• Title/Summary/Keyword: low-back pain

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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The Effects of Farming in Greenhouses with Respect to Subjective Fatigue Symptoms (비닐하우스 재배자의 피로자각증상에 관한 연구)

  • Hwang, Gyeong Ae;Lee, Sok Goo
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.177-185
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    • 1998
  • The purposes of this study were to investigate the effects of farming in greenhouses with respect to subjective fatigue symptoms among farmers and the degree of symptoms. The study compared 176 green-house farmers with 216 open field farmers using a subjective fatigue symptoms rating scale developed by the Industrial Research Institute of Fatigue, Japanese Association for industrial Hygiene. 1. With respect to complaint rates of the subjective fatigue symptoms, the results indicated that greenhouse farmers have, in order of severity, high degrees of low back pain, difficulty in collecting thoughts, and apt to forget. 2. With respect to cumulative scores of fatigue symptoms, the results indicated that both groups of farmers exhibited a lack of attentiveness and a high degree of dullness and sleepiness(category I), body projection of fatigue(category II), and difficulty in concentration(category III). 3. With respect to general characteristics, it was found that the degrees of subjective fatigue symptoms were found to be higher among females, people with lower educational levels, and the elderly, regardless of the group. 4. With respect to work related factors, farmers with more years of experiences were found to have higher degrees of subjective fatigue symptoms, except for open field farmers with less than nine years experience. Both groups of farmers were found to have high degrees of subjective fatigue symptoms when working less than eight hours a day and less than six months a year. 5. With respect to health habits, for people who get less than eight hours of sleep per day exhibited higher fatigue scores than people who get more than eight hours. People who do not smoke and drink also exhibited higher fatigue scores than people who smoke and drink. 6. The results of multiple regression showed that the risk factors related to the subjective fatigue symptoms of farmers in the greenhouse group were ages, levels of education, sex and for the comparison group, were sex. years of farming, and hours of sleep. The R-square were 12.5% in the greenhouse group and 12.1% in the comparison son group. The differences between the greenhouse and open field farmers in the degrees of fatigue symptoms were found not to be statistically significant even if the working conditions of the greenhouse farmers were poor. This may be attributed to non-work related factors, i.e., social, economical, and psychological factors among greenhouse farmers.

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Comparison of Muscle Activity During a Push-up on a Suspension Sling and a Fixed Support (슬링(sling)과 고정된 지지면에서의 팔굽혀펴기 동작 시 근 활성도 비교)

  • Oh, Jae-Seop;Park, Jun-Sang;Kim, Suhn-Yeop;Kwon, Oh-Yun
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.29-40
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    • 2003
  • The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.

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The Experimental Study of the Effects of Continuous Traction Therapy in Meridian Sinews Therapy (경근 치료방법 중 지속적 견인요법의 효과에 관한 실험적 연구)

  • Shin, Jeong-Hun;Hwang, Sung-Yeoun;Keum, Kyung-Soo;Kim, Jae-Hyo;Sohn, In-Chul;Ahn, Seong-Hun
    • Korean Journal of Acupuncture
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    • v.29 no.3
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    • pp.385-395
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    • 2012
  • Objectives : Meridian sinew theory was introduced in Miraculous Pivot, Huangdi's Internal Classic, to explain in relation with locations of meridian sinews, causes, mechanisms, and treatment of diseases. The meridian sinews are understood to include muscles, tendons and ligaments, or muscles in the superficial body made up with muscles, ligaments, tendons, fascia etc. This theory shows the similarity or organic relationship between the meridian sinews and muscles. From the Hippocrates(460-385 BC) ages, traction therapy was used as a treatment method on muscular diseases such as low back pain, scoliosis, etc in western medicine. The effects of traction therapy, however, were unclear so that this study was purposed to illustrate the effectiveness of continuous traction therapy and to develop meridian sinews treatment. Methods : We made 2 hypotheses to explain the cause of scoliosis occurrence, muscles contraction and relaxation. As the hypothesis, we made the spinal model having 3 joints with wood and rubber bands. Each of the three joints in the spinal model represents the case of normal(NT; control), contraction(AT 1)and relaxation(AT 2) condition, and distance between the vertebrae joints was measured. Results : Under normal circumstance models, the normal type 1(NT 1; muscle relax state) and normal type 2(NT 2; muscle contract state) all joints were being towed equally. But in an unusual contracted situation, regardless of the relationship of joint area, contracted part of joint was not released. And in a relaxed situation, regardless of joint areas, released parts of joint were further released. These observation results mean that the effects of traction might be different from the purpose of traction therapy of Hippocrates. Conclusions : To explain the effect of traction therapy for scoliosis, the spinal cord model and scoliosis model were made. After vertebral bodies were pulled with different tensile forces, we compared the observed length of the each joints pulled. The results suggested that there were no effects of traction in objected parts with traction method from Hippocrates' design, continuous traction method. Moreover, it may worsen the symptom in worst case. Of course, our results are just the result of experimental models and clinical results may be different. More careful studies, therefore, are required.

Korean Medicinal In-patient Treatments for Chronic Renal Disease : 2 cases report (만성신질환 환자의 한의 입원치료 치험 2례)

  • Oh, Jeong Min;Jung, Eun Sun;Choi, Koh Eun;Heo, Jong Won;Kim, Hyun Tae;Ryu, Ju Young;Lee, Kang Wook;Cha, Ji Yun;Seol, In Chan;Cho, Hyun Kyoung;Yoo, Ho Ryong;Cho, Min Kyoung;Kim, Yoon Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.4
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    • pp.289-299
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    • 2016
  • This study is aimed to report two cases of chronic kidney disease treated with Korean traditional medicine. We treated the patients with traditional herbal medicine and other treatments including acupuncture. We measured serum creatinine, estimated glomerular filtration rate(eGFR), blood urea nitrogen(BUN), albumin, red blood cell count(RBC), hemoglobin for several times during admission. Case 1 patient was diagnosed with right medulla infarction, bladder stone, chronic kidney disease. The symptoms were quadriplegia, right side dysesthesia, drowsiness and edema. Case 2 patient was diagnosed with acute cerebral infarction, hypertension, chronic kidney disease. The symptoms were right side weakness, delusion, anorexia, low back pain. Case 1 patient was hospitalized for 80 days, and case 2 patient was for 31 days. Korean traditional medicine decreased serum creatinine and BUN level, improved eGFR, increased RBC and hemoglobin. The symptoms of chronic kidney disease such as edema, general body weakness and anorexia were also improved. These cases suggest that Korean traditional medicine can be effective and safe for patients with chronic kidney disease.

The Variation of Position of the Conus Medullaris in Korean Adults - A Magnetic Resonance Imaging Study - (한국 성인에서 척수원추 위치의 다양성 - 자기 공명 영상 연구 -)

  • Joo, Sung-Pil;Kim, Soo-Han;Lee, Jung-Kil;Kim, Tae-Sun;Jung, Shin;Kim, Jae-hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.451-455
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    • 2001
  • Objectives : There have been several studies documenting the changing level of the conus throughout infancy and childhood, but there is only a little detailed study that documents the range of conus positions in a living adult population, especially in Korean, without spinal deformity. Methods : we made a sequential study of magnetic resonance images of the lumbar spine to determine the variation in position of the conus medullaris in 650 living korean adults population without spinal deformity who checked MRI to identify the cause of low back pain. The study population consisted of patients over the age of 16 years. A T1-weighted, midline, sagittal image was reviewed for identifying the postion of conus. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disc. Results : The study group consisted of 305 men(47%) and 345 women(53%) with a mean age 45.9 years(range, 16-79 years). The conus existed commonly at the middle third of L1(131cases, 20.2%), at the L1-2 intervertebral space(129cases, 19.8%), and the lower third of L1(123cases, 18.9%). The mean position of conus was the lower third of L1(range, middle third of T12 to middle third of L3). Conclusions : The mean position of conus was at the lower third of L1(range, middle third of T12 to middle third of L3). This results was same as that of foreign study. Our results of living korean adult population could allow for safe clinical procedures such as lumbar puncture, spinal anesthesia, and help to explain the differences among observed neurologic injuries from fracture-dislocation at the thoracolumbar junction.

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Sacroiliac Joint/Sacrum Uptake Ratio Measured by Quantitative Sacroiliac Joint Scintigraphy (골(骨)스캔을 이용(利用)한 천장관절(薦腸關節)/천골섭취비(薦骨攝取比)의 정량적(定量的) 측정(測定))

  • Lee, Young-Yiul;Park, Seon-Yang;Lee, Myung-Chul;Choi, Sung-Jae;Cho, Bo-Youn;Choe, Kang-Won;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.63-70
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    • 1982
  • To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

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Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

Analysis of the Relationship between Hip Internal Rotation Angle and the Site of Herniation of Single Level Lumbar Intervertebral Disc Using Logistic Regression (로지스틱 회귀 분석을 이용한 고관절 내회전 각도와 단분절 요추 추간판 탈출증 발생 부위의 상관성 분석)

  • Kim, Shin-Woong;Nam, Hang-Woo;Kim, Se-Jun;Son, Seol-Ki;Kim, Jong-Su;Chung, Jai-Hyeon;Yun, Young-Ung;Choi, Young-Jun;Moon, Byung-Heon;Yoo, Su-Bin;Im, Han-Bit;Kim, Dong-Hwan
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.117-127
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    • 2014
  • Objectives The purpose of this study is to find out the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Methods This study was carried out to 418 patients with lumbar disc herniation diagnosed by M.R.I, who visited Bu-Chun Jaseng Hospital of Korean Medicine with low back pain. Researchers measured their hip internal rotation angle and analyzed the relationship between the hip internal rotation angle and the site of herniation of single level lumbar intervertebral disc. Results 1. Excessive right internal rotation of hip joint increases risk of L5/S1 HIVD. 2. Limited left internal rotation of hip joint decreases risk of L4/L5 HIVD. 3. In cases of L4/L5 HIVD level, there was evidence that the prevalence of HNP in men was 1.85 times as higher than that in women. 4. In cases of L5/S1 HIVD level, there was the evidence that the prevalence of HNP in men was 0.64 times as lower than that in women. Conclusions In single-segment lumbar HIVD patients, limited left internal rotation of hip joint decreases risk of HIVD of L4/5 and excessive right internal rotation of hip joint mainly leads to L5/S1 HIVD.

A Study on Health condition and Drug use of Female Workers in Incheon area (산업장 여성 근로자의 건강과 약물사용)

  • Cho Wonsun
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.17-32
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    • 1995
  • The purpose of this study is to promote health for young female workers. It is based on questionnaires collected from 215 female workers in Incheon area. This study includes health condition (fatigue scores), occupational disease, knowledge of abused drugs and the actual condition of drug use. The results are summerized as follows: - $47.4\%$ visited their health center and were treated with diseases like cold and headache $(34.9\%)$, gastroenteric disease $(6.5\%)$, trauma $(7.9\%)$ and chronic disease such as diabetes and hypertension $(3.3\%)$ - $44.7\%$ received regular health education and $4.7\%$ among them received education on abused drugs. - $20.5\%$ were suffering from work related diseases such as gastroenteric disease, headache, trauma, repiratory disease, skin problem, arthritis, low back pain, shortsightness and tuberculosis. - Total mean fatigue score as an indication of health status was $9.0\pm5.4$ points out of 30 points. Physical mean score (group I) was $3.92\pm2.2$ points and psychological mean score was $2.5\pm2.3$ points and neurosensory mean score was $2.6\pm2.1$ points out of each 10 points. - They recognized analgesics $(55.0\%)$ and the next are laxatives $(49.8\%)$, inhalants $(40.0\%)$, narcotics $(24.2\%)$, stimulants $(24.0\%)$, antihistamines$(5.9\%)$, diuretics $(3.0\%)$, tranquilizer $(2.4\%)$ and sedatives $(1.4\%)$ - They used analgesics $(37.2\%)$ the most and then laxatives $(6.0\%)$, stimulants$(5.6\%)$, diuretics $(1.9\%)$, antihistamines$(0.5\%)$, And nobody used tranquilizer, sedatives, narcotics and inhalant. - The relationship between career, drug abuse education, health center utilization and and the actual condition of drug using was examined. The longer the career and the more educated with drug abuse, the less drug used. And those who utilized health center rarely used more drugs. - The relationship between career, health center utilization, the score of fatigue and use of analgesics was also examined. Those group who have a longer career above 3 years and the group who have never used health center used more analgesics. And the group of fatigue score above 11.0 points used a little more analgesics than the other group. These results indicate that analgesics are the most frequent used drugs among female workers. Those analgesics such as geborin, penzal, saridon, aspirin, tyrenol should be used properly. These basic data is submitted for the education and consultation which are carried out by industrial nurses for promoting health of industrial workers.

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