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Effects of Low Grade Axial Loading on Discogenic Low Back Pain: A Case Report

  • Chang, Duncan;Boby, Arantxa;Madonna, James
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.4
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    • pp.1683-1686
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    • 2018
  • Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.

A Heuristic for Service-Parts Lot-Sizing with Disassembly Option (분해옵션 포함 서비스부품 로트사이징 휴리스틱)

  • Jang, Jin-Myeong;Kim, Hwa-Joong;Son, Dong-Hoon;Lee, Dong-Ho
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.44 no.2
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    • pp.24-35
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    • 2021
  • Due to increasing awareness on the treatment of end-of-use/life products, disassembly has been a fast-growing research area of interest for many researchers over recent decades. This paper introduces a novel lot-sizing problem that has not been studied in the literature, which is the service-parts lot-sizing with disassembly option. The disassembly option implies that the demands of service parts can be fulfilled by newly manufactured parts, but also by disassembled parts. The disassembled parts are the ones recovered after the disassembly of end-of-use/life products. The objective of the considered problem is to maximize the total profit, i.e., the revenue of selling the service parts minus the total cost of the fixed setup, production, disassembly, inventory holding, and disposal over a planning horizon. This paper proves that the single-period version of the considered problem is NP-hard and suggests a heuristic by combining a simulated annealing algorithm and a linear-programming relaxation. Computational experiment results show that the heuristic generates near-optimal solutions within reasonable computation time, which implies that the heuristic is a viable optimization tool for the service parts inventory management. In addition, sensitivity analyses indicate that deciding an appropriate price of disassembled parts and an appropriate collection amount of EOLs are very important for sustainable service parts systems.

Nitroxergic Nerve Relaxes Rat Gastric Smooth Muscle by NO-cGMP Pathway

  • Yoon, Yoong-Sam;Choi, Hyoung-Chul;Jung, Young-Sook;Kim, Jong-Ho;Lee, Kwang-Youn;Sohn, Uy-Dong;Ha, Jeoung-Hee;Kim, Won-Joon
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.5
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    • pp.369-378
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    • 2000
  • This study was undertaken to investigate an involvement of nitroxergic innervation in gastric smooth muscle of rat. Isometric tension study, the measurement of single cell length, NADPH diaphorase stain of smooth muscle layers and neuronal nitric oxide synthase (nNOS) western blotting were performed. Sodium nitroprusside (SNP), a nitric oxide donor, relaxed the muscle strips precontracted by acetylcholine (ACh) in a concentration-dependent manner. Pretreatment of L-arginine decreased the contraction induced by electric field stimulation (EFS). Pretreatment of $N^G-nitro-L-arginine$ methyl ester (L-NAME), a NOS inhibitor, increased the EFS-induced contractions. LY 83583, a guanylate cyclase (GC) inhibitor, reversed the inhibitory actions of L-arginine on the muscle contractions. The effects of L-Arginine, L-NAME and LY 83583 on ACh-induced contractions were not significant. L-arginine reduced the EFS-induced contraction in circular muscle, whereas L-NAME enhanced the EFS-induced contraction in longitudinal strips. By EFS, the phasic contractions appeared approximately $20{\sim}25$ seconds later. L-NAME significantly shortened the delay time to about $2{\sim}3$ seconds. In single cell study, ACh contracted gastric smooth muscle cells, SNP relaxed the cells, and the latter also inhibited the ACh-induced contraction. LY 83583 enhanced the ACh-induced contraction and antagonized SNP-induced relaxation. NADPH diaphorase activity was assessed by a histochemistry, nitroblue tetrazolium (NTB) staining. Positive staining was observed in both circular and longitudinal muscle layers. L-arginine increased the staining, while L-NAME decreased the staining. Western blotting for nNOS proved the presence of nNOS in rat gastric smooth muscle. EFS and additional $Ca^{2+}$ increased nNOS protein expression. These results suggest that in rat stomach, both circular and longitudinal muscle layers are innervated with nitroxergic nerves which relax the gastric smooth muscle via NO-cGMP pathway.

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CLINICOSTASTICAL STUDY OF INPATIENTS OF ABSCESS IN FASCIAL SPACES FOR THE LAST 5 YEARS (최근 5년간 치성감염으로 인한 구강악안면부 근막간극에 발생한 농양환자의 임상 통계학적 검토)

  • Lee, Won-Hyuk;Ahn, Kyung-Mi;Jang, Bo-Young;Ahn, Mi-Ra;Lee, Jung-Yub;Sohn, Dong-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.497-503
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    • 2004
  • One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral & Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.

Effects of one-to-one Labor Support on Labor Pain, Labor Stress Response, Childbirth Experience and Neonatal Status for Primipara (일대일 분만지지간호가 초산모의 분만동통, 분만스트레스 반응, 분만경험 및 신생아 상태에 미치는 효과)

  • Hur, Myung-Haeng
    • Women's Health Nursing
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    • v.7 no.2
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    • pp.188-202
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    • 2001
  • This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

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A Study on Children's Park Facility Planning Scheme according to User Behavior and Characteristics (이용자 행태 및 특성에 따른 어린이공원 시설 계획 방안에 관한 연구)

  • Lee, Dong Hun;Lee, Seok Hwan;Baek, Ki young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.232-241
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    • 2016
  • Among city parks, children's parks are more accessible than other parks in the city, and there are many users. They are used not only for children's playgrounds, but also for relaxation and leisure spaces for local residents. On the other hand, as a result of focusing on the quantitative increase by the engineering division by the Urban park Act, the consideration of the users of various classes is insufficient. The purpose of this study was to analyze the actual use of children parks in single - family housing and communal housing areas, and to identify the problems and future directions of the use of children parks. For this purpose, a case study and a document survey were conducted. First, through scholarship research, the theoretical review and the present situation were summarized based on the data, such as the papers and research reports related to the existing children's park. The status of the location, facilities and management were then identified through interviews and site visits with the children's park management staff. As a result, the children's park was utilized as a leisure space with high accessibility in the living area. As a result, the residence time of most users was within 1 hour to 2 hours. In particular, use by elderly people was higher than the use by children. Therefore, it would be desirable to design the future planning of the children's parks and to plan the arrangement in accordance with the future - oriented multi - purpose neighborhood type children's park.

Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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