• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.883-890
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• 2001

Objectives : An in vitro biomechanical study of posterior lumbar interbody fusion(PLIF) with threaded cage using two different approaches was performed on eighteen functional spinal units of bovine lumbar spines. The purpose of this study was to compare the segmental stiffnesses among PLIF with one long posterolateral cage, PLIF with one long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages. Methods : Eighteen bovine lumbar functional spinal units were divided into three groups. All specimens were tested intact and with cage insertion. Group 1(n=12) had a long threaded cage($15{\times}36mm$) inserted posterolaterally and oriented counter anterolaterally on the left side by posterior approach with left unilateral facetectomy. Group 2(n=6) had two regular length cages($15{\times}24mm$) inserted posteriorly with bilateral facetectomy. Six specimens from group 1 were then retested after unilateral facet joint screw fixation in neutral(group 3). Likewise, the other six specimens from group 1 were retested after fixation with a facet joint screw in an extended position(group 4). Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and torsion. Results : PLIF with a single cage, group 1, had a significantly higher stiffnesses than PLIF with two cages, group 2, in left and right torsion(p<0.05). Group 1 showed higher stiffness values than group 2 in pure compression, flexion, left and right bending but were not significantly different. Group 3 showed a significant increase in stiffness in comparison to group 1 for pure compression, extension, left bending and right torsion(p<0.05). For group 4, the stiffness significantly increased in comparison to group 1 for extension, flexion and right torsion(p<0.05). Although there was no significant difference between groups 3 and 4, group 4 had increased stiffness in extension, flexion, right bending and torsion. Conclusion : Posterior lumbar interbody fusion with a single long threaded cage inserted posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. In combination with a facet joint screw fixation, adequate postoperative stability can be achieved. We suggest that posterolateral insertion of a long threaded cage is biomechanically an ideal alternative to PLIF.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.5
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• pp.894-899
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• 2001

Intakes and excretions of zinc and copper were determined for 8 female adolescents (aged 16.4$\pm$0.5 y; body mass index 20.4$\pm$1.3kg/$m^2$; body fat 33.3$\pm$2.5%; bone mineral density of lumbar spine in L2-L4; 0.96$\pm$0.08g/$\textrm{cm}^2$) when they consumed diets basal and high in calcium for 6 days each. All subjects consumed a basal Ca diet containing 800 mg, Korean RDA level of the subjects, and a high Ca diet containing 1200mg, RDA plus 2 SDs of calcium intake. The diets provided 58% of energy intake as carbohydrate, 25% as fat, and 17% as protein. Food, urine and fecal samples were collected during the last 3 days of each feeding period and were assayed. Mean daily intakes on the basal and high calcium diets, respectively, were 6.57 and 6.37 mg for zinc and 910 and 812 $\mu\textrm{g}$for copper. Fecal excretion of copper and zinc in relation to intake was significantly greater on the high calcium than on the basal calcium diet. Hence, apparent absorption rate was significantly lowered from 98.7% on the basal calcium diet to 97.9% on the high calcium diet for zinc from 66.3% to 56.4% for copper, respectively. Urinary loss of copper was not detectable but that of zinc was 0.38mg on the basal diet and 0.47mg on the high calcium diet. Copper retention was 899$\pm$105$\mu\textrm{g}$/day on the basal calcium diet and 792$\pm$20.8$\mu\textrm{g}$/day on the high calcium diet, and zinc retention was 3.95$\pm$0.91mg/day and 3.11$\pm$0.89mg/day. Thus, copper and zinc retention was significantly decreased on the high calcium diet (p<0.05). Summarizing the results, apparent absorption and retention of zinc and copper were significantly decreased by calcium supplementation. Therefore, it is suggested that interactions among minerals should be considered in determining RDA.

• 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 Society of Radiology
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• v.15 no.1
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• pp.63-70
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• 2021

Radiographic contrast agents are used for diagnostic purposes and are one of the factors affecting measured values in bone density tests. They are absorbed into tissues and have an effect of increasing the measured values of bone density, so they are avoided as much as possible before performing a bone density test. MRI contrast agents, which have different physical properties and mechanisms of action than radiographic contrast agents, are based on gadolinium, a metal element. They have radiopacity characteristics, so MRI are generally performed prior to examination using radiation. The purpose of this study was to investigate the effects of MRI contrast agents on bone mineral density examination using dual energy X-ray absorption. Two types of gadolinium based MRI contrast agents were injected into an acrylic water tank for each volume, and the humanoid spine phantom was inserted and the BMD and T-score from (L1-L4) were analyzed by scanning a total of 30 times, 5 times for each injection type. The average value of the measured total (L1-L4) bone density for each of the two contrast agents was 0.952±0.052, 0.957±0.050, and 0.956±0.05g/㎠, respectively, for the Gadoterate Meglumine component 0mL, 7.5mL and 15mL, when the gadobutrol components were 0mL, 5mL, and 10mL, there was no statistically significant difference at all sites at 0.953±0.001, 0.954±0.001, and 0.945±0.001g/㎠, respectively(p>0.05). The average value of total T-score was -0.46±0.05, -0.4±0, -0.42±0.04 when the Gadoterate Meglumine component was 0mL, 7.5mL and 15mL, respectively. When the Gadobutrol ingredients were 0mL, 5mL and 10mL, there was no statistically significant difference in all areas, with -0.46±0.05, -0.46±0.05, and 0.5±0.00, respectively. In this experiment, the MRI contrast agent was found to have no effect on bone density tests, using the dual-energy X-ray absorption method. There is a limitation in that physical conditions such as kidney and health conditions etc. were not taken into consideration, so further clinical research is expected to be conducted in the future.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.383-396
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• 2020

Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.

• 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 the Korean Orthopaedic Association
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• v.56 no.6
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• pp.512-518
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• 2021

Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.419-426
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• 2021

Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.

• Journal of the East Asian Society of Dietary Life
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• v.20 no.2
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• pp.218-230
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• 2010

This study was conducted to survey isoflavone intake among adult women in menopause with diseases such as metabolic syndrome and osteoporosis and to analyze the relationship between each of these chronic diseases followed by isoflavone intake and the related health risk index. The average age of the subjects was 49.97 years old, while that of the pre-menopausal subjects was 45.14 years, and the post-menopausal subjects was 55.99 years. The average body mass index (BMI), waist-hip circumference, body fat percentage, blood pressure, blood sugar and blood lipid content of the post-menopausal subjects were higher in significant difference than those of the pre-menopausal subjects. The bone density of the hip and spine in post-menopausal subjects was lower in significant difference than that of the pre-menopausal subjects. After menopause, the subjects had a lower ratio of individuals at risk of anemia when compared with the subjects before menopause, but had higher health risk ratio related to each type of chronic disease, including obesity, hypertension, high cholesterol and osteoporosis than the subjects before menopause. The intake frequency of each soybean food was similar among subjects before/after menopause. The most common soybean based foods consumed by the subjects were soybean, soybean curd and soybean paste. The average daily intake level of isoflavone among subjects before menopause was 25.48 mg, while that of subjects after menopause was 32.25 mg. Evaluation of the distribution of the isoflavone level revealed that the pre-menopausal subjects consumed 3.29~78.36 mg and the post-menopausal subjects consumed 3.18~116.59 mg. The intake level by each individual varied greatly. The pre-menopausal subjects had a low BMI index and systolic blood pressure as much as their isoflavone intake level was high. Additionally, the post-menopausal subjects had a low menarche age and high menopause age when their isoflavone intake level was high, the BMI index and waist-hip circumference ratio was highest among individuals with lowest isoflavone intake level. This study showed that there was a possible relationship between soybean isoflavone intake and health problems such as obesity, high cholesterol, and osteoporosis in women after menopause with diseases such as metabolic syndrome and osteoporosis, even if this relationship was not great.