• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.33-38
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• 2014

목적: 신경성형술로 치료한 추간판 탈출증 환자들 중 호전되지 않은 환자들을 대상으로 초음파 유도하 내측 분지 차단술을 시행하여 치료적으로 유용한가를 분석하고자 하였다. 대상 및 방법: 2011년 11월에서 2013년 2월까지 추간판 탈출증으로 신경성형술을 받은 만성 요통 환자 559명 중 시술후에도 요통 혹은 하지 연관통 증상을 보여, 초음파 유도하 내측 분지 차단술을 시행받고 1개월 추시가 가능하였던 88명과 이 중 6개월 추시가 가능하였던 39명의 환자들을 대상으로 하였다. 한 명의 의사가 모든 증례를 시술하였으며 방사선 피폭의 위험을 없애고자 방사선 투시 하가 아닌, 초음파 유도하에 23 G, 10 cm 주사 바늘을 삽입하고 약제를 주사하였다. 내측 분지를 목표로 하기 위하여 횡축 영상에서 상 관절 돌기와 횡 돌기의 교차점에 바늘이 놓이도록 하였다. 시술 후 각 시점에서 Visual Analog Scale (VAS) score와 Oswestry Disability Index (ODI)를 측정하여 시술 전과 통증의 정도와 기능의 변화를 비교 분석하였다. 의미 있는 통증 및 기능의 호전 기준은 VAS 50% 이상의 감소, ODI 40% 이상의 감소를 기준으로 하였다. 결과: 시술 전 VAS는 평균 $7.35{\pm}1.68$점, ODI는 평균 $32.82{\pm}8.77$점이었다. 이에 대하여 시술 후 1개월에 VAS는 평균 $3.36{\pm}2.98$점, ODI는 평균 $15.14{\pm}14.01$점으로 의미있게 감소하였으며(p<0.05) 시술후 6개월에는 VAS는 평균 $3.05{\pm}2.27$점, ODI는 평균 $12.97{\pm}8.82$점으로 의미있게 감소하였다(p<0.05). 1개월 군에서는 통증이 64.49%에서 의미있게 감소하였으며 59.81%에서 기능이 유의하게 향상되었다. 3개월 군에서는 통증이 64.10%에서 의미있게 호전되었고 61.54%에서 의미있게 기능이 향상되었다. 결론: 초음파 유도하 내측 분지 차단술은 추간판 질환으로 인해 이차적으로 발생한 후방 관절의 문제에 대한 치료로서 효과적이라고 생각한다.

• 한국콘텐츠학회논문지
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• 제11권6호
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• pp.270-278
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• 2011

이 연구는 20대와 40대의 급성과 만성 요통환자를 대상으로 척추 주위근육의 단면도를 비교하는 것이다. 20대(남자-9, 여자-10)와 40대(남자-8, 여자9)의 대상자들은 MRI로 요추(4번 하부 종단판) 단면도의 척추주위근육(장요근, 다열근, 척추기립근)들의 크기를 PACS(free-handling technique of the picture archiving and communication system(PACS)을 이용하여 측정하였다. 연구 결과 20대 급성과 만성 요통 환자들의 척추 주위근들의 차이는 통계학적으로 유의성이 없게 나타났으나, 40대 급성과 만성 요통환자들의 척추 주위근들의 차이는 만성 요통환자들이 근 위축이 통계학적으로 유의성 있게 나타났다. 또한 20대와 40대의 만성요통환자 척추 주위근들의 차이도 40대 만성요통 환자들에게 유의성 있게 나타났다. 연구에서 20대 만성환자들의 근 위축은 나타나지 않았으나 40대 만성환자들은 다양한 이유로 근 위축이 나타났다. 따라서 40대의 만성 요통환자들은 조기의 다양한 요부 근력 운동 및 기능적 활동 등으로 허리 주위근육의 위축을 감소시키는 것이 필요하다.

• 대한정형외과학회지
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• 제55권1호
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• pp.29-37
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• 2020

도수치료는 전 세계적으로 다수의 지역에서 각각 독립적으로 시행되고 발전되어왔던 학문으로 2,500년의 역사를 가진 아주 오래된 치료 방법이다. 최초의 역사적 기록은 기원전 4세기경 그리스에서 확인할 수 있는데 이후 오랜 세월 동안 도수치료는 의학계와 같이 연구하고 발전하기도 했지만 대립된 길을 걸어왔던 것도 사실이다. 우리가 도수치료를 제대로 이해하려면 의학적 치료의 한계를 넘어서기 위해 19세기 후반에 정립된 카이로프랙틱, 정골의학, 물리치료학의 관점에서 각각 연구되고 발전되어 온 도수치료의 세 분야에 대해 알고 있어야 한다. 아주 오랜 옛날부터 시작했고 전 세계적으로 사용된 치료법임에도 불구하고 도수치료에 대한 문헌들은 많지 않고 근거 수준이 낮은 논문들이 대부분이다. 그러나 현재 그 효과에 대한 논란에도 불구하고 도수치료는 점점 더 많은 환자들에게 시술되고 있는 실정이다. 저자들은 이 논문에서 고대부터 도수치료의 역사와 한국 도수치료의 역사, 그리고 현재 도수치료에 대한 최신 지견을 논하고 그것을 근골격계 통증의 치료를 담당하는 의사들에게 소개하고자 한다.

• 척추신경추나의학회지
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• 제2권2호
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• pp.17-32
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• 2007

Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

• 한국산학기술학회논문지
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• 제21권5호
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• pp.39-46
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• 2020

그레엄 그린(Graham Greene)의 『조용한 미국인』(The Quiet American)은 베트남을 배경으로 한 전쟁소설이다. 따라서 전쟁과 관련된 정치적인 이야기가 주를 이루고 있지만, 그 안에서는 기본적으로 유색인종인 베트남인들보다 서양인들이 우월하다는 것을 전제하고 있으며 이러한 인종적 차별에 더하여 여성이 처한 이중적 차별과 불평등을 그대로 표현하고 있다. 서양남성과의 결혼을 통해 부유하고 편안한 삶을 바라는 베트남 여성 푸엉은 자본과 남성이라는 존재로부터 억압 받는 젠더적 약자이다. 그녀는 육체적 고통은 느낄 수 있지만 정신적 고통을 느끼지 않을 정도로 무지하게 표현되며, 남성들의 즐거움이나 이기심을 충족시키기 위한 상대로 묘사되는 등 남성들이 만들어낸 이기적인 시각으로 인해 불평등한 차별을 받고 있다. 젠더적 강자인 남성 주인공 파울러와 파일은 동양 여성인 푸엉을 서양인들과 질적으로 다른 저급한 인간 취급을 하며 단순히 자신들의 이기심을 충족하기 위해 여성을 이용하고 착취한다. 따라서 이들은 기본적으로 젠더 불평등한 관계를 전제로 하고 있기 때문에 그들이 말하는 사랑은 진실한 사랑이라고 보기 어렵다. 결국 작품 결말부분에서 파일의 죽음으로 인해 푸엉이 파울러에게 돌아오게 됨으로써 동양 여성은 서양 남성에 대한 젠더적 열위의 위치에서 벗어날 수 없음을 확인시켜 준다.

• Journal of Acupuncture Research
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• 제21권5호
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• pp.79-99
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• 2004

Objective : This study was designed to find out the effect of scolopendrid aquacupuncture classified by the type of HIVD(Herniation of Inter-Vertebral Disc) in lumbar spine. Methods : The 50 patients who had a diagnosis of HIVD by lumbar-CT or lumbar-MRI and admitted to Gwangju oriental medical hospital in wonkwang university from June 2003 to March 2004 were observed. The symptom of inpatients is low back pain with or without sciatica. We treated 50 patients by scolopendrid aquacupuncture besides the general consevative treatment of oriental medicine. Results and Conclusion : The scolopendrid aquacupuncture treatment led to improvement in the pain and symptom of HIVD as determined by all efficacy measures. After scolopendrid aquacupuncture treatment, there was improvement in VAS, oswestry disability index, ROM and SLRT. The improvement index of scolopendrid aquacupuncture treatment classified by the type of HIVD showed that the effects of scolopendrid aquacupuncture had correlation with the type of HIVD. The more the herniation of intervertebral disc decreased, the more the effect of scolopendrid aquacupuncture increased. This results suggest that scolopendrid aquacupuncture is good method for treatment of HIVD but we have to consider the clinical correlation with the degree of herniation.

• Journal of Oral Medicine and Pain
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• 제25권4호
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• pp.415-425
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• 2000

In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

• 성인간호학회지
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• 제12권4호
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• pp.517-532
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• 2000

The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

• Journal of Acupuncture Research
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• 제25권6호
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• pp.135-143
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• 2008

Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.

• 한방재활의학과학회지
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• 제23권3호
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• pp.177-186
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• 2013

Objectives This study is to evaluate the current situation of Russian tourists for medical tourism of Spine Specialty Korean Medicine Hospital. Methods 133 Russian tourists visiting Spine Specialty Korean Medicine Hospital from January 1, 2012 to December 31, 2012, were analysed in the statistics. Their data was sourced from the computerized medical records. And 87 of them answer a questionnaire about reasons for selection of Spine Specialty Korean Medicine Hospital and satisfactory for medical service. Results A total of 133 Russian visited Spine Specialty Korean Medicine Hospital for medical service, consisting of 73 females (54.8%), the fourties to fifties 58.9% by age. They avoided visiting in the winter. The average number of visiting was 7.1 times. The average treatment period was 9.9days. Majority of the elapsed time from the onset to the arrival was more than 1 year (56.6%). Low back pain (56.4%) is the most in musculoskeletal disorders and obesity (21.7%) and gynecological diseases (30.4%) were the most in a non-musculoskeletal disorders. Medication and acupuncture was the major treatment. 89.2% of the prescribed medication was the efficacy of musculoskeletal. Russian medical tourists most visited by support of travel agent (58.6%). The main reason of their visiting was non-surgical treatment for spinal disorder (31%). 96.6% of them were satisfied because rapid pain relief and kindness. Conclusions For this study, we confirmed a possibility for the Korean medical treatment of Russian tourists for medical tourism. Still, more research and goverment support for the expansion of Korean medical tourism is needed.