• Title/Summary/Keyword: 통증 양상

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Case Report of Two Cases on Effect of Combined Bee Venom and CS Pharmacopuncture with Koream Medicine Treatment on HIVD of L-spine (요추 추간판탈출증 환자에 대한 봉약침과 CS약침을 병행한 한의학적 복합치료 효과에 대한 증례보고)

  • Hwang, Ji Hye;Kim, Deok-Hyun
    • Korean Journal of Acupuncture
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    • v.35 no.4
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    • pp.239-246
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    • 2018
  • Objective : This case study reports the therapeutic effect of Korean Medicine (KM) treatments including CS(care special pain) and BV(bee venom) pharmacopuncture on herniated intervertebral disc(HIVD) of lumbar spine(L-spine). Methods : Two patients diagnosed with HIVD of L-spine were treated with CS and BV pharmacopuncture on GV3 and EX-B2, acupuncture, cupping, and herbal medicine. The Numeric Rating Scale(NRS), the Oswestry low back pain Disablility Index(ODI) and the Roland Morris Disability Questionnaire(RMDQ) scores were evaluated before and after treatment for comparison. Results : Low back pain(LBP) and radiating pain was improved with a decrease in patients' NRS, ODI and RMDQ scores. Conclusion : These results suggest that KM treatments including combined CS and BV pharmacopuncture could be an effective treatment on patients with HIVD of L-Spine.

Clinical Characteristics of Patients with Taste Disorders (미각 장애 환자의 임상적 특성에 관한 연구)

  • Lee, Eun-Jin;Park, Won-Kyu;Nam, Jin-Woo;Yun, Jong-Il;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.341-351
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    • 2009
  • There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

Evaluating Quadriceps Muscle Damage after Downhill Running of Different Intensities using Ultrasonography (내리막 달리기 후 국소 근손상의 영상학적 비교분석 : 운동 강도의 영향)

  • Sun, Min Ghyu;Kim, Choun Sub;Kim, Maeng Kyu
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.3
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    • pp.1028-1040
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    • 2019
  • The current study was performed to investigate the magnitude of exercise-induced muscle damage (EIMD) after downhill running (DR) of different intensities and to examine the availability of muscle echo intensity as biomarkers to detect regional damage within quadriceps muscle group (QG) following DR. Healthy college-age men (n=11) were experienced twice DR sessions [$50%HR_{max}$ DR, LDR; $70%HR_{max}$ DR, HDR] separated by a 2-week wash-out period with the random order. After DR, severity of EIMD according to exercise intensity were determined by serum creatine kinase (CK) activity, muscle tenderness, and neuromuscular function indicators such as a maximal voluntary isometric contraction (MVIC) and range of motion (ROM). Transvaginal B-mode imaging had been employed to evaluate regional muscle echo intensity within QG [rectus femoris, RF; vastus lateralis, VL; vastus medialis, VM; vastus intermedius, VI]. After both DR sessions, changes in serum CK activity and muscle tenderness have tended to more increase in HDR compared to those of LDR. There was a significant interaction effect between exercise intensity during DR and the time course of serum CK activity(p<.05). However, there were no statistical differences between sessions in muscle tenderness. The time course of changes in the neuromuscular functions after DR were similar to those of regional muscle echo intensity regardless exercise intensity. Although neuromuscular function showed to decline in HDR more than those of LDR after DR, no statistical differences between sessions. In contrast, there were significant interaction effects between sessions and time course of changes in RF and VL muscle echo intensity(p<.01), but not shown in those of VI and VM. These results indicated that each muscles within the QG show different response profiles for EIMD during DR, exercise intensity influences on these responses as well. In particular, current findings suggested that muscle echo intensity derived from ultrasound imaging is capable of detecting regional muscle damage in QG following DR.

Occlusal Analysis of the Patients with Temporomandibular Disorders Using T-Scan II System (T-Scan II 시스템을 이용한 측두하악장애 환자의 교합 분석)

  • Yang, Dong-Hyo;Lee, Won-Seop;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.105-111
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    • 2007
  • Correlation between occlusal contact pattern and TMD have been hypothesized and partially investigated but results are controversial and not conclusive. The purposes of this study were to compare right-to-left difference of occlusal contact pattern, through contact points, contact force and occlusal balance, in the patients with unilateral TMD and also to evaluate its change related with TMD treatment. 36 patients with unilateral TMD from Department of Oral Medicine in Dankook University Dental Hospital were selected in this study (M:F=7:29, mean age of $29.2{\pm}14.8$ years). A computerized T-Scan II system (Tekscan, INC., USA) was employed for occlusal analysis and the simultaneity and occlusal balance through the number of tooth contact and magnitude of contact force were determined before and after TMD treatment. The number of contact points and contact force was more on the unaffected side than the affected side before treatment (p=0.056 and p=0.060, respectively) while significant difference between both sides was not found after treatment. The number of contact points and contact force on the affected sides significantly increased after treatment (p=0.038 and p=0.052), but the unaffected sides exhibited no significant difference between before and after treatment. In addition, sides difference in relative contact force decreased from about 27% to about 12% after TMD treatment (p=0.001). According to the results of this study, it is likely that unilateral TMD impairs right-to-left occlusal balance and that conservative TMD treatment alleviates the imbalance, subsequently leading to more symmetrical occlusal condition with increased contact points and force.

The Occurrence of Degenerative Change in the Mandibular Condyles of Korean Patients with Temporomandibular Disorders (측두하악장애 환자에서 하악과두의 퇴행성 변화의 발생 양상에 대한 연구)

  • Jo, Jung-Hwan;Park, Min-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.53-63
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    • 2011
  • Osteoarthritis (OA), the most common form of arthritis, is a result of both mechanical and biological events that destabilize the normal coupling of degradation and synthesis of articular cartilage chondrocytes and extracelluar matrix, and subchondral bone. Although it is likely that the molecular basis of pathogenesis is similar to that of other joints, additional study of the temporomandibular joint (TMJ) is required due to its unique structure and function. This study was carried out to evaluate the epidemiologic characteristics of TMJ osteoarthritis. The purpose of this study was to investigate the prevalence of TMJ OA in Patients with temporomandibular disorders (1405 men and 2922 women whose mean age was $30.2\; {\pm}\; 15.4$ and $33.1\;{\pm}\;15.2$ years, respectively) who had visited the TMJ and Orofacial Pain Clinic of Seoul National University Dental Hospital in 2007. Orthopantomograms, TMJ tomograms and transcranial radiographs were used to evaluate degenerative change of the mandibular condyle. The obtained results were as follows: 1. Degenerative change of the mandibular condyle was observed in 883 (20.4%) of 4327 subjects. The prevalence was significantly higher in women (706 patients, 24.1%) than in men (177 patients, 12.6%), and this significant difference between genders was observed in all age groups. 2. The prevalence of degenerative change of the mandibular condyle in TMD patients showed a gentle increase along with age. Such increase was statistically significant in women (P < 0.001), but not in men. 3. Sclerosis was observed the most frequently in all age groups and the mean age of the patients with osteophyte was the highest among four types of degenerative change. 4. Although men showed degenerative change in the left side more often and women showed degenerative change more frequently in both sides, the difference of distribution in sides between genders was not significant. In conclusion, the prevalence of degenerative change of the mandibular condyle in TMD patients is higher in women than in men, and increases steadily with aging, but not as dramatically as in other joints that show a steep increase in prevalence around the age of 45 years. It can be suggested that the epidemiologic characteristic of OA of the TMJ differs from those of other joints, and that a more extensive study based on the general population is necessary.

The Effect of Argon Laser on Periodontal Disease (치주질환에 대한 Argon 레이저의 효과)

  • Ahn, Hyung-Joon;Ryu, Ji-Won;Kim, Jae-Hong;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.277-285
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    • 2005
  • The purpose of this study was to evaluate photothermal effect of laser, which eliminates and reduces bacteria causing periodontal disease, on treatment of periodontal disease. This study included subjects with moderate periodontitis who visited the Department of Oral Medicine, College of dentistry, Yonsei University. The subjects were divided into experimental group, where Argon laser treatment was used, and control group, where conventional subgingival curettage was used. Gingival fluids from each subject were collected prior and after 1 week of the treatment, and changes in number of bacterial colonies cultured from aerobic as well as anaerobic bacteria responsible for the periodontal disease, and changes in clinical indices related to the periodontal disease, such as plaque index, gingival index, sulcus bleeding index, were analysed. As a result, the number of bacterial colonies of aerobic and anaerobic bacteria reduced after 1 week of the treatment in both groups, especially the bacterial colonies of anaerobic bacteria which showed statistically significant reduction(p<0.1). However, there was no significant difference between the experimental group and the control group. Clinical indices including plaque index, gingival index, sulcus bleeding index were reduced after 1 week of the treatment in both groups. In the experimental group, gingival index(p<0.1) and sulcus bleeding index(p<0.01) showed significant reduction, and, in the control group, sulcus bleeding index(p<0.01) showed significant reduction. However, there were no significant differences in each indices between the two groups. The above results suggest that Argon laser could be used as a substitute of conventional subgingival curettage, or in combination with subgingival curettage which would increase the effect of the treatment. Although the possibility of clinical application of Argon laser was observed in this study, more randomized-controlled research, including acquirement of sufficient samples as well as long-termed follow up, would be necessary before clinically effective application of Argon laser.

Synaptic Organization of Vibrissa Afferent Terminals in the Trigeminal Interpolar Nucleus (삼차신경중간핵에서 저역치기계자극수용기 유래 들신경섬유 종말의 연접양상)

  • Ahn, Hyoung-Joon;Paik, Sang-Kyoo;Bae, Yong-Chul;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.87-106
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    • 2005
  • In order to evaluate the mechanism of transmission as well as processing of sensory information originating from low-threshold mechanoreceptor in oral and maxillofacial region at primary synaptic region of trigeminal nervous system, vibrissa afferent fibers of adult cat were labeled with intra-axonal HRP injection. Serial sections containing labeled boutons were obtained from the piece of trigeminal interpolar nucleus. Under electron microscope, total 30 labeled boutons were observed, and ultrastructural characteristics, frequency of occurence, synaptic organizations of vibrissa afferent terminals were analysed. The results were as follows: 1. Labeled boutons contained clear, spherical synaptic vesicles with diameter of 45$\sim$55nm. They formed asymmetrical synapse with dendrites showing definite postsynaptic density, larger synaptic cleft, multiple synaptic structures at various regions. With unlabeled axon terminals(p-ending) containing polymorphic synaptic vesicles, they formed symmetrical synapse showing indefinite postsynaptic density and narrower synaptic area. 2. Each labeled bouton formed 1 to 15 synapses, the average of 4.77$\pm$3.37 contacts per labeled bouton, with adjacent neuronal profiles. Relatively complex synaptic organization, which formed synapses with more than 5 neuronal profiles, was observed in a large number(46.7%, n=14) of labeled boutons. 3. Axo-somatic synapse was not observed. The number of axo-dendritic synapse was 1.83$\pm$1.37 per labeled bouton. Majority(85.0%) of axo-dendritic synapses were formed with dendritic shafts, nonprimary dendrites(n=47, 1.57$\pm$1.38/1 bouton), however, synapses formed with primary dendrites(n=6, 0.20$\pm$0.41/1 bouton) or dendritic spines(n=2, 0.07$\pm$0.25/1 bouton) were rare. 4. 76.7%(n=23) of labeled boutons formed axo-axonic synapse (2.93$\pm$2.36/1 bouton) with p-endings containing pleomorphic vesicles. Synaptic triad, in which p-endings formed synapses with labeled boutons and dendrites adjacent to the labeled boutons simultaneoulsy, were also observed in 60.0%(n=18) of labeled boutons. From the above results, vibrissa afferent terminals of adult cat showed distinctive synaptic organization in the trigeminal interpolar nucleus, thus, suggests their correlation with the function of the trigeminal interpolaris nucleus, which participates in processing of complex sensory information such as two-point discrimination and motivational-affective action. Further studies on physiologic functions such as quantitative analysis on ultrastructures of afferent terminals and nerve transmitters participating in presynaptic inhibition are required.

The Surgical Outcome of Thoracic Outlet Syndrome (흉곽출구증후군 환자의 수술성적)

  • Hwang Jung Joo;Joung Eun Kyu;Paik Hyo Chae;Lee Doo Yun
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.844-848
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    • 2005
  • Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

Psychopathology, Self Esteem and Quality of Life in Cancer Patients with Radiotherapy (방사선 치료 중인 암환자의 정신병리, 자아존중감 및 삶의 질)

  • Jeong, Chan-Young;Yang, Jong-Chul;Shin, Il-Seon;Choi, Young;Yoon, Jin-Sang;Lee, Moo-Seok;Lee, Hyung-Young;Nah, Byung-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.92-100
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    • 2002
  • Objectives : As medical science develops, survival rate of cancer patients rises. Therefore, psychologic understanding and improving quality of life in cancer patients is getting greater significance. The Object of this study is to investigate sociodemographic and clinical characteristics, psychopathology, self esteem and quality of life in cancer patients and to provide useful information for therapeutic approach to cancer patients. Methods : The subjects were 41 patents who had been treated by radiotherapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients were investigated, and SCL-90R for psychopathology, Rosenberg Self-esteem Scale for self esteem, WHOQOL-BREF for quality of life were administered to subjects. The results of both groups were compared and analysed, and correlation between variables were evaluated. Results : 1) The tendency of Somatization, obsession-compulsion, depression, anxiety, hostility, phobia, psychosis in cancer group were higher than normal group. Especially, somatization and anxiety in cancer group were significantly higher than normal group. 2) Self esteem and quality of life in cancer group were significantly lower than normal group. 3) No significance were found in comparison of psychopathology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, higher somatization was shown in case of more weight loss, and higher somatization and lower quality of life was shown in the presence of pain. 4) Higher anxiety was significantly associated with lower self esteem, and Higher somatization and anxiety was significantly associated with lower quality of life. Conclusion : Cancer patients had various kinds of psychopathology, low self esteem and low quality of life. In particular, somatization and anxiety, self esteem and pain were found to be important factors to quality of life of cancer patients. Therefore, management of psychopathology, improving self esteem, pain control is necessary to improve quality of life in cancer patients.

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A Comparison Study on Animal Models for Osteoarthritis in Temporomandibular Joint (측두하악관절에서의 골관절염 유도 동물모델 비교연구)

  • Yu, Sun-Nyoung;Yi, Young-Chul;Park, Hae-Ryoun;Ryu, Mi-Heon;Jeon, Hye-Mi;Kim, Kwang-Youn;Kim, Sang-Hun;Ok, Soo-Min;Ko, Myung-Yun;Ahn, Yong-Woo;Ahn, Soon-Cheol;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.261-271
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    • 2011
  • Osteoarthritis in patients with temporomandibular disorders(TMDs) induces pain, limitation of mouth opening, occlusal problems, and most commonly affects their life quality. Control method and progressive process of osteoarthritis are being extensively researched. The researchers focus on histologic changes, synovial changes, muscular and ligamental changes and observed reaction to pain. Therefore most of them developed the animal model for osteoarthritis in TMD patients. In this study, we applied several methods which induces osteoarthritis of temporomandibular joint(TMJ) in rats or mice. For locally induce osteoarthritis in TMJ, Monosodium iodoacetate(MIA) or interleukin-$1{\alpha}$(IL-$1{\alpha}$) were injected into TMJ joint space for 5 or 3 weeks. Other groups are chosen for osteoarthritis under systemic control including hormonal changes and aging. To observe cellular change, increased collagen, degenerative bony destruction and distribution of proteoglycans (PGs), safranin-O staining and Masson's trichrome staining were used.