• Physical Therapy Korea
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• v.4 no.2
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• pp.18-35
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• 1997

The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by $x^2$ test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was $7.6{\pm}14.9$ degrees in low back pain group, $16.5{\pm}8.7$ degrees in non-low back pain and averaged lordosis angle of resting sitting posture was $10.8{\pm}13.7$ degrees in low back pain, $18.9{\pm}9.6$ degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1210-1219
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• 2001

Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.6 no.1
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• pp.15-26
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• 2000

Purpose : This study was done to examine the actual effect of the scapular position in these flexibility tests. The purpose of this study was to examine the differences between the measurement of SRT(Sit-and-Reach Test) without intentional abduction of the scapular (pre-test) and with intentional abduction of the scapular (post-test). The hypothesis is: 1. There is no differences in the SRT result of the pre-test and the post-test. 2. There is no differences in the HJA(Hip Joint Angle) result of the pre-test and the post-test. 3. There is no differences in the Spine Motion Test(SMT) result of the pre-test and the post-test. Method : The total 60 people (30 men, 30 women) were participated in this study. In the pre-test, the subjects were asked to sit on the examination table and try the SRT motion; and then the HJA, SRT and the SMT numerical values were taken. In the post-test. the subjects were instructed to intentionally bring the scapula outward from the midline; and the HJA, SRT and the SMT numerical values were taken. Result : In the pre-test. the SRT result averaged 34.17cm. and in the post-test. the SRT result averaged 36.68cm. The difference was about 2.81cm which showed a significant mean statistically (p<0.01). The measurement increased by 8.22%. The HJA was $85.9^{\circ}$ in pre-test, and it was $85.5^{\circ}$ in post-test. giving the $0.4^{\circ}$ differences. Therefore, it didn't have a statistical mean (p>0.05). The SMT value was 69.56cm in the pre-test. and it was 69.28cm in the post-test, about 0.28cm decreased. Therefore, it didn't have a statistical mean (p>0.05). SRT values and HJA values were correlated (p<0.01). SMT values and SRT values (p<0.01), and SMT values and HJA values(p<0.05) were each in counter correlation. Conclusion : The result of the SRT without intentional scapular abduction (34.17cm) and with intentional scapular abduction (36.68cm) showed a significant increase about 8.22% (p<0.01). In SRT, the effect of the intentional scapular abduction on SMT showed no significant means, the pretest value being 69.56cm and the post-test value being 69.28cm (p>0.05).

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.240-248
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• 2000

Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

• Progress in Medical Physics
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• v.29 no.1
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• pp.8-15
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• 2018

This work reports the acceptance testing and commissioning experience of the Robotic Intensity-Modulated Radiation Therapy (IMRT) M6 system with a newly released $InCise^{TM}2$ Multileaf Collimator (MLC) installed at the Yonsei Cancer Center. Acceptance testing included a mechanical interdigitation test, leaf positional accuracy, leakage check, and End-to-End (E2E) tests. Beam data measurements included tissue-phantom ratios (TPRs), off-center ratios (OCRs), output factors collected at 11 field sizes (the smallest field size was $7.6mm{\times}7.7mm$ and largest field size was $115.0mm{\times}100.1mm$ at 800 mm source-to-axis distance), and open beam profiles. The beam model was verified by checking patient-specific quality assurance (QA) in four fiducial-inserted phantoms, using 10 intracranial and extracranial patient plans. All measurements for acceptance testing satisfied manufacturing specifications. Mean leaf position offsets using the Garden Fence test were found to be $0.01{\pm}0.06mm$ and $0.07{\pm}0.05mm$ for X1 and X2 leaf banks, respectively. Maximum and average leaf leakages were 0.20% and 0.18%, respectively. E2E tests for five tracking modes showed 0.26 mm (6D Skull), 0.3 mm (Fiducial), 0.26 mm (Xsight Spine), 0.62 mm (Xsight Lung), and 0.6 mm (Synchrony). TPRs, OCRs, output factors, and open beams measured under various conditions agreed with composite data provided from the manufacturer to within 2%. Patient-specific QA results were evaluated in two ways. Point dose measurements with an ion chamber were all within the 5% absolute-dose agreement, and relative-dose measurements using an array ion chamber detector all satisfied the 3%/3 mm gamma criterion for more than 90% of the measurement points. The Robotic IMRT M6 system equipped with the $InCise^{TM}2$ MLC was proven to be accurate and reliable.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.63-74
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• 2008

Purpose : The purpose of this study was to compare trunk repositioning errors between subjects with and without low back pain in sitting and standing. Methods : Total 81 participants were recruited who consisted of 41 subjects with low back pain and 40 normal subjects. The subjects were instructed to replicate the predetermined target positions of the trunk toward upright and $30^{\circ}$ flexion in sitting and standing. During each of movement, digital inclinometer was used to measure the angular movement of $T_{12}$ spinal process. Repositioning error was calculated as the absolute difference between the predetermined target positions and replicated target positions. Results : In subjects with low back pain, upright repositioning error was $1.26^{\circ}{\pm}0.14^{\circ}$ in sitting and $1.55^{\circ}{\pm}0.24^{\circ}$ in standing, and $30^{\circ}$ flexion repositioning error was $3.23^{\circ}{\pm}0.33^{\circ}$ in sitting and $5.50^{\circ}{\pm}0.50^{\circ}$ in standing. In subjects without low back pain, upright repositioning error was $1.38^{\circ}{\pm}0.15^{\circ}$ in sitting and $1.67^{\circ}{\pm}0.18^{\circ}$ in standing, and flexion repositioning error was $2.61^{\circ}{\pm}0.28^{\circ}$ in sitting and $3.70^{\circ}{\pm}0.52^{\circ}$ in standing. It was demonstrated that flexion repositioning error increased significantly in standing position. In subjects with low back pain, $30^{\circ}$ flexion repositioning error was significantly higher in standing than in sitting. Conclusion : The repositioning error of subjects with low back pain increased during flexion and it implies that some aspects of proprioception are decreased in subjects with low back pain. Therefore, it will be emphasis that a clinical trial to increase the trunk flexion stability of subjects with low back pain in standing.

• Journal of Korean Medical Ki-Gong Academy
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• v.11 no.1
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• pp.236-261
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• 2009

'Jeom-hyeol-gigong(點穴氣功)' gives a drill, Gi(氣) as a place to jam. This pathogen(邪氣) is removed. Given the low places and supplement it energy to flow up the well is the cure. This is an internal organ and muscular Gi allows a natural flow. Blood, one that moves and guides Gi is Gi I still feel that it makes any blood, making you feel good in life is flowing with vitality. Gi driving our whole body, while supplying vital energy and blood circulation, helping to defend the body is functioning. 'Jeom-hyeol-gigong' principle of Gi where the blockages to flow naturally energy is to let the flow. Aura of the voluntary and proactive action will be to have healthy bodies. Gi as a whole-body blood circulation leading to the cells in each tissue to supply energy and nutrients to every cell as the original principles of free activities that will maximize your life. Gi to prevent the three causes Internal causes: 5 greed and 7 emotions External causes: climate, food, pathogens, stress, etc. The internal nor the external causes: internal and external factors that cause the complex elements, incorrect position of the bone caused by an imbalance Heart disease will be police officers and raise their resistance to disease than the body, what jung-gi(正氣) have to develop. Beneficial to human body's resistance to raise the jung-gi people young-gi(營氣) and wi-gi(衛氣) should be enhanced. If the form is perfectly possible, Gi cycle itself should not have to breathe. Abdominal diagnosis 'bok-su-ap-an-beop(伏手壓按法)', 'sam-ji-tam-an-beop(三指探按法)' hands are like this, which outlined five viscera in order to understand the problem, the lower side of the clavicle (lung), the pit of stomach (Heart), both the lower ribs (liver), navel below (kidney) can be diagnosed at such areas. In each area of the skin, abdominal muscle tension, aching, or pressing a fuss about, beating the ruling of the state and the problem is a clue. And mo-hyeol(募穴) and certain Acupressure group, the chest, back, belly, so that scattered around each' book 'of the problem can be found. This is also the target of such a diagnosis, such as shape, color of skin, muscle Mostly the scope of the pitch in the cervical spine is broad across the hips. sugi(手氣) method that 'an method(按法) and 'ma method(摩法), bak method(拍法) is.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.47-51
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• 2009

Background: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. Methods: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. Results: The oblique angle was $5.4{\pm}2.9^{\circ}$. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were $3.8{\pm}0.8cm$ and $0.9{\pm}0.6cm$, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were $3.4{\pm}0.7cm$ and $3.9{\pm}0.6cm$, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). Conclusions: The measurements in this study can be used as a reference standards for the blind SIJ block.

• Journal of Biomedical Engineering Research
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• v.39 no.1
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• pp.48-54
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• 2018

In this study, We developed a Ancillary device for child radiography for X-ray of children under 5 years old and verified its effectiveness. Chest X-rays of children younger than 5 years of age were performed by Supine method at the position of Table detector, Short - Source to Image Receptor Distance(SID). Existing Supine and Short -SID imaging methods cause many problems, such as errors in image reading and excessive radiation exposure dose to patients, but the use of an Ancillary device for child radiography(ADCR) solves these problems. A total of 160 children were divided into the Upright group using ADCR and Supine group without ADCR. The chest X-ray image was visually evaluated by two radiologists with reference to the European Commission's List of Quality Criteria for Diagnostic Radiographic Images in Pediatrics. The total score of the qualitative evaluation was 5.15% higher in the chest upright method using ADCR than in the chest supine method without ADCR, and the chest upright method score was higher than that of the chest supine method in items 1 to 7. whether infants have deep inspiration or not, 4.87% higher for item 1, whether infants rotate or not and the degree of tilting, 0% higher for the item 2, the reproduction of image from just above apices of lungs to T12/L1, 0% for the item 3, reproduction of the vascular pattern in central 2/3 of the lungs, 6.92% higher for the item 4, reproduction of the trachea and the proximal bronchi, 12.9% higher for the item 5, visually sharp reproduction of the diaphragm and costo-phrenic angles, 10% higher for the item 6, reproduction of the spine and paraspinal structures and visualisation of the retrocardiac lung and the mediastinum, and 3.65% higher for the item 7. Items 2 and 3 showed no statistically significant differences(P > 0.05), and items 1, 4, 5, 6, and 7 showed statistically significant differences(P < 0.05). In conclusion, Upright method using ADCR in pediatric chest X-ray is considered as a good alternative to existing Supine method.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.45-52
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• 2005

Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.