• 제목/요약/키워드: low-back pain

검색결과 1,510건 처리시간 0.032초

Nd:YAG 레이저조사가 치경부 백악질에 미치는 영향에 관한 주사전자현미경적 연구 (A Scanning Electron Microscopic Study on the Effect of Nd:YAG Laser Irradiation on the Cervical Cementum)

  • 최복;이정연;신금백
    • Journal of Oral Medicine and Pain
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    • 제25권4호
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    • pp.415-425
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    • 2000
  • In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

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요추척추궁 절제술 환자의 표준관리지침서 개발 (Development of a Critical Pathway for Patients with Lumbar Laminectomy)

  • 박재정;박형숙
    • 성인간호학회지
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    • 제12권4호
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    • pp.517-532
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    • 2000
  • The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

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교통사고 환자 120례에 대한 임상적 고찰 (The Clinical Study on 120 Cases with Traffic Accident)

  • 이지은;정효근;류충열;조명래;위준;류미선;김자영
    • Journal of Acupuncture Research
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    • 제25권6호
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    • pp.135-143
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    • 2008
  • Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

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척추전문 한방병원에 내원한 러시아 환자의 의료관광 현황 조사 (A Research of Trend on Russian Medical Tourism in Spine Specialty Korean Medicine Hospital)

  • 정훈;김동섭;김미령;김은수;박지용;박현민;조남훈;김하늘;우인
    • 한방재활의학과학회지
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    • 제23권3호
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    • pp.177-186
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    • 2013
  • Objectives This study is to evaluate the current situation of Russian tourists for medical tourism of Spine Specialty Korean Medicine Hospital. Methods 133 Russian tourists visiting Spine Specialty Korean Medicine Hospital from January 1, 2012 to December 31, 2012, were analysed in the statistics. Their data was sourced from the computerized medical records. And 87 of them answer a questionnaire about reasons for selection of Spine Specialty Korean Medicine Hospital and satisfactory for medical service. Results A total of 133 Russian visited Spine Specialty Korean Medicine Hospital for medical service, consisting of 73 females (54.8%), the fourties to fifties 58.9% by age. They avoided visiting in the winter. The average number of visiting was 7.1 times. The average treatment period was 9.9days. Majority of the elapsed time from the onset to the arrival was more than 1 year (56.6%). Low back pain (56.4%) is the most in musculoskeletal disorders and obesity (21.7%) and gynecological diseases (30.4%) were the most in a non-musculoskeletal disorders. Medication and acupuncture was the major treatment. 89.2% of the prescribed medication was the efficacy of musculoskeletal. Russian medical tourists most visited by support of travel agent (58.6%). The main reason of their visiting was non-surgical treatment for spinal disorder (31%). 96.6% of them were satisfied because rapid pain relief and kindness. Conclusions For this study, we confirmed a possibility for the Korean medical treatment of Russian tourists for medical tourism. Still, more research and goverment support for the expansion of Korean medical tourism is needed.

한방병원에 요통으로 내원한 환자에서 X-ray상 요추측만과 MRI상 HIVD와의 연관성 분석 (Correlation Analysis Between Lumbar Scoliosis of X-ray and HIVD of L-spine MRI in LBP Patients who Visit Korean Medicine Hospital)

  • 김길환;최영준;권옥준;주영국;송승배;송광찬;서지연;추원정
    • 척추신경추나의학회지
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    • 제11권1호
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    • pp.41-51
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    • 2016
  • Objectives : This study is planned to classify Correlation between Cobbs Angle of Lumbar scoliosis and prevalence of Lumbar Intervertebral Disc. Methods : We Measured the lumbar scoliosis angle of the 114men and 91 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. We use Cobb's angle method for measuring the lumbar scoliosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results : 1.There was no statistical relation between the Cobbs angle and gender(P>0.05) 2.There was no statistical relation between the Cobbs angle and age(P>0.05) 3.There was significant relation between the direction of lumbar scoliosis and the direction of disc herniation(P<0.05) 4.There was no statistical relation between on the Cobbs angle and disc herniation. The more severe of lumbar scoliosis has not tendency of disc herniation. 5.There was no statistical relation between lumbar scoliosis Cobbs Angle on HIVD of L-spine patient and direction of disc herniation on horizontal plane. Conclusions : The direction of disc herniation has tendency of the opposite direction of lumbar scoliosis. When disc herniation, opposite side bending broad intervertebral foramen and reduce pressure.

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최근 5년간 교통사고 후유증의 한의학적 치료에 대한 국내 연구 동향 (The Domestic Trends of Korean Medicine Treatments on Traffic Accident for Recent 5 Years)

  • 최영일;김민영;최희승;정윤규;노해린;김세준;신동재
    • 척추신경추나의학회지
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    • 제8권1호
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    • pp.27-38
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    • 2013
  • Objectives : The purpose of this study is to investigate the latest trends of korean Medicine treatments on traffic accident for recent 5 years. Methods : We investigated the studies on korean Medicine treatments for traffic accident via searching 6 Korean web databases. As a result, 65 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the number of cases, the sites of injury, the types of treatments the instruments for assessment and ethics approvals. Results : 65 articles were published since 2008. The studies on korean Medicine treatments about traffic accident were mainly published in Journal of Oriental Rehabilitation Medicine. 10 case studies, 14 case series, 11 non randomized controlled trials, 21 randomized controlled trials and 9 systemic reviews had been under research. The most frequently occurred symptoms were neck pain and low back pain. In most studies, various korean Medicine treatments were used to treat the symptoms. Visual analogue scale(VAS) and neck disability index(NDI) were used as primary assessments. In most clinical studies, there were no mention about approval of institutional review board(IRB). Conclusion : In this study, we analyzed the trends of korean Medicine treatments on traffic accident from 2008 to 2012. Reviewing the domestic trends of studies on korean Medicine treatments for traffic accident and examining the strong and weak points of those treatments are essential for the future studies. It is needed to adopt the qualitative methods of evaluation in order to develop a level of evidence.

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척추전방전위증의 한방 치료에 관한 임상적 고찰 (Clinical Study of the Treatment of Spondylolisthesis)

  • 김현중;이삼로;변재영;안수기
    • Journal of Acupuncture Research
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    • 제17권3호
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    • pp.106-115
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    • 2000
  • 1997년 4월 1일부터 2000년 1월 31일까지 요통 및 하지통을 주소로 원광대학교 부속 광주한방병원에 척추전방전위증을 진단받고 입원 치료한 환자 28례를 분석하여 다음과 같은 결론을 얻었다. 1. 성별은 여성에 호발(82.1%)하였고, 원인에 따른 성별 분포는 협부형은 여성이 16례(76.2%)였고, 퇴행형은 여성이 7례(100%)였다. 2. 병력기간별 분포로는 최급성기가 32.1%로 가장 많았다. 남자는 80%가 최급성기 환자였고, 여자는 각 유형별로 고른 분포를 보였다. 3. 발병동기별 분포는 과로가 35.7%로 가장 많았다. 4. 원인별 분류에 따르면 협부형이 75%였고, 퇴행형이 25%였다. 5. 병변의 발생부위는 협부형의 경우 57.1%가 제5요추, 퇴행형의 경우 57.1%가 제4요추이다. 6. 전위정도는 대부분(96.4%)이 grade I이다. 7. 증상은 요통이 78.6%, 하지방산통이 92.9%이고, grade III 이상의 통증이 심한 환자가 25례(89.3%)로 거의 대부분 이었다. 8. 치료성적은 71.4%에서 good 이상의 만족스런 결과를 보였다. 이상의 결과로 보아 철추전방전위증 역시 요통의 범주로 놓고 볼 때 한방적인 치료만으로도 만족할만한 효과를 거둘 수 있음을 알 수 있으며 앞으로 척추전방전위증의 한방적 치료에 대한 더 깊이 있는 연구가 필요하리라 사료된다.

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말총의 원발성 T세포 림프종에서 MR 영상 소견: 증례 보고와 문헌 고찰 (MR Imaging Characteristics of Primary T-Cell Lymphoma of the Cauda Equina: A Case Report and Literature Review)

  • 김영욱;이근영;김수진;송광섭;김희성
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1613-1618
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    • 2021
  • 중추신경계의 원발성 림프종은 비호지킨림프종의 드문 형태이다. 그중에서도 말총의 원발성 T세포 림프종은 극히 드물다. 이 증례 보고는 4개월 전부터 시작된 허리통증과 하지방사통을 주소로 내원한 56세 여성의 증례에 대한 것이다. 요추 MRI에서 10 cm 크기의 길다란 다결절의 경막 내 병변이 4번 요추에서부터 2번 미추까지 있었으며 T1 강조영상에서는 등신호강도이고 T2 강조영상에서는 비균질적인 등신호강도와 고신호강도, 가돌리늄 조영증강 T1 강조영상에서는 비균질적인 강한 조영증강을 보였다. 말총 종괴에 대한 수술적 경막 내 생검을 시행하였고 면역조직화학염색과 T-cell receptor gamma 유전자 재배열 분석을 통한 진단은 말총의 말초 T세포 림프종이었다.

중(中)·고등(高等) 학생(學生)들의 책상 및 의자(椅子)의 표준호식(標準號數) 사용여부(使用與否)와 통증(痛症) 호소율(呼訴率) (Pain Complaint according to Usage of Standard-Sized Desks and Chairs for Middle and High School Students)

  • 강경열;차병준;박재용
    • 한국학교보건학회지
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    • 제8권2호
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    • pp.219-232
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    • 1995
  • 대구지역 중 고등학교 학생들의 학교 책상과 의자의 표준 호수 사용 여부와 그에 따른 신체적 자각 증상 호소율을 조사하기 위하여 1995년 3월 20일에서 4월 19일 사이에 대구지역내에 소재한 남.여, 중 고등학교 전학년 학생 1,201명을 대상으로 설문 조사를 실시하여 분석한 결과는 다음과 같다. 중 고등학교 학생들이 사용하는 책상과 의자는 표준 호수보다 1~3호 정도 높은 것이 대부분이었으며, 희망 호수 역시 조금 높은 것을 선호하는 것으로 나타났다. 표준 호수를 사용하고 있는 학생은 책상 30.5%, 의자 21.0%였고. 표준호수보다 큰 호수를 사용하고 있는 경우는 책상 61.3%, 의자65.2% 였으며 표준 호수 보다 작은 경우는 각각 8.2%, 13.8%였다. 중학교의 표준 호수 사용율은 책상 44.1%, 의자 26.8%로 고등학교의 16.1% 및 14.7%보다 높았고, 남학생은 책상 31.5%, 의자 24.5%로 여학생의 29.6% 및 17.6%보다 높았다. 공립학교의 표준 호수 사용율은 책상 34.2%, 의자 24.5%로 사립학교의 27.1%, 및 17.5%보다 높은 편이지만 양군 모두 표준호수 사용율은 낮았다. 책상 사용시 가장 불편한 점으로는 낡았다, 서랍이 좁다, 낮다, 면이 고르지 않다의 순이었고. 의자 사용시 가장 불편한 점은 의자면이 딱딱하다, 등받이가 딱딱하다, 낡았다, 낮다, 높다, 면이 좁다의 순이었다. 책상 및 의자의 사용으로 인한 신체부위별 통증 호소율은 중학교 남.여학생에선 목 어깨 호소율이 각각 32.2%, 36.0%로 가장 높았고, 고등학교 남.여학생은 허리 호소율이 각각 37.9%, 44.1%로 가장 높았다. 신장이 증가할수록 허리 통증 호소율이 높은 것으로 나타났으며, 목 어깨 통중은 전반적으로 높게 호소했다. 책상 및 의자를 표준 호수로 사용활 경우 목 어깨 통증 호소율은 각각 25.4% 및 23.8%인데 비해 표준 호수보다 큰 책상이나 의자를 사용하는 경우는 각각 31.5% 및 31.8%로 호소율이 높았으며, 작은 경우 역시 26.5% 및 28.9%로 높았다. 표준 호수 보다 크거나 작은 책상 및 의자를 사용하는 경우에 비해 표준 호수를 사용할 경우 허리통증 호소율이 모두 낮았다. 대구지역 중 고등학교 학생들의 책상 및 의자의 표준 호수 사용율은 매우 낮았으며, 사용하는 책상과 의자 호수가 자신이 희망하는 호수와 많은 차이를 보이고 있으며, 이에 따른 신체 부위별 통증 호소율은 비교적 높게 나타났다. 따라서 학생들의 체격조건을 고려하여 책상과 의자를 구입, 배분하는데 최대한의 배려를 하여야 할 것이며, 표준호수와 선호도를 반영한 다양한 호수의 잉여책상과 의자의 보유비율을 높여야 할 것으로 생각한다.

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초음파를 이용한 미추 경막외 차단술의 결과 비교 - 추간판 탈출증과 척추관 협착증 - (Comparison of the Results of Ultrasound-guided Caudal Epidural Block - Herniated Intervertebral Disc vs Spinal Stenosis -)

  • 김영태;조규정;안치훈
    • 대한정형외과 초음파학회지
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    • 제7권2호
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    • pp.105-112
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    • 2014
  • 목적: 미추 경막외 차단술은 요통과 하지 방사통에 효과적으로 외래환자의 치료에 자주 사용되고 있으나 임상 경험이 풍부한 의사에 의해 시술되어도 25%의 실패율이 보고되고 있다. 저자들은 초음파 유도하 미추 경막외 차단술의 유효성을 추간판 탈출증 환자군과 척추관 협착증 환자군으로 나누어 결과를 비교하였다. 대상 및 방법: 요통과 하지 방사통을 호소하여 본원 외래에 내원한 55명의 환자를 대상으로 초음파 유도하 미추 경막외 차단술을 시행하였다. 환자를 복와위 자세로 눕힌 후 방사형 탐지자(round probe)를 이용하여 22게이지 바늘이 천-미추막을 통과한 것을 확인 후 약물을 투여하였다. 추간판 탈출증 환자군은 31명이었으며, 척추관 협착증 환자군은 24명이었다. 임상적 평가는 시각통증척도(VAS)를 이용하여 통증의 변화를 평가하였으며, 시행 전, 시행 후, 시행 2주 후, 시행 4주 후 전화 인터뷰와 외래 방문 시 조사하였다. 결과: 초음파 유도하 미추 경막외 차단술은 55예 중 53예에서 바늘이 성공적으로 삽입되어 96.4%의 성공률을 보였다. 추간판 탈출증 환자군과 척추관 협착증 환자군에서 성별의 차이는 없었으나 나이는 추간판 탈출증군에서 $42.3{\pm}10.8$세로 척추관 협착증군의 $62.8{\pm}15.1$세와 비교할 때 유의한 차이가 있었다(p<0.001). 시각통증척도는 추간판 탈출증 군에서 시행 전 6.8, 시행 후 3.1, 시행 2주 후 1.8, 시행 4주 후 1.77로 나타났으며, 척추관 협착증 군에서 시행 전6.9, 시행 후 3.6, 시행 2주 후 4.3, 시행 4주 후 4.9로 나타났다. 시행 전에 비해 시행 후 시각통증척도는 양 군에서 유의하게 호전되었으며(p<0.001), 나이를 보정한 후의 결과, 시간에 따라 양 군간 시각통증척도의 차이는 통계적으로 유의하였다(p<0.001). 결론: 초음파 유도하 미추 경막외 차단술은 높은 성공률을 보이며 척추관 협착증 환자군에 비해 추간판 탈출증 환자군에서 더 효과적인 것으로 사료된다.

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