• Title/Summary/Keyword: Joint Diseases

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일개 한방병원에 내원한 산욕초기 산모의 한국표준질병·사인분류 분석 (Korean Standard Classification of Diseases of Early Postpartum Women in a Korean Medicine Hospital)

  • 김평화
    • 대한한방부인과학회지
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    • 제32권1호
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    • pp.73-84
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    • 2019
  • Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

Relationships between Intermittent Locking History and Self-Reported Bruxism in Temporomandibular Joint

  • Lee, Myeong-Ok;Lee, Yeon-Hee;Kang, Soo-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • 제42권2호
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    • pp.29-34
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    • 2017
  • Purpose: To evaluate aggravating factors of intermittent locking among temporomandibular joint using magnetic resonance imaging (MRI) and diagnostic criteria for temporomandibular disorder (DC/TMD) diagnosis. Methods: A retrospective analysis was conducted of 35 patients with intermittent locking history but normal intra-articular findings between September 2012 and June 2015 in Kyung Hee University Dental Hospital. A standardized DC/TMD assessment was performed on subjects with MRI findings. Clinical findings were assessed on the basis of maximum mouth opening (active & passive), self-reported habits, patients' age, gender, systemic diseases at the initial visit. First, chi square test was used to examine differences with variables and then risk factors for intermittent locking were assessed using multivariate logistic regression. Results: Self-reported bruxism was strongly associated with intermittent locking history. Conclusions: The new DC/TMD protocol is intended for use within any clinical setting and supports the full range of diagnostic activities from screening to definitive evaluation and diagnosis. Self-reported sleep bruxism has been associated with a higher likelihood of intermittent locking. Comorbidity is therefore a factor that must be assessed. It is necessary to consider the amount of contact of the teeth and the duration.

관절7호방이 Type II collagen으로 유발된 흰쥐의 관절염에 미치는 영향 (Suppressive Effect of GJB-7 on Collagen-Induced Arthritis in Mice)

  • 민부기;오민석
    • 대한한의학회지
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    • 제31권4호
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    • pp.63-78
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    • 2010
  • Objectives: This study was carried out to know the effects of Gwan-Jul-Bang-7 (hereafter referred to GJB-7) on the inhibition of arthritis induced by collagen on the mouse. Methods: To assess the effects of GJB-7 on mouse with arthritis induced by collagen II, we conducted several experiments such as analysis of cytotoxicity, hepatotoxicity, arthritis index, total cell number of draining lymph nodes and paw joints, value of immunocyte in PBMC (peripheral blood mononuclear cell), DLN (draining lymph node) and paw joint, measurement of cytokine and anti-collagen II, observation of the histological changes of joint. Results: 1. Cytotoxicity against HFC (human fibroblast cells) was not observed in any concentration and hepatotoxicity was not observed in the GJB-7 treated group. 2. The incidence of arthritis significantly decreased. 3. Total cell number of draining lymph nodes significantly increased and total cell number of paw joints significantly decreased. 4. The percentage of $CD8^+$ cells in PBMC (peripheral blood mononuclear cell) significantly increased. The percentage of $CD3^+/CD69^+$, and $CD3^+/CD49b^+$ cells in PBMC significantly decreased. 5. The percentage of $CD19^+,\;CD3^+$, and $CD4^+/CD25^+$ cells in DLN (draining lymph nodes) significantly increased. The percentage of $B220^+/CD23^+$ cells in DLN significantly decreased. 6. The percentage of $CD3^+,\;CD4^+$, and $CD11b^+/Gr-1^+$ cells in paw joints significantly decreased. 7. The production of TNF-$\alpha$, IL-6, and MCP-1 significantly decreased. 8. Anti-collagen II in serum significantly decreased. 9. With the hematoxylin and eosin stain, inflammation of joint decreased. Under Masson's trichrome stain, the cartilage destruction and synovial cell proliferation and the expression of collagen fibers decreased. Conclusions: Comparison of the results for this study showed that GJB-7 had immunomodulatory effects. So we expect that GJB-7 could be used as an effective drug for not only rheumatoid arthritis but also another auto-immune diseases.

Comparative Analysis of Three Different Cervical Lateral Mass Screw Fixation Techniques by Complications and Bicortical Purchase : Cadaveric Study

  • Baek, Jin-Wook;Park, Dong-Mook;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제48권3호
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    • pp.193-198
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    • 2010
  • Objective : The purpose of this study is to compare the incidence of possible complications of cervical lateral screw fixation and the achievements of bicortical purchase using the Roy-Camille, Magerl and the modified methods. Methods : Six fresh-frozen cervical spine segments were harvested. The Roy-Camille technique was applied to C3 and C4, and the Magerl technique was applied to C5, C6, and C7 of one side of each cadaver. The modified technique was applied to the other side of each cadaver. The nerve root injury, violation of the facet joint, vertebral artery injury, and the bicortication were examined at each screwing level. Results : No vertebral artery injury was observed in any of the three methods. One nerve root injury was observed in each cervical spine segment using the Roy-Camille method (8.3%), the Magerl method (5.6%), and the modified method (3.3%). Facet joint injuries were observed in two cervical spinal segments using the Roy-Camille method (16.7%) and three with the Magerl method (16.7%), while five facet joint violations occurred when using the modified method (16.7%). Bicortical purchases were achieved on ten cervical spinal segments with the Roy-Camille method (83.3%) and Magerl method (55.6%), while twenty bicortical purchases were achieved in the modified method (66.7%). Conclusion : The advantages of the modified method are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known methods. This modified method can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

골관절염 환자를 위한 웃음요법 적용 자조타이치 프로그램과 자조타이치프로그램의 효과 비교 (Effects of Tai-Chi Exercise and Self-help Management Program Applying Laughter Therapy in Patients with Osteoarthritis)

  • 김금순;유정아;김진아;이임선;이인옥
    • 근관절건강학회지
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    • 제17권1호
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    • pp.68-78
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    • 2010
  • Purpose: This study was conducted to determine the effects of Tai-Chi exercise and self-help management program applying laughter therapy in patients with osteoarthritis. Methods: This quasi-experimental study recruited a sample of 61 patients with osteoarthritis (experimental group: 30, control group: 31) through the community healthcare centers located in Seoul and Kyung Gi area. The primary outcome measures included symptoms of osteoarthritis, basic physical performance, fatigue, and depression assessed before and after the study. The data were analyzed using SPSSWIN V. 12.0. Results: At the end of the six-week intervention, left shoulder flexibility (t=2.011, p=.049), 6m walking speed (t=3.639, p=.001), and right balance (t=-2.30, p=.025) were significantly improved in the control group. Fatigue (t=3.012, p=.004), stiffness (t=2,093, p=.041), right shoulder flexibility (t=2.138, p=.037), right balance (t=-2.065, p=.043), and 6m walking speed (t=2.683, p=.009) were significantly improved in the experimental group. Conclusion: A twice a week, 6-week tai-chi exercise self-help management program applying laughter therapy is effective in decreasing fatigue and stiffness. Osteoarthritis is one of common chronic diseases that the patients should be required to continue self management for the rest of their life. Therefore, there is a need to develop the more effective self-help management program and nursing intervention to motivate them to maintain their own self-help management.

국내 초.중.고등학생들의 척추질환 진료경향 분석 (Analysis of Clinical Tendency of Spinal Disorder in Primary, Middle and High School Students in Korea)

  • 김민정;손창규;허동석;홍권의
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.43-49
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    • 2010
  • Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

ACGIH Hand Activity Level TLV®의 현장 적용 및 평가 (Field Application and Evaluation of the ACGIH Hand Activity Level TLV®)

  • 김부욱;우지훈;강동묵;신용철
    • 한국산업보건학회지
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    • 제16권2호
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    • pp.81-90
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    • 2006
  • The Strain Index(SI) has been commonly used to evaluate the musculoskeletal disorders(MSDs) of upper extremities. Recently, the American Conference of Governmental Industrial Hygienists(ACGIH) adopted the Threshold Limit Value for hand activity level (HAL TLV) focused on the hand, wrist, and forearm. The MSDs risks of 37 repetitive works conducted at an automobile climate control system manufacturing factory were evaluated using both the HAL TLV and the SI, and the results by two methods were compared. Also, measured repetitive frequencies of upper limbs joint were mesured using electromyogram and electrogoniometer. The evaluation results of the HAL were related with the repetitive frequency data of upper limbs joint by electrogoniometer, and the NPF was related with %MVC of ECU. The evaluation result of HAL TLV was highly related with the SI score(r=0.66, p<0.01). Of total 37 tasks, 25 tasks(67.6%) were exceeded the TLV and 34 tasks(91.9%) exceeded the SI limit. Although there was a high relationship between the HAL TLV and SI score, the HAL TLV underestimated the risk in comparison with the SI. The correlation coefficients(r) between the HAL TLV data and the repetitive frequency of upper limbs joint were 0.45~0.55(p<0.01). The MSD symptoms was significantly different between high risk groups and low risk groups evaluated by HAL TLV(p<0.01), but was not different between two groups by SI. In conclusion, the HAL TLV is a proper tool for repetitive works.

한방의료기관 이용환자의 추나 이용실태 - 21개 한방병의원 전자의무기록 자료를 이용하여 - (Usage Report of Chuna Manual Therapy in Patients Visiting Korean Medical Institutions -Using Electronic Medical Records(EMR) of 21 Korean Medicine Hospitals and Clinics -)

  • 김민영;하인혁;이진호;김종호;정보영
    • 대한한의학회지
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    • 제40권1호
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    • pp.86-98
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    • 2019
  • Objectives: This study analyzes the electronic medical record (EMR) data of the spine specialist oriental hospital and clinic in various regions, and reports the actual number and used cases of Chuna therapy. Methods: 2,470,772 data was extracted retrospectively from electronic medical records of all inpatients and outpatients who were treated chuna therapy at 21 Korean medicine hospitals and clinics from January 1, 2018 to December 31, 2018. The characteristics of medical treatment using chuna therapy reflect the minimum, maximum and average values of the number of hospitalized patients, length of hospitalization, frequency of hospitalization, number of outpatients, frequency of treatment and frequency of visit. Diseases were classified in the proportion of Chuna treatment according to the KCD, 7th edition. The chuna and blindness charts were derived accordingly from illness and disease of each part of the body. Results: During the study period, a total 1,342,022 inpatients and outpatients visited the study sites. The male proportion was a little higher than the females' (male: 53.7%, female: 46.3%). According to age, the 30s and 40s were more than half the total(30s: 33.0% and 40s: 20.1%). Chuna therapy was treated to more outpatients than hospitalized patients (outpatient: 83.6%, hospitalization: 16.4%), and most treatments were related to musculoskeletal illness(99.06%). Conclusions: As a result of this study, 1,342,389 chuna therapy was performed in 21 hospitals for one year. As highly demanded by the public, we look forward to ensuring national health care options and medical access when health insurance for chuna therapy is applied beginning March 2019.

From diagnosis to treatment of mucopolysaccharidosis type VI: A case report with a novel variant, c.1157C>T (p.Ser386Phe), in ARSB gene

  • Yoo, Sukdong;Lee, Jun;Kim, Minji;Yoon, Ju Young;Cheon, Chong Kun
    • Journal of Genetic Medicine
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    • 제19권1호
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    • pp.32-37
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    • 2022
  • Mucopolysaccharidosis type VI (MPS VI) is an autosomal recessive lysosomal disorder caused by the deficiency of arylsulfatase B due to mutations in the ARSB gene. Here, we report the case of a Korean female with a novel variant of MPS VI. A Korean female aged 5 years and 8 months, who is the only child of a healthy non-consanguineous Korean couple, presented at our hospital for severe short stature. She had a medical history of umbilical hernia and recurrent otitis media. Her symptoms included snoring and mouth breathing. Subtle dysmorphic features, including mild coarse face, joint contracture, hepatomegaly, and limited range of joint motion, were identified. Radiography revealed deformities, suggesting skeletal dysplasia. Growth hormone (GH) provocation tests revealed complete GH deficiency. Targeted exome sequencing revealed compound heterozygous mutations in the ARSB genes c.512G>A (p.Gly171Asp; a pathogenic variant inherited from her father) and c.1157C>T (p.Ser386Phe; a novel variant inherited from her mother in familial genetic testing). Quantitative tests revealed increased urine glycosaminoglycan (GAG) levels and decreased enzyme activity of arylsulfatase B. While on enzyme replacement therapy and GH therapy, her height increased drastically; her coarse face, joint contracture, snoring, and obstructive sleep apnea improved; urine GAG decreased; and left ventricular mass index was remarkably decreased. We report a novel variant-c.1157C>T (p.Ser386Phe)-of the ARSB gene in a patient with MPS VI; these findings will expand our knowledge of its clinical spectrum and molecular mechanisms.

만성발목불안정성 환자의 진동자극이 가동범위 및 고유수용성감각에 미치는 즉각적인 효과: 무작위 교차 연구 (Immediate Effects of Vibration Stimulation on the Range of Motion and Proprioception in Patients with Chronic Ankle Instability: Randomized Crossover Study)

  • 박치복;박성환;정호진;김병근
    • 대한물리의학회지
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    • 제18권1호
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    • pp.9-14
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    • 2023
  • PURPOSE: This study examined the effect of vibration stimulation of a vibration foam roller on the change in the range of motion of the ankle joint and proprioception in patients with chronic ankle instability. An additional aim was to provide basic data for rehabilitation programs for chronic ankle instability patients. METHODS: This study was a randomized crossover design of 22 patients with chronic ankle instability. All subjects were divided into a vibrating group, a non-vibrating group, and a control group. The vibration and non-vibration groups performed the interventions, but the control group did not. For the measurement, the range of motion and proprioception of the ankle joint was measured using an electronic protractor (Electrogoniometer, BPM Pathway, UK). RESULTS: The vibration group showed significant differences in the dorsiflexion angle, dorsiflexion proprioception, and plantar flexion proprioception (p < .05). The non- vibration group showed significant differences in the dorsiflexion angle and dorsiflexion proprioceptive sensation (p < .05). The vibration group and the control group showed significant differences in dorsiflexion proprioception and plantar flexion proprioception (p < .05). CONCLUSION: The range of motion and proprioception of the ankle joint were improved in the group that received vibration stimulation after the intervention than before the intervention. Future research will be needed on patients with various diseases.