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Drug-Resistant Pulmonary Tuberculosis In Kosin Medical Center (부산지역의 한 3차 진료기관을 방문한 폐결핵 환자의 약제내성률)

  • Kim, Ji-Ho;Kim, Ji-Hong;Jang, Tae-Won;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.831-837
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    • 1995
  • Background: We conducted a study to determine the factors associated with, patterns of, and proportion of cases of pulmonary tuberculosis with multiple drug-resistance at Kosin medical center in Pusan. Methods: We abstracted data from 141 patients, who had active pulmonary tuberculosis and report forms of drug susceptibility between 1986 and 1994, and related the previous treatment history, the extent of lung involvement and the presence of cavities on chest X-ray films to the drug resistance. Results: Overall, 59(41.8%) of the 141 cases of tuberculosis were resistant to at least one drug and 29(20.9%) of the 139 cases were resistant to isoniazid(INH) and rifampin(RIF). Among the 63 patients with previous tuberculosis therapy, 40(63.5%) had isolates that were drug-resistant and 24(38.1%) were multi-drug resistant. Among the 78 without previous therapy, 19(24.4%) had isolates that were drug-resistant and 5(7.5%) were multi-drug resistant. For all 141, resistance to INH was most common(39.0%) followed by RIF(21.6%), ethambutol(EMB, 16.3%), $\rho$- aminosalicylic acid(10.8%), streptomycin(SM, 8.7%), and pyrazinamide(PZA, 8.0%). INH, RIF and PZA resistances were independently associated with a history of previous tuberculosis therapy (odds ratio; 3.3, 7.2 and 10.8 respectively), and RIF and SM resistance were significantly high according to the extent of lung involvement on the chest films(odds ratio; 2.9 and 2.8 respectively). Conclusions: We conclude, (1) that all persons in whom pulmonary tuberculosis is diagnosed should initially receive at least four-drug therapy(INH, RIF, PZA, and EMB or SM), (2) that susceptibility testing be done in all culture-positive patient, and (3) that those with a history of previous tuberculosis therapy or those who have advanced pulmonary tuberculosis need very careful clinical and microbiological follow-up.

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Effect of Ondansetron Alone and Combination of Naltrexone and Ondansetron on Alcohol Intake in C57BL/6 Mice (Naltrexone과 ondansetron의 병합투여가 C57BL/6형 생쥐의 알코올 섭취량에 미치는 영향)

  • Kim, Hyeun-Kyeung;Kim, Sung-Gon;Kang, Cheol-Joong;Park, Sang-Ick;Kim, Won-Ho
    • Journal of Life Science
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    • v.17 no.11
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    • pp.1576-1581
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    • 2007
  • Dopamine reward pathway projecting from ventral tegmental area to nucleus accumbens is well known as playing an important role in alcohol dependence. It is supposed that this dopamine pathway is modulated by $5-HT_3$ nervous system, and it was reported that ondansetron (OND), $5-HT_3$ receptor antagonist, reduced drinking amount and increased abstinence rate in alcohol-dependent patients. The purpose of this study is to investigate the effect of combination of OND and naltrexone (NTX), non-specific opioid receptor antagonist, on alcohol intake in C57BL/6 mice. In 40 C57BL/6 mice in the state of alcohol dependence, vehicle, while OND 0.01 mg/kg, or NTX 1.0 mg/kg administrated respectively, or OND 0.01 mg/kg and NTX 1.0 mg/kg administrated simultaneously for ten days, medication effects on 2-hr alcohol, 22-hr water, 24-hr food intake and body weight were studied. When vehicle group was compared with 3 medication groups respectively, using a repeated measure ANOVA, NTX alone and vehicle groups showed a significant medication by time interaction (p=0.042) in 2-hr alcohol intake, but in the other 2 groups, OND and NTX combination group and OND alone group, there was no significant interaction with vehicle group in 2-hr alcohol intake. From these results, it is suggested that there is no effect on alcohol intake in mice treating with OND, and naltrexone#s suppression effect on alcohol intake in mice is attenuated when treating with OND and NTX simultaneously. It is supposed that a further study looking at the interactions of serotonin, dopamine and opioid nerves systems will be needed.

Mid-Term Results of Fixed Bearing Unicompartmental Knee Arthroplasty: Minimum 5-Year Follow-Up (고정형 슬관절 단일 구획 치환술의 중기 추시 결과: 최소 5년 추시)

  • Oh, Jeong Han;Joo, Il-Han;Kong, Dong-Yi;Choi, Choong-Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.498-504
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    • 2018
  • Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

Development of smartphone-based voice therapy program (스마트폰기반 음성치료 프로그램 개발연구)

  • Lee, Ha-Na;Park, Jun-Hee;Yoo, Jae-Yeon
    • Phonetics and Speech Sciences
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    • v.11 no.1
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    • pp.51-61
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    • 2019
  • The purpose of this study was to develop a smartphone based voice therapy program for patients with voice disorders. Contents of voice therapy were collected through analysis of mobile contents related to voice therapy in Korea, experts and users' demand survey, and the program was developed using Android Studio. Content needed for voice therapy was collected through analysis of mobile contents related to voice therapy. The user satisfaction evaluation for application was conducted for five patient with functional voice disorders. The results showed that the mobile contents related to voice therapy in Korea were mostly related to breathing, followed by voice and singing, but only 13 applications were practically practiced for voice therapy. Expert and user demand surveys showed that the patients and therapists both had a high need for content that could provide voice training in places other than the treatment room. Based on this analysis, 'Home Voice Trainer', an smartphone based voice therapy program, was developed. Home Voice Trainer is an application for voice therapy and management based on Android smartphones. It is designed to train voice therapy activities at home that have been trained offline. In addition, the records of voice training of patients were managed online so that patients can maintain voice improvement through continuous voice consulting even after the end of voice therapy. User evaluations show that patients are satisfied with the difficulty and content of voice therapy programs provided by home voice trainers, but lack of a portion of user interface, such as the portion of home button and interface between screens. Further study suggests the clinical application of home voice trainer to the patients with voice disorders. It is expected that the development study and the clinical application of smart contents related to voice therapy will be actively conducted.

Analysis of Prognostic Factors Related to Survival Time for Patients with Small Cell Lung Cancer (소세포폐암 환자의 생존기간에 관련된 인자 분석)

  • Kim, Hee-Kyoo;Yook, Dong-Seung;Shin, Ho-Sik;Kim, Eun-Seok;Lim, Hyun-Jeung;Lim, Tae-Kwan;Ok, Chul-Ho;Cho, Hyun-Myung;Jung, Maan-Hong;Jang, Tae-Won
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.57-70
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    • 2003
  • Background : Small cell lung cancer represents approximately 20% of all carcinomas of the lung, and is recognized as having a poor long term outcome compared to non-small cell lung cancer. Therefore, this study investigated the prognostic factors in small cell lung cancer patients in order to improved the survival rate by using the proper therapeutic methods. Material and method : The clinical data from 394 patients who diagnosed with small cell lung cancer and treated from 1993 to 2001 at the Kosin University Gospel Hospital, were analyzed. Result : There were 314 male patients (79.7%), and 80 female patients (20.3%). The number of those with limited disease was 177 (44.9%), and the number of those with extensive disease was 217 (55.1%). Overall, 366 out of 394 enrolled patients had died. The median survival time was 215 days (95% CI : 192-237days). The disease stage, Karnofsky performance state, 5% body weight loss for the recent 3 months, chemotherapy regimens, and the additive chest radiotherapy were identified as being statistically significant factors for the survival time. The median survival times of the supportive care group, one anticancer therapy, and two or more treatment groups were 17 days, 211 days, and 419 day, respectively (p<0.001). These data emphasize the importance of anticancer treatment to improve survival time for patients. The group of concurrent chemoradiotherapy (30 patients) showed significantly longer survival time than the group given sequential chemoradiotherapy (55 patients) (528 days versus 373 days, p=0.0237). The favorable prognostic factors of laboratory study were groups of leukocyte =8,000/mm3, ALP=200 U/L, LDH=450 IU/L, NSE=15 ng/mL, s-GOT=40 IU/L. In extensive disease, there was no difference according to the number of metastatic site. However, the median survival time of patients with ipsilateral pleural effusion had longer than patients having other metastatic sites. According to the survey periods, three groups were divided into 1993-1995, 1996-1998, and 1999-2001. The median survival time was significantly prolonged after 1999 in comparison to previous groups (177 days, 194 days, 289 days, p=0.001, 0.002, respectively). Conclusion: Disease stage and 5% body weight loss for recent 3 months at diagnostic state were significant prognostic factors. In addition, the performance status, serum ALP, LDH, NSE, CEA levels also appear to be prognostic factors. The survival time of those patients with small cell lung cancer has been prologned in recent years. It was suggested that the used of the EP (etoposied and cisplatin) chemotherapy method and concurrent chemoradiotherapy for patients with a limited stage contributed to the improved survival time.

A Study of Educational System for Medical Technologists in Korea (한국(韓國)의 의료기사(醫療技士) 교육제도(敎育制度)에 관(關)한 조사(調査) 연구(硏究))

  • Song, Jae-Kwan;Lee, Gun-Sub;Kim, Byong-Lak;Kim, Chung-Rak;Cho, Jun-Suk;Huh, Joon;Lee, Joon-Il
    • Journal of radiological science and technology
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    • v.6 no.1
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    • pp.131-181
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    • 1983
  • After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

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A Study on Knowledge and Disease Management of Tuberculosis by Themselves of Tuberculosis Patients Among the Middle and High School Students in Seoul. (서울시내 중고등학교 결핵이환학생에 대한 결핵관리실태 및 지식에 관한 조사연구)

  • Do Sung-Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.32-44
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    • 1987
  • The purpose of this survey was to find out the knowledge and the disease management of the Tuberculosis patients by themselves among the first grade middle and high school students in Seoul city during the period of June 15-July 19, 1986. Questionaires were used to collect the data and were analysed from answers of 188 students at the 113 schools. The results were as follows: 1. The ages of the students were distributed as follows: in middle school, 13 years old was $70.0\%$. 14 years old, $20.0\%$, and 15 years old, $6.7\%$. In high school, 16 years old was $66.5\%$, 17 years old, $18.4\%$, and 15 years old, $10.1\%$. 2. In X-ray mass examination by school, the rate of execution was $50.4\%$ in middle school and $96.7\%$ in high school, and in X-ray mass examination by student, it was $50.1\%$ in middle school and $97.3\%$ in high school. 3. The prevalence of Tuberculosis among the middle school students was $00.3\%$and high school students, $0.15\%$. 4. Of the total, $77.1\%$ of the respondents did not realized Tuberculosis bdore X-ray mass examination 5. The perfect cure rate of the respondents was $52.7\%$. 6. General characteristics of the respondents: a. The educational background was varied as follows: of the total $47.9\%$ of the fathers had the level of high school education and $37.2\%$ of the mothers had the level of middle school education. The educational background of the parents had no statistical significant to the medical cure rate of Tuberculosis. (P>0.05). b. The average monthly income of the family was as follows : above five hundred thousand won was $21.8\%$, three or four hundred thousand won was $22.9\%$, and below two hundred thousand won was $10.6\%$. The most frequent family size was 5-6 persons. $(59.6)\%$. 7. The actual situation of Tuberculosis control and the variables related to the treatment: a. $69.1\%$ of the respondents wanted mental support from their surroundings. $48.7\%$ of the respondents answered that their parents or the other family helped treatment as mental supporter, b. As a medical service, $53.2\%$ of the respondents were treated at Health Center, $38.8\%$ were treated at a hospital. A medical service was statistically significant to the medical cure (P<0.01). c. Family members of $61.7\%$ of the respondents had checked chest X-ray. A X-ray examination of family was statistically significant to the medical cure (P<0.005). d. $73.9\%$ of the respondents had taken the Anti-Tuberculosis-drugs regularly. Regular taking of Anti-Tuberculosis drugs was statistically significant to the medical cure (P<0.005). e. $89.4\%$ of the respondents had received a regular examination during the treatment. A regular examination was statistically significant to the medical cure (P<0.05). f. The period of perfect cure was that $50.0\%$ of the respondents took from half a year to one year, $25.2\%$ took below half a year and $16.2\%$ took from one year to one year and a half. g. The rate of the respondents who abhored to let anyone know their disease was $93.1\%$. 8. Knowledge related with Tuberculosis: a .$63.3\%$ of the respondents answered that Tuberculosis is a communiable disease. b. $89.9\%$ of the respondents answered that there is a preventive method of Tuberculosis. Among them, $28.4\%$ answered that it is B.C.G. vacination. c. $96.8\%$ of the respondents belived they can be cured perfectly. d. $42.4\%$ of the perfect curer answered that they had have permanent immunity of Tuberculosis. According to the results of above study, it is desired to be practiced X-ray mass examination to the total middle school students. Nurse teachers and the responsible persons who participated to the helping of disease management to the Tuberculosis patients must make an offer knowledge of Tuberculosis to the Tuberculosis patients. And also, it will be very helpful to the cure of Tuberculosis patients if they do their best and to have a mental supporter.

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A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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Radiosynthesis of $[^{11}C]6-OH-BTA-1$ in Different Media and Confirmation of Reaction By-products. ($[^{11}C]6-OH-BTA-1$ 조제 시 생성되는 부산물 규명과 반응용매에 따른 표지 효율 비교)

  • Lee, Hak-Jeong;Jeong, Jae-Min;Lee, Yun-Sang;Kim, Hyung-Woo;Lee, Eun-Kyoung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.241-246
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    • 2007
  • Purpose: $[^{11}C]6-OH-BTA-1$ ([N-methyl-$^{11}C$]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole, 1), a -amyloid imaging agent for the diagnosis of Alzheimer's disease in PET, can be labeled with higher yield by a simple loop method. During the synthesis of $[^{11}C]1$, we found the formation of by-products in various solvents, e.g., methylethylketone (MEK), cyclohexanone (CHO), diethylketone (DEK), and dimethylformamide (DMF). Materials and Methods: In Automated radiosynthesis module, 1 mg of 4-aminophenyl-6-hydroxybenzothiazole (4) in 100 l of each solvent was reacted with $[^{11}C]methyl$ triflate in HPLC loop at room temperature (RT). The reaction mixture was separated by semi-preparative HPLC. Aliquots eluted at 14.4, 16.3 and 17.6 min were collected and analyzed by analytical HPLC and LC/MS spectrometer. Results: The labeling efficiencies of $[^{11}C]1$ were $86.0{\pm}5.5%$, $59.7{\pm}2.4%$, $29.9{\pm}1.8%$, and $7.6{\pm}0.5%$ in MEK, CHO, DEK and DMF, respectively. The LC/MS spectra of three products eluted at 14.4, 16.3 and 17.6 mins showed m/z peaks at 257.3 (M+1), 257.3 (M+1) and 271.3 (M+1), respectively, indicating their structures as 1, 2-(4'-aminophenyl)-6-methoxybenzothiazole (2) and by-product (3), respectively. Ratios of labeling efficiencies for the three products $([^{11}C]1:[^{11}C]2:[^{11}C]3)$ were $86.0{\pm}5.5%:5.0{\pm}3.4%:1.5{\pm}1.3%$ in MEK, $59.7{\pm}2.4%:4.7{\pm}3.2%:1.3{\pm}0.5%$ in CHO, $9.9{\pm}1.8%:2.0{\pm}0.7%:0.3{\pm}0.1%$ in DEK and $7.6{\pm}0.5%:0.0%:0.0%$ in DMF, respectively. Conclusion: The labeling efficiency of $[^{11}C]1$ was the highest when MEK was used as a reaction solvent. As results of mass spectrometry, 1 and 2 were conformed. 3 was presumed.

Dentofacial changes of non-orthodontically treated female patients with TMJ disk displacement: a longitudinal cephalometric study (교정 치료를 받지 않은 측두하악관절원반변위가 있는 여성 환자의 두부계측방사선사진을 이용한 안모 및 치열 변화 연구)

  • Han, Jung-Woo;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.40 no.6
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    • pp.398-410
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    • 2010
  • Objective: The purpose of this study was to investigate the changes in dentofacial morphology of non-orthodontically treated female patients with TMJ disk displacement. Methods: The sample consisted of 25 Korean female patients with bilateral TMJ disk displacement who visited the Department of Orthodontics, Seoul National University Dental Hospital from 1996 to 2006. Disk displacements were diagnosed using the magnetic resonance imaging (MRI) of both TMJs. Baseline (T1) and follow-up (T2) lateral cephalograms were analyzed. The mean age of samples at T1 was $18.1{\pm}3.5$ years (range 14.2 - 25.8 years) and at T2, $21.1{\pm}3.5$ years (range 16.2 - 28.0 years). The mean observation period was $3.0{\pm}1.9$ years. Descriptive statistics for each variable were calculated at baseline (T1) and follow-up (T2) stages, and during the observation period (T2-T1). Results: Skeletal changes were found in 64% of the non-orthodontically treated female patients with TMJ disk displacement during the observation period. The L1 to Mandibular plane distance (mm) increased significantly by 0.8 mm (p < 0.01). But there were no significant differences in the other dental relationship variables (overjet, overbite, U1 to palatal plane) during the observation period. Most patients with skeletal changes showed a backward rotation of the mandible. The ratio of the rotation was a decrease of SNB by $0.43^{\circ}$ for every $1^{\circ}$ increase of FMA (Spearman rho = -0.660, P < 0.01). A few patients showed a distal shift of the mandible without rotation or significant changes in the vertical dimension. Conclusions: During observation periods without orthodontic treatment, non-growing patients with TMJ disk displacement showed dentoskeletal changes, mainly backward rotation of the mandible.