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      • KCI등재

        Kambin’s Triangle Approach of Lumbar Transforaminal Epidural Injection with Spinal Stenosis

        박지웅,Hee Seung Nam,Soo Kyoung Cho,Hee Jin Jung,박용범 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.6

        Objective To compare the short-term effect and advantage of transforaminal epidural steroid injection (TFESI)performed using the Kambin’s triangle and subpedicular approaches. Method Forty-two patients with radicular pain from lumbar spinal stenosis were enrolled. Subjects were randomly assigned to one of two groups. All procedures were performed using C-arm KMC 950. Th e frequency of complications during the procedure and the effect of TFESI at 2 and 4 weeks after the procedure between the two groups were compared. Short-term outcomes were measured using a visual numeric scale (VNS) and a five-grade scale. Multiple logistic regression analyses were performed to evaluate the relationship between possible outcome predictors (Kambin’s triangle or subpedicular approach, age, duration of symptoms and sex) and the therapeutic effect. Results VNS was improved 2 weeks after the injection and continued to improve until 4 weeks in both groups. There were no statistical diff erences in changes of VNS, effectiveness and contrast spread pattern between these two groups. No correlation was found between the other variables tested and therapeutic effect. Spinal nerve pricking occurred in five cases of the subpedicular and in none of the cases of the Kambin’s triangle approach (p<0.05). Conclusion The Kambin’s triangle approach is as efficacious as the subpedicular approach for short-term effect and offers considerable advantages (i.e., less spinal nerve pricking during procedure). The Kambin’s triangle approach maybe an alternative method for transforaminal epidural steroid injection in cases where needle tip positioning in the anterior epidural space is difficult.

      • KCI등재

        Extensive Neuromusculoskeletal Complications—Including Multi-Level Vertebral Osteomyelitis, Myelopathy, Polyradiculopathy, and Multiple Muscle Abscesses—After Lumbar Transforaminal Epidural Block: A Case Report

        박지웅,Noh Jeong Se 대한근전도전기진단의학회 2022 대한근전도 전기진단의학회지 Vol.24 No.3

        Vertebral osteomyelitis (VO) is a rare, slowly progressing disease that often causes neuromuscular complications. Epidural block is a non-surgical treatment used in patients with radicular pain to deliver drugs to the epidural space; it is generally known to be a safe method, but it can occasionally cause infection. Herein, we present a rare case of VO with severe neuromuscular complications that developed in a patient who underwent lumbar transforaminal epidural block for back pain. Imaging studies showed VO, multiple pyogenic abscesses, and compressive cervical myelopathy. Electrodiagnostic studies showed clear evidence of cervical myelopathy and polyradiculopathy. With early treatment using a multidisciplinary approach, including medical treatment, surgery, and comprehensive rehabilitation, recovery of motor weakness and functional improvement were achieved after 2 months of treatment. Electrodiagnostic studies are advantageous for localizing and determining the degree of neuromuscular damage following VO. A multidisciplinary approach to the diagnosis and treatment of VO could improve patients’ prognosis, functional ability, and quality of life.

      • KCI등재

        Usefulness of Posterolateral Transforaminal Approach in Lumbar Radicular Pain

        박지웅,박용범,남희승 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.3

        Objective To compare the short-term effects and advantages of transforaminal epidural steroid injection (TFESI)performed using the conventional (CL) and posterolateral (PL) approaches. Method Fifty patients with lumbar radicular pain from lumbar spinal stenosis and herniated lumbar disc were enrolled. Subjects were randomly assigned to one of two groups (CL or PL group). All procedures were performed using a C-arm (KMC 950, KOMED, Kwangju, Kyunggi, Korea). We compared the frequency of complications during the procedure and the effects of the pain block between the two groups at 2, 4, and 12 weeks after the procedure. Results There were no significant differences in the demographic data, initial VNS (Visual numeric scale), or ODI (Oswestry disability index) between the CL group (n=26) and the PL group (n=24). Th ere was no statistically signifi cant difference in the outcome measures (VNS and ODI) between the groups at 2, 4, or 12 weeks. Symptoms of nerve root irritation occurred in 1 case of the CL group and in 7 cases of the PL group (p<0.05). Pricking of spinal nerve during the procedure and transient weakness after the procedure occurred in 6 cases and 3 cases,respectively in the CL group, but did not occur in the PL group. Conclusion Our fi ndings suggest that the posterolateral approach represents an alternative TFESI method in cases with diffi cult needle tip positioning in the anterior epidural space, and could lower the risk of target nerve root irritation and nerve penetration.

      • KCI등재

        동북아 부가가치 석유물류 비즈니스 모델에 관한 연구

        박지웅,이충배 한국항만경제학회 2023 韓國港灣經濟學會誌 Vol.39 No.1

        In the Northeast Asian region, including Korea, China, and Japan, with rapid economic growthsince the 1990s, intra-regional oil logistics has been increasing. Under such external circumstances,Korea has been pursuing a policy to become a Northeast Asian petroleum logistics hub since themid-2000s. In order to become a Northeast Asian logistics hub, it is important to establish and promotea business model to promote the value-added oil logistics business. This study aims to proposepolicies and practical implications for increasing petroleum logistics by analyzing Korea's petroleumlogistics business model in Northeast Asia. The results of case analysis through interviews with 23 tank terminal companies are as follows. First, most of the oil storage tank terminal companies interviewed are conducting value-added petroleumlogistics such as blending, breaking bulk, and consolidation etc. Second, value-added petroleumlogistics is caused by an imbalance in supply and demand among neighboring countries inNortheast Asia. In particular, there is a high demand for breaking bulk and blending connectingJapan, Oceania, the United States, and South America. Third, it is necessary to promote the promotionof value-added logistics by improving infrastructure, institutions, and regulations in response tothe demand for value-added petroleum logistics, which will greatly contribute to Korea's policy forbeing Northeast Asian oil hub. 한·중·일을 포함하는 동북아지역은 1990년대 이후 급속한 경제성장과 더불어 역내외 석유물류가증대되고 있다. 우리나라는 이러한 대외적인 환경하에서 2000년대 중반 이후 동북아 석유물류허브화 정책을 추진해 왔다. 동북아 물류허브화를 위해서는 부가가치 석유물류의 비즈니스 활성화를 위한 비즈니스 모델의 구축과 촉진이 중요하다. 동북아 지역에서 우리나라 석유물류 비즈니스 모델을 분석함으로써석유물류 활성화에 대한 정책적·실무적 시사점을 제시하는 데 목적이 있다. 전체 23개 탱키지 업체를 대상으로 면담조사에 의한 사례분석결과는 다음과 같다. 첫째, 면담조사한대부분의 유류저장탱크터미널업체들은 블랜딩, 소분화, 집적화와 같은 부가가치 석유물류를 실시하고 있다. 둘째, 부가가치 석유물류의 발생은 주변국들간 수급의 불균형에 의해 발생하고 있는데 특히 일본,오세아니아, 미국, 남미 등을 연결하는 소분화와 블랜딩 수요가 높다. 셋째, 부가가치 물류수요에 대응한 인프라, 제도 및 규제 등에 대한 개선을 통해 부가가치 석유물류의 활성화를 촉진해야 할 것이며 이는 우리나라의 동북아 오일허브 정책에 크게 기여하게 될 것이다.

      • KCI등재

        뉴욕 주 사법입원 및 외래치료 지원제도에 대한 고찰

        박지웅,최준호,최영민,손보경 대한신경정신의학회 2020 신경정신의학 Vol.59 No.4

        In recent decades, laws for involuntary treatment have evolved in ways that protect human rights as well as public safety. Globally, many nations have legislation for psychiatric patients that provide procedural advocacy during their involuntary treatment while a court or another independent organization reviews its lawfulness. In contrast, people with severe mental illness in Korea risk encountering human rights violations and loss of timely treatment, because their involuntary admissions are primarily initiated by family members and civil doctors and not by courts or government. The Mental Health Promotion and Welfare Act, revised in 2016, does not address this fundamental weakness, instead restricting involuntary admission criteria and bypassing the implementation of any procedural assistance programs. Subsequently untreated patients lead to clinical aggravation and even serious felony offenses. This paper introduces New York State’s court-ordered treatment system via the Mental Hygiene Law as a model for the revision of Korean legislation. The findings show that involuntary admissions in New York State are initiated by many parties as well as familial relatives and may be held up to 60 days without any court order. However, patients are assigned legal counsel for the ability to request for a court hearing at any time during their admission. The Assisted Outpatient Program is another legal intervention that requires a person with a mental illness that would likely result in serious harm to self or others to receive supervised outpatient treatment. We argue that the New York State model can be implemented effectively in Korea considering its current medical and judicial status.

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