• Journal of Acupuncture Research
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• 제29권4호
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• pp.35-42
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• 2012

Objectives : This study was to observe clinical application of auto-microneedle therapy system (AMTS) in patients with peripheral facial paralysis. Methods : 27 peripheral facial paralysis patients were observed after taking AMTS at Facial Palsy Center, Kyung Hee University Oriental Medicine Hospital from March 1, 2011 to January 9, 2012. We assessed the symptoms of facial paralysis with Yanagihara unweighted grading system, Sunnybrook facial grading system(SBGS) and facial disability index(FDI), and observed adverse events and total safety of the treatment. Results : The scores of facial palsy scales increased after AMTS in Yanagihara grading system and Sunnybrook facial grading system. AMTS-related adverse events were mild pain(5.9%) and fatigue(3.5%), which needed no extra treatment. The total safety evaluation was between 'safe' and 'nearly safe' level. There were no other serious adverse events. In addition, patients were satisfied with subjective improvement including facial tingling and numbness. Conclusions : AMTS can be applied as an adjunctive treatment for patients with peripheral facial paralysis due to its safety and clinical usefulness. It is easier to stimulate wide skin area in a short time. Further clinical research is required to investigate the effectiveness of ATMS in a more rigorous RCTs.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.627-651
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• 1994

In this study, literature review was done to examine and compare the current status and problems of different evaluation approaches toward permanent impairment in Korea. Alternatives and improvements in the current approaches in Korea were suggested. Series of cases were also examined to compare different approaches applied to the real cases, using 105 cases from a hospital data and another 207 cases from a insurance company data. The main findings of the literature review are as follows; 1. The current evaluation methods of permanent impairment in Korea are grouped into two categories, grading and rating. Gradings of impairments are expressly specified in 17 various statutes. 2. In Grading methods, the rigid system of 74 different grades has been adopted uniformally for the convenience of administration, which may not be, appropriate or valid from medical and scientifical aspect. 3. The adventage of McBride method is assessment of occupational disability rate. However the classified compensable occupations are only 280 and limited to manufacturing industries in 1960s'of U.S.A., which is not appropriate to current Korean circumstances. Especially, the job list does not include managerial officers or mental workers. 4. AMA Guides is the scientific and reasonable method for the assessment of physical impairment rate. However compensation and reparation of impairment case is difficult because this method cannot assess the disability rate according to occupation, age, etc. The results of cases comparative study are as follows: 5. The physical Impairment could be compared in 167 out of total 312 cases, and for the cases of complex impairment, McBride method underestimate physical impairment rate compared with AM A method. 6. When disability late was assessed, occupation was considered the compensation of only 85 cases, and age was used in only 21 cases. This was because occupation and age compensation in McBride method are unreasonable. 7. The most Ideal alternative is to assess physical impairment according to AMA method and then to develop a compensation method appropriate for the circumstances of Korea society.

• 한국콘텐츠학회논문지
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• 제17권10호
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• pp.280-288
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• 2017

본 연구는 지적 장애인들의 감각처리 유형에 따른 감각처리능력을 확인하고자 진행하였다. 장애인복지시설에 생활하는 98명의 지적 장애인을 대상으로 청소년/성인 감각 프로파일을 사용하여 감각처리능력을 알아보았다. 연구결과 지적 장애인들의 감각처리능력은 4가지 영역(낮은 감각등록, 감각찾기, 감각민감성, 감각회피)에서 모두 평균보다 낮은 점수를 보여 대부분의 사람들보다 적거나 매우 적은 반응을 보이고 있었다. 성별에 따른 차이는 통계적으로 유의하지 않았지만, 연령을 청소년기(11세에서 17세)와 성인기(18세 이상)로 구분하여 비교한 결과에서는 낮은 감각등록, 감각찾기, 감각민감성 유형에서 통계적으로 유의한 차이가 나타났다. 장애 등급에 따른 감각처리능력은 낮은 감각등록과 감각회피 유형에서 통계적으로 유의한 차이가 확인되었다. 차후 연구에서는 지적 장애인의 거주 환경에 따른 감각처리능력을 확인하고, 대상자 수를 확대하여 장애등급에 따른 감각처리능력을 비교하는 연구들이 이루어져야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.108-112
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• 2000

Objective : Many authors suggest that patients with traumatic subarachnoid hemorrhage(tSAH) visible on first CT after heve injury had a significantly worse prognosis than patients who do not. The aim of this study is to identify patients with tSAH who present with a bad prognosis by reviewing their clinicoradiological features and plan appropriate treatments. Patients and Methods : We reviewed and analysed the factors that influenced discharge outcomes in 172 patients with tSAH for a 3-year period. The outcome was divided into good(good recovery and moderate disability of glasgow outcome scale) and good(severe disability, vegetative state and death). Results : A regression analysis of statistical significant factors(p<0.05) among the clinical and CT features ranked them by descending order of contribution to Glasgow Outcome Scale(GOS) scores at the time of discharge from acute hospitalization as follows 1) clinical : admission Glasgow Coma Scale(GCS), hypotension, CT grade, abnormal APTT, skull fracture, hyperglycemia(>160mg/dl), hypoxia, operation, 2) CT : basal cistern effacement(BCE), mass lesion, cortical sulcal effacement(CSE), midline shift. Conclusion : We have also experienced that the CT grading scale proposed by Green et al is a simple and useful prognostic factor. The authors believe that the patients with high CT grade need adjuvant therapies as of well surgery but it seems mandatory to consider early identification and correction of hypotension, hyperglycemia, and hypoxia in emergency setting.

• The Korean Journal of Pain
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• 제28권2호
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• pp.75-87
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• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• 대한감각통합치료학회지
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• 제18권2호
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• pp.55-68
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• 2020

목적 : 본 연구에서는 최근 10년간 국내에서 발표된 아동 감각통합치료에 대한 중재효과를 체계적으로 분석하여 이해하기 쉽도록 제시하고자 한다. 연구방법 : 학술연구정보서비스(RISS)와 디비피아(DBpia)의 검색엔진을 사용하여 2011년에서 2020년 6월까지 출판된 국내 논문을 대상으로 하였다. 검색어는 "감각통합", "감각처리", "ASI(Ayres Sensory Integration)"이었다. 총 19개의 논문을 분석하였다. 연구결과는 PICO(Population, Interventions, Outcomes, Comparisons), 국제기능장애 건강분류(International Classification of Function, Disability and Health; ICF)방법과 수정한 The Evidence Alert Traffic Light Grading System을 사용하여 그림으로 제시하였다. 결과 : 아동 감각통합치료를 가장 많이 적용한 진단은 발달지연이었고, 중재법은 개별 감각통합치료가 가장 많았다. ICF의 신체구조 및 기능에 해당하는 중재는 91%에서 긍정적인 효과를 보였다, 세부 영역은 감각조절 및 감각처리, 소운동과 대운동, 신체도식, 신체-자기개념, 균형, 기본 움직임, 자세조절 및 손기능, 집중, 자존감이었다. 결론 : 아동 감각통합치료의 중재효과를 ICF의 분류와 그림으로 간단히 제시하여 치료사, 연구자, 아동의 가족들이 쉽게 이해하고 이용할 수 있는 근거를 마련하고자 하였다.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.53-62
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• 2024

Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.117-124
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• 2011

Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

• Journal of Acupuncture Research
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• 제26권4호
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• pp.19-27
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• 2009

Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.67-74
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• 2017

Objective : The purpose of this study was to investigate the prevalence of and the relevant risk factors for lumbar spondylosis (LS) among middle-aged and elderly rural Korean residents and to explore the association between radiographic LS and lower back pain (LBP) in relation to age and gender. Methods : This community-based, cross-sectional study evaluated 1512 subjects with available radiograph. The prevalence of LBP was obtained using a questionnaire and disability resulting from LBP was measured using a validated Korean version of the Oswestry disability index (ODI). In lumbar spine radiographs, vertebral levels from L1/2 to L4/5 were evaluated for the presence of osteophytes and joint-space narrowing (JSN), and Kellgren-Lawrence (KL) grading was applied. Results : Of 4261 subjects aged 40-79 years, data from 1512 subjects were included. The prevalence of radiographic LS indicated by grade ${\geq}2$ osteophytes and JSN were 53.9 and 15.8%, respectively. Seventy-three percent of subjects had KL grade ${\geq}2$ spondylosis and LBP was present in 36.5% of subjects. Although LS was more common among males, the prevalence of LBP was higher among females. Age, male gender and history of hand or knee arthritis were risk factors for LS. LS was significantly associated with LBP mostly among females over 60 years old and correlated with the ODI after adjusting for age and gender. Conclusion : Our study among rural Korean residents revealed a high prevalence of LS and LBP. The association between LS and LBP was observed mostly among females and LS was significantly correlated with the severity of back pain.