• Title/Summary/Keyword: 관절질환

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Signs and symptoms of temporomandibular disorders in instrumental performers (악기연주자의 측두하악장애 징후와 증상)

  • Jang, Jae-Young;Choi, Young-Chan;Bae, Jung-Hee;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.86-95
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    • 2015
  • Purpose: The aim of the study was to evaluate the subjective symptoms and clinical signs through the TMD-questionnaire, clinical examination and radiography against the many instrumental performers and to investigate the association between playing instruments and TMDs. Materials and Methods: A total of 803 instrumental performers received TMD-related questionnaire and evaluations of prevalence and disease distribution were performed. Among those who reported at least one symptom of TMD, 70 volunteers visited in clinic then received clinical examination and radiography for diagnosis and evaluations of prevalence and disease distribution were performed. 70 subjects were divided into three groups as woodwind, brass wind, string. Comparative analysis of disease distribution was performed. Results: Among 803 instrumental performers, 610 people (75.97%) were reported to one or more symptoms of TMD. The most frequent symptom was click (29.68%).70 subjects underwent a clinical examination and radiography survey results, the most frequent symptom was a click (29.75%). Most commonly diagnosed disease was a myofacial pain (30.53%).Comparison of the three groups, a significant difference was not observed in the clinical sign. But among subject symptom, muscle pains howed significant differences in accordance with the Group (P = 0.024). During the 70 people who underwent clinical examination, 66 people (94.3%) showed moderate to severe attrition, mild to severe tongue ridging, mild to severe cheek ridging assigns of parafunction. Conclusion: Instrumental performers showed a high prevalence of TMD and the most of the musicians with temporomandibular disorder had bruxism or clenching habits.

Comparisons of Health Status and Health Behaviors among the Elderly between Urban and Rural Areas (도시와 농촌지역 노인의 건강행태 및 건강수준 비교)

  • Chun, Jong-Duk;Ryu, So Yeon;Han, Mi Ah;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.38 no.3
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    • pp.182-194
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    • 2013
  • Objectives: To identify and compare the health behaviors and health status of the elderly between urban and rural areas using the data of the Korean National Health and Nutrition Examination Survey (KNHANES). Methods: The study population comprised 3,823 elderly people aged 65 years or older who participated in the $4^{th}$ KNHANES (2007-2009). The areas were classified into "large cities," "cities," and "rural areas" using the administrative and residential areas. The health behaviors and health status of the elderly between the rural and urban areas were compared using a complex sample design with the Rao-Scott chi-square test and weighted multiple logistic regression analysis. Results: Compared to large cities, the odds ratios (ORs) (95% confidence interval [CI]) of rural areas were as high as 1.58 (1.25-2.01) for the influenza vaccination and as low as 0.47 (0.37-0.59) for flexibility exercises, 0.56 (0.38-0.81) for muscular exercises, and 0.76 (0.62-0.92) for obesity. The ORs (CI) for osteoarthritis and diabetes mellitus were as low as 0.81 (0.66-0.99) and 0.70 (0.55-0.89), respectively. Conclusions: The health behaviors and health status of the elderly are better in rural areas than in urban areas despite the fact that the socioeconomic conditions in rural areas are poorer that those in urban areas. These findings suggest that programs suitable for residential areas should be developed and that studies to explain the differences in residential areas are needed.

Outbreak of Hepatitis A in TaeJon in 1996 : Clinical and Epidemiologic Study in Children (1996년 대전시 서북부에서 발생한 A형 급성 간염)

  • Choi, Jin-Ook;Lee, Kyung-Yil;Lee, Dong-Joon;Han, Ji-Whan;Hwang, Sung-Soo;Lee, Kyong-Su
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.90-96
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    • 1997
  • Purpose : Recently a shift in hepatitis A incidence from children to adults has been well noted. We experienced under 15-years old 31 patients who presented hepatitis A infection. In order to prepare for the prevention on hepatitis A outbreak in the future, we studied the clinical and epidemiologic manifestations of these patients. Methods : We enrolled patients from July to December in 1996 (6 months) and evaluated the monthly incidence, geographical distribution, age and sex, and clinical manfestations, including laboratory fadings. Results : Many cases of hepatitis A occured in the summer months, especially August (16/31 cases). Most of patients (87%) were living in the Seo-Ku area (northwest district of the city). In age distribution, there were no cases under 3 years of age, 3 cases from 4~5 years, 13 cases from 6~10 years, 15 cases from 11~15 years. Clinical profiles showed that dark urine, nausea and vomiting, anorexia, abdominal pain, fever, and fatigue were the common presenting symptoms. The initial presenting laboratory tests included total bilirubin 3.3mg/dl, alkaline phosphatase of 856units/L, and serum asparate aminotransferase and alanine aminolransferase levels of 910IU/L and 1239IU/L, respectively. No patient presented atypical clinical courses or complications. Conclusions : Hepatitis A in children shows benign clinical features. This study showed that the possibility of another outbreak of Hepatitis A in the TaeJon area or elsewhere in the near future Korea will be possible. To prevent an outbreak we will be concerned about the anti-HAV IgG prevalance rate in children and preventive modalities including vaccination against hepatitis A.

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Surgical Treatment of Giant Cell Tumor of the Spine (척추 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Rhyu, Kee-Won;Rhee, Seung-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Park, Chang-Goo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.138-145
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    • 2009
  • Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

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Giant Cell Tumor of Tendon Sheath in Hand (Comparative Studies Between Single and Multifocal Lesions) (수부 건초에서 발생한 거대 세포종 (단발성 및 다발성 거대 세포종의 비교))

  • Rhee, Seung-Koo;Kang, Yong-Koo;Bahk, Won-Jong;Yang, Sung-Chul;Shin, Yun-Hack
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.52-60
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    • 2003
  • Purpose: To analyse their end results and also to differentiate the single or multiple giant cell tumor(GCT) of tendon sheath in hand. Materials & Methods: Total 21 cases with GCT of tendon sheath in hand were treated surgically and analyzed their end results with clinically, radiologically and pathologically to allowed for average 16 months after surgical excision. Results: The finger flexor tendons, especially on index and ring finger, involving distal interphalangeal joint and mid-phalanges in fourth decades (average age of 47 years old) were frequently involved, and the mass was not exceed than 2 cm in size, fixed on tendon sheath with rubbery hard tenderness but rare bony involvements except 4 cases of bony erosion and cortical perforation. The three cases with multiple GCT of hand was also combined with familial hypercholesterolemia, and are commonly involved the extensor tendons as well as achilles tendons bilaterally, treated with partial excision because of multiplicity. Average 16 months after surgical excision for single GCT cases was followed and showed the recurrence in 3 cases(3/18,16.7%), treated with wide excision. The single and multifocal GCT are similar in pathologic changes but different soft tissue tumors in their pathogenesis, treatment and prognosis. Conclusion: Incomplete excision of GCT of tendon sheath in hand are thought to be the cause of recurrence, especially in cases with incomplete lesional excision, in multilobular and bony involvement etc. So careful wide excision is necessary to prevent the recurrence.

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Initial Symptoms of Malignant Bone Tumors (악성 골 종양의 초기 증상)

  • Oh, Joo-Han;Lee, Sang-Hoon;Suh, Sung-Wook;Lee, Ho-Kyoo;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.18-23
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    • 2003
  • Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Determination of homogentisic acid in human plasma by GC-MS for diagnosis of alkaptonuria (GC-MS를 이용한 혈장 중 호모겐티식산의 분석;알캅톤뇨증의 진단)

  • Thapa, Maheshwor;Yu, Jundong;Lee, Wonjae;Islam, Fokhrul;Yoon, Hye-Ran
    • Analytical Science and Technology
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    • v.28 no.5
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    • pp.323-330
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    • 2015
  • Alkaptonuria, a rare inherited metabolic disease, is characterized by a lack of homogentisate dioxygenase and accumulation of homogentisic acid (HGA), leading to homogentisic aciduria, arthritis, and ochronosis. In this study, a rapid analytical method, without an expensive and tedious solid phase extraction step, was developed to quantify HGA in plasma using GC-MS. HGA-spiked pooled plasma samples were subjected to liquid-liquid extraction (LLE) with ethyl acetate, followed by trimethylsilyl derivatization (TMS) and GC-MS quantification using selected ion monitoring. The formation of TMS derivative of the 1 carboxylic and 2 hydroxyl functional groups was performed by reacting BSTFA (with 10% TMCS) for 5 min at 80 ℃. For selected ion monitoring, quantification and confirmation ions were determined based on specific ions (m/z 384, m/z 341 and m/z 252) of the TMS derivative of HGA. Calibration curves of pooled normal plasma specimens showed a linear relationship in the range of 1-100 ng/µL. The precision and accuracy were within a relative standard deviation (RSD) of 1 to 15% and a bias of -5 to 25%. Recoveries were obtained in the range of 99-125% and 95-115% for intra-day and inter-day assay, respectively, at 2, 20 and 80 ng/µL. The limit of detection (LOD) and limit of quantification (LOQ) were 0.4 ng/µL and 4 ng/µL, respectively. No homogentisic acid was excreted from normal Korean plasma samples. Collectively, the results from the present study suggest that this method could be useful for routine diagnosis and therapeutic monitoring of alkaptonuria patients with excellent sensitivity and rapidity.

The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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Foodservice Characteristics and Satisfaction of the Elderly with the Welfare Facilities in the Northern Gyeonggi-do Area (경기 북부지역 복지시설 이용노인의 급식 현황 및 만족도 조사)

  • Kim, Young Soon;Park, Young Shim;Choi, Byung Bum
    • The Korean Journal of Food And Nutrition
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    • v.27 no.5
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    • pp.872-880
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    • 2014
  • This study was conducted to assess the characteristics and satisfactions related with facility foodservice for the elderly in the Northern Gyeonggi-do area (Republic of Korea). To accomplish this, a survey was conducted to investigate the general characteristics of the elderly, health information, and satisfaction with the foodservice of a welfare facility in the area. The main sources of health information for both the male and female elderly included 'health professionals' (49.0, 45.7%) and the 'mass media' (34.4, 33.5%), and they were revealed to trust the information from 'health professionals' (65.6, 59.5%), more so than the 'mass media' (19.8, 20.8%). The principal diseases of the elderly were 'hypertension' (27.1%), 'diabetes' (21.9%), 'palsy' (19.8%) in males, and 'hypertension' (32.4%), 'diabetes' (24.9%), 'arthritis' (15.0%) in females. Most male and female elderly indicated the main reasons for skipping a meal to be 'no appetite' (37.5, 53.8%) and 'indigestion'(19.1, 17.3%), respectively. The facility foodservice was used by the male elderly for the reasons of 'irritating to cook' (28.1%), 'to meet a friend' (26.0%), and 'economic' (14.6%), while the female elderly used it for the reasons of 'economic' (25.4%), 'to meet a friend' (23.1%), and 'irritating to cook' (23.1%). The reasons for satisfaction with the facility were subject to 'meal supply' (28.0, 37.2%), 'social exchanges' (20.0, 22.3%), and 'good facilities' (18.7, 18.2%). Regarding the officers and nurses of the facility, 13.3% and 9.3% of males and 8.3% and 12.4% of females indicated satisfaction, respectively. The satisfaction with foodservice influenced the welfare facilities, and providing a successful environment for foodservice requires strengthening of the education of facilities employees to become friendlier. Based on these results, greater efforts should be made to provide meaningful information regarding the facility foodservice for the elderly related to the silver service industry in the Northern Gyeonggi-do area as soon as possible.