• Title/Summary/Keyword: 임상 평가

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Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

Outcome of Conservative Treatment for Patients with Disc Displacement of Temporomandibular Joint (측두하악관절 원판변위 환자의 보존적 치료결과)

  • Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.305-318
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

Clinical Long-term Assessment of Bioactive Glass Graft (Bioactive glass의 장기 임상적 평가)

  • Lee, Hang-Bin;Baek, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chong-Kwan;Chai, Choong-Kyoo
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.187-198
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    • 2002
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79${\pm}$0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61${\pm}$0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.44${\pm}$0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18${\pm}$1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35${\pm}$0.28) and Non F/U group(0.78${\pm}$0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

COMPARATIVE STUDY ON THE EARLY DETECTION OF ENAMEL LESIONS USING DIFOTI AND LASER FLUORESCENCE (Digital Imaging Fiber-Optic Trans-Illumination과 Laser Fluorescence를 이용한 법랑질 우식증의 조기 진단에 관한 비교 연구)

  • Maeng, Myoung-Ho;Kim, Seung-Oh;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.207-220
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    • 2006
  • The newly developed equipments for the early detection of carious lesion are LFD (laser fluorescence device), Ultrasonic diagnostic system, CLSM(confocal laser scanning microscopy), QLF(quantitative light-induced fluorescence) and DIFOTI (digital imaging fiber-optic trans-illumination) system. In this study, DIFOTI system and LFD were used for the detection of early enamel caries. Twenty five primary teeth extracted from twenty one children at around the dentitional exchanging period were selected as samples. The results obtained from DIFOTI imaging and LFD measurement were compared with those of CLSM and comprehensive evaluations were made for the diagnostic capacity of each device. In vitro test, 40 sample teeth with their buccal & lingual surface formed by a window of $2{\times}3mm$ in diameter were immersed in artificial demineralizing solution for the period of 4, 8, 12 and 16 days. The results obtained from the experimental groups (DIFOTI, LFD) were compared to control group (CLSM) and we have reached to the following conclusions. 1. The sensitivity and specificity of DIFOTI system operated in oral environment was 88.2% and 76.9% respectively. 2. The sensitivity and specificity of LFD measured in oral environment was 76.5% and 69.2% respectively. 3, Regression analysis on the light transparent rate of DIFOTI showed its decrease according to the length of primary enamel decalcification performed in vitro(r=-0.96, p<0.05). 4. No statistically significant difference between LFT measurement and the length of in vitro decalcification was found in regression analysis (p>0.05). 5. The correlation coefficient of DIFOTI image transparent rate and the lesion depth of CLMS was -0.6988 (p<0.05), whereas no statistically significant difference was found for LFD measurement.

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EFFECT OF STEP CURING ON THE CONTRACTION STRESS AND MARGINAL ADAPTATION OF RESIN RESTORATION (단계별 광중합 방식이 복합레진 수복물의 수축 응력과 변연 접합도에 미치는 영향)

  • Park, Jong-Whi;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.221-232
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    • 2006
  • The purpose of this study was to investigate the effect of step-curing mode on polymerization shrinkage and contraction of composite resin restoration. Class I cavities were prepared on the extracted human premolars. The cavities were ailed with Filtek $Z-250^{TM}$ (hybrid resin, 3M ESPE, USA) and Filtek $flow^{TM}$ (flowable resin, 3M ESPE, USA) and cured with one of the following irradiation modes; Halogen 40sec with continuous curing, LED 10sec with continuous curing, and LED 13sec with step-curing. Contraction stress was measured with strain gauge which was connected to TML $Datalogger^{TM}$ (TDS-102, SOKKI, Japan) and resin-dentin interfaces were observed by scanning electron microscope. The results of present study can be summarized as follows : 1. Composite resin restoration showed transient expansion just after irradiation of curing light. Contraction stress was increased rapidly at the early phase of polymerization and reduced slowly as time elapsed (P<0.05) 2. $Filtek\;flow^{TM}$ showed lower contraction stress than Filtek $Z-250^{TM}$ regardless of curing modes. 3. LED step-curing mode showed lowest contraction stress in Filtek $Z-250^{TM}$ compared with other curing modes(P<0.05). 4. LED step-curing mode showed lowest contraction stress in $Filtek\;flow^{TM}$ compared with other curing modes(P<0.05), but difference in contraction stress was not so greate as in $Filtek\;Z-250^{TM}$. 5. Polymerization of composite resin by LED light with step-curing mode and halogen light with continuous ode resulted in better marginal sealing than LED light with continuous mode.

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The Effects of Weighted Vest During Task-Oriented Training on Gross Motor Performance and Balance Abilities of Children With Spastic Diplegia : A Randomized Clinical Trial Study (경직형 양마비 아동의 과제지향훈련 시 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향: 무작위배정 위약비교 연구)

  • Kwon, Hae-Yeon
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.46-65
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    • 2017
  • Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

A Proposed Algorithm and Sampling Conditions for Nonlinear Analysis of EEG (뇌파의 비선형 분석을 위한 신호추출조건 및 계산 알고리즘)

  • Shin, Chul-Jin;Lee, Kwang-Ho;Choi, Sung-Ku;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.52-60
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    • 1999
  • Objectives: With the object of finding the appropriate conditions and algorithms for dimensional analysis of human EEG, we calculated correlation dimensions in the various condition of sampling rate and data aquisition time and improved the computation algorithm by taking advantage of bit operation instead of log operation. Methods: EEG signals from 13 scalp lead of a man were digitized with A-D converter under the condition of 12 bit resolution and 1000 Hertz of sampling rate during 32 seconds. From the original data, we made 15 time series data which have different sampling rate of 62.5, 125, 250, 500, 1000 hertz and data acqusition time of 10, 20, 30 second, respectively. New algorithm to shorten the calculation time using bit operation and the Least Trimmed Squares(LTS) estimator to get the optimal slope was applied to these data. Results: The values of the correlation dimension showed the increasing pattern as the data acquisition time becomes longer. The data with sampling rate of 62.5 Hz showed the highest value of correlation dimension regardless of sampling time but the correlation dimension at other sampling rates revealed similar values. The computation with bit operation instead of log operation had a statistically significant effect of shortening of calculation time and LTS method estimated more stably the slope of correlation dimension than the Least Squares estimator. Conclusion: The bit operation and LTS methods were successfully utilized to time-saving and efficient calculation of correlation dimension. In addition, time series of 20-sec length with sampling rate of 125 Hz was adequate to estimate the dimensional complexity of human EEG.

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Characteristics of Sleep Apnea Syndrome in the Elderly in a Clinical Setting (나이에 따른 수면무호흡증 임상적 특성의 변화)

  • Shin, Yoon-Kyung;Yoon, In-Young;Hong, Min-Chul;Yun, Yong-Don
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.39-44
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    • 2005
  • Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.

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Comparison of Awareness of Symptoms and Illness Between Patients with Obstructive Sleep Apnea and Simple Snoring (수면무호흡증과 단순 코골이 환자의 증상과 질환 인식도 비교)

  • Lee, Seyoung;Kang, Jae Myeong;Cho, Yoon-Soo;Yoon, Hyun Jin;Kim, Ji-Eun;Shin, Seung-Heon;Park, Kee Hyung;Kim, Seon Tae;Kang, Seung-Gul
    • Sleep Medicine and Psychophysiology
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    • v.23 no.1
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    • pp.16-24
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    • 2016
  • Background and Objectives: Obstructive sleep apnea (OSA) is often undiagnosed but is an important risk factor affecting the health of an individual. The level of awareness of the illness among patients with OSA is low and is not correlated with severity of the illness. This study was conducted to compare awareness of OSA symptoms and illness between patients with OSA and simple snorers. Materials and Methods: Two hundred eighty-two patients who were suspected of having OSA participated in this study. All subjects underwent overnight polysomnography. Those with an apnea-hypopnea index (AHI) ${\geq}5$ were classified as the OSA group, while those with an AHI < 5 were classified as the simple snoring group. A sleep questionnaire, which included items on awareness of the illness, OSA, and sleep symptoms, was administered to all subjects and their bed-partners. Results: Simple snorers were much more aware of their symptoms such as snoring, irregular breathing, and apnea than were patients with OSA. Bed-partners of simple snorers were also more aware of the participants' sleep symptoms than were partners of patients with OSA. However, the duration of OSA symptoms was longer in the OSA group. In the correlation analysis, the level of awareness of OSA symptoms was negatively correlated with AHI, age, body mass index, and Epworth Sleepiness Scale score. Among the sleep questionnaire and polysomnography results, only Pittsburgh Sleep Quality Index was positively correlated with level of awareness of OSA symptoms. The minority of the respondents had heard about the treatment methods of continuous positive airway pressure and oral appliance and preferred them as treatment options. Conclusion: This study suggests that simple snorers are more aware of their symptoms than are patients with OSA. A higher severity of OSA, represented by a higher AHI, is correlated with lower awareness of one's OSA symptoms.

Prognosis of Patients with Non-Small Cell Lung Cancer after Surgery (비소세포 폐암 환자의 수술 후 예후)

  • Kang, Min-Jong;Park, Gye-Young;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.331-338
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    • 1996
  • Background : Lung cancer continues to be the leading cause of cancer death in the United States and it's incidence has been rapidly increasing in Korea, too. The overall cure rate for non-small cell lung cancer(NSCLC) is approximately 10%, and the cure is generally achieved by surgery. Unfortunately, however, less than 15% of all patients and less than 25% of those who present with localized disease are candidates for curative surgical resection. So preoperative staging evaluation followed by curative resection has a major role in determining the long tenn prognosis of NSCLC patients. Therefore, we have conducted this study to compare pre-operative and post-operative staging and the long-tenn relapse-free survival rates in NSCLC patients according to its stage. Methods : We analyzed the medical records of 217 NSCLC patients who were operated on for curative resection in Seoul National University Hospital, retrospectively. Among them, 170 patients who were completely resected were selected to determine the long term relapse-free survival rates. Results : Among 217 NSCLC patients, men were 157 and women were 30. The median age was 58 and the difference between men and women was not found. The discrepancy rate between preoperative and postoperative staging was 40.1%. Its major cause was due to the difference of nodal staging. The 3-year relapse-free survival rates were 73%, 53% and 48% in stage I, II and IIIa, respectively. There was no difference of relapse-free duration in recurred patients according to the stage or histologic types. Conclusion : The postoperative pathologic staging determines the long tenn prognosis of patients with NSCLC after surgery, but current preoperative clinical staging can not predict the postoperative pathologic staging correctly. So the improved modality of staging system is required to predict the pathologic staging more correctly.

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