• 셀메드
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• 제12권2호
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• pp.6.1-6.5
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• 2022

Objectives: Sciatica is a musculoskeletal pain sensed in the leg along with the distribution of the sciatic nerve, which is sometimes accompanied by low back pain and is most commonly caused by a disc herniation. In the Unani system of Medicine, Irq-un-Nasa (Sciatica) is defined as the pain which starts from the hip joint and descends towards the foot. It is a type of Waja-ul-Mafasil which is developed due to the accumulation of Khilt-e-Dam or Khilt-e-Balgham ghaleez in the hip joint. The conventional system of Medicine offers several medications and surgeries to manage sciatica with limited clinical evidence of effectiveness. These cases aim to provide insight into the effects of Fasd (Venesection) in Irq-un-Nasa. Case Presentation: Fasd was performed in the saphena minor vein of two clinically diagnosed patients with sciatica after the initial assessment. Two sittings of Fasd, once a week in each patient, were performed, followed by telephonic assessments for two months. The intensity of sciatic pain reduced with subsequent sittings of Fasd, and there was no recurrence of any symptoms and signs again during complete follow-up. Conclusion: Based on the results of the present case report, it appears that such cases of Irq-un-Nasa can be managed with Fasd, and the quality of life of such patients can also be improved.

• Clinical Pain
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• 제18권2호
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• pp.130-132
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• 2019

Acupuncture is generally regarded as a safe procedure and as a popular treatment for patients with musculoskeletal disorders. We report a case of a 47-year-old male patient with late-onset tetraplegia, developed after acupuncture. He had no trauma, medical, and social history relevant to tetraplegia. Right after the acupuncture, he felt discomfort in his right arm. After 6 days, all 4 extremity weakness developed. Whole-spine magnetic resonance imaging revealed the presence of spinal subdural hematoma extending from the C5 vertebra to the coccyx level. Hand coordination dysfunction, neurogenic bladder, and neuropathic pain were other symptoms. After the management, he recovered muscle strength, but incomplete bladder control and neuralgia were sustained. It is important to be aware of the possibilities of severe complications after acupuncture.

• 대한골관절종양학회지
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• 제11권2호
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• pp.155-159
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• 2005

목적: 슬관절 주위 골연골종 환자의 병리적 증상과 슬내장이 동반되는 빈도 및 임상적 중요성을 알아보고자 하였다. 대상 및 방법: 1995년부터 2004년 사이에 슬관절 주위에 골연골종이 있어 제거술을 시행 받았던 20세 미만의 45예를 대상으로 후향적 연구를 하였다. 연령, 성별, 과거 병력, 가족력, 골연골종의 다발성 여부와 병리적 증상 및 슬내장의 원인 등을 조사하였다. 결과: 총 45예 중 슬내장은 9예(20%)에서 확인되었다. 다발성 골연골종은 4예이었으며, 1예에서 슬내장이 동반되었다. 병리적 증상 중 무통성 종괴가 39예로 가장 많았고, 이 중 9예는 슬내장으로 슬관절에 동통이 있었다. 슬내장의 원인은 반월상 연골판 파열이 7예, 병적 추벽 증후군이 2예이었고, 반월상 연골판 파열 중 4예는 원판형 연골이었다. 결론: 슬관절 주위 골연골종과 슬내장의 동반 발생에 대한 연관성은 부합적으로 사료되지 만, 그 빈도는 낮지 않은 것으로 판단되므로, 반드시 자기공명영상 등 특수 검사와 세심한 관찰을 해야 할 것이다.

• 동의신경정신과학회지
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• 제30권3호
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• pp.251-263
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• 2019

Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.361-373
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• 1999

ROC곡선의 AUC는 측전도구의 기준 타당도를 나타내는 가장 일반화된 지표다. 본 연구는 ROC분석법을 이용하여 현행의 근로자건강진단에서 업무관련성 근골격계 질환의 고위험군을 변별하는 표준 설문지를 개발하고자 하였다. 컴퓨터를 이용하는 선박 설계업 종사자 89명, 전화번호 안내원 113명, 일반 직업 여성 79명, 주부 89명 등 총 370명의 일차 연구대상군에 대한 재활의 학과 전문의의 최종 진단결과를 기준으로 1996년에 개발된 '근로자의 신체 증상에 관한 설문지'의 응답결과를 비교하였다. 근골격계 질환과의 관련성이 높은 문항조합을 선정하고 문항별 가중치를 산출하기 위해 로짓회귀분석, 상관분석 등을 실시하였으며, 문항조합 및 가중치 산출방법이 서로 다른 4가지 설문모형에 따른 AUC를 비교 하였다. 또한, 국내 모 자동차조립공장 근로자 225명의 설문결과와 산업의학 전문의의 진단결과 자료를 이용하여 4가지 설문모형의 AUC 재현도를 확인하였다. 분석 결과, 통계적으로 유의 한 차이는 없었으나 문항수를 줄여도 문항별 응답수준별 가중치를 부여하면 AUC가 일관되게 증가함을 확인하였다. 증상문항 4개와 신체부위문항 7개를 통합한 11개 문항에 가중치를 부여하는 모형이 변별력, 재현도, 편의성 측면에서 우수한 것으로 나타나, 이를 기준으로 새로운 업무관련성 근골격계 질환 설문지를 설계할 수 있었다. 문항수가 적으면서도 타당도는 높은 설문지를 개발하고, 상대적인 비교평가에 쓰일 수 있는 정량적 가중치를 제시한 것이 본 연구의 주요성과라 할 수 있다. 본 연구는 전문의 사이의 진단기준 차이를 고려하지 못한 점, 다양한 인구집단에 적용할만한 절대적인 참고치를 제시하지 못한 점 등에서 한계가 있다. 그러나, '측정 도구의 정량적 타당도 검증을 통한 질병 감시용 도구 개발'이라는 본 연구의 기본 취지 및 접근방법은 향후 조직적인 질병 예방활동에 활용될 여지가 있을 것이다.

• 대한지역사회작업치료학회지
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• 제3권1호
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• pp.1-10
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• 2013

목적 : 충남지역 일개 농촌마을에서 농작업 자세를 기초로 설계한 근골격계 질환 예방운동 프로그램이 참여자의 균형능력, 요통의 기능적 장애 수준 및 사회 심리적 스트레스에 미치는 영향을 알아보고자 하였다. 연구방법 : 충남지역 일개 마을의 농업인으로 근골격계 증상이 있는 21명에게 2008년 7월 10일부터 10월 11일까지 총 12주간, 주 1회, 회당 90분씩의 운동프로그램을 제공하였다. 운동프로그램은 농작업 자세를 고려하여 유연성 및 근력을 강화하도록 구성하였다. 참여자 중 8회 이상 출석하고 중재 전, 후 평가에 모두 참여한 13명의 자료를 기초로 균형능력, 요통의 기능적 장애 수준 및 사회 심리적 스트레스 수준을 분석하였다. 결과 : 참여자 13명은 모두 여성으로 평균 70.55(${\pm}6.78$)세였다. 참여자들은 대부분 일반 밭농사(92.3%)에 종사하고 있으며, 작업 중 통증을 주로 느끼는 부위는 허리(69.2%)와 무릎(61.5%)이었고, 전반적인 건강상태에 대해서는 46.2%가 '건강하지 않다'고 응답하였다. 균형능력은 눈뜨고 오른발서기가 중재 전 평균 9.27(${\pm}5.53$)초에서 중재 후 14.22(${\pm}5.47$)초로 유의하게 증가하였다(p<.05). 요통의 기능적 장애 수준은 평균 19.84(${\pm}6.89$)점에서 14.38(${\pm}7.58$)점으로 유의하게 감소하였다(p<.05). 그러나 사회 심리적 스트레스 수준에는 변화가 나타나지 않았다. 결론 : 밭농사를 주로 하는 여성 농업인을 대상으로 실시한 본 운동프로그램은 참여자의 균형능력 향상 및 요통의 기능적 장애의 감소에 기여하였다. 향후에는 작업특성에 따라 차별화된 운동프로그램의 효과에 대한 연구가 진전되기를 기대한다.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.779-790
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• 1997

본 연구는 목과 상지의 누적외상성장애를 호소하는 대상자들중에서 근막동통증후군으로 진단받은 환자군과 단순 증상호소군인 대조군사이에서 검사결과의 분석을 통하여 집단 검진시 고려해 볼 수 있는 검사항목을 찾고자하였다. 조사대상은 컴퓨터를 통한 자료검색 및 대화형태의 업무를 하는 여성 전화교환원 904명이었으며, 근막동통증후군으로 진단받은 105명의 환자군과 상지의 누적외상성장애의 증상만을 호소하는 550명의 대조군을 비교하여 다음과 같은 결론을 얻었다. 1. 신체계측과 악력 및 Pinch strength 측정결과, 키와 몸무게, 앉은 자세의 높이 등에서는 환자군과 대조군의 차이가 없었으나, 약력은 환자군의 우측손이 대조군보다 유의하게 낮았으며, Pinch strength는 두 군간의 유의한 차이는 없었다. 2. 시각적 상사척도는 환자군의 평균값이 $6.74{\pm}2.29$이며, 대조군은 $4.37{\pm}2.32$으로 나타나 두 군간 뚜렷한 차이를 보였다. 3. 근육효소검사에서는 비정상으로 분류된 이상자의 분포가 환자군과 대조군에서 유사한 분포를 보여 실제 진단과정에 미치는 영향은 미비한 것으로 나타났다. 4. 다중 로지스틱 회귀분석을 이용한 유의한 변수는 나이, 우측 상부승모근의 압통역치값과 시각적 상사척도로 나타났다. 5. 압통역치검사와 시각적 상사척도는 근막동통증후군의 진단에 객관적 검사로서 고려할 만한 검사로 나타났다.

• 한국산학기술학회논문지
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• 제13권8호
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• pp.3552-3560
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• 2012

본 연구는 한 비철금속 제조업 생산직 남성 근로자들의 인구사회학적특성, 건강관련행위 특성 및 직업관련 특성별 근골격계 자각증상호소율을 파악하고 그의 관련요인을 알아보고자 시도하였다. 조사대상은 대전광역시 소재한 비철금속 제조업체 근로자 302명을 대상으로 하였으며, 2011년 5월 1일부터 6월 30일까지의 기간 동안에 표준화된 무기명식 설문조사를 실시하였다. 연구결과, 연구대상자의 근골격계 질환 발생부위별 증상 호소율은 어깨부위의 증상이 42.7%로 가장 높았고, 다음은 허리부위 36.8%, 목 부위와 손/손목/손가락 부위가 각각 30.5%, 다리/발 부위 30.1%, 팔/팔꿈치 부위 20.9%의 순위였다. 인구사회학적 특성별 근골격계 자각증상 호소율은 연령, BMI가 낮을수록, 주관적인 건강상태가 좋지 않다는 군에서 유의하게 높았다. 건강관련 행위 특성별 자각증상 호소율은 질병으로 인한 결근한 적이 있다는 군, 외래 진료를 받은 적이 있다는 군, 입원진료를 받은적이 있다군, 규칙적인 운동이 비운동군, 수면시간이 부적당한 군에서 유의하게 높았다. 직업관련 특성별 자각증상 호소율은 업무의 신체적 부담정도가 힘들다는 군, 허리를 구부리는 작업을 하는군, 직장생활에 만족하지 않는다는 군, 근속기간이 10년 이상인 군, 허리를 구부리는 작업을 한다는 군, 반복 작업을 한다는 군에서 유의하게 높았다. 결론적으로, 생산직 남성근로자들의 근골격계 자각증상은 여러 인구사회학적 특성, 건강관련 행위특성 및 직업관련 특성과 유의한 관련성이 있었다.

• 한방재활의학과학회지
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• 제34권1호
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• pp.65-81
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• 2024

Objectives This study aimed to understand the general research trends, applicated disease, and methodology of transcutaneous/percutaneous vagus nerve stimulation, contemplating its clinical use in traditional Korean medicine and future research directions. Methods A scoping review was conducted following Arksey and O'Malley Framework Stage and adhering to the PRISMA extension for scoping reviews: checklist and explanation. Papers published until October 30, 2023, were investigated across 10 databases (PubMed, Embase, Scopus, Web of Science, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, KMbase, Science ON, Research Information Sharing Service. The search terms used were 'Transcutaneous/Percutaneous vagus nerve stimulation'. Results Since 2021, the application of transcutaneous/percutaneous vagus nerve stimulation for musculoskeletal symptoms has been actively researched, predominantly in Asia (37%), Europe (37%), and North America (21%). All 19 papers were part of clinical studies. Chronic pain was noted that most applied disease, it also was found to potentially aid in acute post-surgical pain relief. Major assessment tools include not only simple pain metrics but also pain perception, vagal nerve tension, quality of life, and inflammatory markers. Most procedures were carried out through the ear, which offers a favorable site for therapeutic stimulation without notable side effects. And parameter analysis, frequencies typically ranged around 25 Hz to 30 Hz, while pulse widths were commonly set at 250 ㎲ or 300 ㎲. Conclusions Transcutaneous/percutaneous vagus nerve stimulation is easily accessible through acupuncture in Korean medicine. Therefore, if future studies establish parameters and clinical significance, it could be utilized as a therapeutic modality.

• 한국직업건강간호학회지
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• 제3권호
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• pp.54-70
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• 1993

According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.