• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.65-72
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• 2017

Purpose: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. Materials and Methods: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. Results: The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. Conclusion: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment-not just simple cyst excision-should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.1
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• pp.83-91
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• 2018

Objectives This study aims to build the baseline data for promoting school health care program by identifying satisfaction level and improvement point through the satisfaction survey after Korean medicine doctor's student health and wellness program in 2016. Methods An association of Korean medicine doctor in Seongnam city conducted Korean medicine doctor's student health and wellness program for 12 middle schools, 6 high schools and 1 special-need school in Seongnam city in 2016. The participating Korean medicine doctor visited each school for 8 times and conducted health consultations, health education classes and Korean medicine treatment for the school students and the school employees. Teachers and administrators from the participating schools answered the self-reported satisfaction questionnaires and the results were analyzed by SPSS 22.0. Results 35 people responded the program satisfaction questionnaires, the overall satisfaction average was $9.40{\pm}0.88$ (out of 10). In the course of the program, satisfaction average regarding the student's health check-ups was $9.05{\pm}0.88$, satisfaction average regarding the informatory brochures for the parents was $9.08{\pm}1.09$, satisfaction average regarding the participation enrollment process was $9.06{\pm}1.16$, and the satisfaction average regarding the questionnaire statistics and the result reports was $8.86{\pm}1.93$. The satisfaction average of the program was as follows: health consultation ($9.20{\pm}1.08$), treatment ($9.31{\pm}0.90$), and health education classes ($8.78{\pm}1.68$). Some of the good things about program were 'Telling students about their physical condition' (57.1%), 'Curing the sick student quickly' (48.6%), 'Providing students with useful information about the health' (48.6%), 'Teaching students how to manage their health and how to manage symptoms' (42.9%). Average satisfaction about sustainability and needs of the program was $9.15{\pm}0.91$, and the participant teachers wanted to learn more about how to manage internet addiction (22.9%), stress (45.7%), atopy (28.6%), neck pain (42.9%), allergic rhinitis (37.1%), and low back pain (34.3%) from the future wellness programs. Conclusions Student health care is one of the most important issue in national health policies. We have designed a bridge model that a local community, school, and doctors can work together to develop. After the implementation of the program, the results of the satisfaction survey showed a very high satisfaction level. This study can be the basis for further improvement of the bridge program as well as the expansion of the program in other settings.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.41-51
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• 2000

Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

• Progress in Medical Physics
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• v.21 no.1
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• pp.70-77
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• 2010

This study tested how S/N (Signal to Noise Ratio) ratios and ADC (apparent diffusion coefficient) values vary with different T-scores in a group of patients with osteoporosis. Based on DEXA (Dual Energy X-ray Absorptiometry) T-scores for L1.L4 for two groups of subjects consisting of 30 healthy people without osteoporosis and 30 patients who came for treatment of waist (lumbar or low back) pain and were suspected to have osteoporosis as judged from the simple X-ray findings, this study classified every spine into two groups of osteoporosis and osteopenia. Signal intensity measurements were made in the four regions of L1 to L4 on diffusion-weighted MR images obtained using 1.5T MR scanner, while ADC measurements were obtained from ADC map images. As an approach for quantitative analysis, the comparison of the variances in S/N ratios and ADC values for varying T-scores in the selected regions of interest was carried out based on averaged T-scores, S/N ratios, and ADC values. Also, the variances in S/N ratios and ADC values for each of the groups of osteoporosis and osteopenia, which were classified into by T-scores, were compared. For qualitative analysis, a careful naked eye examination of signal intensity differences in the area of L4 was made on T1-weighted sagittal images for each of the healthy (normal), osteopenia, and osteoporosis groups. In the qualitative analysis, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the S/N ratios on diffusion-weighted MR images also decreased, with the greatest decrease in the S/N ratio found in the osteoporosis group. Additionally, among the three groups, the lowest S/N ratio was found in the osteoporosis group. With respect to ADC map, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the ADC values on diffusion-weighted MR images also decreased, with the greatest decrease in the ADC values found in the osteoporosis group. Additionally, among the three groups, the lowest ADC value was found in the osteoporosis group. On the other hand, in the qualitative analysis, the osteoporosis group showed the highest signal intensity. Additionally, among the three groups, the lowest signal intensity was found in the healthy (normal) group. It was found that as osteoporosis progressed, S/N ratio and ADC decreased, whereas signal intensity increased on T1-weighted images. Also, in diagnosing osteoporosis, MRI tests turned out to be (more) effective.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.62-66
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• 2006

Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• The Journal of Korean society of community based occupational therapy
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• v.3 no.1
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• pp.1-10
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• 2013

Objective : This study investigates the impact of the musculoskeletal disorder prevention exercise program designed on the basis of agricultural work posture on the balance ability, Oswestry Disability level, and Psychosocial stress of participants from one rural village in Chungnam area. Method : The exercise program was provided to 21 farmers with musculoskeletal symptoms living in one village in Chungnam area. Such program was performed once a week, 90 minutes per session, for a total of twelve weeks from July 10 to October 11, 2008, and was constructed in a way to increase flexibility and muscular strength, taking agricultural work posture into account. The balance ability, Oswestry Disability Index, and Psychosocial Well-being Index scores were analyzed based on the data of 13 of the farmers who participated in the program for more than eight times and in all of the pre- and post-assessments. Result : Thirteen participants were all women who were 70.55(${\pm}6.78$) years old on average. Most of them were engaged in general dry-filed farming. The parts where they mainly felt the pain were low back(69.2%) and knees(61.5%), and 46.2% responded 'not healthy' to the question on the overall health status. The static balance ability when standing on the right foot significantly increased from the average 9.27(${\pm}5.53$) seconds before intervention to 14.22(${\pm}5.47$) seconds after intervention(p<.05). The Oswestry Disability Index showed a significant change, decreasing from the average 19.84(${\pm}6.89$) seconds to 14.38(${\pm}7.58$) seconds(p<.05). However, there was no change in the Psychosocial Well-being Index. Conclusion : This exercise program that has been conducted for the female farmers who are mainly engaged in the dry-filed farming has contributed to the improvement of their static ability and reduction of their Oswestry Disability Index scores. It is expected that the studies on the effects of the differentiated exercise programs depending on work characteristics will make progress in the future.

• Korean Journal of Organic Agriculture
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• v.26 no.4
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• pp.661-676
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• 2018

Veronica persica (V. persica) is a perennial plant that is broadly distributed in Europe, Asia and so on. V. persica is used for pain about the lower abdomen and low back. The aim of this study was to investigate the anti-oxidant and anti-inflammatory effects of V. persica ethanol extract in LPS-induced RAW 264.7 cells. To evaluate the anti-oxidant activity, the DPPH and ABTS radical scavenging, total polyphenol and flavonoid contents, and reducing power activity were carried out. The DPPH and ABTS radical scavenging activity were evaluated as 72.0% and 73.0% at the concentrations of 200 and $500{\mu}g/mL$, respectively. Total polyphenol and flavonoid contents of V. persica extracts were measured as 65.22 mg/g and 43.82 mg/g at the concentration of 1 mg/mL. The reducing power activity measurement showed 53.0% activity at 1 mg/mL. The anti-inflammatory effects of the V. persica extract were evaluated in LPS induced RAW 264.7 cells. In the evaluation of cell viability by proliferation ＆ cytotoxicity assay kit, the cytotoxicity of the extract was not confirmed at $0{\sim}800{\mu}g/mL$ concentration. And the V. persica significantly inhibited NO production in a concentration dependent manner. The inhibition effects of NO in cell medium of V. persica was over 80% at $800{\mu}g/mL$. The V. persica also suppressed the expression of iNOS, COX-2, and phosphorylation of $NF-{\kappa}B$ and $IkB-{\alpha}$ proteins. These results indicate that the V. persica has anti-oxidant and anti-inflammatory effects by modulating $NF-{\kappa}B$ signaling pathways and can be used as natural functional materials.