• Title/Summary/Keyword: 통증정도

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Video Assisted Thoracic Surgery(VATS) of Pericardial Window Operation (비디오 흉강경을 이용한 심낭막 개창술)

  • 윤석원;김동관;김정원;박창률;김용희;박기성;박승일
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.812-816
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    • 2002
  • Pericardial effusions result from various conditions such as inflammation, malignancies, open heart surgery and uremia. Recently, video assisted thoracic surgery (VATS) has been used for diagnostic and therapeutic purposes in the management of pericardial effusion and intrathoracic lesions due to its ability to provide outstanding visibility of intrathoracic structures with less pain, superior cosmetic effects, and shorter hospital stay Material and Method: From April 1995 to October 2001, 51 patients received pericardial window operation via either thoracoscopic(Group A, n=37, m:f=18:19, mean age=56.4 yrs)or thoracotomy approach(Group B, n=14, m:f=8:6, mean age=58.4 yrs). Result: In group A, the operation time, duration of chest tube insertion, recurrence rate of pericardial effusion, and postoperative hospital stay were 61.2 minutes, 9.3 days, 2.7%, 16.2 days, respectively while in group B these values were 58.4 minutes, 12.2 days, 7.1, and 17.3 days. The number of injections for pain control in group A were 4.2 times, whereas in group B it was 6.3 times. Although there was a tendency for the mean hospital stay and duration of chest tube insertion to be shorter in group A than in group B, these differences did not reach statistical significance. There was also no significant difference in the operation time and recurrence rate between the two groups. Conclusion: The safety and effectiveness of VATS in the management of pericardial effusion is comparable to the open thoracotomy method. It allows for a shorter hospital stay, duration of chest tube insertion, lesser postoperative pain and a smaller skin incision.

Dental Care Utilization Patterns and Its Related Factors of the Rural Residents (경상북도 일부 농촌지역 주민의 치과의료이용양상 및 관련요인)

  • Chang, Bun-Ja;Kim, Ji-Young;Song, Keun-Bae;Kam, Sin;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.171-182
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    • 2003
  • Objectives: This study was conducted to analyze the dental care utilization patterns and related factors of the rural residents. Methods: The data collected by interview and self-administered questionnaire survey of 524 peoples of Seongju county in Gyeongsanbuk-do. The summarized results are as follows. Results: The rate of persons who experienced the oral disease was 52.5% during 1 year and it was at most in the age group of 40-49. The rate of persons who had experienced the oral disease were investigated according to general characteristics, perception of oral health, being of regular treatment facility. Therefore the rate of persons who had experienced the oral disease was significantly higher the younger peoples, worse oral health status and being of the regular treatment source than the other groups. During 1 year period, 64.0% of the cases had treated the perceived oral disease, 36.0% did no action at all during last year. Among respondents, 49.4% had treated their oral disease at dental clinics, 8.0% had treated at community health center or subcenter and remains did not treated at all. The results of logistic regression analysis suggested that statistically significant factors in dental health care utilization were educational level, degree of pain, oral health status and regular treatment facility. Therefore the dental health care utilization rate was higher at groups with the high educational level, serious pain, better oral health status and being of the regular treatment source than other groups. 45.5% of the rural residents did not treat their oral disease immediately due to the no identified need, limitation of time(19.2%), economic limitation(19.2%), and geographical limitation(9.0%). Conclusions: In consideration of above findings, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically.

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A Study on the Actual Conditions of Denture Prosthodontics used by the Elderly Aged 65 or Older in Seoul (시술장소에 따른 65세 이상 노인의 의치보철 실태 조사연구)

  • Jung, Jung-Ock
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.113-119
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    • 2007
  • This study attempts to find factors contributing to the use pattern of prosthetics by investigating the current condition of prosthetics for the aged of over 65 years old by place of practice. Among those of over 65 years old who live in Gangnam-gu, Seocho-gu, Seongbuk-gu, and Gwanak-gu of Seoul and use the apartment senior's center, those having prosthetics were selected as subjects of this study, and this study was conducted in forms of interview and record. Findings of this study are summarized as follows: First, in regard of the state of prosthetics and relevant symptoms in the mouth according to the place of prosthetics practice, there was significant difference in the questions except the medical benefit of prosthetics between unlicensed facilities and dental clinics and hospitals. Second, regarding difference in satisfaction according to the place of prosthetics practice, dental clinics and hospitals showed a higher level of aesthetic satisfaction than unlicensed facilities. For difference in satisfaction at pronunciation, chewing, pain, a sense of foreign body, and holding power, dental clinics and hospitals showed a higher level than unlicensed facilities, Third, after factor analysis on the perception factors of unlicensed treatment and dental treatment, unlicensed facilities showed the highest level of reliability, and then convenience, word of mouth, and modernity in order. Dental clinics and hospitals also showed the highest level of reliability, however, and then convenience, modernity, and word of mouth in order. Fourth, as a consequence of analyzing the factors to influence the use pattern of prosthetics, regarding residential pattern, there were higher possibilities to use dental clinics and hospitals when the subjects lived together with their children and in Gangnam, and the more were the number of pyeong for the residence, pocket money, medical expense, and property in their name, compared to unlicensed facilities. In conclusion, economic factors appear to be the most important factors in selecting facilities for denture prosthodontics. Therefore, it is important to ensure the denture prosthodontics for the elderly are reimbursable so that they can enjoy a healthier life.

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A Study on Oral Health Related Quality of Life in Elders Concerning to Residence at Urban and Rural (도시농촌 노인의 구강건강과 삶의 질에 관한 연구)

  • Yoon, Young-Suk
    • Journal of dental hygiene science
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    • v.6 no.1
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    • pp.23-28
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    • 2006
  • This study was conducted to investigate the oral health related quality of life in elders concerning to residence at urban and rural. The subjects were 215 old persons who were over the 60 years old, living at Sahagu in Busan(113persons) and Geojer Si in Kyungnam (102persons). The data for this study were collected by direct interviewing method from May 30 th to June 30 th and September 12 th, 2005. Cushing & Sheiham's Sociodental Scale which measures oral health related quality of life was used for this study. The data were analysed by a computerized program named statistical package for social science including frequency, percentage, t-test. The results of this study were summarized as follows; 1. Mean score of the oral health related quality of life in elders is $2.42{\pm}1.03$ 2. There was a significant difference in oral health related quality of life in elders between the age 60 ~ 70 years group and the over than 71 years group(P < 0.01). 3. There was a significant difference in oral health related quality of life in elders between the urban and rural group(P < 0.05). Above findings suggest that further study about proper program for geriatric oral health evaluation is necessary in improving the oral health related quality of life in elders.

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Effects of 12 weeks of home-based exercise program in patients with ankylosing spondylitis (강직성 척추염 환자에 대한 12주간의 가정기반 운동 프로그램의 효과)

  • Cho, Kyoung-Hwan;Jeon, Yunah
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.3
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    • pp.771-785
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    • 2021
  • This study was performed to provide detailed and comprehensive information on inflammation-related blood indicators, joint range of motion, pain scale, and psychological indicators by patient characteristics by performing a 12-week home-based exercise program for ankylosing spondylitis patients. For the purpose of this study, 10 patients with ankylosing spondylitis were selected by age (30s vs. 40s vs. 50s), gender (male vs. female), and duration (less than 5 years vs. 5 years or more). The home-based exercise program was a combination of aerobic exercise and Pilates-based resistance exercise, and was performed 4 times a week for 12 weeks at an intensity of 50-70% of maximal heart rate (MHR). As a result, after 12 weeks of home-based exercise intervention, the blood C-reactive protein (CRP) concentration of patients with ankylosing spondylitis decreased (-35.6%, p=.002), and the blood inflammation level was improved, and each joint (hip, lumbar, cervical) improved mobility (p<.05). In addition, the bath ankylosing spondylitis disease activity index (BASDAI) was decreased by -67% (p=.001) and the visual analogue scale (VAS) was decreased by -64.8% (p=.001), stiffness and pain has been alleviated. In particular, as the degree of depression decreased by -65.5% (p=.001) and the degree of anxiety by -55.2% (p=.003), 12 weeks of home-based exercise improved not only physical changes but also psychological factors. On the other hand, there was no difference in exercise effect according to age, gender, and disease duration in ankylosing spondylitis patients (p>.05). These results suggest that the 12-week home-based exercise applied in this study can be an effective exercise program that can be universally used for ankylosing spondylitis patients regardless of patient characteristics.

Pain Complaint according to Usage of Standard-Sized Desks and Chairs for Middle and High School Students (중(中)·고등(高等) 학생(學生)들의 책상 및 의자(椅子)의 표준호식(標準號數) 사용여부(使用與否)와 통증(痛症) 호소율(呼訴率))

  • Kang, Kyung Yull;Cha, Byong Jun;Park, Jae Yong
    • 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.

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Reliability of a Questionnaire for Evaluation of Dry Mouth Symptoms (구강건조증 증상 평가를 위한 설문지의 신뢰도에 관한 연구)

  • Lee, Jeong-Yun;Lee, Young-Ok;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.383-389
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    • 2005
  • Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

Need Assessment of Home-based Cancer Patients (재가암환자 요구도 조사)

  • Kim, Tae-Sook;Yang, Byung-Guk;Jeong, Eun-Kyeong;Park, No-Rai;Lee, Young-Sook;Lee, Young-Sung;Lee, Sok-Goo;Kim, Young-Taek;Yun, Young-Ho;Huh, Gil-Ja
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.36-45
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    • 1999
  • Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.

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Association between Dental Fear and Anxious Thoughts and Tendencies and Dental Experience of Dental Patients (치과내원 환자의 불안취약사고 경향 및 치과경험과 치과공포의 관련성)

  • Hwang, Hye-Rim;Choi, Ha-Na;Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.11 no.1
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    • pp.15-21
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    • 2011
  • Introduction The aim of this study, personal trait and their dental care based on experience level of dental fear is to analyze the differences. Catastrophizing is an irrational belief that something is far worse than it actually is. Because it makes it possible to analyze patients' anxious thoughts and tendencies. Methods The Dental Fear Survey(DFS) and Anxious Thoughts and Tendencies(AT&T) were used as measuring tools, and the independent sample t-test and ANOVA were performed on the basis of the mean value of the summated scale scores and the standard deviation. On the factors to dental anxiety, the multiple regression analysis was performed. Results Demographically, the total DFS score was higher in women($25.73{\pm}8.27$) than in men. Also, AT&T was higher in women($31.01{\pm}7.05$) (p<0.05). Dental fear was intense in the group of patients who visited dental clinics only problems($25.29{\pm}8.57$) than in those regular visited($22.29{\pm}7.78$). In relation to dental experiences, the DFS score was significantly higher in children. In many cases, patients experienced therapeutic pains in children($26.40{\pm}9.54$) (p=0.004). Also in many patients, dental anxiety began to occur in adolescence(44.3%). The multiple regression analysis result, it was found that dental treatment pain and their AT&T wielded great influence upon dental fear.