• Title/Summary/Keyword: 환자 불편감

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Full-mouth rehabilitation of a patient with severe wear using digital facebow transfer and virtual articulator (디지털 안궁이전과 가상교합기를 이용한 광범위한 치아 마모 환자의 완전구강회복 증례)

  • Jinmook Chung;Younghoo Lee;Seoung-Jin Hong;Janghyun Paek;Kwantae Noh;Hyeong-Seob Kim;Kung-Rock Kwon;Ahran Pae
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.275-283
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    • 2023
  • The progressive wear of teeth is a physiologic process of aging, but excessive wear can lead to occlusal disharmony, tooth sensitivity and pulp exposure, decreased masticatory efficiency, and aesthetic problems. It should be treated by evaluating the cause of tooth wear and establishing a stable centric relation with appropriate vertical dimension of occlusion and occlusal plane. The present case report successfully rehabilitated a full-mouth case of a severely worn dentition with the use of digital facebow transfer and virtual articulator.

Awareness of the Causes of Drug-Induced Liver Injury: A Case of Hepatotoxicity Resulting from Antipsychotics (사례로 본 한방임상에서 양약으로 인한 약인성간손상에 대한 인식 필요성)

  • Chang-gue Son
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.751-756
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    • 2023
  • Objective: This study attempts to increase awareness of hepatotoxicity caused by antipsychotic drugs and to provide updated information on drug-induced liver injury (DILI) to physicians in Korean medicine (KM) clinics. Methods: This study presents a detailed case of a female patient diagnosed with DILI attributed to antipsychotic drugs, highlighting the improvement observed through laboratory findings. Results: A 56-year-old female patient with underlying disorders, including mixed connective tissue disease and depression, was under medical care. One day, she reported experiencing intense fatigue and distressing sensations, prompting the author to order blood tests. The levels of AST and ALT were significantly elevated by more than 2.5-fold, indicating hepatocellular DILI. The RUCAM score for antipsychotic drugs was 9, as no other medications, including herbal medicine, were being taken. Upon discontinuation of the antipsychotic drugs, the patient's laboratory findings returned to normal levels within 2 weeks, accompanied by a recovery of subjective symptoms. Conclusion: This study presents a noteworthy case of hepatotoxicity caused by antipsychotic drugs, serving as an illustrative example that highlights the crucial need for awareness among doctors of KM in clinical settings.

Evaluated the L-spine Magnetic Resonance Imaging for the Scanning Method of the Lateral Recumbent Position with to the Embarrassed Control of the Acute Low Back Pain (자기공명검사에서 통증제어가 불가능한 급성 요통 환자의 옆으로 누운 자세에 대한 영상평가)

  • Lee, Jaeheun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.255-260
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    • 2014
  • The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.

Quality of life in patients with diabetes mellitus compared with non-diabetic subjects in Korea: The 5th Korea National Health and Nutrition Examination Survey (비당뇨병 환자와의 비교를 통한 우리나라당뇨병 환자의 삶의 질; 제5기 국민건강영양조사(2010-2012))

  • Shin, Hwan Ho;Han, Mi Ah;Park, Jong;Ryu, So Yeon;Choi, Seong Woo;Park, Seon Mi;Kim, Hyo Ju
    • Journal of agricultural medicine and community health
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    • v.40 no.1
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    • pp.21-31
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    • 2015
  • Objective: This study was to evaluate the health-related quality of life (HRQoL) among patients with diabetes in Korea and to compare them with the HRQoL of individuals without diabetes history. Methods: The study subjects were 17,655 adults aged over 19 who participated in the 5th Korea National Health and Nutrition Examination Survey (2010-2012). The EuroQoL-5Dimension was used to evaluate HRQoL. Chi-square test, t-test, ANOVA and multiple regression analysis were performed to test the difference of HRQoL in diabetic subjects and controls. Results: The mobility dimension was the highest reported problem: 36.4% for diabetic subjects. The proportion of any reported problem was significantly high among diabetic subjects compared with two controls in terms of mobility [reference group: diabetic subjects, chronic controls: adjusted odds ratio (aOR)=0.77, 95% confidence interval (95% CI)=0.66-0.91, healthy controls: aOR=0.61, 95% CI=0.50-0.75], self-care [reference group: diabetic subjects, chronic controls: aOR=0.68, 95% CI=0.55-0.83, healthy controls: OR=0.69, 95% CI=0.51-0.94]. and usual activities [reference group: diabetic subjects, chronic controls: aOR=0.85, 95% CI=0.72-0.99, healthy controls: OR=0.79, 95% CI=0.62-0.98]. Also, EQ-5D index were significantly low in subjects with diabetes compared to two controls. Conclusions: Subjects with diabetes had a significantly lower HRQoL compared with two controls. To improve the quality of life of diabetics, it is necessary to study various variables related to the quality of life, and develop and manage various health programs or welfare policies reflecting socio-demographic characteristics and health related features that affect the quality of life.

Scintigraphic Evaluation of Inhalation Injury in Fire Victims (화재사고시 흡입에 의한 기도손상의 핵의학적 평가)

  • Chun, Kyung-Ah;Cho, Ihn-Ho;Won, Gyu-Jang;Lee, Hyung-Woo;Shin, Kyung-Chul;Jeong, Jin-Hong;Lee, Gwan-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.1
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    • pp.28-32
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    • 2006
  • Purpose: Conventional chest X-ray and pulmonary function test cannot sensitively detect inhalation injury. Bronchoscopy is known to be the gold standard but it is invasive method. We evaluated whether lung inhalation/perfusion scans can sensitively detect inhalation injury of fire victims. Materials and Methods: Nineteen patients (male 9, female 10, mean age 31.6 yr) of fire victims were enrolled in this study. Inhalation lung scan was performed 2 days later after inhalation injury with $^{99m}Tc$-technegas. Perfusion lung scan was performed 4 days later with $^{99m}Tc$- MAA (macroaggregated albumin). Follow up lung scans were performed 16 and 18 days later for each. Chest X-ray was performed in all patients and bronchoscopy was performed in 17 of 19 patients at the same period. Pulmonary function test was performed in 9 patients. Results: Four of 19 patients showed inhalation and perfusion defects and one showed inhalation defect but, normal perfusion scan findings. These five patients with abnormal scan findings showed abnormal bronchoscopic findings and severe respiratory symptoms. On chest X-ray, 2 of them had pulmonary tuberculosis and one of them showed pulmonary congestion. FEV1 /FVC was abnormal in 3 patients. On the follow up scan, all patients with abnormal initial scan findings showed improved findings and they had improved clinical state. Conclusion: Inhalation/perfusion lung scans can detect inhalation burn injury noninvasively in early stage and may be useful in therapeutic decision making and follow up of patients.

Is Radiotherapy Necessary for Stage 1 Testicular Seminoma? (제1병기 성인 고환 정상피종에 대한 임상적 고찰 및 치료결과 분석)

  • Lee, Jung-Ae;Park, Won;Lim, Do-Hoon;Ahn, Yong-Chan;Huh, Seung-Jae;Yu, Jeong-Il;Choi, Han-Yong;Lee, Hyun-Moo;Cho, Eun-Yoon
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.49-54
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    • 2009
  • Purpose: To report on the clinical outcome of patients with stage I testicular seminoma by postoperative radiotherapy (PORT) or surveillance after radical inguinal orchiectomy. Materials and Methods: This study is a retrospective review of 32 stage I pure seminoma patients treated between 1996 and 2005 at the Samsung Medical Center. Twenty two of the patients were treated by PORT, which was directed at the paraaortic lymphatics with a median dose of 25.2 Gy in 14 fractions for 3 weeks. The 10 remaining patients were managed by surveillance. The median follow-up period was 96 months with a range of 24 to 155 months. Results: Clinically, most patients presented with a testicular mass or discomfort. Two of the patients had a history of undescended testes. Pathologically, 23 of the patients had intratubular germ cell neoplasia with seminoma. Both recurrence-free survival (RFS) and overall survival (OS) rates of patients treated by PORT were 100%. In the control group, 1 of the 10 patients suffered a para-aortic lymph node relapse. The RFS and OS rates of the surveillance group were 88.9% and 100%, respectively. Conclusion: No difference in survival was observed between the two groups. Moreover, symptom recurrence was only observed in 1 patient in the control group. The use of PORT may reduce the risk of relapse. With the availability of effective diagnostic and salvage modalities, surveillance monitoring may be considered for patients in good compliance.

1 Case of Primary Aldosteronism Caused by Adrenal Hyperplasia (부신증식으로 인한 원발성 Aldosterone증 1예)

  • Park, Shie-Hwoa;Choi, Soo-Bong;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.313-318
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    • 1986
  • Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production resides within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attension and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical features in 1 case of primary aldosteranism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mensioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarian section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120. 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss.(228 mEq/day). Plasma renin activity was decreased under normal range with furosemide administration.(Basal renin; 0.01ng/ml/hr, stimulated renin 0.12ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range. (Basal aldosterone; 320.68pg/ml stimulated aldosterone; 451.86pg/ml). And posture test showed decreased plasma renin activity and increased plasma aldosterone level. - PRA(ng/ml/hr)=Bsal: 0.05(0.15~2.33), Stimulated: 0.22(1.31~3.95) - Aldosterone(pg/ml)=Bsal: 242.77(10~160), Stimulated: 432.09(40~310) 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactone was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.

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Relationship between Low Back Pain and Lumbar Paraspinal Muscles Fat Change in MRI (편측 요통을 호소하는 환자에 있어서 척추 주위 근육의 지방량과 통증과의 관계)

  • Kim, Ha-Neul;Kim, Kyoung-Hun;Kim, Joo-Won;Jin, Eun-Seok;Ha, In-Hyuk;Koh, Dong-Hyun;Hong, Soon-Sung;Kwon, Hyeok-Joon
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.1
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    • pp.135-143
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    • 2009
  • Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

A 15-year clinical retrospective study of Br${\aa}$nemark implants (Br${\aa}$nemark 임플란트의 15년 임상적 후향 연구)

  • Park, Hyo-Jin;Cho, Young-Ye;Kim, Jong-Eun;Choi, Yong-Geun;Lee, Jeong-Yol;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.61-66
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    • 2012
  • Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.

The Evaluation of Bone Scan and SPECT Before and After Treatment of TMD Patients (골관절염을 가진 측두하악장애 환자의 치료 전, 후 골스캔과 SPECT의 평가)

  • Kim, Byeong-Soo;Ahn, Yong-Woo;Ko, Myung-Yun;Park, June-Sang
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.57-67
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    • 2005
  • The aim of this study was to evaluate bone scan(SUR) and SPECT(hot spot) in patients with TMJ osteoarthritis. 99mTc-MDP bone scan and SPECT were done in 27 patients, total 54 temporomandibular joints were examined with clinical examination, plain radiography. 42 TMJs were osteoarthritis and 12 TMJs were normal case, clinically diagnosed. We compared osteoarthritis group and control group of bone scan(SUR) and SPECT(hot spot). thus we compared before and after treatment of bone scan(SUR) and bone SPECT(hot spot) according to history, contributing factor, symptom degree, treatment, treatment period. The obtained results were as follows. 1. Bone scan(SUR) and SPECT(hot spot) activity of osteoarthritis group were higher than control group(P<0.05, P<0.01). 2. Bone scan(SUR) and SPECT(hot spot) activity were decreased after treatment at TMJ with osteoarthritis(P<0.01). 3. Bone scan(SUR) and SPECT(hot spot) activity were decreased at treatment group with splint(P<0.01, P<0.05). 4. Bone scan(SUR) and SPECT(hot spot) activity were decreased at Chronic group(P<0.01, P<0.05). 5. Bone scan(SUR) and SPECT(hot spot) activity were decreased at low noise NAS(<6) group(P<0.01,P<0.05). 6. Bone scan(SUR) and SPECT(hot spot) activity were decreased at TMD patient with parafunctional habit and without trauma history, psychosocial factor. 7. Bone scan(SUR) and SPECT(hot spot) activity were higher at before treatment required more treatment period.