• 대한치과보철학회지
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• 제60권4호
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• pp.420-430
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• 2022

개방교합이 있는 환자는 치아접촉 및 수직피개의 감소를 나타내며 교합평면의 부조화, 저작 곤란, 언어 장애, 외모 변화 및 정상보다 낮은 교합력을 가지는 경우가 많다. 교합이 완성된 성인에서 측두하악관절장애로 인해 발생한 개방교합은 원인요소의 제거 또는 관절상태의 안정화가 먼저 이루어진 후 교합 수정이 이루어져야 하며, 이를 위해 교정치료, 교합조정, 보철 치료, 외과적 치료법 등이 있다. 본 증례보고는 교합이 완성된 성인에서 하악의 변위로 인해 개방교합이 발생한 두 명의 환자에서 교합 변화의 원인을 추정해 보고 원인에 따라 다른 치료 접근방법에 대해 살펴 보는 것이다. 관찰한 환자 중 한 환자는 측두하악관절의 안정화 후 교합조정을 통하여 기능적인 면과 심미적인 면에서 만족스러운 결과를 얻을 수도 있었기에 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• 정신신체의학
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• 제7권1호
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• pp.134-141
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• 1999

연구목적 : 암환자에서는 암의 임상적 특성이나, 치료방법에 따라 다양한 심리적인 문제들이 발생한다. 특히 방사선 치료는 다른 방법의 치료를 받는 환자들에서 볼 수 없는 다른 심리적 반응을 보이는 경우가 많으며, 정서적 고통과 갈등이 가중될 수 있다. 이에 저자들은 방사선 치료중인 암환자들에게는 어떠한 정신과 장애가 발생하는지 알아보고, 정신과 질환이 암과 관련된 다양한 임상적 특성과 어떠한 연관성을 지니는지 알아보고자 본 연구를 시행하였다. 방법 : 방사선 치료를 위해 치료방사선과에 입원한 암환자 47명을 대상으로 하여. DSM-IV 진단기준에 따라 정신과 장애를 평가하고, 환자들의 인구학적 자료, 암의 부위, 이환기간, 재발횟수 등의 임상적 특성, 암환자의 암에 대한 인지여부, 치료결과에 대한 기대 등의 요인과 정신과 장애의 관련성을 살펴보았다. 결과 : 1) 21 명(44.7%)의 환자가 정신과 장애를 가지고 있었다. 적응장애가 14명(66.7%)으로 가장 많았고, 다음은 5명(23.8%)의 환자에서 동반된 주요 우울장애였다. 2) 성별, 연령, 학력, 결혼상태, 종교 등의 인구학적 변인과 정선과적 장애와의 관련성은 통계적 유의성을 보이지 않았다. 3) 암의 부위별로는 골반부에 위치하는 암이 22명(46.8%)으로 가장 많았으며, 암의 부위, 이환기간과 정신과 장애와의 유의한 관련성은 없었다. 4) 암의 재발에 있어 재발의 증거가 없는 경우에 비해 재발한 경우 통계적으로 유의하게 정신과 장애의 이환율이 높았다. 5) 암의 인지여부와 정신과 장애는 통계적으로 유의한 연관은 없었다. 6) 치료결과에 대한 기대와 관련하여, 방사선 치료가 단지 보조적인 것으로 생각하는 군이 방사선치료에 의해 완치될 것으로 생각하는 군에 비해 통계적으로 유의하게 정신과 장애의 이환율이 높았다.

• 임상간호연구
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• 제29권3호
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• pp.223-237
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• 2023

Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.

• 대한인간공학회지
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• 제24권2호
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• pp.65-70
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• 2005

Evaluation of repetitiveness for upper extremity intensive tasks is essential to determine the level of risk for upper extremity musculoskeletal disorders at the workplace. However, experimental data available to establish the acceptable levels of repetitiveness for various postures and forces is lacking. The present study examined the maximum acceptable frequencies(MAFs; motions/min.) of shoulder, elbow, wrist, and index finger motions at different forces(1kgf and 4kgf for shoulder, elbow, and wrist; 0.25kgf and 1 kgf for index finger) in sitting. Seventeen right-handed males in 20s without having any history musculoskeletal disorders participated in the MAF experiment. The participants determined their MAFs for the upper extremity motions by using the self-adjustment method and their work pulse(increase in heart rate; beats/min.) and rating of perceived exertion(RPE) were measured when working at MAF. The MAFs of elbow, wrist, and index finger motions for each force level were about 2, 3, and 6 times the corresponding MAF(9 at the high force and 24 at the low force) of shoulder motion and the MAFs at the low force increased about 2 times those at the high force. The work pulses of elbow, wrist, and index finger motions for each force level were 70%, 50%, and 30% of the corresponding work pulse(17 at the high force and 12 at the low force) of shoulder motion and the work pulses at the low force were about 70 % of those at the high force. Lastly, the RPEs of the upper extremity regions were about level 3(moderate) or below.

• 대한불안의학회지
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• 제6권2호
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• pp.131-136
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• 2010

Objectives : In this study, we aimed to elucidate the demographic and psychological characteristics of maladaptive soldiers in the Republic of Korean Army. Methods : Study participants included 110 male conscripts who had participated in the Green camp, which was a form of group psychosocial treatment program for maladaptive soldiers. All participants were interviewed and diagnosed by a psychiatrist, and classified into two groups according to whether they left or rejoined the army. We analyzed the differences between these two groups in terms of demographic features, psychiatric diagnosis and the Minnesota Multiphasic Personality Inventory (MMPI) subscores. Results : Compared with soldiers who rejoined their units, those who left military service exhibited significantly lower educational level (p=0.041) and a higher rate in psychiatric treatment prior to enlistment (p=0.011). Among the 106 subjects, 63 (59.4%) and 23 (21.7%) were diagnosed with personality disorder and adjustment disorder, respectively. Further, those who left military service were diagnosed more frequently with mood disorder (p=0.001) and schizophrenia (p=0.014) than those who rejoined their units. Additionally, the MMPI scores of soldiers who left military service were significantly higher on the psychasthenia (p=0.028) and schizophrenia (p=0.039) scales than those of soldiers who rejoined their units. Conclusion : Most of the maladaptive soldiers were diagnosed with mental disorders. The results of this study suggest that systematic, consistent psychiatric evaluation and intervention for maladaptive male conscripts is crucial in the Republic of Korean army.

• Journal of Oral Medicine and Pain
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• 제47권4호
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• pp.198-205
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• 2022

Purpose: The first-line treatment of temporomandibular joint disorders (TMDs) should include self-management and education. Self-management techniques include moist heat application, stretching, diet control, and mandibular rest position adjustment. Although the effectiveness of video educational resources has been studied in multiple sectors, their application in TMD management has not yet been explored. This study seeks to assess how effective media education was at motivating TMD patients to self-management and improve symptoms. Methods: Data were obtained from the hospital records of TMD patients who visited the Department of Oral Medicine, Yonsei University Dental Hospital, between May 2020 and December 2021. First, without any differences between groups, a significance analysis was conducted between the degree of self-management and symptom improvement over time. At the second visit, one group received media education (n=31) linked to TMD management, while the other received written-oriented education (n=45). At the third visit, the number of precautions taken by the patients was determined and contrasted to that recorded in the previous visit between the groups. Generalized estimated equation multivariate models were applied for statistical analysis. Results: In the media education group, the frequency of stretching and the number of patients on pain-free diets increased substantially. Taking precautions improved daily pain intensity, maximum mouth opening, and pain intensity during the maximum unassisted opening. Conclusions: Media education could be beneficial for TMD patients because it allows them to take self-management precautions. The symptoms of the media education group improved, with no considerable distinction between both groups.

• Clinical and Experimental Pediatrics
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• 제57권6호
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• pp.257-263
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• 2014

The incidence of people living with congenital heart disease (CHD) has been increasing every year owing to remarkable advances in surgical and catheter intervention techniques and devices, and improved knowledge of critical care for patients with CHD. However, these patients continue to face physical, psychosocial, and environmental challenges, and a number of studies have shown higher rates of depression and anxiety disorders than the general population. To improve psychosocial functioning and quality of life for adults with CHD, health care providers are recommended to inform CHD patients of an accurate diagnosis, and overall treatment process, beginning in adolescence to facilitate a smooth transition from adolescence to adulthood. Active cooperation with psychiatrists, psychologists, social workers, chaplains, and family members is highly recommended to help CHD patients feel normal and optimistic and to promote good social interactions, close family relationships, and a strong sense of coherence.

• Applied Microscopy
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• 제46권2호
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• pp.100-104
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• 2016

Electron microscopy is currently the only available technique with a spatial resolution sufficient to identify fine neuronal processes and synaptic structures in densely packed neuropil. For large-scale volume reconstruction of neuronal connectivity, serial block-face scanning electron microscopy allows us to acquire thousands of serial images in an automated fashion and reconstruct neural circuits faster by reducing the alignment task. Here we introduce the whole reconstruction procedure of synaptic network in the rat hippocampal CA1 area and discuss technical issues to be resolved for improving image quality and segmentation. Compared to the serial section transmission electron microscopy, serial block-face scanning electron microscopy produced much reliable three-dimensional data sets and accelerated reconstruction by reducing the need of alignment and distortion adjustment. This approach will generate invaluable information on organizational features of our connectomes as well as diverse neurological disorders caused by synaptic impairments.

• 대한치과의사협회지
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• 제50권5호
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• pp.244-255
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• 2012

Temporomandibular disorder(TMD) is described as a cluster of disorders characterized by pain in the preauricular area and/or the muscles of mastication; limitations or deviations in mandibular range of motion; and noises in the TMJ during mandibular function. The most common symptom in TMD patients is pain that is aggravated by chewing or other jaw function. These symptoms are appeared when the stimuli loaded in TMJ are over the physiologic tolerance. The primary goal in treatment of TMD is to alleviate pain and lor mandibular dysfunction. TMD treatment can be divided into 2 categories: reversible and irreversible methods. Reversible methods include medication, thermal therapy, habit modification, physical therapy, appliance therpy and arthrocentesis and lavage and irreversible methods include arthroscopic lysis, surgery, occlusal adjustment et al. It is widely accepted that reversible methods are ther first choice of treatments. However if reversible ones are not effective, irreversible methods are considered.