know how to stretch to prevent the diseases (3.73±.826). The differences were statistically significant(p<.001).

국내 6형 뮤코다당증의 임상 양상, 분자유전학적 특징 및 효소치료의 효과에 대한 고찰 (Clinical Features, Molecular Analysis, and Outcome of ERT in Korean Patients with Mucopolysaccharidosis Type VI)

  • ;김진섭;양아람;손영배;이범희;유한욱;조성윤;진동규
    • 대한유전성대사질환학회지
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    • 제16권1호
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    • pp.24-33
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    • 2016
  • 뮤코다당증 6형(Mucopolysaccharidosis type VI)은 ARSB 유전자의 변이로 인하여 dermatan sulfate 대사에 관여하는 arylsulfatase B 효소의 결핍으로 유발되는 상염색체 열성 리소좀 축적 질환이다. 본 연구는 국내에서 뮤코다당증 6형으로 진단된 3명의 환자를 대상으로 하였다 3명의 환자는 최초 진단 시 뮤코다당증 6형의 특징적인 증상인 저신장, 다발성 골형성 부전, 심장 판막 이상 및 각막 혼탁을 보였으며 이후 손목 터널 증후군 및 제한성 폐질환의 양상을 보였다. 모든 환자에서 소변의 GAG (glycosaminoglycan)는 증가되어 있었으며 피부 섬유아세포 또는 백혈구에서 측정한 arylsulfatase B는 모두 감소되어 있었고 중합효소 연쇄반응-염기서열분석법에 의한 ARSB 유전자 검사에서는 c.200T>G (p.Ile67Ser), c.982G>A (p.Gly328Arg), c.571C>T (p.Arg191*), c.1054G>A (p.Asp352Asn)의 이형접합체 돌연변이 및 c.512G>A (p.Gly171Asp) 동형접합체 돌연변이를 발견할 수 있었다. recombinant human Arylsulfatase B (rhASB)를 통한 효소 대체 치료는 2008년부터 국내에서도 허가되었으며 효소대체치료 시행 후 소변 GAG (glyco-saminoglycan)는 감소하였으며 관절 운동 및 지구력은 향상되었다. 그러나 관절 침범 및 각막 혼탁, 심장 및 폐 침범 소견은 호전되지 않았다. 본 연구는 뮤코다당증 6형의 특징적인 증상을 보였으며 생화학적 검사 및 분자유전학적 검사를 통해 뮤코다당증 6형으로 확진된 3명의 환자를 대상으로 시행한 효소대체치료의 효과를 보고하는 바이다.

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