• Title/Summary/Keyword: Spinal Disease

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A Study on the Demand for Equipent Development in Nursing (간호기기 개발수요 조사연구)

  • Chang, Soon-Book;Kim, Eui-Sook;Whang, Ae-Ran;Kang, Kyu-Sook;Suh, Mi-Hae
    • The Korean Nurse
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    • v.35 no.2
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

A Trend Analysis of Dynamic Chair and Applied Technology

  • Hyeong, Joon-Ho;Roh, Jong-Ryun;Park, Seong-Bin;Kim, Sayup;Chung, Kyung-Ryul
    • Journal of the Ergonomics Society of Korea
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    • v.33 no.4
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    • pp.267-279
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    • 2014
  • Objective: The objective of this study was to define the Dynamic Sitting (DS) through trend analysis and research on the Dynamic Chair (DC) and applied technologies. Background: The effects of changing posture on the human body have been studied to find out healthy sitting postures. It is believed that changing posture is effective in reducing disc pressure on spinal cord and preventing back pain and musculoskeletal disease. But, the definition of DS and trends of DC have not been researched yet. Therefore, trend analysis of DC and its applied technologies are required to define dynamic sitting posture. Method: We researched the type of occupant postures from previous studies. And then, sitting behaviors were classified into three types; (1) sitting and standing, (2) working and studying, (3) taking a rest. Results: Variety shapes of DC and applied technologies were found out. From the result, the trend of DC and applied technology were summarized from three perspectives. ; (1) changing the chair functions according to user's intention, (2) conversion of dynamic chair technologies to office chair mechanism, (3) enables the user to change their sitting posture without operating control device. Conclusion: From this study, we defined dynamic sitting posture and analyzed the trend of DC and its applied technologies. This result might be used to develop an office chair for healthy sitting. But further investigation is required to figure out the technologies and functions for development of healthy chair. Application: The results of the publishing trend analysis might help to determine design concept of office chair.

Epidemiology of Primary CNS Tumors in Iran: A Systematic Review

  • Jazayeri, Seyed Behzad;Rahimi-Movaghar, Vafa;Shokraneh, Farhad;Saadat, Soheil;Ramezani, Rashid
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3979-3985
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    • 2013
  • Background: Although primary malignant CNS tumors are registered in the national cancer registry (NCR) of Iran, there are no available data on the incidence of the primary malignant or benign CNS tumors and their common histopathologies in the country. This study analyzed the 10-year data of the Iranian NCR from March 21, 2000 to March 20, 2010, including a systematic review. Materials and Methods: The international and national scientific databases were searched using the search keywords CNS, tumor, malignancy, brain, spine, neoplasm and Iran. Results: Of the 1,086 primary results, 9 papers were selected and reviewed, along with analysis of 10-year NCR data. The results showed that primary malignant brain tumors have an overall incidence of 2.74 per 100,000 person-years. The analysis of the papers revealed a benign to malignant ratio of 1.07. The most common histopathologies are meningioma, astrocytoma, glioblastoma and ependymoma. These tumors are more common in men (M/F=1.48). Primary malignant spinal cord tumors constitute 7.1% of the primary malignant CNS tumors with incidence of 0.21/100,000. Conclusions: This study shows that CNS tumors in Iran are in compliance with the pattern of CNS tumors in developing countries. The NCR must include benign lesions to understand the definitive epidemiology of primary CNS tumors in Iran.

Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI

  • Ahn, Sang-Soak;So, Wan-Soo;Ku, Min-Geun;Kim, Sang-Hyeon;Kim, Dong-Won;Lee, Byung-Hun
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.129-136
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    • 2016
  • Objective : The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods : A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results : Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion : The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

Domestic and Foreign Research Trend on the Pediatric Chuna Treatment (소아 추나에 대한 국내·외 연구 동향)

  • Lee, Jin Hwa;Han, Jae Kyung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.4
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

2 Cases of Amyotrophic Lateral Sclerosis(ALS) with Oriental Medical Treatment Evaluated by K-ALSFRS-R and ALSSS (K-ALSFRS-R과 ALSSS로 평가한 근위축성 측삭 경화증 2례 증례보고)

  • Ryu, Mi-Seon;Wi, Jun;Bang, Sung-Pil;Lee, Ji-Eun;Kim, Jae-Hong;Yun, Yeo-Choong
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.173-185
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    • 2009
  • Objectives : Amyotrophic Lateral Sclerosis(ALS) is a progressive disease that causes degeneration of the motor neurons of the brain and spinal cord. The purpose of this case study is to improvement of oriental mediacl treatment on ALS. Methods : The patients were treated by acupuncture, moxibustion, cupping therapy, herbal medication, physical treatment. To determine the effects of Oriental medical treatment, we evaluated weekly used by Korean version of Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised(K-ALSFRS-R), Amyotrophic Lateral Sclerosis Severity Scale(ALSSS). Results : Symptoms such as cervical and shoulder pain, knee pain, cold sweating, insomnia etc were improved after above treatment. But K-ALSFRS-R and ALSSS were no improvement after above treatment. Conclusions : The Oriental medical treatment is effective on local symptoms of ALS, but there were no functional improvement of ALS in this case study. It is necessary to have more examination about ALS.

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A Case of Fatal Hyperinfective Strongyloidiasis with Acute Respiratory Failure and Intestinal Perforation in Lung Cancer Patient (폐암환자에서 급성호흡부전과 장천공을 동반한 분선충 감염증 1예)

  • Kim, Hyeon-Sik;Kim, Yu-Eun;Yun, Eun-Young;Ju, Ji-Hyun;Ma, Jeong-Eun;Lee, Gi-Dong;Cho, Yu-Ji;Kim, Ho-Cheol;Lee, Jong-Deok;Hwang, Young-Sil;Jeong, Yi-Yeong
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.29-33
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    • 2010
  • Strongyloides stercoralis is an intestinal nematode that is a parasite to humans. The infecting filariform larvae of S. stercoralis enters the host body via the bloodstream, passes through the lungs, penetrates the alveoli, and then ascends the airway to transit down the esophagus into the small bowel. The infection can persist for decades without causing major symptoms and can elicit eosinophilia of varying magnitudes. Of note, this infection can also develop into a disseminated, often fatal, disease (hyperinfection) in patients receiving immunosuppressive corticosteroids. A 65-year-old man who was receiving corticosteroid therapy for the treatment of spinal stenosis was admitted to the emergency room with complaints of abdominal pain and severe dyspnea. We detected many S. stercoralis larvae in the sputum and in the bronchoalveolar-lavage sample collected by bronchoscopy. Here, we report a fatal case of strongyloidiasis with acute respiratory failure and intestinal perforation. In addition, we provide a brief review of the relevant medical literature.

Case Report on 4 Patients with Lumbar Disc Herniation Treated with Concurrent Embedding Therapy under Conventional Korean Medical Treatments (매선요법을 병행한 요추 추간판 탈출증 환자 치험 4례)

  • Lee, Hyung Ggeol;Im, Jeong Gyun;Jung, Da Jung;Yook, Tae Han;Kim, Jong Uk
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.124-129
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    • 2013
  • Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.

C7 Posterior Fixation Using Intralaminar Screws : Early Clinical and Radiographic Outcome

  • Jang, Sang-Hoon;Hong, Jae-Taek;Kim, Il-Sup;Yeo, In-Sung;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.129-133
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    • 2010
  • Objective : The use of segmental instrumentation technique using pedicle screw has been increasingly popular in recent years owing to its biomechanical stability. Recently, intralaminar screws have been used as a potentially safer alternative to traditional fusion constructs involving fixation of C2 and the cervicothoracic junction including C7. However, to date, there have been few clinical series of C7 laminar screw fixation in the literature. Thus, the purpose of this study is to report our clinical experiences using C7 laminar screw and the early clinical outcome of this rather new fixation technique. Methods : Thirteen patients underwent C7 intralaminar fixation to treat lesions from trauma or degenerative disease. Seventeen intralaminar screws were placed at C7. The patients were assessed both clinically and radiographically with postoperative computed tomographic scans. Results : There was no violation of the screw into the spinal canal during the procedure and no neurological worsening or vascular injury from screw placement. The mean clinical and radiographic follow up was about 19 months, at which time there were no cases of screw pull-out, screw fracture or non-union. Complications included two cases of dorsal breech of intralaminar screw and one case of postoperative infection. Conclusion : Intralaminar screws can be potentially safe alternative technique for C7 fixation. Even though this technique cannot be used in the cases of C7 laminar fracture, large margin of safety and the ease of screw placement create a niche for this technique in the armamentarium of spine surgeons.