• Journal of Korean society of Dental Hygiene
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• v.19 no.5
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• pp.665-676
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• 2019

Objectives: The purpose of the study was to analyze the association between indirect vision skills and neck, shoulder, and back pain in dental hygienists. Methods: This cross-sectional study included 85 dental hygienists working full-time at dental clinics. A survey was performed for musculoskeletal symptoms in the neck, shoulders, and back of the subjects. The O'Connor tweezer dexterity test was performed using a mirror to evaluate their indirect vision skills. For statistical analyses, the t-test and one-way analysis of variance were performed. Results: The neck was the most common region of musculoskeletal pain (89.4%). The most intense pain was experienced in the neck (70.6%) and right shoulder (60.0%). Neck pain (20.0%) caused the most interference with clinical practice. Indirect vision skills were lower in the group with severe pain in the left shoulder or with high interference in work due to the left shoulder pain (p=0.026 and p= 0.017, respectively) or right shoulder pain (p=0.004). Conclusions: In this study, neck pain was a major musculoskeletal symptom among dental hygienists, and poor indirect vision skills were associated with the development of shoulder pain. Therefore, to prevent such musculoskeletal symptoms, dental hygienists should become proficient in indirect visualization, which enables a balanced and neutral posture.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.219-227
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• 2001

중국 낙양의 평악곽씨(平樂郭氏) 정골법은 중국의학의 골상과(骨傷科) 중에서 중요한 학술유파로 널리 알려져 있다. 그 치료법에 있어서 독특하고 체계적인 시술법을 갖추고 있는데, 교정 수기법, 고정방법, 기능훈련, 약물치료 등의 내용을 포함하고 있다. 창상(創傷)에 대한 약물요법에서 "파(破) 화(和) 보(補)" 3단계로 분류된 약물사용 원칙을 제시하였는데, 즉 골정손상의 초기에는 기혈어체(氣血瘀滯)의 병리기전에 입각하여 약물은 활혈화어제(活血化瘀劑)를 주로 사용하고, 중반에는 기혈부화(氣血不和) 경락부통(經絡不通)의 기전으로 파악하고 주로 활혈통락(活血通絡)시키는 약물을 사용하며, 말기에는 구병(久病)으로 기형(氣血)이 휴손(虧損)되므로 보기혈(補氣血) 및 장근골(壯筋骨)의 약물을 주로 사용한다. 이와 같은 평악곽씨(平樂郭氏)의 正骨(정골)에 관한 약물사용 원칙을 토대로 선조의 처방과 경험방 및 후세의 통용방(協定方)을 근간으로 심은 평악곽씨(平樂郭氏)의 正骨(정골)에 대한 전통약물시리즈가 형성되었다. 이러한 처방들은 장기간의 임상활용에서 그 효과가 뛰어나고 안전성이 확보된 것으로 입증되었다. 근골통소환(筋骨痛消丸)은 활혈행기(活血行氣), 온경통락(溫經通絡), 소종지통(消腫止痛)의 효능이 있어 근골의 퇴행성 질환이나 만성 노손(勞損)으로 일어나는 종창(腫脹), 통증, 관절활동의 제한, 목 어깨 허리 다리 등의 통증, 발꿈치 통증, 골절 후 지체(肢體)의 종통(腫痛), 어혈 등에 활용한다. 활혈접골지통고(活血接骨止痛膏)는 접골속근(接骨續筋), 통락지통(通絡止痛)의 효능이 있어 골상(骨傷)을 입은 후 지체(肢體)의 종창(腫脹)이나 통증 또는 골절 등에 사용한다. 이 약은 크림제와 고약제 두가지가 있다. 평악내복접골교양(平樂內服接骨膠襄)은 활혈소종(活血消腫), 접골속근(接骨續筋)의 효능이 있어 각종 근육의 손상이나 골정상에 활용된다. 평낙전근단(平樂展筋丹)은 활혈화어(活血化瘀), 서근지통(舒筋止痛), 통리관절(通利關節), 등의 효능이 있어 타박상으로 인한 지체(肢體)의 종통(腫痛), 관절강직, 활동제한 및 골관절 질환과 풍습비통(風濕痺痛) 등을 치료한다. 전통적으로 외용(外用)에 사용되는 산제(散劑)는 마사지에 주로 활용된다. 임상에서 다양한 제형(劑型)으로 개발되어 분무형태로 쓰이는 근상정(筋傷酊)과 마사지 크림으로 사용되는 평악낙전근접마유제(平樂展筋接摩乳劑)가 있다. 소종활혈(消腫活血) 대포제(袋泡劑)는 산제(散劑)를 티팩 형식으로 사용하는 외용제형(外用劑型)이며, 서근활혈(舒筋活血), 소종지통(消腫止痛)의 효능이 있어 타박상 말기에 근육이 굳어지고, 어반이 형성되면서 통증이 나타나며, 종창(腫脹) 등이 생길 때 사용한다. 사용방법은 따뜻한 물에 담가 우려낸 다음 상처부위를 씨어주면 된다. 특별히 제작된 접골환(接骨丸)은 배보간신(培補肝腎), 익기건비(益氣健脾), 활혈통락(活血通絡), 강근건골(强筋健骨) 등의 작용이 있어 파박상이나 골절이 잘 치유되지 않고 오래 지속되는 경우에 사용된다. 이와 같은 다양한 평악곽씨(平樂郭氏)의 전통적인 정골(正骨)에 관한 약물들은 약리학적 실험을 거쳐 그 독성반응이나 부작용 및 임상효과를 관찰한 결과 통제학적으로 p<0.05-0.01로 나타나 98%의 치료효과를 보였으며, 독성 및 부작용이 없어 안정성이 인정되었으므로 긍정적인 치료효과를 확인할 수 있었다.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.93-101
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• 2019

PURPOSE: This study tries attempted to provide basic clinical data to reduce pain and improve function by comparing the muscle fatigue of the superficial neck muscles and neck disability index (NDI) by performing McKenzie exercise or passive stretching exercise for chronic neck pain patients. METHODS: Sixteen chronic neck pain patients were selected and divided into the McKenzie group (n=8) and passive stretching group (n=8). The intervention program was performed three times a week for four weeks. The time for one exercise was 30 minutes. Before the intervention, the muscle fatigue the superficial neck muscles and NDI were measured. They were measured again after four weeks using the same method. RESULTS: The median frequency of the superficial neck muscles increased significantly in the McKenzie group and passive stretching group (p<.05). The NDI of both the McKenzie group and the passive stretching group decreased significantly. A comparison of the groups, revealed a significant difference in only the median frequency values of the upper trapezius muscle and splenius capitis muscle (p<.05). The NDI values of both groups were similar. CONCLUSION: Both McKenzie exercise and passive stretching exercises showed a significant difference in the degree of fatigue and NDI. McKenzie exercise delayed the replace of the fast twitch fibers which helped improve the muscle fatigue of the upper trapezius muscle and splenius capitis muscle. On the other hand, additional studies applying more variables for the muscle function to improve the symptom of chronic neck pain patients will be needed.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.695-701
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• 2003

Purpose : It had been suggested that pain arising from deep somatic body regions influences neural activity within periaqueductal gray(PAG) of midbrain via distinct spinal pathways. Aspirin is one of the popular non-steroidal anti-inflammatory drugs used in the management of pain. Fos expression was used as a marker for neuronal activity throughout central neurons following painful peripheral stimulation. This study was prepared to investigate changes of c-Fos immunoreactivity in midbrain by deep pain and effects of aspirin. Methods : Male Sprague-Dawley rats were injected with 0.1 mL of 5% formalin in the plantar muscle of the right hindpaw. For experimental group II, aspirin was injected intravenously before injection of formalin. An aspirin-untreated group was utilized as group I. Rats were sacrificed at 0.5, 1, 2, 6 and 24 hours after formalin injection. Rat's brains were removed and sliced in rat brain matrix. Brain slices were coronally sectioned at interaural 1.00-1.36 mm. Serial sections were immunohistochemically reacted with polyclonal c-Fos antibody. The numbers of c-Fos protein immunoreactive neurons in ventrolateral periaqueductal gray(VLPAG) and dorsomedial periaqueductal gray(DMPAG) were counted and analyzed statistically with Mann-Whitney U tests. Results : Higher numbers of c-Fos protein immunoreactive neurons were found in VLPAG. In both VLPAG and DMPAG of formalin-treated group, the numbers of c-Fos protein immunoreactive neurons were significantly higher at all time points than the formalin-untreated group, which peaked at two hours. The numbers of c-Fos immunoreactive neuron of the aspirin-treated group were less compared to the aspirin-untreated group at each time point. Conclusion : These results provide some basic knowledge in understanding the mechanism of formalin-induced deep somatic pain and the effects of aspirin.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1248-1252
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• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.481-486
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• 2008

Purpose : The aims of this study were to test the efficacy of vapocoolant spray to decrease the symptoms associated with pain in newborns undergoing heel stick and intramuscular injection and compare the pain relief effect of oral glucose. Methods : Randomized, controlled study including sixty newborns undergoing heel stick and intramuscular injection. Group 1 was heelsticked, Group 2 was intramuscular injected, Group A did not recieve any treatment, Group B recieved 30% glucose solution orally, Group C was applied vapocoolant spray symptoms and signs associated with pain at heel stick and intramuscular injection were measured with the premature Infant Pain Profile (PIPP) scale. Results : There was no significant difference in the PIPP score between intramuscular injected group control and heel stick group control (P=0.07). The mean PIPP score of Group 1A (control) $10.6{\pm}2.4$, Group 1B $5.5{\pm}2.0$, Group 1C $5.2{\pm}1.8$. The mean PIPP score 1B and 1C were significantly lower than control (1B P<0.001, 1C P<0.001). The mean PIPP score of Group 2A (control) $12.5{\pm}1.4$, Group 2B $7.0{\pm}1.7$, Group 2C $6.4{\pm}1.6$. The mean PIPP score 2B and 2C were significantly lower than control (2B P<0.001, 2C P<0.001). Conclusion : The antinociceptive effect of vapocoolant sparay is as effective as 30% oral glucose solution for pain control. So this study support the use of vapocoolant spray for reducing pain during painful procedure in the neonatal intensive care units.

• Journal of the Korean Society of School Health
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• v.8 no.2
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• pp.219-232
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• 1995

This study was conducted to examine both usage rate of standard sized desks and chairs for the middle and high school students and pain complant of students who use standard-size desk & chair in Taegu, Korea, by means of questionnaires with 1,201 students of both male and female middle and high schools in Taegu area from March 20 to April 19, 1995. The result of this study is summarized as follows. It was mostly shown that the desks and chairs used by those middle and high school students were 1-3 higher than their standard sizes, and that they also preferred a little higher size with respect to their desired sizes. The rate of students who use the standard size showed that the desk accounted for 30.5%, and chair for 21.0%, that the size bigger than the standard accounted for 61.3%, respectively, and 65.2, and that the size smaller than the standard accounted for 8.2%, respectively, and 13.8%. The using rate of the standard sized for the middle school students indicated that their desk accounted for 44.1%, and their chair for 26.0% which were higher than 16.1% and 14.7% for the high school students. Then, the rate of the male students indicated that their desk accounted for 31.5% and their chair for 24.5% which were higher than 29.6% and 17.6% of the female students. In addition, the using rate of the standard size for the public schools showed that the desk accounted for 34.2% and chair for 24.5% which were also higher than 27.1% and 17.5% of the private schools. It was shown, however, that the using rate of the standard size for both groups was lower. The most inconvenient factor in the usage of their desks appeared in such orders as their wear, narrow drawers, too low height and uneven face, while the factor in their chairs did in such orders as too hard chair body the surface and back part, wear, lower and higher height and narrow width. Their physical pains resulting from usage of those desks and chairs showed that the male and female middle school students' complaint rate of pains in their neck and shoulder accounted for 32.1%, respectively, and 36.0% which were highest, while those high school students' complaint rate in their waist accounted for 37.9%, respectively, and 44.1% which were hight. It was also shown that the bigger their height, the higher their complaint rate of pain in the waist, and that their complaint rate in the shoulder and neck was totally higher. When using the standard-sized desks and chairs, their complaint rate of pain in the shoulder and neck accounted for 25.4%, respectively, and 23.8%. As compared with them, when using the desks or chairs bigger than the standard size, their complaint rate accounted for 31.5%, respectively, and 31.8% which were high while it did 26.5% and 28.9% when using them smaller than the standard size which were also high, the usage of those standard-sized desks and chairs indicated lower complaint rate of pain in their waist than used the desks and chairs bigger or smaller than the standard size. The rate of the middle and high school students who use their standard size is very low and the size of their desks and chairs are quite different from those they hope to use and many students appeal their discomfort with their desks and chairs. Therefore, the school should try to provide the desks and chairs of the various students' standard sizes in consideration of their physical condition and it also should try to get extra desks and chairs of various sizes according to the students' standard size and their preference.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.79-84
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• 2009

Objectives: Chronic pain is one of the most common experiences of humans and a typical psychophysiological disorder. The aim of this study was to measure the psychophysiological responses in chronic pain patients using a biofeedback system, and to compare them with the results from normal healthy subjects. Methods: Forty two patients with chronic pain (17 males and 25 females, average age $44.67{\pm}11.10$ years) and 42 normal healthy controls (17 males and 25 females, average age $45.17{\pm}10.46$ years) participated in this study. Electromyography (EMG), skin conductance (SC), and skin temperature (ST) were recorded using biofeedback system during the 3 phases (baseline, stress, and recovery) of stress reactivity test, and average values of them were calculated. Difference of values between two groups in each corresponding phase was analyzed with independent t-test, and change of values across phases of stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). Results: Compared to normal controls, chronic pain patients had higher value of EMG (baseline: $8.10{\pm}5.97{\mu}V$ vs $4.72{\pm}1.52{\mu}V$, t=-3.56, p<0.01; stress: $11.25{\pm}6.89{\mu}V$ vs $8.49{\pm}4.78{\mu}V$, t=-2.13, p<0.05; recovery: $7.12{\pm}3.77{\mu}V$ vs $4.78{\pm}1.59{\mu}V$, t=-3.70, p<0.01) and SC (baseline: $1.06{\pm}1.0{\mu}S$ vs $0.42{\pm}0.29{\mu}S$, t=-4.0. p<0.01; stress: $1.87{\pm}2.05{\mu}S$ vs $1.03{\pm}0.86{\mu}S$, t=-2.47, p<0.05; recovery: $1.74{\pm}1.77{\mu}S$ vs $0.64{\pm}0.59{\mu}S$, t=-3.8, p<0.01) in all the 3 phases. But, skin temperature comparison did not reveal significant differences in all the 3 phases between two groups. Conclusion: Psychophysiological responses of chronic pain patients in stress reactivity test were different from those of normal healthy controls. These results suggest that sympathetic nervous system is more activated in chronic pain patients.

• Journal of Oral Medicine and Pain
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• v.37 no.3
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• pp.183-188
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• 2012

Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).

• 월간산업보건
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• s.175
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• pp.24-28
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• 2002

우리나라에서 근골격계 질환으로 인한 업무상 질병 인정 건수가 매년 급격히 늘고 있다. 근골격계 질환이란 생산직과 사무직에서 단순반복작업으로 인하여 목, 어깨, 팔꿈치, 손목, 손 등의 근육, 건, 신경 등 주변조직에 스트레스가 누적되면서 손상을 입혀 만성적 통증이나 감각이상 등을 나타내는 질환으로,2001년에는 산재로 승인된 질환자 수가 1,598명으로 전년보다 58%가 증가하는 등 우리나라에서 중요한 직업병의 하나로 자리매김하고 있다. 그러나 우리나라에서는 재해판정기준은 있으나 구체적인 인정요건에 대한 지침이 정립되지 않고 있어 업무상 질병으로 인정할 때 어떻게 판단하여야 하는지에 대한 문제가 심각해질 우려가 있다. 따라서 본고에서는 한국, 일본, 미국의 업무상 질병 인정기준을 비교하고 그중에서 작업관련성에 대한 각국의 ㅊ차이를 비교함으로서 어떤 문제가 해결되어야 할 것인지를 논하고자 한다.