• Journal of Chest Surgery
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• 제43권1호
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• pp.53-57
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• 2010

배경: 이 연구는 늑골 수상 후 발생하는 늑간 신경병증에 대한 평가를 위하여 숫자통증등급, 통증 기간 및 체질량 지수에 따른 늑간 신경병증에 대한 심한 정도를 알고자 하였다. 대상 및 방법: 늑골 골절 수상 후 3개월 이상 동안 보존적인 치료에도 불구하고 심한 통증을 호소하는 환자 47명을 대상으로 근전도 검사를 시행하여 흉부의 늑간 및 척추 주위 근육에 대한 평가를 하였다. 결과: 47명 중에서 11명에 대하여 늑간 신경병증의 진단을 얻을 수 있었으며, 남자 8명과 여자 3명이었으며, 그 연령은 직업적으로 활동적인 연령대였다. 늑간 신경병증이 호발하는 부위는 7번부터 12번 부위 늑골 골절의 늑간이었다. 그 빈도는 단일 골절보다는 다발성 골절과 밀접한 상관 관계를 알 수 있었다. 그 증상으로는 흉통(90.9%), 감각이상(81.8%), 무감각(63.6%), 후부 흉통(27.2%), 그리고 근위축(18.2%) 순이었다. 근전도에 의한 숫자통증등급, 통증 기간 및 체질량 지수와 관계는 없었다. 결론: 늑골 골절수상 후 3개월 이상 지속적인 통증을 호소하는 환자에서 지속적인 늑간 신경통에 대한 진단을 위한 평가로 근전도가 도움이 될 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제25권1호
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• pp.26-33
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• 1992

반복작업에 종사하는 모 사업장 포장부서 근로자 42명을 대상으로 수근터널증후군에 대한 중상, 이학적 검사 및 근전도 검사를 1991년 11월부터 1992년 3월까지 실시하였다. 양손 모두에서 근전도상 이상소견을 보인 경우가 4명, 오른쪽 손에만 이상소견을 보인 경우가 4명 그리고 왼손이 1명 등 총 9명으로서 21.4%의 높은 유병률을 나타내었다. 임상중상은 전체 42명중 66.7%에 해당되는 28명에서 나타났다. Tinel과 Phalen sign 등 이학적 검사에서 이상소견을 보인 경우는 14명으로 전체의 33.3%를 차지하였다. 그리고 키와 임신 횟수를 제외한 수근터널증후군에 대한 다른 일반적 위험요인은 환자군과 비환자군에서 유의한 차이는 없었다. 근전도 검사를 기준으로 하였을 때 임상증상에 대한 민감도는 0.89, 특이도는 0.39이었고 Tinel sign에서는 각각 0.33, 0.88 그리고 Phalen sign에서는 0.56, 0.82 등이었다. 임상증상이 있고 Tinel과 Phalen sign에서 어느 하나 양성으로 나타나는 것을 선별기준으로 하였을 경우의 민감도와 특이도는 0.57, 0.76이었다.

• 대한한의학회지
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• 제16권2호
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• pp.9-16
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• 1995

1994년 3월부터 1995년 2월까지 1년동안 말초성 안면신경마비로 경희의료원 한방병원 침구1과에 침치료를 받기 위하여 내원한 환자중 발병한지 1주일 이내로 이부(耳部) 대장포진(帶狀疱疹)이나 종양 또는 외상을 당하지 않은 초발환자 44명을 대상으로 일주일에 3회씩 합곡(合谷)(L14), 족삼리(足三里)(ST36), 영향(迎香)(LI20), 찬죽(BL2), 예풍(TE17), 지창(地倉)(ST4), 협차(頰車)(ST6), 수구(水溝)(GV26), 승장(承漿)(CV24), 양백(陽白)(GB14)과 어요(魚腰)(Ex-HN4)를 선혈(選穴)하여 자침하고 치료경과를 관찰하였다. 지창(地倉)에서 협차(頰車), 수구(水溝)와 승장(承漿)에서 지창(地倉), 양백(陽白)에서 어요(魚腰)로는 투자법을 실시하였다. 환자의 평균연령은 39.3세이었고, 여성이 63.6%를 차지하였고 그중 한 명은 임신중이었다. 안면신경마비의 회복판정 척도는 House-Brackmann facial nerve grading scales를 사용하여 초진부터 초진후 7주까지 또는 7주이내 완전히 회복될 때까지 매주 평가하였다. 86.4%의 환자가 초진후 7주이내에 완전히 회복 되었으며, 회복되는데 걸리는 기간은 평균 3.7주로 관찰되었다.

• Korean Journal of Acupuncture
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• 제20권3호
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• pp.35-47
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• 2003

Objective : The purpose of this study was to investigate the significance of the Oriental medical treatment using He-Ne laser with low energy intravascular Laser Irradiation of Blood(ILIB) through the superficial venules. Methods : The investigation of details connected with the superficial venules in the literature is performed. The investigation of details connected with the pricking blood techniques through the superficial venules in the literature is performed. The classification of the pricking blood techniques through the superficial venules by the blood-letting puncture methods in the literature is performed. The arrangement of domestic clinical treatises on the effectiveness of medical treatment using He-Ne laser with low energy ILIB through the superficial venules is performed. The consideration on the methodology for the improvement of the clinical effectiveness of He-Ne laser with low energy ILIB through superficial venules is performed. Results and Conclusions : The superficial venules are small arteries, veins and capillaries in the superficial region of the human body. In the pricking blood techniques, there are the blood-letting puncture using the implement of acupuncture to the Jing points, Extra points and superficial blood vessels and the acupuncture using the Hirudo. The methods of the blood-letting puncture are classified into the venous blood-letting puncture, the pricking , the picking out white fiber-like substances from the subcutaneous tissue, the cluster needling, the scattered needling, the blood-letting puncture of the tready collateral branch of the large channel and the blood-letting puncture of skin. The He-Ne laser with low energy ILIB through the superficial venules belongs to the Oriental medical treatment as the method of the blood-letting puncture in the vein of cubital fossa. The He-Ne laser with low energy ILIB has an effect on hyperfibrinogenemia, hyperlipidemia, speech and motor dysfunction in the case of cerebral infarction, headache, dizziness, pain and numbness. It is considered that fundamental research on the biological change of the human body, the experimental animal and the unicellular animal, and research on the effectiveness and the safety, and the development of He-Ne laser with low energy ILIB of an effective wavelength range are necessary.

• Journal of Periodontal and Implant Science
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• 제36권3호
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• pp.661-671
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• 2006

The purpose of this study was to evaluate cumulative survival rate (CSR, %) of mandibular posterior single tooth implants replaced with ITI SLA (sand-blasted, large-grit, acid-etched) implant system and compare the CSR between first and second molar. The findings from the results were as follows; 1. Total of 158 implants were inserted into 147 patients. 68 patients were males, 79 patients were females and their mean age was 47.8 years. 98 implants were placed in first molar area and 60 implants were placed in second molar area. In terms of diameter, implants with wide diameter over 4.8mm dominated (91.1%). Implants with length over lOmm were used (96.2%). 2, In the two cases, there was a slight transient numbness which recovered within 1-2 months. Nine SynOcta screw type abutments demonstrated screw loosening, There were ten cases of crown fallen-out from decementation. 3. Only one failed out of 158 implants. The CSR was 99.4%. The CSRs for first molar and second molar were 99% and 100%, respectively. From the results, it was concluded that single tooth replacement implant in the mandibular posterior area, might be considered as the effective treatment modality comparable to the conventional crown and bridge.

• 사상체질의학회지
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• 제10권1호
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• pp.235-252
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• 1998

1. 연구배경 및 목적 : 태음인(太陰人) 신방법(新定方)의 하나인 청심연자탕(淸心蓮子湯)의 효능(效能)과 활용(活用)에 대한 임상적(臨床的) 연구(硏究)를 통하여 사상체질병증(四象體質病證)의 이해(理解)와 방제(方劑)의 운용(運用)에 도움을 주고자 한다. 2. 방법 : 1997년 3월부터 1998년 2월까지 1년간 동국대학교 분당한방병원 체질의학클리닉에 내원(來院)한 환자를 중 청심연자탕(淸心蓮子湯)이 20점(貼) 이상 투여되고 경과관찰(經過觀察)이 가능(可能)했던 125명(남자 62명, 여자 63명)을 대상으로 청심연자탕(淸心蓮子湯)이 투여된 환자(患者)의 특성(特性), 치료효과(治療效果), 부작용(副作用)등에 관하여 조사하고 분석하였다. 3. 결과 : 태음인(太陰人)의 청심연자탕(淸心蓮子湯)은 남녀(男女) 구별없이 20세 이상의 전 연령층(年齡層)에서 사용되었으며, 대상환자(對象惠者)들의 주소증(主訴症)은 수족비(手足痺), 두통(頭痛), 피로(疲勞) 등 60 종류였다. 치료효과(治療效果)의 분포는 호전(好轉)(60.8%), 우수(優秀)(15.2%), 별무변화(別無變化)(24.0%)였으며 악화(惡化)는 없었다. 전신상태의(全身狀態)의 특징으로는 설태(舌苔)가 백태(白苔) 또는 황태(黃苔)를 띠거나 수면(睡眠)에 장애(障碍)가 있는 경우가 많았다. 처방(處方)을 활용(活用)할 때는 다른 치료법이나 처방의 변경없이 청심연자탕(淸心蓮子湯)만을 사용한 경우가 많았으며 병증(病症)에 따라 2~3 종류(種類)의 약물(藥物)을 가미(加味)하여 사용하였다. 청심연자탕(淸心蓮子湯)의 치료효과(治療效果)에는 질환(疾患)의 이환기간(罹患期間), 치료기간(治療期間), 투여량(投與量)등이 영향(影響)을 미쳤으며 부작용(副作用)으로는 설사(泄瀉), 소화불량(消化不良) 등이 있었다.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.121-132
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• 2000

This study was carried out to determine the influencing of electrical stimulation to cervicothoracic sympathetic ganglion(CTSG; stellate ganglion) u the sympathetic tone. For the purpose of this study. the stimulation was given to both the interferential current stimulation(ICS: AMF 100Hz) group consisting of 10 person(males 8, females 2) and the transcutaneous nerve electrical stimulation(TENS: 100 Hz) group of 10(males 7, females 3) in the right side of the trachea with probe electrodes. Then. the temperature changes on the surfaces of the forehead. cheek, neck and internal ear of cephalocervix, which is subject to the influence of the cervicothoracic sympathetic ganglion, and the palm. which is the end of the upper limbs. measured before. immediately alter. 10 minutes after and 20 minutes after experiment. The results are summarized as follows. 1. The emergence of remarkable Horner's symptoms which appear due to the changes of the tone of cervicothoracic sympathetic ganglion was not seen. However, in the interferential current stimulation group there were two felt the sense of warmth in the facial region and one person who felt it in the upper limbs, and in the transcutaneous nerve electrical stimulation group there was each one person who felt the sense of warmth in the facial region and in the upper limbs, respectively. Both groups have each one person who felt the sense of oppression in the eyelids. Three persons of the interferential current stimulation group and two persons of the transcutaneous nerve electrical stimulation group have the sense of hoarse voice or numbness in the neck. These are the symptoms that appeared during stimulation, so it is difficult for them to be considered as the direct effects of the changes of the tone of cervicothoracic sympathetic ganglion. 2. The t-test was performed to determine the significance between the right, which is the experimental side, and the left, which is the non-experimental side. Significance between the right, which is the experimental side, and the left, which is the non-experimental side. Significant changes were seen in the necks of the interferential current stimulation group and in the cheeks and internal ears of the transcutaneous nerve electrical stimulation immediately after experiment(P<.05). And the interferential current stimulation group showed a very high significance in the cheeks immediately after experiment and in the necks ten minutes after experiment(p<.01). Therefore, it could be seen that the electrical stimulation had an influencing on the changes of body temperature of the cephalocervix. 3. In both the interferential current stimulation group and the transcutaneous nerve electrical stimulation group, the forecheads, checks and necks of the cephalocervix in the experimental side(right) rather than the non-experimental side(left) had mostly a statistically significant rise in temperature immediately after experiment. The one-way ANOVA was carried out to determine the temperature change of on the surface of the body with the lapse of time; before, immediately after, ten minutes after and tewenty minutes after experiment. But no statistical significance was found from both the right and left sides.

• 대한한의학회지
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• 제26권1호
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• pp.115-122
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• 2005

Background and objective: Gastrodiae Rhizoma (GR), the rhizoma of Gastrodia elata BL., is one of the popular drugs to treat headache, dizziness, blackout, numbness of limbs, hemiplegia, facial paralysis, dysphrasia, and infantile convulsions. It has been reported that it provides an antihypertensive effect and lowers cerebrovascular resistance in animal experiments. However, there has been no data about these effects with human subjects. In this study, the author examined the effect of Gastrodiae water extracts on blood pressure and cerebrovascular reactivity in human subjects. Methods: We selected 16 normal volunteers, who were divided into 2 groups: Gastrodiae extract administration group and placebo (creamy powder) group. Using transcranial Doppler ultrasound, we monitored changes of mean flow velocity and breath-holding induced CO2 reactivity of middle cerebral artery in both groups. Mean blood pressure, heart rate and PETCO2 were measured using Compact Anesthesia Monitor. In both groups, all evaluation was performed during basal condition, and repeated at 30, 60, and 90 min after administration. Results: Gastrodiae extract decreased CO2 reactivity after administration, reaching the lowest level at 90 minutes $(-29.1\%\;vs.\;basal\;level)$, which showed significant difference compared with the placebo group (p = 0.004). In the placebo group, the pulse rates tended to decrease over time (at 90 minute, $-5.2\%$ vs. basal level) while in the Gastrodiae group the values showed nearly no change, which showed significant difference between both groups (p = 0.036). However, the changes of mean blood pressure and mean flow velocity did not show significant difference between both groups. Conclusion : This study demonstrated that Gastrodiae extract significantly decreased breath-holding induced CO2 reactivity. This result suggests that the clinical effect of Gastrodiae extract might be caused by increasing cerebral blood flow via dilation of cerebral resistant vessels instead of antihypertensive effect.

• The Korean Journal of Pain
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• 제8권2호
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• pp.257-265
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• 1995

Patient-Controlled Analgesia (PCA) has been widely used for postoperative pain relief. Meperidine is useful for PCA and has efficient analgesia, rapid onset, and low incidence of adverse effect. To compare the analgesic effect, total dose and hourly dose, side effect and neonatal status of breast feeding with meperidine via intravenous or epidural PCA for 48 hours after Cesarean Section, 40 parturient women undergoing elective Cesarean Section were randomly divided into two groups. Each respective group of 20 parturient women received meperidine via one of the intravenous PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after epidural block with 2% lidocaine 20ml combined with general anesthesia with only $N_2O$ and $O_2$ (EpiPCA group) when they first complained of pain in recovery room. Following the administration of analgesic initial dose, parturient women of IVPCA group were allowed intravenous meperidine 10 mg every 8 minutes when they felt pain. The EpiPCA group received additional bolus dose of meperidine 2 mg and bupivacaine 0.7 mg were administered every 8 minutes as requested the patients with hourly continuous infusion of meperidine 4 mg and bupivacaine 1.4 mg. Data was collected during the 48 hours observation period including visual analog scale (VAS) pain scores, total meperidine dose, hourly dose during 48 hours and each time interval, incidence of adverse effect, satisfaction, and neonatal status with breast feeding. VAS pain scores of analgesic effect in EpiPCA group was significantly lower than in IVPCA group at 2 hours after the initial pain after Cesarean Section. Total dose and hourly dose of meperidine significantly reduced in EpiPCA group. Hourly dose of meperidine at each time interval significantly reduced during first 6 hours and from 12 hours to 24 hours in EpiPCA group. The side effects in IVPCA group were mainly sedation, nausea, and local irritation of skin. And EpiPCA group experienced numbness and itching. The degree of satisfaction of parturient women was 88.2 % in IVPCA group and 85.7 % in EpiPCA group. We did not observe any sedation, abnormal behavior, or seizure like activity in any neonates of breast feeding. From the above results we conclude that epidural PCA was more efficiently analgesic, less sedative, and consumptional, and safer for neonate than intravenous PCA, and could be an alternative method to intravenous PCA.

• The Korean Journal of Pain
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• 제2권1호
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• pp.66-71
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• 1989

It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.