• The Korean Journal of Pain
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• 제1권2호
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• pp.164-170
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• 1988

상북부 통증을 호소하는 암성통증 환자 18예, 만성 췌장염환자 4 예에서 통증제거 목적으로 60% dehydrated ethanol 30~50ml을 방척추법으로써 복강신경총의 지각전도를 차단한 후 얻은바 결론을 다음과 같이 요약한다. 1. 위암, 간암, 췌장암등으로 인한 상복부 통증에 대해서 86%의 우수한 진통효과가 있었다. 2. 만성췌장염 환자에서도 양호한 효과를 얻을 수 있었다. 3. 진통효과의 지속시간은 55%에서 약 4개월 내지 7개월간 지속되었다. 4. 시술후 일시적인 기립성 혈압하강이 16%에서 나타났다. 5. 시술후 합병증은 경미한 정도에서 안면홍조 혈압하강 요통등이 있었다. 6. 시술전 마약성 약물 사용이 습관화된 경우는 시술후 마약성 약물 투여금단 효과를 억제하기 어려웠다.

• 대한방사선치료학회지
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• 제33권
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• pp.35-46
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• 2021

목 적 : 폐암의 정위 절제 방사선 치료(Stereotactic Ablative Radiation Therapy, SABR)시 복부압박을 이용한 치료계획과 양압지속유지기(The Continuous Positive Air Pressure, CPAP)를 이용한 치료계획을 비교, 분석하여 방사선 치료 효과 향상에 기여하고자 한다. 대상 및 방법 : 본원의 폐의 SABR 환자 중 2명을 대상으로 복부 압박 고정 장치(the Body Pro-Lok, BPL)와 CPAP를 이용한 치료 계획을 수립하여, RTOG 0813에서 제안한 parameter들과 균질도(Homogeneity Index, HI), 일치도(Conformity Index, CI)를 통해 치료계획을 분석하였다. 또한 모든 4D CT에서 각 Phase별 계획용 표적 체적(Planning Target Volume, PTV) 중심의 X, Y, Z축 움직임을 분석하고, PTV와 손상위험장기(Organ At Risk, OAR)의 체적과 평균 선량을 구하여 비교하였다. 그리고 4개의 원뿔형빔 전산화단층촬영(Cone Beam Computed Tomography, CBCT)을 이용하여, PTV 중심점과 0°, 90°, 180°, 270° 중 세 방향에서의 흉강내 접점까지의 직선거리를 측정하고, 각 방향에서 평균거리 값과의 차이를 비교하였다. 결 과 : BPL과 CPAP를 사용하여 얻은 치료계획은 모두 RTOG의 권고값을 따랐으며, 균질도와 일치도에서도 큰 차이가 없었다. PTV 중심의 X축, Y축, Z축 움직임은 A 환자의 경우 BPL 사용시 0.49 cm, 0.37 cm, 1.66 cm, CPAP 사용시 0.16 cm, 0.12 cm, 0.19 cm을 보였고, B 환자의 경우 BPL 사용시 0.22 cm, 0.18 cm, 1.03 cm, CPAP 사용시 0.14 cm, 0.11 cm, 0.4 cm을 보였다. CPAP 사용시 BPL 사용시보다 A 환자의 경우 ITV가 46.27% 감소하였고 좌측 폐의 체적이 41.94% 증가하였으며, 평균선량은 심장에서 52.81% 감소하였다. B 환자의 경우 좌측 폐 106.89%, 우측 폐 87.32% 체적이 증가하였고, 평균선량은 위에서 44.30% 감소하였다. 각 방향의 직선거리 값과 평균거리 값과의 최대 차이는 A 환자의 경우 a방향에서 0.05 cm, b방향에서 0.05 cm, c방향에서 0.41 cm 났고, B 환자의 경우 d방향에서 0.19 cm, e방향에서 0.49 cm, f방향에서 0.06 cm 차이가 났다. 결 론 : CPAP 사용시 폐용적의 증가를 통해 표적 근처 OAR의 선량을 BPL 사용시보다 더 효과적으로 감소시킬 수 있으며, 호흡에 따른 종양의 움직임 제한에도 더 효과적으로 기여할 수 있다는 것을 확인하였다. 추후 CPAP의 다양한 부위 적용과 다른 치료기와의 결합을 통해 방사선 치료 효과를 개선시킬 수 있을 것으로 사료된다.

• 재활복지공학회논문지
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• 제11권3호
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• pp.207-214
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• 2017

몸통안정성에 문제가 발생하면 허리에 통증이 발생된다. 허리 불안정성을 해소하기 위한 몸통안정화운동 방법 중 하나인 복부드로우인기법(ADIM)은 복부안정화근육 중 선행적자세조절과 관련된 배가로근에 대한 선택적인 수축을 유도하는 운동법이다. ADIM은 일반적으로 바로누운자세에서 허리 밑에 압력생체되먹임장치(PBU)을 적용하여 시각적되먹임을 한 상태에서 실시하는데 이러한 자세는 앉은자세에 비해 기능적이지 못하다. 본 연구에서는 바로누운자세와 앉은자세에서 실시하는 ADIM의 효과를 알아보기 위해 31명의 건강한 남녀를 대상으로 무선 근전도를 이용해 배곧은근(RA), 배바깥빗근(EO), 배가로근/배속빗근(TrA/IO), 그리고 척추세움근(ES)에 대한 근활성도를 비교하였다. 본 연구 결과 RA와 EO에서는 두 자세 간에 유의한 차이가 없었으며 TrA/IO와 ES에서는 두 자세 간에 유의한 차이가 나타났다. 또 RA에 비해 TrA/IO의 활성도가 높게 나타나 ADIM로 인한 몸통안정화는 두 자세 모두에서 효과적으로 나타났으며 반면 TrA/IO와 ES는 앉은 자세에서 더 높은 활성도를 보여 자세 안정화 근육의 활성도가 앉은 자세에서 더 증가한 것으로 사료된다. 따라서 일상생활에서 보다 쉽게 적용할 수 있는 앉은 자세의 ADIM은 허리안정성 향상에 유용할 것이다.

• The Journal of Korean Physical Therapy
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• 제17권3호
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• pp.311-327
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• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• 한국임상수의학회지
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• 제30권1호
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• pp.66-70
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• 2013

This report compared paramedian and flank approaches for the effective removal of abdominal unilateral cryptorchidism in calves. Two Korean native calves of approximately 300 kg in body weight, which had undergone the removal of a testis from the scrotum, were diagnosed as having abdominal unilateral (left) cryptorchidism by rectal palpation. One calf was administered with xylazine (0.2 mg/kg, IV) and was restrained in the dorsal recumbency position on the ground of barn for the paramedian approach, while the other calf was sedated with xylazine (0.03 mg/kg, IV) and restrained in the standing position for a flank approach. For the two calves, 2% lidocaine was administered by local infiltration, along the proposed incision line. Following incisions of the skin, muscle and peritoneum, the testis, which was located between the left kidney and inguinal canal, was grasped, exteriorized out of the abdominal cavity and detached from the gubernaculum testis. Then spermatic cord was ligated and cut. Finally, the testis was removed. An assistant was required to restraint a calf in dorsal recumbency for paramedian approach, and cryptorchidectomy was carried out with operator in a rather uncomfortable squatting posture, while restraint was rather simple and cryptorchidectomy was proceeded with operator in a standing posture where the flank approach was taken. During surgery, the gubernaculum testis was more strained during pulling the testis in the flank approach than in the paramedian approach, as the distance between incision site and the gubernaculum testis was greater in the flank approach than that in the paramedian approach. On the other hand, intra-abdominal pressure was greater in the paramedian approach than in the flank approach during surgery. The elapsed time between restraint and the end of surgery was 10 min shorter where the flank approach (35 min) was taken, than where the paramedian approach (45 min) was taken. In conclusion, this case study demonstrated that the flank approach might be more convenient than the paramedian approach for abdominal unilateral cryptorchidectomy in calves.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.57-62
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• 2010

Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.

• 대한간호학회지
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• 제43권3호
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• pp.331-340
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• 2013

Purpose: The purpose of this study was to investigate the effects of the lifestyle modification coaching program on self efficacy, lifestyle and physiologic indexes related to the recurrence of stroke in patients with stroke. Methods: Sixty-one patients with stroke registered with a stroke center participated in this study. Of the participants, 32 were assigned to the experimental group and 29 to the control group. Self efficacy, alcohol drinking, smoking, physical activity, BMI (body mass index), WHR (waist-hip ratio), blood lipid level, and blood pressure were measured both for the baseline, as well as after intervention. The lifestyle modification coaching program consisted of an 8-week telecoaching session following face-to-face education. The control group received only the face-to-face education. Results: There were significant differences in physical activities, WHR, blood pressure within and between groups after intervention. The lifestyle modification coaching program had significant influences on blood pressure even after gender, age, and physical activity had been adjusted. Conclusion: The results of the study indicate that lifestyle modification coaching program is effective for physical activity, abdominal obesity and blood pressure. Therefore it can be used by nurses in hospitals and communities as one of the secondary stroke prevention programs for patients with stroke.

• 성인간호학회지
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• 제25권3호
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• pp.241-249
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• 2013

Purpose: The aim of the study was to identify the effects of education from using cellular phones and a short messaging service. Methods: Collected data included baseline demographics, blood pressure, abdominal circumference, total cholesterol, body mass index and health behavior index (Dietary Practice Guidelines Score, Physical Activity, Drinking frequency, Stress score, Subjective health status, and Action change stage score). Data were collected at public health centers in Chungcheongnam-do from January to December, 2011. Data obtained from Individual health counseling Programs in Chungcheongnam-do. Analysis was divided into health risk group and Disease management group, using a paired t test. Results: Following the education of using short messaging service of cellular phones Health risk group was a reduction in the systolic blood pressure, diastolic blood pressure, waist circumference. Disease management group was a reduction in the systolic blood pressure and body mass index. In both groups, there were improvement in the Health behavior index; dietary practice guidelines score, physical activity, stress score, subjective health status and action change stage scores. Conclusion: These results indicated that education using short messaging service of cellular phone for Community was effective in improving health behaviors and status. By applying the results, development of customized teaching messages for stable settlement is required.

• The Journal of Korean Physical Therapy
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• 제31권4호
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• pp.248-253
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• 2019

Purpose: To improve pulmonary function and decrease in balance ability with increasing forward head position and vertebral curvature, we applied Figure-8 brace to confirm the immediate effect on vital capacity and balance and to see if it is applicable. Methods: A total of 34 elderly women aged 65 or older and young women in their 20s with FHP were screened to measure vital capacity, measuring the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and measuring the foot pressure to see the change in balance. For statistical analysis, the difference between pre and post values was compared using pared t-test. Results: As a result of vital capacity measurements, there was no significant difference between FEV1 and FVC for women over 65 years old (p>0.05). Young women in their 20s had no significant difference in FEV1 (p>0.05), and FVC had significant differences (p<0.05). In measuring foot pressure to measure balance, both women aged 65 and above and young women in their 20s had a significant decrease in anterior foot pressure, and a significant increase in posterior foot pressure (p<0.05). Conclusion: The results of this study did not positively affect the vital capacity of elderly women with FHP. However, the significant increase in vital capacity of young women in their 20s suggests that contraction of the abdominal muscle is necessary during forced expiration. Therefore, it is believed that proper application and therapeutic interventions should be combined when applying Figure-8 brace.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.395-399
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• 1999

Backgroud: Excess abdominal fat, expressed as an increased ratio of waist to hip circumferences (WHR), is independently associated with higher levels of blood pressure. Although a WHR greater than 1.0 in men has been shown to predict complications from obesity, the WHR has not been evaluated in all ethnic groups. Methods: In order to ascertain the association between WHR and classification of blood pressure and to investigate the critical value of WHR as a predictive factor of hypertension in Korean middle-aged men, we compared the mean of WHRs according to the classification of blood pressure in Seoul Cohort participants. Results: Through a surrey of direct measurement of waist and hip girth, 452 subjects were recruited from the cohort. The mean of WHR was 0.88 and its standard deviation was 0.04. The mean of WHRs was higher in the systolic blood pressure group (above 140 mmHg), diastolic blood pressure group (above 90 mmHg), and hypertension group than in the systolic blood pressure group (below 140 mmHg), diastolic blood pressure group (below 90 mmHg), and normotensive group, respectively. And WHR of above 0.89 was associated with hypertension (z-value =6.66). Conclusion: It is necessary for Korean males with WHR greater than 0.89 to recommend the primary prevention and early defection of hypertension.