• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1248-1252
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• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.3
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• pp.158-167
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• 2024

Purpose: To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. Methods: A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected. Results: We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males. Conclusion: In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

• Women's Health Nursing
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• v.7 no.2
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• pp.169-187
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• 2001

This study was performed to probe the effect of exercise program on muscle strength, endurance, flexibility, pain, disability level and life satisfaction in female teachers of elementary school who complain of low back pain. For this study, 44 female teachers aged 30-50 years with mechanical low back pain of 6 months' duration, who had the structural normalities in the lumbar spine, were recruited from April 1 to July 10 1999. Twenty three out of them were assigned to the experimental group and twenty one to the control group. The exercise program consisted of education on right postures, the etiology and diagnosis of low back pain, and exercise intervention such as muscle relaxation, elongation and strengthening. With 8 weeks program, the subjects received two sessions of education and six sessions of group exercise in the 1st week, while three sessions of group exercise and four sessions of individual exercise weekly and two sessions of education during the later 7 weeks. The muscle strength and endurance were measured by Cybex 770, the flexibility by flexibility measurement machine, the intensity of pain by Visual Analogue Scale (VAS), the level of disability by Oswestry low back pain disability scale, depression by Beck depression inventory (BDI), and life satisfaction by Life satisfaction index-Z. Study measurements were taken before and after 8 weeks exercise program. Data were analyzed using paired t-test, t-test, and ANCOVA. The results were as follows ; 1. The flexors and extensors peak torque and flexors peak torque per body weight of experimental group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of control group. There was no significant difference in extensors peak torque per flexors peak torque at $30^{\circ}/sec$, $60^{\circ}/sec$ between experimental and control group. 2. The flexors and extensors total work and flexors total work per body weight of experimental group were significantly increased at $120^{\circ}/sec$, compared with those of control group. 3.The flexibility of lumbar spine in experimental group was significantly increased compared with that of control group. The pains in anterior, posterior, left lateral and right lateral bending and in rotation of experimental group were significantly increased compared with those of control group. 4. The Oswestry disability scores of experimental and control group were significantly decreased, and there was no difference in the Oswestry disability score change between experimental and control group. 5. The scores of BDI of experimental group were significantly decreased compared with those of control group. Life satisfaction index-Z scores of experimental group were not changed, but those of control group were significantly decreased. There was no difference in the score change of Life satisfaction index-Z between experimental and control group. 6. ANCOVA analysis for the data variables of inhomogeneous baseline represented that there was no significant difference in extensors peak torque and extensors total work at $120^{\circ}/sec$ and extensor total work per body weight at $120^{\circ}/sec$ change between experimental group and control group. These findings indicate that the exercise program could be effective in increasing the muscle strength, endurance, flexibility and decreasing pain, improving depression in female teachers of elementary school with chronic low back pain. It is suggested that the exercise program could be an essential factor for the effective nursing intervention to the patients suffered from chronic low back pain.

• Journal of Oral Medicine and Pain
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• v.37 no.1
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• pp.9-17
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• 2012

Lichen planus is a chronic inflammatory mucocutaneous disease that affects multiple sites of the body. Often it involves the oral mucosa, but also involve other sites such as skin, genitals, scalp and nails. There is no clear cause of oral lichen planus (OLP), current data suggest that OLP is a T-cell mediated autoimmune disorder which may have an altered self-peptide triggering apoptosis of oral epithelial cells. Usually OLP appears in middle-aged women which tends to be chronic with periods of exacerbation and remission. There are many theories those causes the OLP such as psychological and environmental factors, genetic tendency, drugs and more. 60-70% of lichen planus is accompanied by oral lesions, and more than half of its cases are not able to defined by their skin. In this study, among all the possibility(possible) theories, we tried to evaluate the influence of emotional stress in exacerbating OLP. There were thirty patients with a clinical or histological diagnosis of OLP and other thirty subjects who did not show any signs of systemic disorders include OLP. They were evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the OLP patients than the control group. Therefore it could be concluded that psychological stressors play an important role in the exacerbating OLP.

• Journal of Oral Medicine and Pain
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• v.35 no.1
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• pp.41-47
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• 2010

Burning mouth syndrome(BMS) is a chronic oral pain and a symptom complex disorder usually unaccomplished by mucosal lesion or other clinical and laboratory signs of organic disease. BMS is characterized by a spontaneous burning sensation that mainly affects middle-aged and postmenopausal women. The etiology of BMS is poorly understood even though evidence for a possible neuropathic pathogenesis. BMS cause from various local or systemic factor, including nutritional deficiencies, hormonal change, local infection, dental procedure, dry mouth, medication and systemic disease including diabetes mellitus. Many studies suggest peripheral alteration in sensory of trigeminal nerve system. BMS patients with supertaster indicates pathologies of central and peripheral nerve system induced by an alteration in the taste system at the level of chorda tympani and glossopharyngeal nerve. The author discuss our current understanding of etiology and pathogenesis of BMS that refered chronic oral pain.

• The Journal of Korean Physical Therapy
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• v.17 no.2
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• pp.22-37
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• 2005

This study was performed to investigate LBP(low-back pain) prevalence rate and its related factors inphysical therapists. A self-administered questionnaire survey was conducted to 522 physical therapists in Daegu and Gyeongsangbuk. The LBP prevalence rate for recent 6 months was $61.7\%$. According to age, the prevalence rate was highest in the group aged 24 or less for both male and female physical therapistis. For male physical therapists , it was higher in smokers and drivers, but for female ones, it was not in a significant relationship with smoking and driving. According to work experience, the prevalence rates of those who had been working for less than one year were the highest, and those who had been working at hospitals and clinics were $69.1\%$, significantly high. According to therapy techinque, the prevalence rate related ti PNF was $71.6\%$, the highest and to occupational therapy was $34.3\%$, the lowest. According to working environment for six months, in both male and female physical therapists. LBP prevalence rate was in a statistically significant relationship with work hours during the day, night and weekend duties, repetitive works, motions that bend or twist the waist, the number of patients per day, the number of time to help patients per day, the number of time to carry medical equipment per day and the length of time to work standing. The rate was also higher when physical therapists fekt nire stress from their work. According to the result of multiple logistic regression analysis, male was in a significant relationship with work experience and motions that bend or twist the waist and female was in a significant relationship with work hours during the night and weekend duties, the number of time to help patients per day, motions that bena or twist the waist, actions taken to protect the waist. As for the developmental pattem of LBP in the group of physical therapists with LBP for six moths, $15.7\%$ of them had LBP for first time, $42.3\%$ had recurred LBP, and $42.0\%$ had chronic LBP. As for the causes of LBP, $51.7\%$ said that it was because they worked in the same posture for a long time, and as for how to treat LBP, 48.8% said that they treated themselvs or got help from their co-wokers. The results presented above suggest that physical therapists are exposed to high risk of LBP caused form occupational activities. Therefire, it is necessary to improve working environment to reduce the occurrence of LBP and to develop education programs for preventing the occurrence and recurrence of LBP.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.99-114
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• 2023

Purpose : The purpose of this study was to determine factors that affect the quality of life (QoL) of people with diabetes. We hope to provide a basis for intervention strategies for health promotion and related research among patients with diabetes in the field of physical therapy. Methods : We selected individuals diagnosed with diabetes who were aged 19 years or higher by using data from the 2019 Korean Health Panel survey and analyzed the results of 1,527 people. The influencing factors were sex, age, household income, marital status, age, education level, subjective health status, body mass index (BMI), smoking, drinking, regular exercise, experience of depression and anxiety, suicidal thoughts, stress, and frequency of walking (days/week). Frequency analysis, descriptive statistics, independent sample t-test, one-way analysis of variance, and multiple regression analysis were performed. Results : The EQ-5D score for QoL was .87 ± .12, with pain and discomfort being the most detrimental to the QoL of people with diabetes. In terms of patients characteristics, the QoL was lower among participants who were female, older, and separated/widowed/divorced; had an education level below middle school; had a poor subjective health status; were non-smokers and drinkers; and did not walk and exercise regularly, experienced a lot of stress, and experienced depression and anxiety; and had suicidal thoughts (p<.001). Being separated/bereaved/divorced; experiencing a lot of stress, depression, and anxiety; and having suicidal thoughts were negatively associated with QoL in people with diabetes (p<.01). On the other hand, age of 65 years or younger; graduation from high school, fair or better subjective health, regular exercise and alcohol consumption, and walking (days/week) were positively associated with QoL (p<.05). Conclusion : Regarding the QoL of patients with diabetes, intervention strategies should be formulated by considering general characteristics and disease-related characteristics. Among the various factors affecting QoL, the number of walking and regular exercise were found to be the factors that improved the QoL of patients with diabetes. These results can be used as a basis for the education and management of patients with diabetes in the field of physical therapy.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.134-142
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• 2015

Lichen planus is an immune-mediated mucocutaneous disease, affects more frequently middle-aged Caucasian women and makes signs and symptoms in the oral mucosa. Cutaneous lichen planus lesions cause itching but they are self-limiting, oral lichen planus lesions are usually chronic, recalcitrant to treatment and potentially premalignant in some cases. Although, oral lichen planus is non-plaque related disease, they possess particular problems because plaque control is complicated by pain and bleeding and might cause plaque-related disease. The resulting condition comprises accumulations of plaque, which again can influence the progress of oral lichen planus with burning sensation, spontaneous gingival bleeding. Thus, it should be noted that both medication and supportive periodontal treatment are essential for the remission of the lesions. This case report introduces topical corticosteroid therapy and supportive periodontal treatment including intensive oral hygiene procedures to obtain an improvement of subjective symptoms and objective changes and to prevent relapse the lesions.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.77-85
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• 2018

Objectives : This study aimed to investigate the level of distress using the distress thermometer (DT) and the factors associated with distress in postoperative breast cancer (BC) patients. Methods : DT and WHOQOL-BREF (World Health Organization Quality of Life Scale Abbreviated Version) along with sociodemographic variables were assessed in patients undergoing surgery for their first treatment of BC within one week postoperatively. The distress group consisted of participants with a DT score ${\geq}4$. The prevalence and associative factors of distress were examined by descriptive, univariable, and logistic regression analysis. Results : Three hundred seven women were recruited, and 264 subjects were finally analyzed. A total of 173 (65.5%) were classified into the distress group. The distress group showed significantly younger age (p=0.045), living without a spouse (p=0.032), and worse quality of life (QOL) as measured by overall QOL (p=0.009), general health (p=0.005), physical health domain (p<0.000), and psychological health domain (p=0.002). The logistic regression analysis showed that patients aged 40-49 years were more likely to experience distress than those aged ${\geq}60years$ (Odds ratios [OR]=2.992, 95% confidence interval [CI] 1.241-7.215). Moreover, the WHOQOL-BREF physical health domain was a predictive factor of distress (OR=0.777, 95% CI 0.692-0.873). Conclusions : A substantial proportion of patients are experiencing significant distress after BC surgery. It would be expected that distress management, especially in the middle-aged patients and in the domain of physical QOL (e.g., pain, insomnia, fatigue), from the early BC treatment stage might reduce chronic distress.