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      • 동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 : 견관절 가동운동범위(ROM) 변화를 중심으로

        남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

        Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block. All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

      • 만성 견비통에 대한 동씨침 치료의 무작위 대조군의 임상 연구

        김찬영,권나현,신예지,남동우,김건형,김종인,최도영,이윤호,이재동 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

        Objectives : To observe the effect of acupuncture treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E GrouP, n=18) and a control group(C GrouP, n=18). The E Group patients received acupuncture treatment on LI_(15), TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results '. The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(P>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C GrouP, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

      • KCI등재

        동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 - 견관절 가동운동범위(ROM) 변화를 중심으로 -

        남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호,Nam, Dong-Woo,Kim, Haeng-Beom,Yang, Dong-Hoon,Lim, Sa-Bi-Na,Kim, Keon-Sik,Lee, Doo-Ik,Lee, Jae-Dong,Choi, Do-Young,Lee, Yun-Ho 대한침구의학회 2006 대한침구의학회지 Vol.23 No.5

        Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

      • KCI등재

        열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

        배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

        Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

      • KCI등재

        두부외상환자에서의 예후인자

        최성혁,문준동,김수진,문철규,이성우,홍윤식 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

        Background: Predicting outcome after head trauma is of great interest for clinicians, especially in the early stage. It may provide a basis for therapeutic strategies and may be helpful to select different approaches. But, reliable outcome prediction from head trauma is still unresolved. The purpose of this study is to determine which clinical parameters can be used effectively after an event of head trauma. Methods: In our study we studied head trauma patients who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of June 1998 to 31th of January 2000, looked into medical records, and studied the records in a retrospective manner. The head trauma patients were divied into two group, a) favourable outcome-related and b) unfavourable outcome-related. The two groups were then subdivided according to their sex, age, the mechanism of their injury, the time they came in, alcohol drinking, loss of consciousness, vomiting, pupil change, previous medical illness, associated injuries and were seperately compared and analyzed. And the factors affecting Glasgow Outcome Scale(GOS) were analyzed in the parameters of Injury Severity Score(ISS), Revised Trauma Score(RTS), Glasgow Coma Scale(GCS), motor score of GCS(mGCS), Marshall Computed Tomographic Classification(MCTC). Statistically, t-test and Mann-Whistney rank sum test using Jandel-sigma were used in the study and then were assessed in Chi-square analysis methods. The statistical significance was determined at a level of p less than 0.05. Results: The total of the head trauma patients, added up to 129 people, 99:males and 30:females. Among this sum, 99 patients showed a favourable outcome and 30 patients showed an unfavourable outcome at discharge. The causes of injury included: automobile accident in 42 cases; fallss in 26; assaults in 6; and accidental-slipping injury etc in 55 cases. 12 patients had bilateral unreactive pupils on admission, 2 had unilateral reactive pupils, and 113 had bilateral reactive pupils. Compared to the favourable outcome-related head trauma group, the unfavourable outcome-relared head trauma group had more history of loss of consciousness, unreactive pupils and tended to have previous medical illness. There were no difference in alcohol related, vomiting and associated injuries between two groups(favourable outcome-related head trauma group: unfavourable outcome-related head trauma group). Substantial difference were observed in GCS, mGCS, ISS, RTS, MCTC between two groups. Patients with unfavourable outcome had a significantly higher ISS, lower RTS, lower mGCS. After MCTC, patients with mass lesion had unfavourable outcome than patients with diffuse injury. Conclusion: Age, history of loss of consciousness, previous medical illness and unreactive pupil change are predictives of outcomes of head trauma patients with respect to Glasgow outcome scale. The lower GCS, lower RTS, lower mGCS, higher ISS, mass lesion based on CT scan provide poorer prognostic outcome in patients with head trauma. Use of prognostic factors thorough complete history taking and physical examination would provide useful prognostic information and facilitate improved therapeutic decision-malting in head-injuried patients.

      • 전방 도달법과 수장부 T자형 금속판 고정을 통한 원위 요골 골절의 치료

        최우성,김원유,최동원,신윤학,김진영 대한골절학회 2003 대한골절학회지 Vol.16 No.2

        목적 : 원위 요골 골절에 대해 전방 도달법을 이용한 관혈적 정복 및 수장부 T자형 금속판 내고정술의 방사선학적 및 임상적 결과를 분석하여 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법 : 도수 정복이 되지 않았거나, 심한 분쇄 골절로 인해 도수 정복 상태가 유지되지 못했거나, 부적절한 관절면의 정복 등의 이유로 원위 전완부 전방 도달법을 이용한 관혈적 정복 및 수장부 T자형 금속판을 이용한 내고정술을 시행 후 최소 1년 이상 추시 관찰이 가능하였던 19예를 대상으로, 수술 전 후의 방사선학적인 평가와 최종 추시시의 기능적 평가를 Green과 O'Brein의 방법을 이용하여 평가하였다. 결과 : 수술 직후 모든 예에서 관절면의 해부학적 정복을 얻을 수 있었다. 방사선학적 결과에서 요골 관절면의 요골 길이는 수술 전 평균 8.8 ㎜ (±4.8 ㎜)에서 수술 후11 ㎜ (±3 ㎜)로, 요골 경사각은 평균 15˚ (±5.7˚)에서 20˚ (±5˚)로, 전방 경사는 평균 -11˚ (±13˚)에서 7˚ (±4˚)로, 척골 양성 변이는 평균 4 ㎜ (±3 ㎜)에서 0 ㎜ (±1 ㎜)로 향상되었으며, 기능적 결과에 있어서는 우수 9예, 양호 7예, 보통 2예, 불량 1예 이었다. 추시 중 초기 수상이 심하였던 1 예에서는 정복의 소실과 함께 장 무지 굴건의 파열이 초래하였다. 결론 : 원위 요골 골절의 수술적 치료에서 일부 제한된 범위에서만 적응증이 되었던 수장부 금속판 내고정술로 방사선학적 측면과 기능적인 측면에서도 만족할 만한 결과를 얻었으며, 초기 분쇄 골절이 심할 경우에는 정복의 소실을 예방하기 위하여 외고정기를 부수적으로 장착하는 것이 좋을 것으로 생각된다. Purpose : To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture. Materials and Methods : We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up. Results : All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 ㎜±4.8 ㎜ vs. 11 ㎜±3 ㎜), radial inclination (15˚±5.7˚ vs. 20˚±5˚), volar tilt (-11˚±13˚ vs. 7˚±4˚) and ulnar plus variant (4 ㎜±3 ㎜ vs. 0 ㎜±1 ㎜) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and I poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury. Conclusion : Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.

      • KCI등재

        생물막 공정에서 질소제거효율 향상을 위한 유기성담체의 효용성 검토

        최동욱,최영균,김대영,김윤중,정태학 대한상하수도학회 2003 상하수도학회지 Vol.17 No.3

        Availability of organic media for improving nitrogen removal efficiency in a biofilter process was studied. Although, aerobic and anoxic phase could be clearly divided during the operation of single-stage biofilter process and nitrification efficiency was about 80%, denitrification efficiency was very low due to depletion of organic substrate in anoxic phase. However, the deficiency could be improved by addition of organic media in anoxic phase from the simulated result. Nitrogen removal efficiency in a biofilter process packed with organic media in anoxic phase was predicted to be 29% higher than that packed with inorganic media. In addition, about 79% of nitrogen removal efficiency could be obtained from a column test using organic media innoculated by activated sludge. Improvement in nitrogen removal efficiency was responsible for organic leaching from the organic media and the leaching rate was 0.21㎎COD/g-org.media/day.

      • KCI등재

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