• 기술사
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• 제13권4호
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• pp.31-47
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• 1980

Since medium and small manufacturing enterprises have , played a very important role not only in national economy but also in political and social relationships all of the countries in the world have paid favorable policies and programmes for protecting and promoting this sector. In Korea main ingredients of promoting policy for this sector consist of (1) encouragement to modernize facilities and rationalize operation (2) special priority in bank loan (3) promotion of industrial cooperatives (4) prevention of infringement by large industries. However, substantial investigation for problems incurred in medium industries has revealed that unless medium industries improve and raise their technological and managerial skillfulness for themselves all other measures are useless to solve the problems. This realization has induced all of the countries to render extension services on both of technology and management to assist and support their own effort for rationalization. Also in Korea during past 20 years many technical and managerial research institutes have rendered free consultancy services to medium industries by the support of government subsidy. Among them the joint extension services project performed by the Medium Industry Bank and UNDP during 1967 and 1975 might he listed as model case because of its broad and integrated activities and participation of foreign experts. We think many precepts should be :learned from the study of this project. Korean economy is expected to develop rapidly throughout coming'80 in spite of many obstacles, tut there is an apprehension that gap in of every facet between medium and large enterprises might he deepened and enlarged. To prevent the actualization of so-called dual structure of national economy and to promote stabilized medium industries with high added value productivity which are shown in well developed countries, consultancy assistance ana extension services should be strengthened much more than ever. Fortunately in 1978 legislation of "Medium and small industry promotion act" has paved the way for the systematic achivement of consultancy and extension services which shall be integrated by the government overall program. Under new framework thoughtfull accomplishment should be undertaken considering precious precepts obtained from past experience and failure. Special attention should be given to the technical liaison officer scheme, exclusive participation of only professional institutes, strict qualification and training for consultants for the future succsseful implementation.

• The Korean Journal of Pain
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• 제11권1호
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• pp.101-104
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• 1998

Backgrouds: Twent five years have passed since the opening of the first pain clinic in korea, in 1973 at Yonsei University Hospital. The number of pain clinics are gradually increasing in recent times. It is important to plan for future pain clinics with emphasis on improving the quality of pain management. Therefore we reviewed the patients in our hospital to help us in planning for the future of our pain clinic. Methods: We analyzed 2656 patients who had visited our Kim Chan Pain Clinic, accordance to age, sex, disease, and type of treatment block, from July 1996 to August 1997. Results: The prevalent age group was in the fifties, 27.3%, seventy years and older compromised 9.2%. The most common disease were as follows: lower back pain(46.2%); cervical and upper extremities pain(23.1%); trigeminal neuralgia(7.2%); and hyperhydrosis(5.8%) Both nerve blocks and medication were prescribed as treatment. Lumbar epidural block(16.3%) and stellate ganglion block(15.6%) were the most frequent blocks performed among various nerve blocks. Among nerve block under C-arm guidance, lumbar facet joint block(24.4%) and lumbar root block(22.5%) were performed most frequently. Trigeminal nerve block(18.4%), thoracic(17.0%) and lumbar sympathetic ganglion block(11.4%) were next most prevalent blocks performed frequent block. Conclusions: Treatments at our hospital were focused on nerve blocks and medications prescriptions. Nerve blocks are of particular importance in the diagnosis and treatment of chronic pain. However in future, to raise the quality of pain management, we need to fucus on a multidisciplinary/interdisciplinary team approach.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.168-172
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• 2007

Objective : Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. Methods : In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. Results : In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. Conclusion : Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.341-347
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• 2011

Objective : The purpose of this retrospective study was to evaluate the efficacy and safety of atlantoaxial stabilization using a new entry point for C2 pedicle screw fixation. Methods : Data were collected from 44 patients undergoing posterior C1 lateral mass screw and C2 screw fixation. The 20 cases were approached by the Harms entry point, 21 by the inferolateral point, and three by pars screw. The new inferolateral entry point of the C2 pedicle was located about 3-5 mm medial to the lateral border of the C2 lateral mass and 5-7 mm superior to the inferior border of the C2-3 facet joint. The screw was inserted at an angle $30^{\circ}$ to $45^{\circ}$ toward the midline in the transverse plane and $40^{\circ}$ to $50^{\circ}$ cephalad in the sagittal plane. Patients received followed-up with clinical examinations, radiographs and/or CT scans. Results : There were 28 males and 16 females. No neurological deterioration or vertebral artery injuries were observed. Five cases showed malpositioned screws (2.84%), with four of the screws showing cortical breaches of the transverse foramen. There were no clinical consequences for these five patients. One screw in the C1 lateral mass had a medial cortical breach. None of the screws were malpositioned in patients treated using the new entry point. There was a significant relationship between two group (p=0.036). Conclusion : Posterior C1-2 screw fixation can be performed safely using the new inferolateral entry point for C2 pedicle screw fixation for the treatment of high cervical lesions.

• 동의생리병리학회지
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• 제28권2호
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• pp.129-136
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• 2014

The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been confirmed to be effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willams's flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So we selected 24 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 20 mode, 30 mode, and 40 mode. And then, we classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, we assorted them by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that "WuQinXi" exercise be a exercise therapy for lumbar spinal disease at an oriental medical clinic in this way. Oriental medical doctors will be able to teach easily patients "WuQinXi" exercise's motions at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• 한국정밀공학회지
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• 제23권4호
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• pp.176-182
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• 2006

Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical changes with its implantation were rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, a nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Biomechanical analysis was performed for two different types of artificial disc having constrained and unconstrained instant center of rotation(ICR), ProDisc and SB Charite III model. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, forces on the spinal ligaments and facet joint, and stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400N were compared. The implanted model showed increased flexion-extension range of motion compared to that of intact model. Under 6Nm moment, the range of motion were 140%, 170% and 200% of intact in SB Charite III model and 133%, 137%, and 138% in ProDisc model. The increased stress distribution on vertebral endplate for implanted cases could be able to explain the heterotopic ossification around vertebral body in clinical observation. As a result of this study, it is obvious that implanted segment with artificial disc suffers from increased motion and stress that can result in accelerated degenerated change of surrounding structure. Unconstrained ICR model showed increased in motion but less stress in the implanted segment than constrained model.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.747-756
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• 2020

Objective : To evaluate the effectiveness and long-term outcome predictors of percutaneous sacroplasty (PSP). Methods : This single-center study assessed 40 patients with sacral insufficiency fractures using the short-axis technique under C-arm flat-panel detector computed tomography (CT). Two radiologists reviewed the patients' magnetic resonance and CT images to obtain imaging findings before PSP and determine technical success, respectively. The short-term outcomes were visual analog scale score changes and opioid usage reductions. Long-term outcomes were determined using telephone interviews and the North American Spine Society (NASS) patient-satisfaction index at least one year after PSP. Results : Technical success was achieved without any significant complications in 39 patients (97.5%). Telephone interviews were possible with 12 patients and failed in 10 patients; death was confirmed in 18 patients. Fifteen patients (50%) re-visited the hospital and received conservative treatment, including spinal injections. Nine patients reported positive satisfaction (NASS patient-satisfaction index 1 or 2), while the negative satisfaction group (NASS patient-satisfaction index 3 or 4, n=3) showed a higher incidence of compression fractures at the thoracolumbar spine level (66.7% vs. 22.2%) and previous spinal injection history (66.7% vs. 33.3%). The poor response group also showed higher incidences of facet joint arthrosis (100% vs. 55.6%), central canal stenosis (100% vs. 22.2%), neural foraminal stenosis (33.3% vs. 22.2%), scoliosis (100% vs. 33.3%), and sagittal malalignment (100% vs. 44.4%). Conclusion : PSP was effective for sacral insufficiency fractures and showed good long-term outcomes. Combined compression fractures in the thoracolumbar spine and degenerative lumbar pathologies could be possible poor outcome predictors.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.374-378
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• 2016

Objective : A modified surgical technique of posterior cervical foramintomy called posterior cervical inclinatory foraminotomy (PCIF) was introduced in previous preliminary article. PCIF allows better preservation of facet joint and capsule than conventional techniques. The authors conducted a study to investigate long-term outcomes of PCIF. Methods : We retrospectively reviewed demographic, radiologic, and clinical data from the patients who underwent PCIFs at our institution. Criteria included a minimum of 48 month follow-up and PCIFs for patients with radiculopathy from foraminal stenosis (C2-T1; single or multilevel) with persistent or recurrent root symptoms despite conservative treatment for more than 3 months. Patients who had undergone previous cervical operation were excluded. The visual analogue scale (VAS) score was used for clinical follow-up, and radiologic follow-up was performed to compare the changes of cervical sagittal alignment, focal angle and disc-space height of treated segment. Results : The PCIFs were performed between April 2007 and March 2011 on 46 patients (32 males and 14 females) with a total of 73 levels affected. The average duration of follow-up was 74.4 months. Improvements in radiculopathic pain were seen in 39 patients (84.7%), and VAS score decreased from $6.82{\pm}1.9$ to $2.19{\pm}1.9$. Posterior neck pain also improved in 25 patients (71.4%) among 35 patients, and VAS score decreased from $4.97{\pm}2.0$ to $2.71{\pm}1.9$. The mean disc-space heights of treated segment were $5.41{\pm}1.03mm$ preoperatively and decreased to $5.17{\pm}1.12mm$ postoperatively. No statistically significant changes in cervical sagittal alignment, focal angle were seen during the follow-up period (Cox proportional hazards analysis and Student t-test, p>0.05). Conclusion : The PCIF is highly effective in treating patients with cervical spondylotic radiculopathy, leading to long-lasting relief in pain. Long-term radiologic follow-up showed no significant spinal angular imbalance.

• Korean Journal of Acupuncture
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• 제32권3호
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• pp.81-89
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• 2015

Objectives : The purpose of this study is to explore the trends of acupoints used for lumbar HIVD(Herniated Intervertebral Disc) and treatment and anatomical location of Hwatahyeopcheock. Methods : We searched the latest clinical studies on acupuncture treatment for lumbar HIVD(Herniated Intervertebral Disc) through domestic studies search. To analyze the data, we categorized them by year and article types of literatures and investigated often-used acupoints and acupuncture types for treatment by reading treatment part of every paper searched. Domestic and Chinese literatures related to Hwatahyeopcheock were also studied for its anatomical location. Results : Total 50 articles are searched and local points are more used than distant points for lumbar HIVD(Herniated Intervertebral Disc) and most of them showed curative effects. Back-su points were used the most and Hwatahyeopcheock use accounted for one-third of the articles. In the articles of Hwatahyeopcheock use, except for one, patients complained of both low back pain and radiating pain, and all of them showed positive results after treatment. Conclusions : Back su point is considered to have its meaning as physical region where patients feel pain including herniated disc level rather than the effect meridian system makes. Through document research and meridian muscle theory, we found that Hwatahyeopcheock means vertebral facet joint, intervertebral foramen and surrounding muscle, nerve, blood vessel and related spinal nerves.

• The Korean Journal of Pain
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• 제20권2호
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• pp.111-115
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• 2007

Background: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an altemative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. Methods: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process, We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). Results: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. Conclusions: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.