• 제목/요약/키워드: Back Pain

검색결과 2,442건 처리시간 0.03초

Value of Additional Instrumented Fusion in the Treatment of Thoracic Ossification of the Ligamentum Flavum

  • Hwang, Sung Hwan;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon;Choi, Yunhee;Yoon, Joonho
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.719-729
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    • 2022
  • Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

자가혈위지압을 활용한 모바일 의료 어플에 대한 체계적 문헌고찰 (A Systematic Review of Mobile Health Applications Using Self-Acupressure)

  • 박서경;이조현;정가영;장세린;김상호
    • Korean Journal of Acupuncture
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    • 제40권1호
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    • pp.1-12
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    • 2023
  • Objectives : This study aims to provide information regarding the status and quality of mobile applications (MAs) using self-acupressure by performing a systematic review. Methods : We conducted comprehensive searching on five international databases and two app markets from inception to July 31, 2022 to identify MAs using self-acupressure. We analyzed the characteristics of each MA regarding the name of the MA, registered app markets, target symptoms, developers, the year and country of development, cost, target age, media function, and expertise. We assessed the quality of each MA using Mobile Application Rating Scale (MARS). Results : We identified a total of 30 MAs using self-acupressure (25 MAs from the app market and 6 MAs from clinical studies, with 1 MA in common). 17 out of 24 MAs from the app market provided self-acupressure regimens for various symptoms and the others provided regimens for specific symptoms such as memory, anxiety, depression, asthma, allergy, low back pain, and headache. 14 developers were reported. 23 MAs were developed after 2013. The largest number of MAs were developed in the United States. The target age group of 12 MAs was above the age of 3, and that of 11 MAs was above the age of 12. 14 MAs provided multimedia functions such as videos. 13 MAs provided information of expertise. From clinical studies, only 3 out of 6 MAs were accessible through the app market. 4 MAs were developed by the researchers of the study. In terms of MARS, the score of MAs from the app market was higher than that of MAs from clinical studies in both objective and subjective evaluation areas. Conclusions : This study summarizes the characteristics of MAs using self-acupressure. More MAs using self-acupressure should be developed and further clinical research for MA on each symptom and disease is warranted for the diversification of MA fields using self-acupressure.

항암 치료에 좋은 반응을 보였던 전이성 췌장암 증례 (Extraordinary Response of Metastatic Pancreatic Cancer to Chemotherapy)

  • 신동우;김진국;이종찬;김재환;황진혁
    • Journal of Digestive Cancer Reports
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    • 제7권1호
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    • pp.22-25
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    • 2019
  • 췌장암은 예후가 불량한 암으로 진단 당시 진행된 상태로 수술적 치료의 적응증이 되지 못해 고식적 항암 치료를 받는 경우가 대부분이다. 진단 당시 전이성 병변을 동반한 췌장암인 경우 예후가 좋지 않을 것으로 예상하지만 고식적 목적으로 항암치료를 한 결과 매우 좋은 반응을 보였던 증례를 문헌 고찰과 함께 보고한다.

퇴행성 요추 질환에서 발생한 후관절 근접 낭종의 방사선적 특징 및 수술의 결과 (Radiologic Features and Surgical Outcome of Juxtafacet Cyst Associated with Degenerative Lumbar Disease)

  • 김환정;장선호;양화열;권원조;성환일;박경훈;최원식
    • 대한정형외과학회지
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    • 제52권1호
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    • pp.65-72
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    • 2017
  • 목적: 후관절 근접 낭종이 동반된 퇴행성 요추부 질환으로 수술 받은 23명의 환자를 대상으로 방사선적 특징과 임상적 결과를 분석하고자 한다. 대상 및 방법: 23명의 환자를 대상으로 척추관 협착증 동반 여부, 불안정성, 척추 전방 전위증 동반 여부, 낭종의 위치 및 방향, 후관절의 퇴행성 변화 정도, 후관절 각도, 추간판 퇴행 정도를 확인하였다. 모든 환자에게 광범위 감압술 및 기기고정 유합술을 시행하였다. 임상적 결과를 Oswestry low back pain disability questionnaire 및 visual analogue scale을 이용하여 평가하였다. 결과: 23예 중 19예(82.6%)에서 척추관 협착증이 동반되었고, 4예(17.4%)에서는 후관절 낭종이 독립적으로 존재하였다. 이 중 7예(30.4%)에서 불안정성과 전방 전위가 동반되었다. 낭종의 발생은 제4-5 요추간(69.6%)이 가장 많았으며 이환된 병변측의 후관절이 반대측에 비하여 심한 퇴행성 변화를 보였다. 후관절 각도는 좌 우측에 유의한 차이가 없었으며 해당 분절의 추간판은 17예(69.6%)에서 퇴행성 변화를 보였다. 임상적 결과는 수술 후 2년 추시 양호하였다. 결론: 낭종의 발생과 퇴행성 변화는 유의한 상관관계가 있었으며 후관절 낭종과 동반된 퇴행성 요추부 질환에서 광범위 감압술 및 유합술이 좋은 임상적 결과을 얻어 유용한 술식으로 생각된다.

아쿠아로빅 운동이 노인 여성의 신체구성, 체력 및건강관련 삶의 질(SF-36)에 미치는 영향 (Effects of Aquarobics Exercise on Body Composition, Fitness andHealth Related Quality of Life(SF-36) in Elderly Women)

  • 소위영;홍지영;전은진;최대혁;김기홍
    • 한국노년학
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    • 제30권3호
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    • pp.683-694
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    • 2010
  • 본 연구는 아쿠아로빅 운동이 노년 여성에게 미치는 신체적, 심리적 효과를 동시에 관찰함으로써, 노인운동처방에 관한 다각도적인 기초자료를 제공하고자 하였다. 본 연구의 피험자는 I시 Y구 보건소 아쿠아로빅 운동프로그램에 참가를 희망하는 60-70대 노년 여성으로 운동군 25명, 통제군 30명으로 분류하였다. 아쿠아로빅 운동은 8주 동안 주 2회 최대여유심박수 40~70%의 운동강도로 실시하여, 운동 전후의 신체구성, 체력 및 건강관련 삶의 질(SF-36)의 변화를 측정하였다. 아쿠아로빅 운동 전후 신체구성의 체중(p=0.044), 체질량지수(p=0.038) 및 체지방률(p=0.005)의 모든 변인에서 시점에 따라 집단 간에 유의한 차이가 나타났다. 체력변인의 의자에서 일어섰다 앉기, 의자앉아 앞으로 굽히기는 시점에 따라 집단 간에 유의한 차이가 나타나지 않았으나, 2분 제자리걷기(p=0.002), 덤벨들기(p=0.005), 등 뒤에서 손잡기(p=0.023), 244cm 왕복걷기(p<0.001)는 시점에 따라 집단 간에 유의한 차이가 나타났다. 건강관련 삶의 질(SF-36)의 신체기능, 신체역할제한, 감정역할제한, 사회적 기능, 정신건강, 피로는 시점에 따라 집단 간에 유의한 차이가 나타나지 않았으나, 신체통증(p=0.039)과 일반적인 건강(p=0.024)은 시점에 따라 집단 간에 유의한 차이가 나타났다. 노년 여성에게 있어서 아쿠아로빅 운동은 신체구성의 개선과 체력의 향상을 위한 좋은 운동형태가 될 수 있음을 확인할 수 있었으나, 건강관련 삶의 질(SF-36)에 관하여서는 8가지 요인 중 2가지의 일부 요인에서만 긍정적인 영향이 나타났음을 확인할 수 있었다.

대순진리회 수행 연구의 경향과 과제 (Research Trends and Problems on Cultivation Practice of Daesoonjinrihoe)

  • 차선근
    • 대순사상논총
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    • 제24_1권
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    • pp.315-349
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    • 2014
  • This paper was carried out to bring the researches on Cultivation Practice of Daesoonjinrihoe which have been at a standstill after analyzing the directions of studies on Cultivation Practice and diagnosing its problems, in addition to that, the paper was also conducted in a way of discussing the research directions in the future. This work enables scholars who have interests in Daesoon Thoughts to easily comprehend over the length and breadth of Cultivation Practice of Daesoonjinrihoe as well as help them understand what level of researches regarding Cultivation Practice has been demanded. Furthermore, this paper will be a step-stone for scholars to ponder how and on what perspective they approach a wide variety of studies on Daesoon Thoughts. The problems reflected on the previous researches on Cultivation Practice are summarized as follows: first, except a few researches in general, problem recognition, research target, style, method, and content are not diverged from the frame defined by Jang Byeong-Gil, who set it up in Daesoon Religion and Thought (Daesoon Jonggyo Sasang) in 1989. Proliferating overlapped researches without developing problem awareness is of great concern. And such researching climate has gradually set in. Secondly, there are numerous researches intending to reveal the researcher's forceful attitude implying faith. Thirdly, most of the previous researches neglect to focus on defining the range of researches. Fourthly, when defining concepts, more thorough insight is needed. Lastly, the researches on analysing symbols and attempting signification analysis are relatively few, only to find many errors. To solve these problems, this paper suggests to develop theories which back up Cultivation Practice by researching on the fields of theory of mind-nature(心性), theory of mind-qi(心氣), theory of pain, Religious Ethics, viewpoint of God/gods, and psychology. Secondly, all the symbols and meanings of elements shown in Cultivation Practice need analyzing more elaborately sophisticatedly and more in-depth. In order to fulfil this goal, by adapting the recent trends of historical studies, it is essential to attempt to engraft Cultivation Practice of Daesoonjinrihoe on cultural phenomena, to analyze thick layers of meanings beneath its surface, to interpret differently, utilizing various perspectives such as focusing on the gender problems, and to extract true meanings out of Cultivation Practice by analyzing everyday events which can occur in real cultivation practices. Thirdly, the terms and concepts regarding Cultivation Practice base the principle themselves. Fourthly, by utilizing methodology of comparative studies on religions, the comparative researches on cultivation practice of different religious traditions are also needed. Lastly, the history of aspects on Cultivation Practice such as transition of mantras, processes which have been conducted through proprieties of prayer and training should be collected and classified. In this context, this work is very important since it helps understand the aspects of transition of originality and characteristics in Cultivation Practice of Daesoonjinrihoe according to passage of time.

개별 알고리즘과 조합 간 정맥 영상의 선명화 차이에 관한 연구 (A Study on the difference in the sharpness of venous images between individual algorithms and combinations)

  • 정진형
    • 한국정보전자통신기술학회논문지
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    • 제16권6호
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    • pp.441-447
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    • 2023
  • 정맥 주입요법은 의료기관에서 대상자의 점액 내로 약물, 수액, 혈액 및 영양분을 환자에게 제공하는 표준적인 간호 절차로, 주로 간호사가 담당하여 실행하고 관리하고 있다. 또한 혈관 속으로 약물을 직접 투여하는 주사법으로서 응급상황 시 신속한 효과를 보기 위해 실시하며, 빠르고 정확한 효과를 기대할 수 있다. 교육 훈련을 통한 숙련된 간호사들도 종종 실수를 하여 환자들에게 불편함을 유발할 수 있을 뿐만 아니라 환자의 안전을 위협하는 다양한 문제를 발생시킬 수 있다. 이러한 실수로 인한 고충을 줄이기 위해 다양한 연구들이 진행되고 있다. 본 논문은 영상 검출 기기를 통해 3명의 피검자의 손등 정맥 영상을 획득하였고 수집한 영상을 영상처리를 통해 선명한 정맥 영상을 제공하기 위한 알고리즘을 도출하기 위한 연구이다. 획득한 정맥 영상의 선명화를 위해 기존 알고리즘인 Histogram Equalization, CLAHE, Unsharp Masking을 선별하고 이를 조합했다. 개별 알고리즘과 알고리즘 조합을 영상에 적용하여 도출한 영상을 비교하기 위해 히스토그램 그래프를 사용하였다. 분포된 픽셀의 최솟값과 최댓값의 차이를 구하고 평균을 내는 방법으로 히스토그램 그래프를 확인했다. 본 논문에서 제시한 알고리즘 조합이 209.1로 개별 알고리즘 평균값인 138.7, 132.3, 126.2보다 높게 나왔으며 실제 영상에서도 가시성이 좋은 것을 확인했다.

Use of custom glenoid components for reverse total shoulder arthroplasty

  • Punyawat Apiwatanakul;Prashant Meshram;Andrew B. Harris;Joel Bervell;Piotr Lukasiewicz;Ridge Maxson;Matthew J. Best;Edward G. McFarland
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.343-350
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    • 2023
  • Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

  • Wittayathorn Pornsiripratharn;Suporn Treepongkaruna;Phatthawit Tangkittithaworn;Niyata Chitrapaz;Chatmanee Lertudomphonwanit;Songpon Getsuwan;Pornthep Tanpowpong;Pat Mahachoklertwattana
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권3호
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    • pp.158-167
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    • 2024
  • Purpose: To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. Methods: A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected. Results: We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males. Conclusion: In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究) (A Study on the Blood-Letting Therapy in Elementary Questions)

  • 이준근
    • 대한한의정보학회지
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    • 제14권1호
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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