• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.176-184
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• 1997

Abnormal illness behavior in patients with somatoform disorders were known formed by their traditional disease concepts and somatization-prone socio-cultural factors. The authors evaluated the characteristics of abnormal illness behavior in patients with somatoform disorders(who had somatization) by using abnormal illness behavior questionnaire. Methods : 29 somatoform disorders(SD) and 57 disease controls were compared by clinical characteristics, severity of pain, state anxiety(by Spielberger's State & Trait Anxiety Inventory), depression(by Beck's Depression Inventory) and level of psychosocial stess(by DSM-III-R). The illness behavior was measured by illness Behavior Questionnaire(IBQ). Results SD group had longer period of somatic symptoms with less severity in pain. The degree of anxiety and depression were higher in SB compared with controls. However, the degree of psychosocial stress was almost same between both groups. In IBQ, SD showed higher scores in general hypochondriasis, disease conviction, and affective disturbance subscales compared to control group. Conclusion: High disease conviction and hypochondriacal nature revealed by IBQ seemed to be a role in making somatization by way of somatic focusing and hypervigilance. And those tended to lead patients visit hospital frequently and report various somatic complaints. Evaluating abnormal illness behavior in somatoform disorders would be not only helpful in understanding the natures of somatoform disorders but also useful differentiating SD with other psychiatric conditions.

• Journal of the Korean Applied Science and Technology
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• v.38 no.3
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• pp.771-785
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• 2021

This study was performed to provide detailed and comprehensive information on inflammation-related blood indicators, joint range of motion, pain scale, and psychological indicators by patient characteristics by performing a 12-week home-based exercise program for ankylosing spondylitis patients. For the purpose of this study, 10 patients with ankylosing spondylitis were selected by age (30s vs. 40s vs. 50s), gender (male vs. female), and duration (less than 5 years vs. 5 years or more). The home-based exercise program was a combination of aerobic exercise and Pilates-based resistance exercise, and was performed 4 times a week for 12 weeks at an intensity of 50-70% of maximal heart rate (MHR). As a result, after 12 weeks of home-based exercise intervention, the blood C-reactive protein (CRP) concentration of patients with ankylosing spondylitis decreased (-35.6%, p=.002), and the blood inflammation level was improved, and each joint (hip, lumbar, cervical) improved mobility (p<.05). In addition, the bath ankylosing spondylitis disease activity index (BASDAI) was decreased by -67% (p=.001) and the visual analogue scale (VAS) was decreased by -64.8% (p=.001), stiffness and pain has been alleviated. In particular, as the degree of depression decreased by -65.5% (p=.001) and the degree of anxiety by -55.2% (p=.003), 12 weeks of home-based exercise improved not only physical changes but also psychological factors. On the other hand, there was no difference in exercise effect according to age, gender, and disease duration in ankylosing spondylitis patients (p>.05). These results suggest that the 12-week home-based exercise applied in this study can be an effective exercise program that can be universally used for ankylosing spondylitis patients regardless of patient characteristics.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.214-222
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• 1988

With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.383-402
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• 1997

The author analyzed 155 cases of Facial Palsy, excluding lesions caused by cerebrovascular attacks, who were treated in the Kwang-ju Oriental Medical Hospital of Wonkwang University from March 1996 to September 1996. I've examined the 155 cases in the view of the etiologic distributions, the age, the relationship of the sex and paralytic side, attended symptoms and analyzed 95 cases who were treated over ten times in the view of the ratio of recovery according to the age, anatomic focus, the relations of sex and paralytic side. The following results are obtained. 1. The ratio of punghan(風寒) was $20.64\%$(32 cases), overwork was $18.70\%$(29 cases), stress was $6.44\%$(10 cases), excessive drinking was $3.23\%$(5 cases), teeth pain was $1.93\%$(3 cases), and idiopathy was $38.05\%$(59) and etc. 2. The ratio of stylomastoid pain was $15.48\%$(24 cases), auricular pain was $10.32\%$(16 cases), headache was $4.51\%$(7 cases), eyedried was $4.51\%$(7 cases), taste paralysis was $2.57\%$(4 cases), tinnitus was $2.57\%$(4 cases) and non-significant symptoms was $50.97\%$(79) and etc. 3. The ratio of 2th and 5th decade were $20.00\%$(31 cases), 4th decade was $18.71\%$(29 cases), 3th decade was $16.71\%$(26 cases), 6th decade was $11.61\%$(18 cases), teenagers in $5.81\%$(9 cases), over seventy and under teenagers were $3.23\%$(5 cases), and infant was $0.65\%$(1 case). 4. The ratio of the male-right was $28.39\%$(44 cases), female-right was $25.82\%$(40 cases), male-left was $23.23\%$(36 cases), female-left was $20.65\%$(32 cases) and male-both side was $1.94\%$(3 cases) in order. 5. Topographically, The ratio of the infrachordal lesion was $72.90\%$(113 cases), transgeniculate lesion was $16.13\%$(25 cases), suprageniculate lesion was $5.81\%$(9 cases), infrastapedial lesion was $3.87\%$(6 cases) and suprastapedial lesion was $1.29\%$(2 cases) in order. 6. When we examined the degree of recovery about the 95 patients who were treated over ten times after on attack, normal improvement was seen in $46.32\%$(44 cases), excellent in $7.37\%$(7 cases), good in $12.63\%$(12 cases), fair in $13.68\%$(13 cases), poor in $20.00\%$(19 cases). The total remedial value of the 95 patients who were treated over ten times was revealed $61.58\%$. 7. When we examined the 95 patients who were treated over ten times, the remedial value of the infant was $50.00\%$, under teenagers $43.75\%$, teenagers $37.50\%$, 2th decade $56.82\%$, 3th decade $64.06\%$, 4th decade $55.00\%$, 5th decade $73.53\%$, 6th decade $77.50\%$, over seventieth $68.75\%$. The remedial value of 3th decade, 5th decade, 6th decade, 7th decade and over seventieth were higher than the total remedial value($61.58\%$) 8. In the point of topographical lesion, when we examined the 95 patients who were treated over ten times, the remedial value of infrachordal lesion was $66.78\%$, infrastapedial lesion $58.33\%$, suprastapedial lesion $50.00\%$, transgeniculate lesion $48.44\%$, suprageniculate lesion $31.25\%$, in order. Only the remedial value of Infrachordal($66.78\%$) was higher than the total remedial value($61.58\%$). 9. In the point of the relationship of the sex and the paralytic side, when we examined the 95 patients who were treated over ten times, the remedial value of male-left was $57.29\%$, male-right $61.54\%$, male-both side $58.33\$%, female-left $57.81\%$ and female-right $68.27\%$. Only the remedial value of female-right($68.27\%$) was higher than the total remedial value($61.58\%$). These results demonstrated that in the point of prognostic view there was more concerned with the topographical lesion, body condition than the traditional rule of sex-paralytic relationship that man is awed left paralysis and woman right paralysis.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Korean Journal of Social Welfare
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• v.60 no.2
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• pp.99-129
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• 2008

This study analyzed the resilience process of persons with disabilities using the grounded theory approach. To conduct this study, the researcher conducted in-depth interviews with 8 persons with disabilities. In data analysis, this study identified 393 concepts on the resilience process of persons with disabilities and the concepts were categorized into 45 sub-categories and 18 primary categories. In the paradigm model on the resilience process of persons with disabilities, it was identified that casual conditions included 'unawareness of disability before being disability', 'extreme pain', 'repressing psychological pain', and the contingent conditions were 'dis-empowerment by staying in home', 'isolation by himself with difficulty in accepting the disability', 'experience of frustration from social barriers with prejudice against persons with disabilities'. Also, it was identified that the resilience process could be dependent on the type and the degree of the disability, the gender, and the length of time being disability. In spite of the casual and contingent conditions, the central way in which persons with disabilities could acquire resilience was identified as 'enhancement of the power of positive thinking'. The control conditions which accelerate or retard central phenomenon were 'the awareness of not being alone through family, friends, neighborhood and the social system' externally and 'finding purpose in life through religion and help from other persons with disabilities', internally. The action/interactional sequences enhanced the efforts, self searching and active acting, and as a result, persons with disabilities could find comfort in life, participate in society and change the perspective of disability in society. The core categories of resilience process in persons with disabilities were a belief in affirmation and choice of life by initiative. In the process analysis, stages developed in the following: 'pain', 'strangeness', 'reflection', 'daily life'. This stage was more continuous and causal than discrete and complete. In this process, the types of resilience of persons with disabilities are divided into 'existence reflection', 'course development', 'implicit endeavor', and 'active execution'. This study showed the details of the paradigm models, the process and types with an in-depth understanding of the resilience process of persons with disabilities using grounded theory as well as theory construction and policy and clinical involvement on the study of persons with disabilities.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.119-133
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• 1997

Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.33-54
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• 1981

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.229-234
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• 2008

Purpose: A urea breath test (UBT) using C-14 or C-13 has been developed for identifying Helicobacter (H) pylori infection on the basis of urease production with release of labeled $CO_2$. We investigated if the C-14 and C-13 UBT have the difference to reflect the presence and degree of H. pylori infection detected by gastro-duodenoscopic biopsies (CBx) in the same patients. Materials and methods: Thirty eight patients (M:F = 28:10, age $53.4{\pm}13.0$ yrs) with upper gastrointestinal symptoms such as indigestion, gastric fullness or pain consecutively underwent C-14 UBT, GBx and C-13 UBT within one week before medications. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (37 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (${\ge}$ 200 dpm), intermediate (50-199 dpm) or negative (50 dpm). For the C-13 UBT, the results were classified as positive (${\ge}2.5\%_{\circ}$) or negative ($<2.5\%_{\circ}$). The results of GBx with Giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT and C-13 UBT results with GBx grade as a gold standard. Results: The prevalence of H. pylori infection by GBx with Giemsa stain was 25/38 (65.8%). In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.0%, 92.3%, 95.8%, 91.7% and 92.1%, respectively. However, the C-13 UBT had sensitivity, specificity, PPV, NPV and accuracy of 96.0%, 84.6%, 92.3%, 91.7% and 92.1%, respectively. The more significant correlation in C-14 than C-13 UBT (r=0.948 vs r=0.819, p <0.001) was found between the value of UBT and the grade of distribution of H. pylori infection. Conclusion: We conclude that the diagnostic performance between C-14 and C-13 UBT to detect H. pylori infection is not significantly different, but the value of C-14 UBT more significantly reflects the degree of bacterial distribution.