• Title/Summary/Keyword: Spinal Disease

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General Radiography Examination Statistical analysis of Patients in Geriatric hospitals (노인요양병원 내원환자의 일반촬영 통계분석)

  • Kim, Kyuhyung;Lee, Junhang;Kim, Youngwan
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.71-79
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    • 2013
  • The purpose of this study is to establish the basic data for the management of the elderly patients aged more than 60 suffering from musculoskeletal disorders in geriatric hospitals. From January, 1 2012 to December 31, 2012, 2,500 patients who were taken the x-ray inspection and were analyzed x-ray order 5,042 cases above spines, upper lower extremities and joints. The elderly age was divided into 3 groups according to Brody elderly statistics. The majority of elderly patients who visited the hospital are exposed to spinal disorders and joint diseases. Shoulder, knee, L-spine examination cases had accounted for more than half the number of total. By age group, the number of the first quarter was most dominant commonly. Second and third quarter was maintaining slightly decrease. The fourth quarter had reduced compared to the first quarter. If the visiting purposes and the disease causes analysis and preventive measures are taken in a study, it is expected to utilize as basic data to make a plan of the education for preventing diseases and elderly behavior planning for geriatric hospitals and to redistribute health care resources of the rural areas efficiently.

Cold stress test for the diagnosis of cold hypersensitivity on hands (냉부하검사를 통한 수부냉증의 진단)

  • Han, Ji-Young;Joe, Jung-Hoon;Jang, Jun-Bock;Kim, Yong-Suk;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.2 no.1
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    • pp.17-23
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    • 2003
  • Purpose The cold hypersensitivity is a subjective symptom and it is very difficult to evaluate the severity. It is possible to detect cold hypersensitivity by measuring the skin temperature on DITI, but there is limitation only using DITI to find the objective grade of the symptom. To set a new objective standard for the diagnosis of cold hypersensitivity, we examined the relationship between the Visual Analogue Scale (VAS) score for the cold hypersensitivity and the change of skin temperature on hands by cold stress test Method 23 patients with symptom of cold hypersensitivity were participated as subjects who visited the women medical center of Kangnam Kyunghee Korean Hospital, Kyung Hee Univ. from May 1, 2002 to August 31, 2002. There were all carefully examined to rule out other disease such as obesity, skin diseases, spinal nerve lesions and external wounds. Thermographic observations for this study were made using DITI. We performed cold stress test three times to compare with the results from thermographic observations by DITI: first, after 15 minutes-resting, second, right after 1 minutes soak in $20^{\circ}C$ water, the third for last, 10 minutes after the soak. VAS score was chosen to determine the severity of cold hypersensitivity. Result 1 male and 22 female patients were participated ranging in age from 22.17 to 45.21. There was a significant negative correlation between the recovery rate of finger skin temperature after cold stress test and the VAS score. And there was a significant positive correlation between the difference of finger skin temperature and the back and palm of hands after cold stress test and the VAS score. Conclusion In cold hypersensitivity patients, the cold stress test combined with DITI could be a accurate method for the objective evaluation of cold hypersensitivity, especially good at deciding the severity by numeric values. Using a more strict criterion, as diagnosing of cold hypersensitivity, and longer follow-up may improve the validity of the results attained in clinical trials.

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Case Report of Hemiplegia after apoplexy in a Patient with Monoplegia on Right upper Extremity Treated with Herbal Prescription (우상지(右上肢) 단마비(單痲痺)가 주증(主症)인 풍비 환자의 만금탕가미방(萬金湯加味方) 투여 호전 1례)

  • Jeong, Byeong-Ju;Woo, Sung-Ho;Kim, Byung-Chul;Kim, Yong-Ho;Seo, Ho-Seok;Hwang, Gyu-Dong;Jang, Ha-Jeong;Nam, Hyo-Ick;Kim, Hoi-Young;Kim, Jin-Won
    • The Journal of Internal Korean Medicine
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    • v.27 no.1
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    • pp.288-293
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    • 2006
  • Background : Monoplegia is the paralysis of a limb. It is commonly caused by an injury to the cerebral cortex, and rarely caused by injury to the internal capsule, brain stem, or spinal cord. Most problems with cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. Objectives : This study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment of monoplegia on an upper extremity to test the validity of acupuncture and herbal treatment for it. Methods : By using Digital Infrared Thermographic Imaging(DITI), thermal differences$({\Delta}T)$ of acupoints on the upper extremity in a patient with monoplegia on the right upper extremity were measured after an attack of the disease. By giving Mangeum-tang(萬金湯) and treating the patient with acupuncture. the temperature changes of the upper extremity were examined through DITI and improvement was observed. Results : Compared with the left arm which suffered no such injury, the right recovered about 80% of sensation, and the grade of monoplegia improved from Grade O to Grade V. Also, the temperatures of right palmar-dorsal hand and the region of Weiguan(外關, Waiguan, TE5) were $1^{\circ}C$ and $1.45^{\circ}C$ higher than the same left region on admission day, but the thermal differences$({\Delta}T)$ narrowed to $0.5^{\circ}C$ by the last day. Conclusions : Results suggest that DITI screening is a reliable method of prognosis and that the time required for treatment can be estimated through this method in cases of monoplegia to an upper extremity. Also, progress in treatment is reflected in thermal differences of acupoints of the monoplegic upper extremity in accordance with the theory of meridian. This supports a role for acupuncture and herbal treatment for monoplegia.

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Development of School Health Nursing Phenomena in Korea by Retrospective Method of ICNP (ICNP의 후향적 개발방법에 의한 한국의 학교간호현상)

  • Kim, Young-Im;Young, Soon-Ok;Wang, Myoung-Ja;Kim, Chung-Nam;Kim, Hyeon-Suk;Park, Tae-Nam;Chung, Mi-Ja;Hyun, Hye-Jin
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.595-607
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    • 2002
  • The objectives of this study were to identify the phenomena of school health nursing at schools in Korea and to contribute to building a school health domain of International Classification for Nursing Practice. A retrospective method was used in this study to develop ICNP during the period from July to October 200l. The procedure of the study involved choosing nursing phenomena using preliminary terms from the reports on the field of school health nursing practice documented by nursing students in 10 different nursing colleges. The detail procedures of the study were as follows. 1) Choosing nursing phenomena by using preliminary terms 2) Choosing the characteristics of school health nursing practice from the selected nursing phenomena 3) In order to make a consensus regarding the appropriate characteristics of phenomena. 15 study group members re-categorized the nursing phenomena through 5 times of cyber meetings and 3 times of formal meetings. 4) To verify each characteristic, 5 community nursing faculties and 25 school health nurses participated in the procedure to give scores on nursing characteristics. 5) Classification of the definite nursing phenomena and characteristics. Following the 5 step procedures, school health nursing phenomena were categorized into human and environmental domains. Human domains were classified into human behavioral and functional domains. Environmental domains were classified into physical and psychosocial domains. The essential characteristics of each phenomena were selected when it obtains the mean score of 3.0 or over at the related characteristics. The human behavioral domain consisted of 7 phenomena including risk for spinal disorder, inadequate dietary habit, inadequate weight control, smoking and substance abuse, inadequate stress management, inadequate sex related coping strategies and inadequate accident management. The human functional domain consisted of 6 phenomena including inadequate eye care and visual management, risk for respiratory disorder, inadequate dental health care, inappropriate infectious disease control, risk for gastrointestinal disorder, and lack of sexual identity. The physical environmental domain consisted of 6 phenomena including risk for incident at inside classroom, risk for incident at outside classroom, risk for incident around school, risk for exposure to hazardous facilities around school. inadequate garbage and disposal management, and inadequate physical environment for learning. The psychosocial domain included impaired social interaction at school. Each phenomenon was composed of 2 to 8 characteristics and all phenomena will include a total number of 85 characteristics. The phenomena of school health nursing in Korea partially confirmed school health architecture of ICNP. Further study on verification of school health nursing phenomena in Korea needs to be done to support the findings of this study through review of literature on nursing classifications or field studies.

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Surgical Outcome of Cervical Arthroplasty Using $Bryan^{(R)}$

  • Kim, Hong-Ki;Kim, Myung-Hyun;Cho, Do-Sang;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.532-537
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    • 2009
  • Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

Necessity and Features of Adequate Service for Home Visiting Physical Therapy - by Physical Therapist - (가정방문 물리치료의 필요성 및 적절한 서비스의 특성 - 물리치료사를 대상으로 -)

  • Han, Dong-Uck;Kim, Young-Gun
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.787-798
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    • 2001
  • This study was performed to investigate the necessity and the features of adequate services of home visiting physical therapy for chronic ill patients. The study subjects were physical therapist visited in Taejon for Korea Physical Therapy Association Seminar on March 19, 2000. Authors developed questionnaire and distributed it to each physical therapist attended at the Seminar. The number of distributed questionnaire was 1,500, and 487 questionnaire were collected and 388 questionnaire analysed finally. 1. The rate of necessity for home visiting physical therapy by kinds of disease was 70.6% in cerebral palsy, 84.3% in spinal cord injury, 89.7% in cerebral vascular accident and traumatic brain injury, 20.1 % in other diseases. 2. The rate of necessity of education for home visiting physical therapy was 94.5% of men, 97.3% of women. 54.4% of answerer replied that the best education method was that developed clinical program. 3. In the general features of adequate service for home visiting physical therapy, 70.9% of men and 69.1 % of women want special isolated physical therapy center, 61.8% of men and 63.7% of women want distance of 15minutes-29minutes by car. 59.4% of men and 47.5% of women want 3 times per week in frequency(P<0.05), 70.9% of men and 61.0% of women want 30-60minutes in treatment duration. and 47.2% of men and 51.6% of women want to teach only evaluation and treatment method. 4. In the payment of adequate service for home visiting physical therapy, 47.9% of men and 49.3% of women want insurance with private charge (P<0.05), 58.8% of men and 55.2% of women want insurance direct charge and traffic fee and visiting fee for the private charge. 37.0% of men wants 4,000won-4,900won and 32.7% of women wants 2,000won-2,900won for the traffic fee. 43.0% of men wants 5,000won-9,900won and 48.0% of women wants 5,000won-5,900won for the visiting fee. 5. In the qualifications for home visiting physical therapy, 44.8% of men wants to have license and learn home treatment method but 47.1% of women wants to have license and career and learn home treatment method(P<0.05). In the career, 38.8% of men wants above 5 years, 39.5% of women wants above 3 years(P<0.01). 63.0% of men and 66.4% of women answered with unconcern but 18.8% of men wants physical therapist worked in general hospital and 20.6% of women wants in welfare center(P<0.01). 92.7% of men and 92.4% of women answered no interested in physical therapist's gender. The most preferential age of home visiting physical therapist was also no interested in physical therapist's age.

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A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

  • Kim, Sam Yeol;Yoon, Seung Hwan;Kim, Dokeun;Oh, Chang Hyun;Oh, Seyang
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.691-700
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    • 2017
  • Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

Effects of Sa-am Acupuncture Treatment on a ALS(Amyotrophic Lateral Sclerosis) Patient (근위축성 측삭 경화증 환자 1례를 대상으로 한 사암침법의 효과)

  • Lee, Sang-Mi;Kim, Sung-Ha;Jeong, Ho-Hyun;Park, Man-Yong;Lee, Jeong-Ju;Park, Ok-Ju;Lim, Jin-Young;Kim, Dong-Woung;Song, Bong-Keun;Kim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.29 no.5
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    • pp.187-195
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    • 2012
  • Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive and incurable disease that causes degeneration of the motor neurons of the brain stem and spinal cord. The purpose of this study was to report the effectiveness of Sa-am acupuncture treatment on ALS patient. Methods : Following the stabilization period, a ALS patient respiratory figures(Et $C_{O2}$, Sp $_{O2}$, RR, pulse) were measured by using capnography & pulse oximetry for 30 minutes before acupuncture treatment. Acupuncture treatment such as lung tonification($SP_3(+){\cdot}LU_9(+){\cdot}HT_8(-){\cdot}LU_{10}(-)$), heart tonification($HT_9(+){\cdot}LR_1(+){\cdot}SI_8(-){\cdot}KI_{10}(-)$), liver tonification ($KI_{10}(+){\cdot}LR_8(+){\cdot}LU_8(-){\cdot}LR_4(-)$) were conducted for 5 days. Each Sa-am acupuncture treatment conducted at AM 7 : 00, AM 11 : 00, PM 4 : 30 of the day. During acupuncture treatment, the patient respiratory figures were measured equally for 30 minutes. The patient was treated by using Dong-bang acupuncture needles($0.30{\times}4.0$) and also stimulated using infra red. Results : The value of Et $C_{O2}$ has decreased more after Sa-am acupuncture lung tonification treatment than others. The value of pulse has decreased more after Sa-am acupuncture heart tonification treatment than others. The value of raspiration rate has decreased more after Sa-am acupuncture liver tonification treatment than others. And the value of Sp $O_2$ has increased more after Sa-am acupuncture liver tonification treatment than others. Conclusions : Although this study was subject to a few limitations, but it shows that Sa-am acupuncture treatment for ALS patients has a meaningful effect. This study needs to be developed further using a larger sample size to obtain more valuable and meaningful data.

Systematic Review of High Frequency of Acupuncture Point and Self Exercise Therapy for Lower Back Pain (요통 치료의 빈용 경혈과 자가 운동 요법에 대한 체계적 문헌 고찰)

  • Nam, Dae-Jin;Huh, Gun;Lee, Hyung-Eun;Choi, Bo-Mi;Lee, Jung-Min;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.59-71
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    • 2013
  • Objectives The aim of this review is to figure out which acupoints are frequently used to treat low back pain and which exercises are effective to low back pain. Methods We searched the three electronic database (RISS, KISS, KTKP) and manually checked related Korean journals and reference lists up to June 2013. We investigated the frequency of acupoints for using treatment of low back pain. We Introduce exercise therapies we can do easily at home without professional skills for treatment low back pain. Results We included 72 articles in this study. The most frequently adopted acupoints were BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34, BL52, BL57, GB39. The most frequently adopted meridian pathways were BL, GB, GV, ST. The most frequently adopted disease causing low back pain were HIVD (Herniated intervertebral disc), Lumbar sprain, Spinal stenosis, Compression fracture, Cauda equina syndrome, Spondylolisthesis, Ankylosing spondylitis. There are many exercise therapies (Lumbar stabilizing exercise, Resistance exercise, Bareunmom physical exercise, Mckenzie exercise, Williams exercise, Emblass exercise, Swiss ball exercise, Thera band exercise, Yoga) for treatment low back pain. Conclusions These results suggest that most frequently adopted acupoints were foot taeyang urinary bladder channel acupoints. Beacuse foot taeyang urinary bladder channel is passes through the waist, it will be effective for treatment of low back pain. Also exercise therapy is effective for enhance Muscular strength. In order to treatment of low back pain, Acupuncture treatment is also important, as well as exercise therapy.

Clinical Manifestation of Eosinophilic Meningitis in Korean Children: A Single Institution's Experience (단일기관에서 소아 호산구성 수막염의 임상특징 분석)

  • Byun, Jung Hee;Choi, Seong Yeol;Kim, Dong Soo;Kim, Ki Hwan
    • Pediatric Infection and Vaccine
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    • v.22 no.1
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    • pp.23-28
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    • 2015
  • Purpose: The aim of this study was to investigate the clinical manifestations and laboratory characteristics of eosinophilic meningitis in Severance Children's Hospital. Methods: We examined 6,335 children under the age of 18 years old who had visited the tertiary hospital in Seoul, Korea, and had received cerebrospinal study results between January 2007 and July 2012. The medical records of the patients identified as eosinophilic meningitis were retrospectively reviewed. Results: Eosinophilic meningitis was diagnosed in 39 patients (0.6%). The mean age was 6 years (range 0-18 years) and the sex ratio was 1.3:1 (22 males and 17 females). The underlying diseases and past history were neurologic disease (n=36, 92%). Eosinophilic meningitis was diagnosed in thirty-five patients who had undergone postoperation neurosurgery (90%). The most common symptoms were fever (50%), headache (20%), vomiting (15%), seizure (10%), and dizziness (5%). The average duration for recovery was five days, and intravenous antibiotics or steroids were used. Conclusions: Manifestations of eosinophilic meningitis are similar to other types of meningitis. The most common cause of eosinophilic meningitis in children was neurosurgery. Eosinophilic meningitis should be considered for patients showing fever and headache after neurosurgery. Through careful investigation, use of improper antibiotics could be avoided.