• 대한정형외과학회지
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• 제55권1호
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• pp.1-8
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• 2020

고령화의 진행 및 근골격계 질환의 증가로 인해 여러 가지 수술적 치료 방법을 포함한 침습적인 치료 방법이 증가되고 있으나 수술적 치료 시행 전 보존적 치료는 충분히 시행되어야 한다. 보존적 치료 중에서 통증 조절을 위한 약물 치료는 오래 전부터 보존적 치료의 가장 대표적인 치료 방법으로 사용되어 왔고 여전히 가장 흔히 사용되는 방법이다. 통증 조절을 위한 약물로는 아세트아미노펜(acetaminophen), 비스테로이드성 항염증제(non-steroidal anti-inflammatory drugs), 스테로이드(steroid), 마약성 진통제(opioid), 항우울제(antidepressants) 등이 있으며 저자는 마약성 진통제 및 항우울제에 대해서 살펴보고자 한다. 통증으로 인해 말초 부위에 있는 통각 수용체에 자극이 전달되면 통증은 중추 신경계로 전달되는 상향성 경로(ascending pathway)를 거쳐 대뇌에 전달되고 대뇌는 통증을 조절하기 위해 하향성 조절 경로(descending pathway)를 통해 엔도르핀(endorphin)과 같은 내인성 마약성 진통제를 분비하게 된다. 마약성 진통제라는 것은 마약성 진통제 수용체(receptor)에 작용하는 물질을 통틀어서 일컫는 말로 마약성 진통제는 세 가지의 수용체가 존재하며 조직이나 환자의 전신 상태에 따라서 각각의 수용체에 대한 친화성이 달라진다. 이와는 달리 항우울제는 중추신경계의 시냅스에 작용하여 통증을 조절하는 상향성 경로를 조절하는 것이 주된 기전으로 만성통증과 신경병성 통증에 효과적이며 이는 마약성 진통제 계열과 효과가 유사한 것으로 알려져 있다. 본 종설에서는 이러한 마약성 진통제와 항우울제의 효과적인 사용 방법, 사용 시 유의점 및 부작용 등에 대해 다루고자 한다.

• Journal of Acupuncture Research
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• 제17권4호
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• pp.139-148
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• 2000

Objectives : Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) is the Jing-Wai-Qi-Xue(經外奇穴) that is widely used in clinic and effective in Acupuncture and Moxibustion. But the location, number, acupuncture method, clinical application of Hua-Tuo-Jia-Ji-Xue have not been explained clearly and consistently; moreover, studies or clinical reports about this are insufficient. The purpose of this study is to investigate the location, number, acupuncture method, clinical apptication of Hua-Tuo-Jia-Ji-Xue. Methods : We investigated Hua-Tuo-Jia-Ji-Xue through survey of 11 books and 26 relevant journals published in China Results : 1. Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each vertebra. 2. There is differ as the number of Hua-Tuo-Jia-Ji-Xue is 34, 48, 56, 58 in each documents. Hua-Tuo-Jia-Ji-Xue located in first, second cervical vertebra and first sacrum is low in application frequency, Hua-Tuo-Jia-Ji-Xue located from third cervical vertebra to fourth lumbar vertebra is high in apptication frequency. Therefore, all of the acupoints located in about 0.5 Cun(寸) both sides of spinous process of cervical, thoracic, lumbar and sacral vertebrae are regarded as Hua-Tuo-Jia-Ji-Xue in wide meaning. 3. There are Kou-Ci-Fa(叩刺法), Qian-Ci-Fa(淺刺法), Yan-Pi-Ci-Fa(沿皮刺法), Shen-Ci-Fa(深刺法) in acupuncture method of Hua-Tuo-Jia-Ji-Xue. Acupuncturing depths, directions is differ in each location(cervical, thoracic, lumbar vertebra, sacrum) and have something to do with therapeutic effect of Hua-Tuo-Jia-Ji-Xue. The feeling that patient receive after acupuncture is the key to the treatment of disease. 4. The clinical application of each Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease. The musculoskeletal diseases in treatment of disease by Hua-Tuo-Jia-Ji-Xue are the most common as 12 cases. Second, there are many reports about nervous system diseases. In addition, good therapeutic results by application of Hua-Tuo-Jia-Ji-Xue are reported in some diseases, for instance, diseases of five viscera and six entrails, organ, tissue Conclusions : Hua-Tuo-Jia-Ji-Xue is located in about 0.5 Cun(寸) at both sides of spinous process of each cervical, thoracic lumbar and sacral vertebra. Therapeutic effect of Hua-Tuo-Jia-Ji-Xue has something to do with acupuncturing depths, directions and feelings. Hua-Tuo-Jia-Ji-Xue is mainly selected by distribution of meridians, nerve roots, vertebral segments which are attacked with a disease and is mainly applied musculoskeletal diseases, nervous system diseases.

• 근관절건강학회지
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• 제7권1호
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• pp.5-24
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• 2000

Middle age for women is one of the most important stages of the whole normal life span and has unique problems concerning the psychological and physical health, specifically degenerative musculoskeletal diseases. Therefore middle age women should prepare in order to lead a healthy and fruitful life as they enter/begin old age. As the population of middle age women increase, the demands of nurses who care for this age group also continue to glow. Nurses must be interested in this middle age group of women in Korea. This study was designed to identify the extent of family support and self-esteem of the middle age women with degenerative musculoskeletal diseases and the relationship between them and nurse's contribution to middle age women's health promotion that maintain and promote qualify of her life. The population of this study was 112 women aged 40-60, attending the out patient clinic one University Hospital and one Hospital, in Pusan. The data was collected from 1st August to the 30th of September, 1998 by using 36 items questionnaire. The instrument used for measuring family support was of Chai's(1983) FSS which was modified by Kang's(1984) Family Support Scale. And that for self-esteem was Rosenberg's(1965) Self-esteem Scale. The reliability of Chai's FSS and Rosenberg's instruments were tested by Cronbach's alpha and showed that they were 0.93 and 0.89 each respectively. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS computer program. The results of the study were summarized as follows : 1. The mean score of the perceived family support was $39.31{\pm}9.42$. 2. The mean score of the perceived self-esteem was $33.16{\pm}6.75$. 3. Statistically significant factors influencing the family support among sociodemographic variables was satisfaction of marriage(F=-3.069, p<0.003). 4. Statistically significant factors influencing the self-esteem among sociodemographic variables were age(F=3.992, p=0.000), education(F=2.260, P=0.026), housing (F=-1.987, P=0.049) and satisfaction of marriage(F=-2.305, P=0.023). 5. There was a significant correlation between family support and self-esteem (r=.621, p<.000). In conclusion, perceived the family support was important for middle age women to increase their self-esteem. Nurses should be aware of the necessity of family support in the supportive nursing of middle age women and should be able to make a plan to educate the family about supporting the wife/mother. The continuing study of the health promotion of middle age women to find out variables influencing middle age women' health must continue.

• 동국한의학연구소논문집
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• 제8권2호
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• pp.47-67
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• 2000

근골격계 질환은 임상에서 가장 흔하게 접할 수 있는 대상의 하나로 그 진단과 평가가 매우 중요하며 여러 가지 진단기기와 평가방법이 이용되고 있다. Thermography는 기존의 진단기기와 달리 질병의 기능적인 측면을 평가할 수 있다는 점과 통증과 같은 주관적인 표현을 어느정도 객관화할 수 있다는 점에서 임상적 가치가 고려되고 있다. 본 연구는 최근 국내외의 임상 논문을 대상으로 근골격계 영역에서 Thermography의 활용 동향을 고찰하여 진단적 가치를 확인하고자 하였다. Thermography는 척추신경병증, 근막동통증후군, 말초신경병증, 반사성 교감신경 이영양증, 레이노 증후군, 악관절 장애 및 일부 기타 질환에서 적용되었으며, 대부분의 질환에서 보조적인 진단기기로 활용가치가 있었다. 특히, 질병의 경과 관찰과 약물 및 기타 처치에 대한 효과 판정에 유용하였으며, 레이노 증후군 및 반사성 교감신경 이영양증과 같은 질병에서는 일차적인 진단기기로도 활용이 가능하였다. 향후 근골격계 영역에서 Thermography의 보다 폭넓은 적용을 위해서는 질환에 따른 적절한 촬영방법의 개발 및 결과 판독에 대한 객관성 확보가 있어야 할 것이다.

• 대한영상의학회지
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• 제81권1호
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• pp.21-40
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• 2020

자기공명영상(magnetic resonance imaging; 이하 MRI)은 다른 영상 기법에 비해 연부 조직 대조도와 해상력이 높아 근골격계 영역에서 중요한 진단 기기로 이용되고 있다. 최근 MRI 관련 기술이 발달함에 따라 빠른 영상 촬영 및 다양한 영상면 재구성이 가능해짐으로써 입체적인 근골격계 해부학적 구조와 병변을 더욱 잘 평가할 수 있게 되었다. 또한, MRI는 최적화 정도에 따라 영상의 질, 진단 정확도 및 촬영 시간 등이 달라지며, MRI 장치의 효율적인 운용과도 관련이 있어, 이를 관리하는 것은 영상의학과 의사의 중요한 역할이다. 본 종설에서는 6개 주요 관절에 따른 환자 자세, radiofrequency 코일 선택, 권장 펄스열, 영상면 구성 및 스캔 파라미터에 대한 지침을 제시함으로써 근골격계 MRI의 최적화에 도움이 되고자 한다.

• Safety and Health at Work
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• 제3권1호
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• pp.67-70
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• 2012

The surveillance programme of work-related diseases (WRD) is based on a network of occupational physicians who notify all WRD diagnosed during a two-week observation period. The aims are mainly to estimate the prevalence of non-compensated WRD in the working population according to socio economic factors; to determine new indicators of occupational health; to update the lists of compensable occupational diseases; to understand and assess under-compensation and under-notification. The participation rate for occupational physicians is around 33% in 2008. The main WRD are the musculoskeletal disorders, followed by the mental disorders. This 2-week protocol, repeated regularly, provides useful data on frequency of pathologies linked to employment as well as an estimate of unreported WRD subject to compensation or non-compensated WRDs, and the trends of WRDs over the time.

• Journal of Acupuncture Research
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• 제25권1호
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• pp.169-178
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• 2008

Objectives : Dong-si acupuncture therapy is being widely used because of good clinical result. The purpose of this study was to compare the location and efficacy of Dong-si acupoints and 14 meridian acupoints. Conclusions : 1. Dong-si acupoints on the lower extremity total 83. Among them, 16 acupoints are the same as 14 meridian acupoints. 2. Between the same location points, the efficacy of each Dong-si acupoints is similar to that of each of the 14 meridian acupoints in cases of musculoskeletal pain diseases, paralytic diseases, urogenital diseases, and gastrointestinal diseases. 3. Dr. Dong studied deeply into the 14 meridian acupoints and created Dong-si acupuncture therapy. He said that the distribution of acupuncture points was closely related to the 14 meridians. 4. I think that we are able to apply Dong-si acupuncture therapy to clinical use widely by comprehending the character of the 14 meridian acupoints and each meridians.

• 대한핵의학회지
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• 제37권3호
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• pp.137-146
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• 2003

Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50 %. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The Image quality of bone scans can be improved by obtaining regional views and images under a pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis.

• 한국산업보건학회지
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• 제30권4호
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• pp.353-363
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• 2020

Objectives: Occupational diseases that occur due to or aggravated by work have commonly been recognized in the manufacturing industry, but there are now more incidences happening in the service industry due to changes in the industrial structure. Health workers are exposed to direct factors and various other causes of occupational disease at work, such as physical, chemical, biological, and psyco-social factors. This study aims to identify work-related diseases affecting health workers that are recognized as occupational diseases. Methods: The research is based on the data of workers whose diseases were accepted as work-related by the Industrial Accidents Compensation Insurance, and filed by the Korean Occupational Safety and Health Agency. Amongst the approved claims during 2011 to 2015, we focused on healthcare workers and health-related workers of the Korean Standard Classification of Occupations. Descriptive statistics were performed. Results: The number of health workers(HWs) with approved work-related disease was 1,707 over 5 years. The number of healthcare workers(HCWs) excluding caregivers was 370 (21.7%) and of health-related workers (HRWs) it was 736 (43.1%). Out of HWs who were approved for their illnesses, females were 80% of HCWs and 88% of HRWs. The most common occupational disease in HWs was musculoskeletal diseases, while that of nurses was infectious disease. Conclusions: HWs are exposed to various risks from their profession and are affected by occupational diseases. It is necessary to focus on this issue and provide preventive measures.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.236-237
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• 1999