• The Korean Journal of Pain
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• v.27 no.3
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• pp.253-259
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• 2014

Background: Caudal block is a common technique in children for reducing postoperative pain, and there have been several reports on the variations of the sacral canal in children. However, previous studies have mainly focused on the needle trajectory for caudal block, and there is limited information on the structural variations of the sacrum in children. The purpose of this study was to analyze the anatomic variations of sacral canals in children. Methods: Three-dimensional computed tomographic images were analyzed. The data from the images included (1) fusion of the sacral vertebral laminae and the sacral intervertebral space (2) existence of the sacral cornua and (3) the types of sacral hiatus. The types of sacral hiatus were classified into 3 groups: group I (fusion of S3 or S4 vertebral laminae), group II (unfused vertebral arch with the distance of the S3 and S4 vertebral laminae < 50% of the distance between the cornua), and group III (unfused vertebral arch with the distance of the S3 or S4 vertebral laminae ${\geq}50%$ of the distance between the cornua). Results: A total of 143 children were included in this study. All of the sacral vertebral arches were not fused in 22 children (15.4%). Cornua were not identified bilaterally in 5 (3.5%) and unilaterally in 6 (4.2%) children. In the sacral hiatus, group II and group III were identified in 22 (15.4%) and 31 (21.7%) children, respectively. Conclusions: The sacral canal has various anatomical variations in children. Careful attention must be paid to identify the correct anatomic landmark.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.100-105
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• 1994

This is a study of decrease in both stump pain and unidentified complaints after removal of neuroma on an amputated left thigh. The patient was a 44 year old woman who received an operation after a motorcycle accident 20th of March, 1991. She started a rehabilitation program in early June of the same year. How ever the patient complained of a squeezing pain on the amputated area. This symptom became more severe after the removal of the nails in September. The pain was perceived as a mental problem and the patient was released from the previous hospital. The pain continued and on the 9th of March, 1992, the patient was introduced to our pain clinic. The patient complained about the cold sensation and pressure pain of the amputated area at the beginning. Later she also expressed various unidentified complaints. No improvement resulted after conducting an epidural block and a lumbar sympathetic ganglion block. MMPI test showed psychological instability. Local injection showed some positive effects, which led to considerations concerning the possibility of neuroma. After confirming the existence of neuroma through CT and MRI, neuromectomy was performed. After the removal of neuroma, the unidentified complaints as well as the stump pain decreased.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.201-213
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• 2005

Objective : The aim of this study is to investigate the effectiveness of Bee-venom therapy for Cervical radiculopathy patients. Methods : To evaluate the effectiveness of Bee-venom therapy, 14 patients were treated by Bee-venom therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale (QVAS), JOA score and Odom's degree. Results & Conclusions : 1. As a objectivity treatment record, they test treatment record excellent(7 case) 50%, good(4 case) 28.57%, fair(,3 case) 21.43%. 2. After Bee-venom therapy, pain rate changed from 8.82 to 3.25.(p=0.000) 3. After Bee-venom therapy, JOA score changed from 11.00 to 12.79.(p=0.000) 4. By the results which puts out the statistics in sex, age, existence of finger numbness and disc type, the pain rate is not significantly difference as a therapy. (p<0.05) 5. By the results which puts out the statistics in sex, age and disc type, the JOA score is not significantly difference as a therapy.(p<0.05) But by the results which puts out the statistics in existence of finger numbness the JOA score is significantly difference as a therapy.(p=.025) There was reports about Bee-venom therapy of the Patient with Cervical radiculopathy. It is very effective to reduce the pain and increase the JOA score.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.223-228
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• 2000

The relationship between TMD and otologic symptoms such as tinnitus, vertigo and dizziness has been noted for many years. The existence of otologic symptoms in patients with TMD can be explained by the anatomic proximity and embryologic origin of the structures of the ear and the temporomandibular joint, however the pathogenesis of the symptoms is poorly understood. Serveral hypotheses have been proposed. : Eustachian tube hypothesis, the tensor tympani hypothesis, the otomandibular ligament hypothesis, excessive somatic concern hypothesis. Some investigators have reported that palpation of the deep masseter muscle, sternocleidomastoid muscle or clenching can intensify a patient's tinnitus and in that case, TMD therapy would improve their otologic symptoms. Although tinnitus and vertigo are common symptoms in the general population and also increase with increasing age, those are highly significantly associated with TMD compared with control group. This case report describes the possible mechanism and management of otologic symptoms in patient with TMD who has visited our clinic complaining asymmetric tinnitus and dull pain on her left masseter muscle.

• The Journal of the Korea Contents Association
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• v.15 no.2
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• pp.363-369
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• 2015

Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.83-88
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• 2010

Purpose: It is not always easy to determine the existence of tendon injuries when it comes to patients with finger lacerations. Thus, we tried to find the difference in effectiveness and in compliance of patients when we employed two different types of diagnosis, conventional gross confirmation and ultrasonographic confirmation. Methods: From December 2009 to March 2010, we enrolled 14 patients with finger tendon injury at Soonchunhyang University Cheonan Hospital. The median age of the patients was $35.9{\pm}14.4$, and the ratio of females to males was 1:2.5 We evaluated the compliance of each patient by measuring four different categories (level of cooperativeness in showing their wound and in following the instructions, level of movement of their fingers during the diagnosis and total number of attempts to diagnose) by using a score from 1 to 3 for each category, for a total possible score of 12 for each patient. We also measured the painfulness of each patient by using a score of 1 to 10 and the time required for each diagnosis. Results: The levels of patients' compliance was $8.9{\pm}2.1$ when diagnosed with gross confirmation and $9.8{\pm}2.1$ when diagnosed with ultrasonographic confirmation (p value=0.042). The pain score of the patients was $3.7{\pm}1.7$ with gross confirmation and $2.9{\pm}1.2$ with ultrasonographic confirmation (p value=0.020). The median duration of time in each test was $6.7{\pm}4.8$ minutes with gross confirmation and $10.5{\pm}4.2$ minutes with ultrasonography (p value=0.006). Conclusion: Comparing gross confirmation and ultrasonographic confirmation, gross confirmation is a better method than ultrasonography because of time efficiency. However, ultrasonographic confirmation has advantages over gross confirmation in pain scale and better compliance of patients. Emergency physicians generally employ gross confirmation rather than ultrasonography in determining the existence of tendon injury in patients. In patients with finger lacerations without bone injury, ultrasonography can be considered as a secondary diagnostic tool, especially when patients have much pain.

• Journal of muscle and joint health
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• v.2 no.1
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.5-28
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• 2001

Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

• Journal of Society of Preventive Korean Medicine
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• v.5 no.2
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• pp.40-68
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• 2001

In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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• pp.1-12
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• 2014

Purpose: This study was done to explore and understand acculturation focusing on reproductive health of immigrant women. Methods: For the research sixteen immigrant women were selected by snowball sampling. Qualitative data were accumulated by in-depth interviews and private document collection. Raw data was analyzed following Mandelbaum's conceptual framework. Results: The dimensions of immigrant women consisted of existence: emerging from the new environment in which it was hard to communicate and to get acquainted with others, reproduction: in the absence of learning and experience, reproductive health crisis, parenting: unmanageable burden. Turnings of life involved 'Inconvenience in one's eyes, vent for conflict and tension: pregnancy', 'strange medical care: accoucheur, rapid medical service', 'pain of morning sickness: poor maternal nutrition', 'manifestation of protective instinct for life'. In adaptations, content was as follows. 1) Standing alone as a Korean housewife, 2) Becoming aware of Korean maternal instinct: thirst for education supporting, 3) Rediscovery of family: growing maternal sense of existence. Conclusion: The results of this study show the acculturation process and the meaning of events related to reproductive health in current lives and can contribute to an integrated understanding of married immigrant women in Korean culture.