• The Journal of Internal Korean Medicine
• /
• v.40 no.2
• /
• pp.220-227
• /
• 2019

Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.4
• /
• pp.432-441
• /
• 2019

Objective : Few studies have reported direct comparative data of lumbar spine angles between direct lateral interbody fusion (DLIF) and oblique lateral interbody fusion (OLIF). The purpose of this study was to investigate the clinical and radiological outcomes of DLIF and OLIF, and determine influential factors. Methods : The same surgeon performed DLIF from May 2011 to August 2014 (n=201) and OLIF from September 2014 to September 2016 (n=142). Radiological parameters, cage height, cage angle (CA), cage width (CW), and cage location were assessed. We checked the cage location as the distance (mm) from the anterior margin of the disc space to the anterior metallic indicator of the cage in lateral images. Results : There were significant differences in intervertebral foramen height (FH; $22.0{\pm}2.4$ vs. $21.0{\pm}2.1mm$, p<0.001) and sagittal disc angle (SDA; $8.7{\pm}3.3$ vs. $11.3{\pm}3.2^{\circ}$, p<0.001) between the DLIF and OLIF groups at 7 days postoperatively. CA ($9.6{\pm}3.0$ vs. $8.1{\pm}2.9^{\circ}$, p<0.001) and CW ($21.2{\pm}1.6$ vs. $19.2{\pm}1.9mm$, p<0.001) were significantly larger in the OLIF group compared to the DLIF group. The cage location of the OLIF group was significantly more anterior than the DLIF group ($6.7{\pm}3.0$ vs. $9.1{\pm}3.6mm$, p<0.001). Cage subsidence at 1 year postoperatively was significantly worse in the DLIF group compared to the OLIF group ($1.0{\pm}1.5$ vs. $0.4{\pm}1.1mm$, p=0.001). Cage location was significantly correlated with postoperative FH (${\beta}=0.273$, p<0.001) and postoperative SDA (${\beta}=-0.358$, p<0.001). CA was significantly correlated with postoperative FH (${\beta}=-0.139$, p=0.044) and postoperative SDA (${\beta}=0.236$, p=0.001). Cage location (${\beta}=0.293$, p<0.001) and CW (${\beta}=-0.225$, p<0.001) were significantly correlated with cage subsidence. Conclusion : The cage location, CA, and CW seem to be important factors which result in the different-radiological outcomes between DLIF and OLIF.

• Journal of Korean Physical Therapy Science
• /
• v.25 no.3
• /
• pp.9-16
• /
• 2018

Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

• Journal of the Korean Society of Radiology
• /
• v.15 no.2
• /
• pp.139-145
• /
• 2021

This study is to confirm the range of tube voltage for Chest X-ray in DR system by comparing with dose area product (DAP) and effective dose in efficient detector exposure index (DEI) range. GE definium 8000 was used to for the phantom study. The range of tube voltage is 60~130 kVp and of mAs is 2.5~40 mAs. The acquired images were classified into efficient DEI groups, then calculated effective dose with DAP by using a PC-Based Monte Carlo Program 2.0. The signal to noise ratio (SNR) was measured at 4 regions, including the thoracic spine, the lung area with the ribs, the lung area without the ribs, and the liver by using Picture Archiving and Communication System. The significance of the group for each tube voltage was verified by performing the kruskal-wallis test and the mann-whitney test as a post-test. When set to 4 groups dependned on the tube voltage, DAP showed significant differences; 60 kVp and 80 kVp, and 60 kVp and 90 kVp (p= 0.034, 0.021). Effective dose exhibited no statistically significant differences from the all of the group (p>0.05). SNR exhibited statistically significant differences from the all of the group in the liver except compared to 80 kVp and 90 kVp (p<0.05). Therefore, high tube voltages of 100 kVp or more need to be reconsidered in terms of patient dose and imaging in order to represent an appropriate chest X-ray image in a digital system.

• Korean Journal of Applied Biomechanics
• /
• v.31 no.2
• /
• pp.133-139
• /
• 2021

Objective: This study aims to verify the conventional deadlift motions using by two different grips, thereby elucidating the grounds for effective training methods that can minimize the risk of injury. Method: Total of 18 healthy young adults were recruited for this study (age: 25.11±2.19 yrs., height: 175.67±5.22 cm, body mass: 78.5±8.09 kg, 1-RM: 125.75±19.48 kg). All participants were asked to perform conventional deadlift with two types of grips which are overhand grip (OG) and underhand grip (UG). In each grip, participant perform the deadlift with 50% and 80% of the pre-measured 1-RM. A 3-dimensional motion analysis with 8 infrared cameras and 3 channels of EMG was performed in this study. A two-way ANOVA (group × load) with repeated measure was used for statistical verification. The significant level was set at α=.05. Results: There were significant differences in grip type and weight on the right shoulder joint, and only significant difference in grip on the left shoulder joint (p<.05). The hip joint ROM was significantly increased as the weight increased in both types of grips on phase 1, while the ROM of hip joint was significantly decreased as the weight increased only in the case of OG on phase 2 (p<.05). In case of the OG, as the weight, increased significantly increased L1 ROM and L3 ROM were revealed on phase 1 and phase 2, respectively (p<.05). Moreover, as the weight increased, UG revealed significantly decreased L5 ROM on phase 1, while both grips showed significantly increased ROM on phase 2 (p<.05). In addition, the erector spinae and the biceps femoris, which are synergist for the motion, showed a significant difference in both types of grip according to the weight (p<.05). The muscle activity ratio of gluteus maximus/biceps femoris showed a significant difference only in the UG according to the weight (p<.05). Conclusion: In conclusion, beginners might be suggested to use the UG for maintaining the neutral state of the lumbar spine and focus on the gluteus maximus muscle, which is the main activation muscle. For the experts, it may recommend alternative use of the OG and UG according to the training purpose to minimize the compensation effect.

• Journal of radiological science and technology
• /
• v.44 no.4
• /
• pp.295-300
• /
• 2021

This study aims to present new chest AP examination exposure conditions through a study on the effect on image quality and patient dose by applying high tube voltage and scatter ray post-processing software during chest AP examination in digital radiography equipment. This study was used a human body phantom and in the chest AP position, the dosimeter was placed horizontally at the thoracic spine 6. The experiment was conducted by dividing into a low tube voltage (70 kVp, 400 mA, 3.2 mAs) group and a high tube voltage (100 kVp, 400 mA, 1.2 mAs) group. The collimation size (14″× 17″) and the source to image receptor distance(110 cm) were same applied to both groups. Radiation dose was presented to dose area product and entrance surface dose. Image quality was compared and analyzed by comparing the difference between the signal-to-noise ratio and the contrast-to-noise ratio of the image according to the application of the scatter ray post-processing software under each condition. The average value of the entrance surface dose in the low and high tube voltage conditions was 93.04±0.45 µGy and 94.25±1.51 µGy, which was slightly higher in the high tube voltage condition, but the dose area product was 0.97±0.04 µGy and 0.93±0.01 µGy. There was a statistically significant difference in the group mean value(p<0.01). In terms of image quality, the values of the signal-to-noise ratio and the contrast noise ratio were higher in the high tube voltage than in the low tube voltage, and decreased when the scattering line post-processing function was used, but the contrast resolution was improved. If there is a scatter ray post-processing function during chest AP examination, it is helpful to actively utilize it to improve the image quality. However, when this function is not available, I thought that applying a higher tube voltage state than a low tube voltage state will help to realize images with a large amount of information without changing the dose.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.1
• /
• pp.78-87
• /
• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• Journal of the Korean Society of Radiology
• /
• v.14 no.7
• /
• pp.975-980
• /
• 2020

Cervical neural foraminal stenosis is a very common spinal disease that affects a relatively large number of people of all ages. However, since imaging methods that quantitatively provide neural foraminal stenosis are lacking, this study attempts to present quantitative measurement results by reconstructing 3D computed tomography images. Using a 3D reconstruction software, the surrounding bones were removed, including the spinous process, transverse process, and lamina of the cervical spine so that the neural foramen were well observed. Using Image J, a region of interest including the neural foramen area of the 3D image was set, and the number of pixels of the neural foramen area was measured. The neural foramen area was calculated by multiplying the number of measured pixels by the pixel size. In order to measure the widest area of the neural foramen, it was measured between 40-50 degrees in the opposite direction and 15-20 degrees toward the head. The measured cervical neural foramen area showed consistent measurement values. The largest measured area of the right neural foramen C5-6 was 12.21 ㎟, and after 2 years, the area was measured to be 9.95 ㎟, indicating that 18% stenosis had progressed. Since 3D reconstruction using axial CT scan images, no additional radiation exposure is required, and the area of stenosis can be objectively presented. In addition, it is good to explain to patients with neural stenosis while viewing 3D images, and it is considered a good method to be used in the evaluation of the progression of stenosis and post-operative evaluation.

• Phonetics and Speech Sciences
• /
• v.13 no.2
• /
• pp.91-101
• /
• 2021

The purpose of this study was to investigate laryngeal characteristics in children with autism spectrum disorders (ASD). A total of 50 children participated, including eight children aged 2 to 4 years old diagnosed with ASD and 42 normal controls at the same age. All children recorded X-ray images of the midsagittal plane of the cervical spine and larynx, and compared the laryngeal positions of ASD and control. In addition, samples of children with vowel prolongation were collected and analyzed for acoustic parameters. X-rays showed that the height of the hyoid bone in the normal group was the lowest at 3 years of age, and ascended at 4 years of age. Nevertheless, the distance from the external acoustic meatus to the hyoid bone was longest at age 4. 4-year-olds with explosive language development showed laryngeal height elevation and anteriorization. In contrast, the hyoid height of the ASD group of all ages was lower than that of the control group, and there was no difference in the hyoid position between the ages. As a result of acoustic evaluation, PFR, vFo, and vAm were significantly higher ASD than control. Low laryngeal height of ASD children may be associated with delayed language development. PFR, vFo, and vAm seem to be voice markers showing the difference between normal and ASD children.

• Journal of the Korean Applied Science and Technology
• /
• v.38 no.3
• /
• pp.891-902
• /
• 2021

This study is an experimental study to confirm the effect of self-care program on exercise performance self-efficacy, Knowledge of self-management and Performance of self-management in patients with lumbar disc removal. The subjects were 26 inpatients in the experimental group and 27 in the control group as inpatients at the D City Material Spine Hospital. The collected material was analyzed using the SPSS 25.0 program with mean, percentage, standard deviation, t-test, x²-test, Independent t-test, and repeated measures ANOVA. Hypothesis that after self-care program mediation, the experimental group had higher scores for orthosis management knowledge (p<.001) and daily life management knowledge (p=.005) as time passed compared to the unprovided control group. The hypothesis is that the experimental group provided with the self-care program has a performance of orthosis management(p=.011), higher degree of orthosis management performance (p=.011) and daily life management performance (p=.007) than the non-provided control group. Was supported. There, it was confirmed that it is an effective self-care program that can be easily applied at home to patients with lumbar disc removal from the day before surgery to after discharge.