• Title/Summary/Keyword: Central pain

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A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War (파월국군장병의 고엽제 위해에 관한 예비적 역학조사)

  • Kim, Joung-Soon;Lee, Hyun-Sul;Lee, Hong-Bok;Lee, Won-Young;Park, Young-Joo;Kim, Sung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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The Correlation between the Number of Fungiform Papillae and Electrogustometric Thresholds in Adults (젊은 성인에서 심상유두개수와 전기미각역치의 상관성)

  • Han, Dong-Hoon;Park, Ji-Il;Lim, Hoi-Soon;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.1-10
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    • 2011
  • The aims of this study were to establish the effect of gender and age on number of fungiform papillae and electrogustometric thresholds of the tongue, and to determine the relation between number of fungiform papillae and electrogustometric threshold. Sixty-two healthy subjects of 20 to 39 years old were enrolled in this study. Examination areas were defined as center, anterior, left lateral, right lateral, and posterior on the dorsal surface of the tongue, which was stained with methylene blue dye and photographed with a scale bar on it. The number of fungiform papillae within $1\; cm^2$ square area of each examination site was counted twice. The counted values were averaged to produce means. Taste thresholds were measured three times on each examination area using an electrogustometer. Means of the threshold values were calculated. 1. The number of fungiform papillae was the largest at the anterior examination area, followed by right lateral, left lateral, posterior and central. Women had more fungiform papillae than men at anterior, right lateral, and center areas. Subjects in twenties showed more fungiform papillae than those in thirties at anterior, right lateral, and left lateral areas. 2. Anterior area of the tongue measured the lowest electrogustometric threshold, followed by left lateral, right lateral, posterior and center. The threshold was higher in men at anterior and right lateral areas. The subjects in thirties had higher threshold only at right lateral area than those in twenties. 3. Electrogustometric threshold was inversely correlated with the number of fungiform papillae at anterior and posterior areas. The results showed that the number of fungiform papillae and taste threshold varied according to tongue locus, and they were influenced by age and gender. The results also suggested that the number of fungiform papillae was related to electrogustometric threshold inversely.

Nocturnal Bruxism and Botulinum Toxin Effect on the Subjects with Masseteric Hypertrophy (야간 이갈이와 교근비대 환자의 보툴리눔 독소 주사 효과)

  • Sohn, Seung-Mahn;Chung, Gi-Chung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.337-346
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    • 2007
  • This study aimed to evaluate a relation of bruxism with clinical effects of botulinum toxin type A(BTX-A) injection. 5 bruxers and 5 nonbruxers with bilateral masseter hypertrophy were participated in this study. After injecting 25 unit of BTX-A(Allergen Inc, $Botox^{(R)}$) into each masseter muscle, the thickness of masseter(Mm) and anterior temporalis(Ta) muscles was measured by ultrasonography and the maximum bite force was evaluated during a 9-month period. Self-estimation on the recovery of occlusal force during mastication was done as well. Regardless of presence of bruxsim, all subjects showed significantly reduced Ms thickness(p<0.001) and maximum bite force at $1^{st}$ molars(p=0.027) with their peak at 3 months after injection, which then started to return. No significant difference was observed in Ta thickness and the bite force at the central incisors. While self-estimated occlusal force was the least at 2 weeks after injection and then rapidly returned to the baseline level with full recovery at the time of 6 to 9 months after injection, the maximum bite force measured by bite force recorder did not recover the original value, particularly in the nonbruxer group. It is assumed that nocturnal bruxism can influence recovery of atrophic masseter and decreased occlusal force due to BTX-A injection. These findings suggest a need of occlusal appliance to control bruxism or clenching habit for longer clinical effect of BTX-A injection.

MORPHOLOGY OF THE TERMINAL ARBORS FROM THE MASSETERIC MUSCLE SPINDLE AFFERENTS IN THE TRIGEMINAL MOTOR NUCLEUS (삼차신경 운동핵에서 교근 근방추 구심성 신경섬유 종말지의 미세구조)

  • Lee, Kyung-Woo;Bae, Yong-Chul;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.321-347
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    • 1994
  • Muscle spindle afferents from masseter muscle were labelled by the intra-axonal HRP injection and were processed for light microscopic reconstruction. Regions containing terminal arbors scattered in the central portion of the masseteric motor neuron pool (type I a) and those restricted to 2-3 small portion of it (type II) were selected and processed for electronmicroscopic analysis with serial sections. The shape of the labelled boutons was dome or elongated shape. Scalloped or glomerulus shape with peripherial indentation containing pre or postsynaptic neuronal propiles, which is occasionally found in the trigeminal main sensory nucleus and spinal dorsal horn, was not observed. Both type Ia and type II boutons had pale axoplasm and contained clear, spherical vesicles of uniform size(dia : 49-52nm) and occasionally large dense cored vesicles(dia : 87-118nm). The synaptic vesicles were evenly distributed throughout the boutons although there was a slight tendency of vesicles to accumulate at the presynaptic site. The average of short and long diameter(short D. + long D./2) of type I a bouton was smaller than that of type II bouton. All the labelled boutons, which showed prominent postsynaptic density, large synaptic area and multiple synaptic contact, made asymmetrical synaptic contact with postsynaptic neuronal propiles. Most of the type Ia and type II boutons made synaptic contact with only one neuronal propile and boutons which shows synaptic contact or more neuronal propiles was not observed. Most of the type Ia boutons(87.2%) were presynaptic to the soma or proximal dendrite and a few remainder(12.8%) made synaptic contact with dendritic shaft or distal dendrite. In contrast, majority of type II boutons showed synaptic contact with dendritic shaft and remainder with soma or proximal dendrite. In conclusion, terminal boutons which participate in the excitatory monosynaptic jaw jerk reflex made synaptic contact with more proximal region of the neuron, and showed very simple synaptic connection, compared with those from the primary afferenst in the other region of the central nervous system such as spinal dorsal horn and trigeminal main sensory nucleus which assumed to be responsible for the mediating pain, tactile sensation, sensory processing or sensory discrimination.

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Analysis of bone bruise associated with anterior cruciate ligament injury (전방십자인대 손상과 관련된 골멍의 패턴 분석)

  • Jung, Dae-Won;Kim, Chang-Wan;Baik, Jong-Min;Seo, Seung-Suk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.44-50
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    • 2012
  • Purpose: The purpose of this study is to analyze the relationship between acute anterior cruciate ligament (ACL) injury and bone bruise using the survey for location and incidence of bone bruise. Materials and Methods: From Jan. 2006 to Feb. 2010, 87 knees from who had complaint a traumatic knee pain were diagnosed as acute ACL tear using MRI evaluation. Associated injury, location and incidence of bone bruise were analyzed using MRI. The location of bone bruise on the MRI was classified as medial, central and lateral area on anteroposterior and lateral view of femur and tibia. The bone bruise was classified with Costa Paz classification. Results: Bone bruise of injury during daily living activity were located at medial area on coronary view and anterior area on sagittal view of distal femur, at medial area on coronary view and anterior area on sagittal view of proximal tibia (p=0.024, p=0.021, p=0.025 and p=0.029, respectively). Bone bruise of injury during sports activity were located at lateral area on coronary view and central area on sagittal view of distal femur, at lateral area on coronary view and posterior area on sagittal view of proximal tibia (p=0.014, p=0.015, p=0.018 and p=0.017, respectively). Bone bruise patterns due to traffic accident were inconclusive (p=0.264, p=0.254, p=0.229 and p=0.267, respectively). Conclusion: Injury mechanism of acute ACL injury from activities of daily living or sports activities compared to that of traffic accident showed a more consistent bone bruise patterns. Special attention to acute ACL tear must be paid in case of bone bruise at lateral tibial plateau and lateral femoral condyle.

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Deduction and Verification of Optimal Factors for Stent Structure and Mechanical Reaction Using Finite Element Analysis (스텐트의 구조 및 기계적인 반응에 대한 최적인자 도출과 유한요소해석법을 통한 검증)

  • Jeon, Dong-Min;Jung, Won-Gyun;Kim, Han-Ki;Kim, Sang-Ho;Shin, Il-Gyun;Jang, Hong-Seok;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.201-208
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    • 2010
  • Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and $0.09\;mm^2$ for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.

CLINICAL AND RADIOGRAPHIC STUDY OF DENTIGEROUS CYSTS ACCORDING TO INVOLVED AREA (함치성 낭의 임상적 및 방사선적 특성)

  • Park, Seung-Youn;Nam, Dong-Woo;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.169-179
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    • 2004
  • The purpose of this study was to discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I, involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second, Group II, involved permanent molar area, and the last, Group III involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I, 36 cases of Group II, and 15 cases of Group III of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group I were 29 cases and, those of Group II were 36 and those of Group III were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%, in Group II and Group III, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%), and pain(9%). 5. When considering the type of the cyst, lateral type is many most in Group I (71.4%) and central type is many most in Group II (94.4%) and Group III (100%). 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group II, above of 4 crown size in Group III. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%), no bone expansion in Group II(66.7%) and palatal bone expansion in Group III (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%), severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group II and in 80.0% of cases of Group III.

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A Study on Oriental Medical Diagnosis of Musculoskeletal Disorders using Moire Image (Moire 영상을 이용한 근골격계 질환의 한의학적 진단에 관한 연구)

  • Lee Eun-Kyoung;Yu Seung-Hyun;Lee Su-Kyung;Kang Sung-Ho;Han Jong-Min;Chong Myong-Soo;Chun Eun-Joo;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.72-92
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    • 2000
  • This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.

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Comparative Medium Term Results of Arthroscopic ACL Reconstruction with Quadrupled Semitendinosus Tendon versus BPB tendon (4겹의 반건양건과 골-슬개건-골을 이용한 관절경적 전방 십자 인대 재건술의 중기적 치료 결과 비교)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyeong;Kim, Ki-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.1-6
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    • 2001
  • Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

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Changes in CGRP-immunoreactive Nerve Fibers during Expansion of Midpalatal Suture of the Rat (백서 정중구개봉합 확대후의 CGRP 면역반응 신경섬유의 변화)

  • Kim, Bo-Kyung;Park, Kuk-Pil;Kyung, Hee-Moon;Kwon, Oh-Won;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.73-81
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    • 1999
  • Midpalatal suture expansion is often used for patients haying narrow maxillary arch, cleft palate, respiratory handicap with narrow nasal cavity. CGRP has been known as a modulator of pain transmission in central nervous system and a local effector to peripheral tissue causing vasodilation, increase of blood flow, modulation of immune system, regulation of macrophagic function and stimulation of bone formation. To investigate changes of CGRP-immunoreactive nerve fibers in midpalatal suture during the expansion, immunohistochemical study was performed by using rats. Experimental rats (10 weeks, 250 gm) were divided into five groups (control, 1, 4, 7, 14 days group (each n=4) and applied orthodontic force (approximately 200gm) to upper anterior incisors. Frozen sections of midpalatal suture area were immunostained by using rabbit antisera. The results were as follows. ${\cdot}$ The CGRP-immunoreactive nerve fibers were hardly observed in control group. ${\cdot}$ In 1 day group, the CGRP-immunoreactive nerve fibers were more increased around the vessels than control group. ${\cdot}$ In 4 days group, the CGRP-immunoreactive nerve fibers were more increased than control group, but not more increased than 1 day group. Vascular diameter was more enlarged. ${\cdot}$ In 7 days group, especially, hematoxilin affinity of cells was remarkable and cells were arranged along the bone margin. The CGRP-immunoreactive nerve fibers were more reduced than 4 days group and vascular diameter was also reduced. ${\cdot}$ In 14 days group, the CGRP-immunoreactive nerve fibers were similar to those of 7 days group and the irregularity of bone margin was almost recoverd. In Conclusion, the CGRP-immunoreactive nerve fibers nay be related to initial neurogenic inflammatory reaction in expanding mid-palatal suture.

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