요추 추간판 탈출증에 의한 기능성척추측만증 치험 3례 -Mckenzie 수기요법을 이용-

김대필 ( Dae Feel Kim ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.2

Objectives : We evaluated the effect of Mckenzie method treatment in three patients with functional lumbosacral scoliosis by lumbar disc herniation. Methods : We examined three patients through Lumbar CT scan and X-ray examination. Those patients were diagnosed as functional lumbosacral scoliosis by lumbar disc herniation. We used acupuncture, physical treatment and Mckenzie method at those patients and measured of Cobb`s angle and VAS(Visual analogue scale) to evaluate treatment effects. Results and Conclusions : The pain level and scoliotic angle were decreased after treatment. These results suggest that acupuncture, physical treatment and especially Mckenzie method treatment was effective to correct the functional lumbosacal scoliosis by lumbar disc herniation, reduce the low back pain and stabilized the lumbar disc herniation.

폐경 전 여성의 비만이 자율신경계 활성도 변화에 미치는 영향

김대필 ( Dae Feel Kim ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.1

Objectives : This study was designed to evaluate the influence of obesity on autonomic nervous system activity. Methods : This clinical study have been carried out with premenopausal 59 women that entered Dong-Guk university Bun-Dang oriental medicine hospital from January, 2004 to May, 2005. 59 women were divided into 27 women non-obese group(<BMI 25) and 32 women obese group(.BMI 25). Results : 1. MHRT, SDNN, RMSSD which obtained by time domain analysis were significantly decreased in obese group. 2. TP, LF, HF, LF/HF ratio which obtained by frequency domain analysis were decreased in obese group, HF was significantly decreased but othres were no significant differences between non-obese group and obese group. Conclusions : These results suggest that both sympathetic and parasympathetic activity were decreased in obese premenopausal women.

화타협척혈 침자극에 의한 손상 말초신경의 재생효과에 관한 연구

김대필 ( Dae Feel Kim ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.4

목 적 : 좌골신경 압좌손상으로 유발된 쥐의 모델을 이용하여 손상된 말초신경의 재생효과에 관한 침자극 효과를 세포분자학적, 조직학적 관점에서 연구하였다. 아울러 손상 좌골신경을 지배하는 척수신경근과 가까운 부위 경혈자극과 좌골신경이 지배하는 말초부위 경혈자극과의 침자극 효과를 비교 연구하였다. 방 법 : 한쪽 좌골신경에 압좌손상을 유발 한 실험쥐들을 1주, 2주로 나눈 뒤 각각에 대해 격일로 1주군은 3회, 2주군은 6회의 침자극을 시행하였다. 손상 좌골신경의 재생효과를 비교실험하기 위해 정상군, 압좌손상만을 유발한 실험군, 침자극 군으로 나누었다. 침자극 군 중 한 군은 손상신경을 지배하는 척수신경근에 가장 가까운 2개의 화타협척혈(EX B2)에 자침(근위부 자극군)하였고, 다른 한 군은 말초부위에 위치한 족삼리혈(ST 36)과 위중혈(BL 40) 2곳에 자침(원위부 자극군)하였다. 실험 후 각각의 조직을 분리하여 Western blotting 혹은 Hoechst staining으로 Gap-43, Cdc2, Cdk2, Erk1/2 단백질을 분석 및 좌골신경의 각 세포수를 측정하였다. Retrograde tracing을 통해 L5의 DRG와 척수에서 말초신경 재생 효과를 관찰하였고, Immunofluorescence staining을 통해 신경돌기 가지의 신장 정도를 파악하였다. 결 과 : 좌골신경 손상 7일된 실험쥐의 근위부와 원위부 침자극군에서 GAP-43와 Cdc2 단백질수준이 향상된 것으로 나타났다. Cdk2 단백질수준은 압좌손상 실험군에서 강하게 증가하였지만 침자극군과 비교해서 별다른 차이는 보이지 않았다. Phospho-Erk1/2 단백질수준은 침자극군에서 향상된 것으로 나타났다. 손상 7일과 14일 된 실험쥐의 손상 원위부에서 슈반세포 수가 증가하였으며 특히 근위부 침자극군에서 더욱 증가한 것으로 나타났다. Retrograde tracing을 이용한 검사 결과 침자극군에서 L5의 DRG와 척수의 염색 세포 수가 증가된 것으로 나타나 침자극이 축삭재생에 효과적인 것으로 나타났다. L5의 DRG 감각신경의 신경돌기 가지 신장정도 및 GAP-43 단백질의 발현 정도를 측정한 결과 근위부 침자극군에서 효과적으로 GAP-43 단백질의 발현 및 신경돌기 가지가 신장된 것으로 나타났다. 결 론 : 본 실험결과 침치료가 손상 좌골신경의 재생에 효과적인 것으로 보여지며, 특히 손상된 좌골신경을 지배하는 척수신경근 주위 화타협척혈에 대한 침자극이 말초부위의 침자극에 비해 신경재생에 더욱 효과적인 것으로 나타났다. Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods : Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, DiI fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and DiI-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increases in regeneration-associated protein levels appeared to be related with increased cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased DiI-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of DiI labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.

심박수 변이도(Heart Rate Variability)를 이용해 고찰한 자율신경실조증 환자의 치험례

김대필 ( Dae Feel Kim ),최유석 ( You Seok Choi ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2004 한방재활의학과학회지 Vol.14 No.3

Objectives: This study was performed to evaluate the effect of acupuncture treatment on the imbalance of autonomic nervous system in the patient with dysfunction of autonomic nervous system by heart rate variability. Methods: The patient was hospitalized Dong-guk univesity Bundang oriental medicine hospital from 20th, Oct., 2003 to 25th, Oct., 2003. To evaluate the effect of acupuncture treatment, the patient was treated on the Back-shu points with acupuncture and tested immediately before and after acupuncture treatment by heart rate variability. Results and Conclusions: In this case, acupuncture treatment on the Back-su points was able to suppress the sympathetic activities and enhance the parasympathetic activities in the patient with dysfunction of autonomic nervous system. So it is suggested that acupuncture treatment was able to improve the imbalance of autonomic nervous system.

근골격계 통증 환자에서 침 치료 후 심박수 변이도 (Heart rate variability) 변화에 관한 연구

김대필 ( Dae Feel Kim ),허광호 ( Kwang Ho Heo ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2005 한방재활의학과학회지 Vol.15 No.2

Objectives : This study was designed to evaluate the changes of autonomic nervous system by heart rate variability(HRV) test on the musculoskeletal pain patients treated with acupuncture on the Back-su points and the unfixed points, and untreated healthy adults. Methods : This clinical study have been carried out with 64 cases of musculoskeletal pain patients and 26 healthy adults. 35 patients were treated with acupunctureon on the Back-su points(GroupⅠ) and 26 patients were treated on the Unfixed points(GroupⅡ), and two groups were tested by HRV at pre and post acupuncture treatment. 26 healthy adults(GroupⅢ) were tested twice by HRV without any stimulation. Results : In GroupⅠ, VAS was decreased 5.83±1.62 to 5.17±1.89 significantly(p<0.05) after acupuncture treatment, and LF/HF ratio was decreased significantly(p<0.05) as compared with other Groups. In GroupⅡ, SDNN & RMSSD were increased significantly(p<0.05) as compared with other Groups. In GroupⅠ&Ⅱ, MHRT was decreased significantly(p<0.05) as compared with healthy control Group. Conclusions :These results suggest that acupuncture treatment on the Back-su points was able to reduce the pain, suppress the sympathetic activities and enhance the parasympathetic activities in musculoskeletal patients.

농촌지역 보건소 한방진료실 확대설치 요구도 및 관련요인

김대필(Dae-Feel Kim),송미숙(Mi-Sook Song),송현종(Hyun-Jong Song) 한국농촌의학 지역보건학회 2003 농촌의학·지역보건 Vol.28 No.1

요통 치료를 위한 흉요추 이행부 (Thoracolumbar Junction) 와 배유혈(背兪穴), 화타협척혈(華他夾脊穴)의 상관성 에 관한 연구

박영회,금동호,김대필,Park, Young-Hoi,Keum, Dong-Ho,Kim, Dae-Feel 척추신경추나의학회 2004 대한추나의학회지 Vol.5 No.1

Objectives : This study was designed to investigate the correlation between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain in the thoracolumbar junction syndrome that was suggested by Maigne R. Method : We Investigate the acupuncture points that was correlated with the location of thoracolumbar junction area. And We tried to find out a common point between thoracolumbar junction and back-su points, Hwatahyeopcheok points for treatment of low back pain. Results and Conclusion : 1. It is considered that these points such as $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points that are located from 11th thoraic spinous process to 2nd lumbar spinous process are correspond to the thoracolumbar junction area. 2. It is suggested that acupuncture treatment on $BL_{20}$, $BL_{21}$, $BL_{22}$, and Hwatahyeopcheok points can release the tenderness of the muscles, recover autonomic nervous function and release smooth muscles and vascular contraction, so it can treat low back pain caused by thoracolumbar junction.

추나수기요법과 자침으로 호전된 만성 미골통 환자

강지훈 ( Ji Hun Kang ),김대필 ( Dae Feel Kim ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2005 한방재활의학과학회지 Vol.15 No.3

Objectives : This study was performed to evaluate the effect of Chuna manipulation and acupuncture treatment on coccygodynia clinically. Methods : The patients were hospitalized Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University, diagnosed as Chronic coccygodynia and treated with Chuna Manipulation, Acupuncture. After measured the VAS(visual analogue scale), we analyzed effect of chuna manipulation and acupuncture treatment on coccygodynia. Result & Conclusions : Symptom of patient such as coccygodynia was improved after above treatment. So it is suggested that oriental medical treatment are effective in the coccygodynia.

제5요추- 제1천추간 후관절증후군 환자의 방사선학적 소견에 관한 임상적 연구

최유석 ( You Seok Choi ),김대필 ( Dae Feel Kim ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2005 한방재활의학과학회지 Vol.15 No.2

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle between the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients. Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients. Results : 1. Van Akkerveeken measurement of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients are not statistically larger than that of sample group patients. Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.