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요각통으로 입원한 요추부 후만곡 환자 1례에 대한 증례보고
권혁준,김주원,류기준,김호준,이명종,Kwon, Hyeok-Joon,Kim, Joo-Won,Ryu, Ki-Jun,Kim, Ho-Jun,Lee, Myeong-Jong 척추신경추나의학회 2009 척추신경추나의학회지 Vol.4 No.2
Objectives : We already know the importance of stability and flexibility on the vertebra. It is important to keep the lumbar lordosis for stability and flexibility. We hope to reduce lower back pain and low extremity pain by changing the angle of the Lumbar Kyphosis through conservative treatment. We have evaluated the effect of conservative treatment with Saamchimbeop Pejeonggyeok by experimenting one patient suffering from Lumbar Kyphosis with lower back pain and low extremity pain. Methods : One patients were diagnosed as Lumbar Kyphosis through X-ray examination. We used conservative treatment, especially Pejeonggyeok Treatment to the patients and measured NRS((Numerical Rating Scale), rating scale for low back pain, low extremity pain and SLR(Straight Leg Raising) test and walking time in whole term of admission, and we also measured flexion, extension angle and lumbar kyphosis using lumbar x-ray lateral view after diganosing by Lumbar Kyphosis. Results and Conclusions : After treating conservative therapy, We figured out that the patient were on the mend, and we found out the angle change in flexion, extension and lumbar Kyphosis. These results suggest that Pejeonggyeok Treatment were effective to improved Lumbar Kyphosis and reduced the low back pain.
요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 임상적 고찰
권혁준 ( Hyeok Joon Kwon ),정해찬 ( Hae Chan Jeong ),김호준 ( Ho Jun Kim ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ),이명종 ( Myeong Jong Lee ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.3
Objectives: To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of Magnetic Resonanse Imaging(MRI) whom were treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods: Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change. Patients underwent MRI examaintion at baseline and after 24th week of treatment. Patients are divided into three groups; improved, unchanged, worsened. 35 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture once a week and took herbal medicine after a meal two times daily. The patients` clinical outcomes were assessed at baseline, 12th week, 24th week by Visual analogue scale(VAS), Oswestry disability index(ODI). Results: 1. MRI follow-up exams on regression of disc herniation resulted on 42.86% of cases by conservative treatment. 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in "improved" and "unchanged" groups compared to "worsened" group(P<0.05). 3. VAS(low back pain and sciatica) and ODI change after treatment did not show any relationship with MRI follow-up change(P<0.05). Conclusions: This study suggests that "improved" and "unchanged" groups compared to "worsened" group on MRI follow-up in patients with lumbar disc herniation were more effective when treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture. MRI follow-up change does not affect clinical changes in patients with lumbar disc herniation.
요추 추간판 탈출증 환자의 보존적 치료 후 변화된 자기공명영상에 따른 1년 후 임상변화 고찰
권혁준 ( Hyeok Joon Kwon ),박영회 ( Young Hoi Park ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2
Objectives: To analyze the therapeutic outcomes of back pain modalities in patients with disc herniation according to the change of magnetic resonanse imaging(MRI) at one year after conservative treatment. Methods: Clinical outcomes of 35 patients diagnosed with lumbar disc herniation by MRI examination, treated conservatively, were analyzed according to MRI follow-up change; improved, unchanged, worsened. Patients underwent MRI examination at baseline and after 24 week of treatment. After 1 year, we followed up 30 patients. The patients` clinical outcomes were assessed at baseline, 24 week, 1 year by visual analogue scale(VAS), oswestry disability index(ODI), and analyzed by each of it`s correlation. Results: 1. VAS of sciatica and ODI of disability of daily activities showed significant decrease in patients after 1 year follow up(p<0.05). 2. VAS(low back pain and sciatica) and ODI of disability of daily activities showed significant decrease in “improved” group and VAS(sciatica) and ODI showed significant decrease in “unchanged” group, “worsened” group showed no statistic significance(p<0.05). 3. The 1 year follow-up of VAS(low back pain and sciatica) and ODI change showed relationship with MRI follow-up change(p<0.05). Conclusions: This study suggests that “improved” groups compared to “unchanged” and “worsened” group on MRI follow-up in patients with lumbar disc herniation were more effective at 1 year after conservative treatment. MRI follow-up change affect clinical changes in patients with lumbar disc herniation after 1 year.
도인(桃仁)이 중대뇌동맥 폐색 유발 흰쥐의 근육형태 변화와 혈관신생에 미치는 영향
권혁준 ( Hyeok Joon Kwon ),소갑석 ( Kab Seog Soh ),김호준 ( Ho Jun Kim ),이명종 ( Myeong Jong Lee ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.1
Objectives: This study was performed to investigate the effects of Semen Persicae(SP) on muscle type change and vascularization effect by measuring expression of Myosin heavy chain (MHC) and Vascular endothelial growth factor (VEGF) protein in the Middle cerebral artery occlusion(MCAo) rats. Methods: The middle cerebral artery was occluded, SP extraction was administrated for 4 days. The effects of SP on muscle type change and vascularization were measured. Results: 1. VEGF protein expressions in the Semen Persicae oral administration group of MCAo group were increased compared to the control group 2. There were no significant difference between the Semen Persicae oral administration of MCAo group and the control group in MHC isoform (Type l, Type lla) expression change. Conclusions: The present study demonstrates the effect of Semen Persicae in the vascularizing after ischemia, but has no significant effect n musle type change and the improvement of musle atrophy.
보존적 치료를 통해 호전된 요추 추간판탈출증 환자의 자기공명영상으로 추적 관찰한 증례 4례 보고
박원상 ( Won Sang Park ),하인혁 ( In Hyuk Ha ),권혁준 ( Hyeok Joon Kwon ),우인 ( In Woo ),윤유석 ( You Suk Youn ),송주혀 ( Joo Hyun Song ) 한방재활의학과학회 2007 한방재활의학과학회지 Vol.17 No.4
Objectives :This study is designed to observe the effect of conservative oriental medicine treatment for HIVD of lumbar spine by MRI. Methods : 4 patients who were diagnosed as lumbar spine herniated intervertebral disc was evaluated after conservative oriental medicine treatment by Visual Analog Scale(VAS), Numeric Rating Scale(NRS), Oswestry Disability Index(ODI), Straight Leg Rasing Test(SLR) six times four week for 6 months. Results : 1. Visual Analog Scale(VAS), Numeric Rating Scale(NRS), Oswestry Disability Index(ODI), Straight Leg Rasing Test(SLR) was significantly improved after conservative oriental medicine treatment for six months.2. Also it was observed that herniated disc was decreased after six months by MRI reexamination. Conclusions : This study suggested that conservative oriental medicine treatment can be effective for decreasing pain and improving functional recovery also decreasing the volume of herniated disc
요추 추간판탈출증 환자의 발병시기에 따른 보존적 치료 결과 비교 연구
윤유석 ( You Suk Youn ),이종수 ( Jong Soo Lee ),하인혁 ( In Hyuk Ha ),김주원 ( Joo Won Kim ),권혁준 ( Hyeok Joon Kwon ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.4
Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc herniation according to the duration by treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : We separated 36 patients with disc herniation into three group according to duration; acute patients within 4 week, subacute patients within 5-12 week, and chronic group within 13-24 week. 36 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients` symptoms were assessed 1 week, 2 week, 4 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. ODI of disability of daily activities showed significantly decreased in acute stage group compared to subacute and chronic stage groups(P<0.05). 2. Physical functioning(PF), bodily pain(BP), social functioning(SF) score of SF-36 showed significantly increased in acute stage group compared to subacute and chronic stage groups(P<0.05). Conclusions : This study suggests that acute stage group compared to subacute and chronic stage groups in patients with lumbar disc herniation is the more effective to improve symptoms treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.
편측 요통을 호소하는 환자에 있어서 척추 주위 근육의 지방량과 통증과의 관계
김하늘 ( Ha Neul Kim ),김경훈 ( Kyoung Hun Kim ),김주원 ( Joo Won Kim ),진은석 ( Eun Seok Jin ),하인혁 ( In Hyuk Ha ),고동현 ( Dong Hyun Koh ),홍순성 ( Soon Sung Hong ),권혁준 ( Hyeok Joon Kwon ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.1
목적: 요통은 임상에서 가장 흔하게 접할 수 있는 질환이며, 동시에 통증으로 인한 근무 결손도나 생활 불편감이 높은 질병이다. 그래서, 많은 연구들이 요통을 일으키는 원인 혹은 악화시키는 유발 인자를 밝혀내려는데 초점이 맞추어져 있다. 이번 연구의 목적은 편측 요통을 호소하는 환자에 있어서 MRI에서 조사된 척추 주위 근육의 지방량과 통증과의 관계에 대해서 알아보는데 있다. 방법: 2007년 11월부터 2008년 4월까지 본원에 요통으로 내원한 환자를 대상으로, 편측 요통을 호소하며, 체질량 지수가 25kg/㎡ 이하이며, 만 20세이상 40세미만인 환자 24명을 대상으로 연구를 진행하였다. MRI에서 조사되어진 L4-5 디스크 레벨의 척추 주위 근육의 지방량을 객관적인 pseudocoloring technique을 이용해 측정하고, paired t-test로 결과를 분석하여 요통이 유발된 측과 지방량의 관계에 대해서 연구하였다. 결과: 요통이 있는 측의 지방량과 요통이 없는 측의 지방량을 측정하여 데이터를 분석하였다. 양측의 지방량과 통증의 유무에 대한 관계는 통계적으로 유의한 수치를 나타냈다(P <0.05). 요통이 있는 측과 없는 측과의 성별, 나이, BMI의 통계적인 차이는 없었으며, 지방량 측정시 남자들이 여자들에 비해 지방량이 더 높게 측정되었다(남자 8.5±5.1%, 여자 6.5±3.6%). 결론: 이 연구를 통해 척추 주위 근육의 지방량과 요통에 대한 상관성의 증거를 제시하였다. 잘 선별되어진 환자의 MRI를 통해 객관적인 방법으로 지방량을 체크를 하였으며, 추후 더 많은 개체수를 이용해 보다 더 정확한 관련성을 파악하고, 나아가 지방량에 따른 통증 강도의 상관성에 대해서 연구가 필요하리라 생각된다. Objectives: Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods: 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results: The amount of fat in the symptomatic side was 7.6±4.51%, asymptomatic side was 6.7±4.29%. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men 8.5±5.1%, women 6.5±3.6%). Conclusions: The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.