• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.27-31
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• 2009

Purpose: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. Methods: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. Results: The mean reduction ratio of the volume of edema comparison normal volume was 41.1${\pm}$35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. Conclusion: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.659-674
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• 1998

This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

• Journal of Digital Convergence
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• v.11 no.8
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• pp.243-250
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• 2013

The present study is to determine the effect of lumbosacral stabilization exercise program on back pain disorder and gait velocity of patients with chronic low back pain. The subject was extracted randomly from 34 patients with chronic low back pain and divided into 18 patients of experimental group and 16 patients of control group. Before the experiment, the Oswestry disability index examination and analysis of gait speed were performed. Then, a conventional interventional therapy of physiotherapy was performed with the experimental group along with the lumbosacral stabilization exercise while only the conventional interventional therapy was done to the control group. Both groups did the above treatment every 30 minutes, four times a week for four weeks. Then, post-examination was carried out followed by comparing the back pain disorder index and gait velocity before and after the experiment for the two groups. The back pain disorder index showed that both experimental and control groups had significant difference within the group (p>.01)(p>.05), With regard to the gait velocity, both experimental and control groups had a significant difference within the experimental group and between the groups (p>.001)(p>.05).

• Journal of Haehwa Medicine
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• v.15 no.1
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• pp.125-140
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• 2006

Study of east & west medical science documentary records of Hip joint pain lead to following conclusions. 1. Easten medicine classify hip joint pain with terms "Bi-chu-tong", "Bi chu in tong" "Bi-chu-choong-tong". 2. Easten medicine asorts cause of hip joint pain with external factor, such as exogenous energy, six yin evil energy and intrinsic factor, which are weakness caused by prolonged deasease, warm-heat evil. 3. In western medicine, causes that trigger hip joint pain are trauma, fracture, dislocation,and bacterial infection. 4. Treatment of hip joint disorder in western medicine, physiotherapy concerning conservative treatment, and pain control with drug treatment, kinesitherapy are used, and concernig fracture, operation is used. 5. In Eastern medicine, principle of treating hip joint pain, sung-juk-sa-ji(盛則寫之), hu-juk-bo-ji(虛則補之), yul-juk-jil-ji(熱則疾之), han-juk-yu-ji(寒則留之), ham-ha-juk-chim-ji(陷下則沈之), bul-sung-bul-hu(不盛不虛), yi-kyong-chui-ji(以經取之) is presented. This priciple of treatment was descended through ages and is now applied to treatments such as Acupuncture, Herbal, physical treatment based on so-san-eo-hyul(消散瘀血), seo-kun-tong-rak(舒筋通絡), so-ri-kwan-jul(疏利關節) principle. 6. In Eastern medicine, meridians used to treat hip joint pain are The Chok yangmyung wi Kyong(足陽明胃經), Chok taeum bi Kyong(足太陰脾經), Chock soyang dam Kyong(足少陽膽經), Chock guelum gan Kyong(足厥陰肝經). In conclusion, hip joint pain should be considered in relationship with internal organs and whole body system. Western & Eastern point of view should be carefully inspected and connected and intensive study of nervous system and meridian is required, in order to adopt best treatment for the patients.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.29-43
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• 2015

Objective : The purpose of this study was to identify characteristics of patients' self-perceived health in traditional Korean medical facilities. Method : This research was conducted based on the survey on patients whom have visited traditional Korean medical facilities in 2011 by the Ministry of Health and Welfares and Korean Institute for Health and Social Affairs. Using a sample of 3,931 (1,180 male and 2,751 female) outpatients' self-perceived health based on the data from usage and consumption of Korean Medicine. 'Healthy', 'Fair', and 'Poor Health' were used to measure patients' self-perceived health status. The data was analyzed by frequency, t-test, cross correlation analysis and multiple logistics regression analysis using the SPSS program package. Results : Sex(P<0.001), age(P<0.001), marital status(P<0.001), education(P<0.001), employment status(P<0.001), occupation(P<0.001), health insurance(P<0.001) and income level(P<0.0001) showed statistical significance. Main Treatment Facilities(P<0.001), experience of taking Korean medicine(P=0.032), experience of receiving acupuncture treatment(P<0.001), number of visits(P<0.001), medical expense (P=0.005), and subjective health status after the treatments showed statistical significance for Korean herbal medicine(P=0.038), acupuncture (P=0.001), cupping therapy(P=0.006), oriental physiotherapy(P=0.003), and treatment satisfaction(P<0.001). For subjective health status based on suffering disorders in the past three months, the response of poor health was higher in the group suffering recent illnesses. Statistical significance was seen in hypertension (P=0.002), arthritis(P<0.001), lumbar pain(P<0.001), diabetes mellitus(P=0.001), stroke(P<0.001), hwa-byung (P=0.001), gastric disorders(P=0.021), common cold(P<0.001), ankle sprain(P<0.001), muscular injury(P<0.001), lumbar sprain(p=0.009) and fracture(P=0.03). Also the number of diseases during the past three months showed statistical significance(P<0.001). Statistical significance was also seen in Level of knowledge(P<0.001), route of information(P<0.001), reliability of Korean medicine(P=0.003), insurance coverage(P=0.005), medical costs(P<0.001), and future willingness to use Korean medicine(P<0.001). As a result of the multiple logistics regression analysis, risks of subjective poor health statistically increased in female population, elderlies, medicaid beneficiaries, less educated, higher medical expense, and more disorders during the past three months. Conclusion : Patients' self-perceived health status has significant differences with each variables such as sex, age, marital status, education, health insurance, medical expense, number of diseases.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.3
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• pp.131-137
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• 2014

Objectives The purpose of this study was to compare the effects of MSAT (Mostion style acuputure treatment) on piriformis muscle regarding leg radiating pain with HIVD of L-SPINE. Methods Forty patients who received inpatient treatment from Febuarary 1 to March 31, 2014 in the Daejon-Jaseng oriental medicine hospital were divided into 2 groups by blocked randomization : Group A (n=20)=routine treatment on HIVD of L-SPINE with MSAT on piriformis muscle and Group B (n=20)=routine treatment on HIVD of L-SPINE (acupuncture, Shinbaro pharmacopuncture, herb medication, chuna treatment and physiotherapy). The MSAT (Mostion style acuputure treatment) on piriformis muscle was administered each day and both groups were received routine treatment each day. Evaluations were made before treatment, after 3 days and 7 days, and before discharge using the NRS (numeric rating scale) and ODI (oswestry disability index). The statistically significance was evaluated by SPSS 18.0 for windows. Results Compared to before treatment, the NRS (numeric rating scale) and ODI (oswestry disability index) of both A and B groups after 3, 7 days and before discharge of treatment significantly decreased (p<0.05). Regarding group comparison, the NRS (numeric rating scale) and ODI (oswestry disability index) of A group was significantly lower than the B group at 3, 7 days, before dischanre (p<0.05). Regarding improvement of the NRS (numeric rating scale) and ODI (oswestry disability index), A group was significantly lower than the B group at 3 day (NRS), 7day (ODI) (p=0.000) but there was no significant difference between the two groups at 7 days (NRS) and before discharge (p>0.05). Conclusions Compared to just routine treatment, the MSAT (Mostion style acuputure treatment) on piriformis muscle significantly improved the NRS (numeric rating scale) and ODI (oswestry disability index) after 3, 7 days, and before discharge. Because early intervention determines the grade of Leg radiating pain with HIVD of L-SPINE, the MSAT (Mostion style acuputure treatment) on piriformisat the early stage will be clinically helpful to patients.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.74-83
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• 1999

In diabetics, the frozen shoulder has been difficult to treat. They tend to respond poorly to manipulation. In this report we present the rationale and results of arthroscopic selective capsular release for those patients. Nine patients, who were diabetics, developed frozen shoulders which failed to respond to conservative management. They had persistent pain, stiffness, and limited function. An arthroscopic release was performed by progressively releasing the anterior structures from superior to inferior. Postoperatively physiotherapy was carried out daily to maintain the range of movement. At a follow up of 12 to 37 months the patients were assessed using the American Shoulder Society scheme. In addition, the patients were assessed preoperatively and postoperatively on four criteria: pain, external rotation, abduction and function. We found that the patients were statistically significantly improved in all four categories. Three of the nine patients had no pain, full range of motion compared with the opposite side and full function. There was one poor result of no improvement. The remaining five patients had improved but still had residual abnormalities. We consider arthroscopic release to be an effective treatment for the resistant diabetic frozen shoulder.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.395-404
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• 2010

Purpose : The object of this study was to examine the effect of motor learning on brain activation depending on the method of motor learning. Methods : The brain activation was measured in 9 men by fMRI. The subjects were divided into the following groups depending on the method of motor learning: actually practice (AP, n=3) group, action observation (AO, n=3) group and motor imagery (MI, n=3) group. In order to examine the effect of motor learning depending on the method of motor learning, the brain activation data were measured during learning. For the investigation of brain activation, fMRI was conducted. Results : The results of brain activation measured before and during learning were as follows; (1) During learning, the AP group showed the activation in the following areas: primary motor area located in precentral gyrus, somatosensory area located in postcentral gyrus, supplemental motor area and prefrontal association area located in precentral gyrus, middle frontal gyrus and superior frontal gyrus, speech area located in superior temporal gyrus and middle temporal gyrus, Broca's area located in inferior parietal lobe and somatosensory association area of precuneus; (2) During learning, the AD groups showed the activation in the following areas: primary motor area located in precentral gyrus, prefrontal association area located in middle frontal gyrus and superior frontal gyrus, speech area and supplemental motor area located in superior temporal gyrus and middle temporal gyrus, Broca's area located in inferior parietal lobe, somatosensory area and primary motor area located in precentral gyrus of right cerebrum and left cerebrum, and somatosensory association area located in precuneus; and (3) During learning, the MI group showed activation in the following areas: speech area located in superior temporal gyrus, supplemental area, and somatosensory association area located in precuneus. Conclusion : Given the results above, in this study, the action observation was suggested as an alternative to motor learning through actual practice in serial reaction time task of motor learning. It showed the similar results to the actual practice in brain activation which were obtained using activation of mirror neuron. This result suggests that the brain activation occurred by the activation of mirror neuron, which was observed during action observation. The mirror neurons are located in primary motor area, somatosensory area, premotor area, supplemental motor area and somatosensory association area. In sum, when we plan a training program through physiotherapy to increase the effect during reeducation of movement, the action observation as well as best resting is necessary in increasing the effect of motor learning with the patients who cannot be engaged in actual practice.

• Journal of Society of Preventive Korean Medicine
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• v.13 no.3
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• pp.55-71
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• 2009

Background : Traditional Korean medicine(TKM) has gained in popularity among chronic patients in recent years. The use of TKM among patients with chronic diseases is common, with about two thirds of patients using some form of TKM in Korea. Objectives : The purpose of this study is to analyze the use of TKM and determine what factors affect to use TKM among patients with chronic diseases. The study also aims to provide information on TKM therapies and assist therapy selection among various TKM therapies for patients with chronic diseases. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 21-item questionnaire. This study was conducted with subjects with confirmed diagnosis of chronic diseases, who live in Jeju Province, Korea. Results : Among the participants, past or current TKM use was 66.7%, with a statistically significant difference in gender and level of health status groups(p<0.05), but no difference in age, marital status, education, occupation, and income groups. The most common therapies of TKM used by the patients included acupuncture(51.1%), physiotherapy(16.8%), cupping(13.5%), and herbal medicine(4.8%). The main benefits from TKM perceived by the patients were chronic diseases management and health promotion. In a logistic regression analysis, significant influencing factors related to TKM use were gender, family income level, the extent of recognition of efficacy, heath status, and health security program. Conclusions : In this study the socio-demographic and health status, recognition of TKM efficacy factors associated with TKM use among patients with chronic diseases were similar to those found in the general population. The findings suggest that due to the relatively high use of TKM among patients with chronic diseases in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system. Additionally proactive and consistent management of TKM is necessary in the health care system in Korea.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1048-1052
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• 2009

Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.