• Title/Summary/Keyword: Joint Diseases

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State's Duty to Manage Pandemic Diseases and the Role of Institutional Review Boards (국가의 팬데믹 감염병 관리 의무와 기관생명윤리위원회의 역할)

  • Park, Hyoung Wook
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.37-55
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    • 2021
  • On March 19, 2021, the Korean Bioethics Association and related academic circles published a joint statement criticizing the partial revision of Infectious Disease Control And Prevention Act. However, according to the Bioethics And Safety Act of Korea, research conducted by the state or local governments for public welfare is excluded from human subjects research project. In addition, since the Korean legal system is not based on the dichotomy between research and surveillance, the discussion of the US Common Rule cannot be directly applied to Korea. For the harmonious operation of the state's duty to manage infectious diseases and the Institutional Review Boards, institutional alternatives should be prepared in consideration of the following issues. First, the related academic community should first pay attention to the problems of the current laws in Korea. Second, it should be understood that the state is carrying out many tasks without the consent of the parties in order to fulfill its duty to manage infectious diseases. Third, when presenting institutional alternatives, it is necessary to consider the feasibility of implementation in Korea. An in-depth discussion of the institutional alternatives by the Medical Law Society and other related academic circles is necessary.

Clinical Utility of Bone Scan in the Diagnosis of Temporomandibular Disorders (측두하악장애의 진단에서 Bone Scan의 유용성)

  • Kim, In-Joo;Kang, Yang-Ho;Son, Seok-Man;Lee, Kyoung-Seog;Lee, Jae-Bok;Kim, Yong-Ki;Seo, Bong-Jik;Park, June-Sang;Ko, Myung-Yun;Son, Seong-Pyo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.511-517
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    • 1995
  • Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement(13 unilaterally affected, 8 bilaterally affected), 25 patients with TMJ arthritis(23 unilateral, 3 bilateral), and 39 volunteers with no signs, symtoms, or history of TMJ disease. TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99mTc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were $1.673{\pm}0.606$ in TMJs affected with arthritis, $1350{\pm}0.351$ in TMJs affected with disc displacement, and $1.084{\pm}0.172$ in TMJs of controls. Significant differences were demonstrated among them(p<0.01) Difference of bith TMJ SUR was highest in patients with unilateral TMJ arthritis($0.608{\pm}$0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ dist displacement patients($0.062{\pm}0.063$ vs $0.122{\pm}0.100$). TMJ SUR of Joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(696% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan nay help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

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Analgesic Effect of Hippophae rhamnoides Extract in Orofacial Pain in Rats (구강안면통증모델에서 산자나무 추출물의 진통효과)

  • Kim, Yun-Kyung;Choi, Ja-Hyeong;Kim, Hee-Jin;Yoon, Hyun-Seo;Hyun, Kyung-Yae;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.495-500
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    • 2017
  • Hippophae rhamnoides L. (sea buckthorn) is a shrub wood that belongs to the bamboo tree family, and is rich in vitamin C, D, and E; it is referred to as a vitamin tree. It is mainly grown in the high mountains of Europe and Central Asia, and has been widely used in China and Russia as natural medicine. Recent studies have shown that it is effective in the treatment of cancer, liver diseases, cardiovascular diseases, and gastrointestinal diseases. However, results of studies on its effect on the regulation of pain are insufficient. In this study, we investigated the effect of sea buckthorn on the development and control of pain in two facial areas. The experimental animals included 7- to 8-week-old Sprague-Dawley rats (240~260 g). Formalin (5%), which is known as an inflammation inducer, was injected into the vibrissa pad or temporomandibular joints to induce orofacial acute pain. Rubbing or scraping of the region injected with formalin was regarded as a pain index, and the behavioral response was observed for 45 minutes after the injection. Sea buckthorn extract diluted to 150, 300 mg/kg (in 1 ml of distilled water) was orally administered 30 minutes prior to the acute pain. The facial pain behavior was effectively reduced in the 300 mg/kg group when compared to the control group (vehicle). Likewise, in an experiment in which formalin was injected into the temporomandibular joints, effective pain alleviation was confirmed at the same drug concentration. These results suggest that sea buckthorn extract may be useful in the development of therapeutic agents for acute inflammatory pain in the orofacial area and for controlling temporomandibular joint pain.

Recent Trends of Immunologic Studies of Herbal Medicine on Rheumatoid Arthritis (류마티스 관절염에 대한 한약의 면역학적 연구동향)

  • Choi, Do-young;Lee, Jae-dong;Back, Yong-hyeon;Lee, Song-shil;Yoo, Myung-chul;Han, Chung-soo;Yang, Hyung-in;Park, Sang-do;Ryu, Mi-hyun;Park, Eun-kyung;Park, Dong-seok
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.177-196
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    • 2004
  • Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

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The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

A study on the job awareness of dental hygienists and their job performance (치과위생사의 수행업무에 대한 인식도 및 실태조사)

  • Sim, Su-Hyun;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.2
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    • pp.153-166
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    • 2007
  • The job of dental hygienists is specialized, and they have to be capable of performing their primary duties including prevention of oral diseases, oral prophylaxis, and oral health education. To ensure their successful job performance, dentists should have an accurate understanding of their duties and need a change of mind-set about them. And there should be written legal and concrete regulations on the coverage of their work in order to let them boost their job performance with pride and a sense of responsibility. The purpose of this study was to examine the actual roles and job performance of dental hygienists in clinical field in an attempt to discuss the substantial job performance of dental hygienists and their job enlargement. It's basically meant to help enhance the efficiency and quality of medical services. The subjects in this study were 471 dental hygienists in dental clinics, dental hospitals, university hospitals and general hospitals across the nation, on whom a survey was conducted in person from March 2 to 25, 2005. The collected data were analyzed with SPSS Win 12.0 program, and the findings of the study were as follows: 1. The major jobs they currently performed included oral health education, hospital management, simple duties, extensive dental hygiene duties and joint treatment assistance. They hoped to continue to be responsible for oral health education, preventive treatment and extensive dental hygiene duties. 2. As for their current job by age, extensive dental hygiene duties, preventive treatment, joint treatment assistance, preserving treatment, prosthetic treatment and pediatric treatment were most conducted by the dental hygienists who were at the age of 26 to less than 31, and those who were at the age of 31 and up were most responsible for hospital management and simple duties. 3. As to job awareness by workplace, their workload was statistically significantly different according to their workplace. The hospital employees took care of more work than those in clinics. 4. Concerning job awareness by age, the younger dental hygienists suffered more role conflicts and were given a less free hand in work handling, the middle-aged group's job was uncertain. Legal regulations about the coverage of their work should be prepared in detail as a measure to stir up their responsible job performance and pride. In order to take advantage of experienced dental hygienists, their duties should be more differentiated and specialized, and their working conditions should be improved to boost their job satisfaction. That is, they should be given ample chances for promotion and serving as a middle manager and be given fair treatment according to their career. If their work is accurately darified and specialized based on career, it will boost the efficiency of dental treatment. Dental hygienists also should direct sustained efforts into self-development in order to become a skilled and professional oral health personnel.

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Disease Characteristics and Behavior Pattern of Treatment for Patient with Fibromyalgia (섬유조직염 환자의 질병 특성과 치료행태)

  • Han, Sang-Sook;Kang, Hyun-Sook
    • Journal of muscle and joint health
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    • v.6 no.1
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    • pp.22-36
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    • 1999
  • The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

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Nurses' Needs and Priority for Developing Advanced Nursing Education Program in Musculoskeletal Care (근관절 전문간호교육 프로그램개발에 관한 요구조사)

  • Kim, Jong-Im;Lim, Nan-Young;Cho, Kyung-Sook;Lee, Eun-Nam;Song, Rha-Yun;Eun, Young;Bak, Won-Sook;Lee, Dong-Suk;Kwon, Young-Sook;Sim, Hee-Sook;Jang, Boo-Young;Choi, Mi-Kyung;Lee, Ji-Hyun
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.120-130
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    • 2012
  • Purpose: The purpose of this study was to assess nurses' educational needs for developing advanced nursing education program for musculoskeletal care. Methods: The participants consisted of 272 clinical nurses who had experience of taking care of patients with musculoskeletal problems. A structured questionnaire with 28 items was used to assess educational needs and priority perceived by clinical nurses. Collected data were analyzed using SPSSWIN V.18.0 program for descriptive statistics. This survey was conducted in accordance with standard ethical guidelines for all research involving human participants. Results: While the majority (93.4%) perceived needs for advanced education program, about half of the participants (48.5%) reported no educational experience about musculoskeletal care. The clinical nurses perceived important for 23 out of 28 areas to be included in advanced nursing education. Especially, the areas of pain management, surgical care, and medication were perceived high priority for education program in caring musculoskeletal patients. Conclusion: The study findings showed that most nurses perceived the need for advanced nursing education program in musculoskeletal care, and the areas with higher priority as perceived by nurses should be reflected in the program.

Does the Pain Associated with Temporomandibular Disorder Increase on Rainy Days?

  • Jeong, Sung-Hee;Lee, Sunhee;Kim, Kyung-Hee;Heo, Jun-Young;Jeon, Hye-Mi;Ahn, Yong-Woo;Ok, Soo-Min
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.161-168
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    • 2016
  • Purpose: Patients who suffer from rheumatic arthritis, fibromyalgia, other various inflammatory diseases and musculoskeletal disorders, which are all similar to temporomandibular disorders (TMD), have been complaining about changes in the level and type of pain in response to changes in weather conditions for a long time. Through an investigation about pain perception in TMD patients in response to weather conditions, our primary objective was to develop base materials for future studies on change in pain in response to meteorological factors. Methods: Among patients who presented with TMD to Department of Oral Medicine, Pusan National University Dental Hospital from August to October 2016, one hundred consecutive TMD patients diagnosed with TMDs according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were recruited for the study and 28 patients were excluded according to exclusion criteria. Survey was done with the questionnaire and investigated whether there was any difference in incidence and level of pain in TMD patients between non-rainy and rainy days. Results: Among a total of 72 samples, 4 patients reported change in pain on rainy days rather than non-rainy days. Two patients from chronic group (joint and complex subgroup) reported increased pain on rainy days rather than non-rainy days but it was not statistically significant (p>0.05). One patient from chronic/muscle group reported the change in pain characteristics while pain intensity remained unchanged. One patient from acute/complex group reported decreased pain intensity. In comparison of the patients who reported increased pain on rainy days between acute and chronic groups, there were two reported cases and were both from chronic group only. There was a significantly higher chance of reporting increased pain on rainy days in chronic group than acute group (p<0.001). Conclusions: It is considered that TMD patients couldn't perceive the change in pain well in response to weather change on rainy days but some chronic patients could perceive the increase in pain in rainy days.

A Comparative Study on BMI, Pain, Depression, Self-esteem and Self-efficacy between Rheumatoid Arthritis Patients and Osteoarthritis Patients (류마티스 관절염과 골관절염 환자의 BMI, 통증, 우울, 자아존중감 및 자기효능에 대한 비교 연구)

  • Hwang, In-Ok;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.11 no.2
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    • pp.187-198
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    • 2004
  • Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

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