• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.33-38
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• 2014

Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.147-153
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• 2018

Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

• 한국노년학
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• v.41 no.4
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• pp.547-566
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• 2021

The purpose of this study is to analyze the effect of social activities on healthy life expectancy (HLE) by gender difference. HLE implies an estimate of how long an individual can expect to live in full health or without disease and/or disability. Morbidity, mortality, and functional health status usually have been known as key variables. Many researchers have tried to investigate factors affecting HLE in countries level by performing comparative analyses. In micro level, there have been some studies about social factors affecting HLE in individual level. However, few studies are found focusing on the relationship between HLE and social activities. This study anlayzes 4,029 over 65 years of age from the first wave (2006) to the seventh wave (2018) of the Korean Longitudinal Study of Ageing (KLoSA), which is a national panel data collected by Korea Employment Information Service. The data has been collected as a part of social and economic policies planning for Korean government. HLE was measured by life period without disease or disability. One of findings is that male older adults (76.9 yrs) show higher HLE in comparing to female group (75.3 yrs). Female group appeared to be more likely to have higher incidence rate and disorders. Another finding indicates that age, number of chronic diseases, and subjective health status affect HLE of both groups. Finally, regarding social activities, religion affiliated activities appear to significantly affect HLE of both groups. In case of male older adults, alumni or hometown gathering also appeared another activities affecting HLE. This study indicates that the effect of social activities types on HLE among older adults appears differently by gender. Further, unlikely of longer life expectancy among female older adults as known, HLE shows a reverse estimate, longer healthy life expectancy among male older adults. This finding may imply that later life of female older adults shows lower quality of life in comparing to that of male group, even if female life expectancy has been higher. This study encourages to develop more social activity programs for older adults in community level. Specifically, more attention is required to planning for programs targeting female older adults.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.165-177
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• 2008

Objectives : Headache is one of the most common symptom in primary medical care. The purpose of this research is to examine persisting effects of acupuncture treatment for CTTH. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture method for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of CTTH was measured by VAS, and Headache Disability Inventory(HDI), Six point Likert Scale, Algometer score(Rt, Lt) before and after treatments. Results : 32 subjects finished study. There were no difference between two group on age, sex, weight, height, blood pressure, pulse, respiratory rate, differentiation of symptoms, surmise of treatment. In change of VAS, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of HDI(Total score, Emotional score, Functional score) and Six point Likert scale, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of two sides Algometer score, after treatment increased than before treatment in two group, and Lt algometer score was statistical significance compared with two group(p<0.001). And both sides Algometer score, threr were statistical significance compared with time. Conclusions : Acupuncture treatment has persisting effects that improve the symptoms and decrease the temporal muscle tenderness in patient with chronic tension-type headache.

• Journal of dental hygiene science
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• v.12 no.2
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• pp.115-121
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• 2012

The aim of this study was to investigate the correlations between the self-reported symptoms of periodontal diseases and the quality of life. This study conducted its questionnaire survey over the subjects of 450 adults who had ever visited dental clinics among the adults of age 35-65 living in Seoul and Gyeonggi-do region from January 7 to March 14, 2010. The data were analyzed using a chi-square test, t-test, binominal logistic regression analysis in the SPSS version 12.0 program. Among the self-reported symptoms of periodontal diseases, 65% of respondents perceived that 'I bleed from the gums in brushing my teeth', which was the most, whereas 18.8% of respondents perceived to 'tooth mobility', which was the least. Self-reported symptoms of periodontal diseases was associated with socio-demographic characteristics such as sex, age, level of education and periodic oral examination, dental scaling(p<0.05). People who perceived the symptoms of periodontal diseases experienced functional limitation, physical pain, psychological discomfort, disability in diverse domains, and social handicap more than the group who did not perceive them(p<0.001). OHIP-14 scores were significantly correlated with sex, bleeding gums, swollen gums and bad breath(p<0.05). This study showed the self-reported periodontal problem had a negative impact on the public's leading their happy life. Therefore, in order to enhance the quality of life in adults, it is necessary to prevent periodontal diseases and reduce the subjective symptoms.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.427-432
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• 2005

This study have been compared and analyzed voice parameter under the condition of normal voice and auditory condition(noise and music) for 29 patients of orofacial pain and 31 normal people to investigate voice feature and vocal variation for auditory condition of orofacial pain patient. 1. Compared to normal voice, orofacial pain patient showed lower and unstable voice feature which has low F0 rate and high jitter and shimmer rate. 2. Voice of orofacial pain patient showed more relaxed and stable voice feature with low F0 and shimmer rate in the music condition than noise condition. 3. Normal people's voice has no significant difference between music and noise condition even though it has high F0 rate under the noise condition. As a result, orofacial pain patient showed difference of feature and different response for external auditory condition compared to normal voice. Providing of positive emotional environment such as music could be considered for better outcome of oral facial pain patient's functional disability.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.193-205
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• 1999

This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.654-660
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• 2017

Objective : Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ${\geq}80$ years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods : Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy. They were divided into a very elderly (${\geq}80$ years) and aged (60-79 years) group, with comparisons in recanalization rates, complications, death and disability on discharge be reported. Results : The mean age was 70.3 years in the aged group and 83.4 years in the very elderly group. Elderly patients had higher rates of mechanical thrombectomy failure than the younger group (40% vs. 14%; odds ratio [OR] 4.1; 95% confidence interval [CI] 1.4-11.9; p=0.012). Results from thrombolysis in cerebral ischemia and modified Rankin scale at discharge were worse in the older group (p=0.005 and 0.023 respectively). There were no differences in mortality rate or other complications, but infarction progression rates were significantly higher in the very elderly group. (15% vs. 2.2%; OR 8.0; 95% CI 1.2-51.7; p=0.038). The majority (92.3%) of the patients who failed in aged group were not successful after several trials. However, in half (4 of 8) of the very elderly group, the occlusion site could not be accessed. Conclusion : Patients older than 80 years of age undergoing mechanical thrombectomy for acute infarction were more difficult to recanalize due to inaccessible occlusion sites and had a higher rate of infarction progression, However, mortality and other complications were similar to those in younger patients.

• Journal of Acupuncture Research
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• v.32 no.4
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• pp.147-156
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• 2015

Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.