• Journal of Chest Surgery
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• 제52권6호
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• pp.392-399
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• 2019

Background: The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA). Methods: Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group. Results: There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period. Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.

• Clinical and Experimental Pediatrics
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• 제45권8호
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• pp.994-999
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• 2002

목 적: SNL는 아시아 지역의 젊은 성인 여성에 호발하고 소아에서의 보고는 적다. 저자들은 소아 SNL의 임상 양상을 알아보고자 하였다. 방 법: 1995년 2월부터 2002년 1월까지 노원을지병원에서 SNL로 진단된 15세 이하 소아 23례의 임상양상을 고찰하였다. 2례는 절제생검으로 진단하였고 21례는 세침흡인으로 진단하였다. 결 과 : 평균 연령은 $8.1{\pm}3.8$세였고 범위는 14개월에서 14세였다. 남녀비는 1 : 1.6이었다. 10례(10/23)가 2000년에 진단되었다. 증세의 발현은 봄철인 경우가 많았다. 주된 임상 증세는 경부 종괴(22/23), 종괴동통(12/20), 발열(8/18)이었다. 발열 기간은 7례(7/8)에서 2주 미만이었고 림프절 종대 기간은 14례(14/15)에서 5개월 미만이었다. 백혈구 수치의 평균은 $7,664{\pm}3,454/mm^3$였다. ESR은 10례(10/12)에서 증가되어 있었고 LDH는 5례(5/6)에서 경도의 증가 소견이 있었다. CRP는 3례(3/4)에서 양성이었다. 방사선학적으로 측정한 림프절의 최대 직경은 14례(14/15)에서 2 cm이하였다. 원형 탈모증 환아에서 발생한 1례와 1형 당뇨병 환아에서 발생한 1례가 있었다. 전례에서 경과는 양호하였다. 결 론: SNL는 우리나라의 소아에서 드물지 않다고 생각되며 경부 림프절 종대를 주소로 내원하는 환아에서 발열이나 종괴동통의 유무에 상관없이 감별진단에 포함되어야 할 것으로 사료된다.

• 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.

• 척추신경추나의학회지
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• 제11권1호
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• pp.11-23
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• 2016

Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

• Journal of Oral Medicine and Pain
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• 제34권3호
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• pp.247-256
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• 2009

코골이와 수면무호흡증은 대부분 상기도의 인두부위의 폐쇄에 의해 발생되므로, 이 부위의 폐쇄를 방지하기 위해 혀나 하악을 전방으로 이동시키는 다양한 구강내 장치가 코골이 및 수면무호흡증의 치료에 사용되고 있다. 본 연구는 세 종류의 코골이장치 즉, 하악전방이동장치(mandibular advancement appliance, MAA), 혀견인장치(tongue retaining appliance, TRA), 하악-혀전방이동장치(mandibular advancement-tongue retaining appliance, MATRA )가 구인두와 하인두 공간을 어떻게 변화시키는지를 비교하고자 하였다. Class I 교합을 갖고 코골이 및 수면무호흡증의 증상이 없으며 체질량지수 (BMI)가 정상인 남성 9명을 대상으로 상기 세종류의 코골이장치를 제작하였으며, 이때 MAA, MATRA의 하악전방이동량은 5mm로 TRA, MATRA의 혀전방이동량은 10-20mm로 설정하였다. 그리고, 코골이장치를 장착하지 않은 CO상태와 MAA, TRA, MATRA를 장착한 상태에서 측모두부 규격방사선사진을 촬영한 후, 구인두와 하인두 공간, 두경부 자세, 연구개와 설골의 위치와 관련된 20가지 측정항목에 대해 통계분석을 시행하였다. 분석결과 MAA, TRA, MATRA 모두 상부 구인두 공간을 유의성 있게 증가시켰으나, MATRA 만이 하부 구인두 공간을 유의성 있게 증가시켰다. 이러한 결과는 코골이와 수면무호흡증을 개선시키는데 있어 MATRA가 MAA와 TRA에 비해 효과적일 수 있음을 시사한다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.8.5-9
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• 1981

식도이물은 이비인후과 영역에서 흔히 볼 수 있는 질환이지만 그 합병증으로 식도천공과 이에 따른 종격동염을 일으키는 예는 매우 드물다. 그러나 이러한 종격동염은 극히 위험한 합병증으로서 생명에 위험을 초래하는 예도 적지 않다. 저자들은 최근 식도이물에 의한 식도천공으로 종격동염이 병발한 경우를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 69세 여자로 음식물에 섞인 유리조각을 오연한 후 심한 연하곤란 및 연하통을 주소로 본원 응급실에 내원하였으며 당시 하경부에 팽창과 심한 피하기종을 볼 수 있었다. 식도천공을 의심하여 식도경검사를 시행한 결과 이물은 발견하지 못했으나 경부 식도 우측벽에 약 4cm가량의 식도 종천공을 확인할 수 있었고 다량의 음식물 찌꺼기를 볼 수 있었다. 음식물 찌꺼기를 제거한 후 금식과 다량의 항생제를 투여하였으나 입원 제 3일에 흉곽통이 있었으며 흥부 X선상상부 종격동 음영의 확장을 볼 수 있었다. 입원 제 4일에는 호흡곤란이 있어 기관절개술을 시행하였으며 피하기종도 감소되었다. 입원 제15일에 시행한 식도경검사에서 경부 식도 우측벽의 천공부위에서 다량의 농이 매출되어 우측하경부의 전면에 배농관을 삽입하였다. 술후농의 양은 감소되었으나 약 15일간 농의 배출은 계속되었고 전신상태가 호전되었으나 환자의 경제적 사정으로 입원 제38일에 퇴원하였다. 그 후 항생제를 투여하며 통원가료후 완전히 회복되었다.

• 대한한의학회지
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• 제23권3호
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• pp.85-95
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• 2002

Objectives : Daechu (Dazhui:GV14 (Governor Vessel 14))-point is located between the spinous process of the 7th cervical vertebra and that of the 1st thoracic vertebra. GV14 has been used to treat hypertension, high fever, neck pain, common cold, headache and so on. Hypertension often negatively affects the improvement of stroke patients. We investigated whether wet-cupping at GV14 had any effect of decreasing blood pressure (BP). Methods : In this study, 81 stroke patients were studied, from Oct. 2000 to Sept. 2001. They were composed of a Sample group (n=36) and Control group (n=45). The Sample group (n=36) was divided into Sample-Normal (n=9), Sample-Mild (n=7), Sample-Moderate (n=l1), and Sample-Severe group (n=9). The Control group (n=45) was divided into Control-Moderate (n=34) and Control-Severe group (n=ll). We checked blood pressure 5 times (just before treatment, then after 30,60, 90, and 120min. (2hrs.)) in each sample group and 3 times (baseline, after 30, and after 120min. (2hrs)) in the control group. Results : In a comparison of before-treatment BP and after-treatment BP in the sample group, SBP significantly decreased as time passed, while DBP slightly decreased but not significantly. In comparison of BP differences in each sample subgroup, BP slightly increased in the Sample-Normal group, but significantly decreased in the Sample-Mild, Sample-Moderate, and Sample-Severe groups. In comparison of BP differences between the sample and control groups, SBP and DBP of the sample group definitely decreased more than those of the control group, but not significantly. Conclusions : This study suggests that wet-cupping at GV14 has significant decreasing effectson blood pressure in stroke patients. Accordingly, we hope that this measure will be used more widely as an emergent treatment for increased blood pressure.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.131-138
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• 2017

Objectives : This study examined the effects of miniscalpel acupuncture (MA) in three patients with cervicogenic headache. Methods : Patients were treated with MA, which was performed once per week for three weeks. A headache score, visual analogue scale (VAS), and neck disability index (NDI) were used for the evaluation of treatment effects. Results : In cases 1, 2, and 3, the headache score decreased from 4 to 1, 3 to 0, and 3 to 1, respectively. The VAS score decreased from 8.5 to 1.9, 5 to 0.4, and 5.3 to 2 in cases 1, 2, and 3, respectively. The NDI score decreased from 28 to 4, 50 to 4, and 38 to 16 in cases 1, 2, and 3, respectively. Conclusion : MA appears to be effective for the treatment of cervicogenic headache. Further data should be collected and a comparative study using other treatment methods should be performed.

• 대한추나의학회지
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• 제5권1호
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• pp.141-150
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• 2004

본 증례는 약 30년전 임신 후부터 강직성 척추염의 증상이 나타나기 시작하였고, 15년 전부터 경추 부까지 강직이 진행되었으며, 10년전부터 고관절의 침습이 나타났고 이후 계속 강직이 진행되어 좌측 고관절에 전치환술을 시행하고 2주후 본원에 내원한 만성 강직성 척추염 환자로서, 그동안 적절한 치료를 꾸준히 받아오지 못하여 척추부 및 고관절의 강직과 흉협통 뿐 아니라 견관절, 슬관절 및 거의 전신관절에 강직과 통증이 나타났고 식욕부진, 소화 장애와 전신피로감까지 호소하여 증상의 별다른 호진을 기대하기 힘들 것으로 예상하였으나 64일간 본원에 입원하여 한의학적인 치료와 운동요법 및 물리요법으로 이학적 검사상의 호전과 전신증상의 호전을 보였다. 식욕부진, 소화불량, 피로감, 체중감소, 빈혈, 발열(發熱), 도한(盜汗) 등 만성 강직성 척추염 환자에게서 나타날 수 있는 전신증상은 한의학에서 허증(虛證)의 범주에 가깝고, 변증시치를 통한 한의학적인 치료로 전신증상의 개선을 도모하면서 꾸준한 운동치료, 호흡치료 등의 재활치료를 병행한다면 보다 나은 임상적 치료효능을 거둘 수 있을 것으로 생각된다.

• The Journal of Korean Physical Therapy
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• 제18권6호
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• pp.67-75
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• 2006

Purpose: Many kinds of musculoskeletal disease and symptom are caused by the longtime computer works. However, trapezius muscle tonus has not been established in regarding to keyboard height during typing. Therefore, this study is to evaluate the relationship between trapezius muscle tonus and the height of keyboard while typing, controling for the postures of neck, Lumbar, cervical vertebra. Methods: The experimental height of keyboard was set at elbow height, 3cm higher, 6cm higher, 9cm higher, than elbow. We studied trapezius tonus with the mean value for 2 minutes by EMG in 15 males and 15 females worker of hospital in seoul, who did not have a history of muscle disease, neurological signs, nerve damage. Results: In this experimental, as the height of the keyboard went up, the trapezius tonus significantly increased with shoulder abduction of brachium. Second, right and left trapezius tonus appeared similar while typing. Third, the best height that release the trapezius tonus the was as high as elbow and 3cm higher than elbow. Conclusion: With these above results, we suggest that the appropriate height of keyboard during typing to release the trapezius tonus most is the height of the elbow and 3cm higher than elbow. The study has important implications for focusing on the height of VDT worktable and complaining of a pain by oneself which are useful to establish a method of prevention of musculoskeletal disorder in work in the future.