• Trans-
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• v.8
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• pp.95-127
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• 2020

This research is based on using Bartenieff Fundamentals to analyze the fundamentals of Tai Chi Chuan's movements in order to develop the methods of relaxation from Tai Chi Chuan's principle movement movements It also shows that the two techniques have commonalities in many ways. First of all, taking a philosophical approach on the body movements of Tai Chi Chuan and Bartenieff, for both methods the ultimate goal is the integration of mind and body. In other words, there is a thread of connection between the East's body and mind monism and the west's Body Awareness. Secondly, looking at it from a Breath Support standpoint as used in the Bartenieff method, the two methods both use the breathing to naturally move the body and relax the body. In Tai Chi Chuan the Breath is the basis of life and the strength of the Body. So the breathing of Tai Chi chuan is what makes body and mind communicate, harmonize and integrate. In other words, Breathing in Tai Chi is realized through mental fusion and affects the movements. This is the same as the Breath Support of Bartenieff. It is said that in every aspect the Breath Support of Bartenieff influences the movement and changes both the inner and outer form of the body. Thirdly, looking at the Core Support used in the Bartenieff method, both methods emphasize core. At the same time of moving and being conscious of one's core, the usage of muscles can be deeper rather than superficial and this enables strong and flexible movement. In Tai Chi Chuan abdominal muscles used when one coughs are consciously engaged through abdominal breathing and so strength is collected in the core. When one exercises like that the core becomes more stable and breathing becomes more smooth. Fourthly, analyzing the Rotary Factor used in the Bartenieff Fundamentals, they both use rotary movement to reach the goal of physical relaxation. The rotation factor of Bartenieff allows movement to be easier and more free because of the characteristic of joint exercise where the center axis moved in three dimensions, this is the same in Tai Chi chuan. According to Tai Chi chuan's circle and Spiral Movements, it can achieve the relaxation through switching into a seamless flow and access space as much as possible. Finally, when looking at Developmental Patterning through Bonnie Bainbridge Cohen's Body-Mind Centering Work theory, presented from Bartenieff developmental model are similar with the developmental process of Tai Chi chuan Breath, Core-Distal Connectivity/Navel Radiation, Head-Tail Connectivity/Spinal Movement, Upper-Lower Connectivity/Homologous, Body-Half Connectivity/Homo-Lateral Connectivity, Cross-Lateral Connectivity/Contra-Lateral Connectivity. They are all similar. In other words, in Tai Chi Chuan energy is gathered in the core through breathing, upper and lower body are connected through the spine, not only homo-laterally but also cross-laterally. Through this study the expression of the dance movements can be more natural. Additionally based on the Body Awareness balance usage of the central axis, joints and body can develop the relax technique.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.411-417
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• 2020

Purpose: This paper reports the short-term clinical and radiological results of unilateral biportal endoscopic decompression (UBE) to prove its efficacy. Materials and Methods: Twenty patients who received unilateral biportal endoscopic far-lateral decompression (UBEFLD) were analyzed statistically using the visual analogue scale (VAS), modified Macnab criteria and Oswestry Disability Index (ODI) clinically. Radiologically, their intervertebral angle (IVA), percentage slip, disc height index (DHI) and foraminal height index (FHI) were analyzed pre- and postoperatively. Results: The VAS scores were 6.20 preoperatively, which improved to 2.05, 1.75 and 1.45 at postoperative one month, three months and one year, respectively (p<0.001). The modified macnab criteria in both the good or excellent category was 70.0%, 80.0% and 85.0% at postoperative one month, three months and one year, respectively (p=0.034). The ODI improved from 59.8% preoperatively to 35.8%, 33.2%, and 17.1% at postoperative one month, three months, and one year, respectively (p<0.001). The IVA was increased 0.40±0.88 after a surgery (p=0.057). Percentage slip was increased 0.19% after surgery (p=0.134). The DHI changed from 0.49 preoperatively to 0.62 postoperatively (p=0.359), and the FHI changed from 0.71 preoperatively to 0.79 postoperatively (p<0.001). Conclusion: UBEFLD displayed satisfactory results. Such a result highlights the potential of UBEFLD as an excellent alternative to spinal fusion or microscopic surgery.

• Journal of Life Science
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• v.32 no.4
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• pp.325-330
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• 2022

While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.310-316
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• 2021

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm³ (32,400-203,904/mm³), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.418-425
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• 2020

Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.83-91
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• 2017

Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.182-188
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• 2003

Background: Although ramicotomy (division of the rami communicantes of the thoracic sympathetic ganglia) is a selective and physiological surgical method for essential hyperhidrosis, it has some problems such as higher recurrence rates and the different surgical results among the patients and between left and right sides in the same individual. As one of the factors that are related to the differences in surgical result and recurrences, we investigated the anatomical variations of the rami communicantes. The purpose of this study is to help develop new surgical methods to decrease surgical differences among the patients or between the left and right sides of the same individual and recurrence rates in the clinical application of ramicotomy. Material and Method: We dissected 118 thoracic sympathetic chains in 59 adult Korean cadavers (male: 33, female: 26) to examine the anatomical variations of the rami communicantes from the second to the fourth thoracic sympathetic ganglia that have major components innervating to the hands. After the dissection of bilateral thoracic sympathetic chains, we compared the anatomy of left and right sides and examined the anatomical variations of rami communicantes. Result: The number and variation of communicating rami connecting the spinal nerves and the second sympathetic thoracic ganglion were much larger than lower levels. There was considerably less variability in the anatomy of the rami communicantes at successive levels. Among the 59 cadavers dissected, only 14.3% (9/59) had similar anatomy of thoracic sympathetic chains at both sides. As the components related to the essential palmar hyperhidrosis, intrathoracic nerve of Kuntz from the second thoracic sympathetic ganglion to the first intercostal nerve or brachial plexus were observed in 55.9% (66/118). The incidence of descending rami communicates from the second thoracic sympathetic ganglion to the third intercostal nerve and from the third thoracic sympathetic ganglion to the fourth intercostal nerve were 49.2% (58/118) and 28.0% (33/118). And the incidence of ascending rami communicates from the third thoracic sympathetic ganglion to the second intercostal nerve and from the fourth thoracic sympathetic ganglion to the third intercostal nerve were 6.8% (8/118) and 3.4% (4/118), respectively. Conclusion: Based on the various anatomical evidences of the rami communicantes from this study, only the ramicotomy at the third sympathetic ganglion level is insufficient for the treatment of the essential palmar hyperhidrosis to decrease the difference of surgical results and recurrences. When one is planning to perform the ramicotomy for the essential palmar hyperhidrosis, it is advantageous to divide the intrathoracic nerve of Kuntz on the second rib and the descending or ascending rami communicantes on the third and the fourth ribs as well as all the communicating rami from the third sympathetic ganglion.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.471-478
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• 1997

Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

• Journal of Haehwa Medicine
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• v.8 no.2
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• pp.211-243
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• 2000

This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.