• Title/Summary/Keyword: Pain severity

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Joint Symptoms During Antituberculous Chemotherapy (결핵 치료 중 나타나는 관절 증상)

  • Kim, Sang-Cheol;Baik, Jae-Joong;Lee, Tae-Hoon;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.162-168
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    • 2000
  • Background : Joint symptoms frequently occur in the course of antituberculous chemotherapy and tend to be ignored and overlooked, but in some cases, they are often very troublesome in obstructing ordinary life. Joint symptoms that develop during antituberculous chemotherapy need to be understood, but there are few materials describing them systematically. Method : This study enrolled 33 patients with tuberculosis treated with first line antituberculous agents for more than 6months. In the course of treatment, joint symptoms not associated with specific cause, such as preexisting joint disease or trauma, were investigated and compared with thæe of the asymptomatic group. We confirmed the incidence of joint symptoms and factors associated with them. Results : Nineteen of 33 patients (58%) had joint symptoms. Joint symptoms developed 1.9$\pm$1.4 months after the beginning of chemotherapy and lasted for 3.6$\pm$2.5months. In 18 of 19 symptomatic patients, multiple joints were involved: shoulder (10 patients, 53%), knee (10, 53%), finger (6, 32 %). Joint symptoms were expressed as pain (19 patiens, 100%), stiffness (7, 37%) and/or swelling (3, 16%). Fourteen patients (74%) took analgesics to relieve their symptoms and in 2 patients, antituberculous agents were discontinued because of the severity of their symptoms. The symptoms seem to be caused by agents other than pyrazinamide, but it was very difficult to identify the definite causative agent. In age, sex, underlying disease and serum uric acid level, no significant differences were noted between the two groups. Conclusions : Although joint symptoms are common during antituberculous chemotherapy, their development is difficult to predict. Because some joint symptoms can become very bothersome, the physician should pay close attention to these symptoms.

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Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

A Validation Study of EQ-5D in the Patients with Osteoarthritis (골관절염 환자에서의 건강관련 삶의 질 도구(EQ-5D)의 타당도 검증)

  • Lim, Nan-Young;Lee, In-ok;Lee, Eun-Nam;Lee, Kyung-Sook;Cho, Kyung-Sook;Rhee, Seon-Ja;Kang, Hyun-Sook;Kim, Keum-Soon;Kim, Jong-Im;Bak, Won-Sook;Lee, Yoon-Kyoung;Chon, Mi-Young
    • Journal of muscle and joint health
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    • v.17 no.2
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    • pp.203-211
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    • 2010
  • Purpose: We aimed to test the validity of the EQ-5D (Euro-Quality of Life-5 Dimension), a brief and simple instrument, in measuring health related quality of life in the patients with osteoarthritis. Methods: 183 participants attending the education programs for osteoarthritis patients at the Health Centers located in Seoul and Gyunggi province area during the periods of June to December in 2009 were interviewed with the EQ-5D and KWOMAC (Korean version of Western Ontario and McMaster Scale). The data were analysed with Spearman correlation coefficents and t-test by using of SPSS/WIN 12.0 version. Results: There was a negative correlation between knee pain, stiffness and difficulty in usual activity of sub category items of KWOMAC and EQ-5Dindex, while there was no correlation between these categories and EQ-VAS. Moreover, as a result of comparing the score of physical function measured by KWOMAC according to the severity degree of the EQ-5Dindex, the group of advanced stage having moderate and severe symptoms reported significantly higher scores of physical function than those of groups having no health problems. Conclusion: The EQ-5D is an acceptable and valid instrument for measuring health-related quality of life in patients with osteoarthritis.

Study on Development of Assessment Guideline and Endpoints for Clinical Trial with Antitumor Natural Products (천연물 항암제제 임상시험 평가지표 개발연구)

  • Namgung, Mi-Ae;Chang, Yoo-Sung;Jeong, Seung-Gi;Kim, Jin-Seung;Yoon, Sung-Woo;Jang, Ki-Young;Yoo, Hwa-Seung;Jung, Myeon-Woo;Lee, Sung-Ho;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1678-1727
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    • 2006
  • This study was perfromed to develop the assessment guideline and endpoints for clinical trial with anticancer herbal medicine. The botanical products used to humans for long time may be applied to phase 3 clinical trial after submitting the evidences for safety and efficacy of them or completion of basic requirement of phase 1 and phase 2 for safety confirmation and dose determination. Syndrome improvement was chiefly evaluated by Zubrod and karnofsky(%) methods. We suggest the general clinical trial assessment with botanical products, by following assessment points, that is, tumor size for 50 points, survival fate for 10 points, major syndromes for 40 points. It is recommendable that the each symptom of Qi deficiency syndrome, blood deficiency syndrome and Qi stagnation syndrome was allocated by assessment points, Similarly, the each symptom was given the assessment points according to the severity of symptom, for example, slight for 3 points, moderate for 2 points and severe for 1 point in hepatocelluar carcinoma and lung cancer. Then, the efficacy of botanical products was evaluated by the difference between pre-treatment and post-treatment. Asking the neoplastic patients of questionnaire on physical, emotional, cognitive, social and role subjects availability, three more syndromes (Fatigue, Pain and Nausea/Vomit), quality of life(QOL) will be evaluated by GLM statistics. In addition, in case of lung cancer, 13 questions will be asked by the EORTC QLQ-C13 forms. As the assessment of endpoints for efficacy to reduce side effects induced by chemotherapy and radiotherapy, the data of image scanning and hemato-urinalysis can be usefully applied on immune response, weight loss, indigestion, hemopoietic damage and injury of liver and kidney, while the changes of syndromes of side effect can be evaluated by differentiation methods of Qi and blood and five viscera. However, it is still necessary to determine the ratio between scientific analytical method and Oriental differentiation method as well as confirm the Oriental assessment endpoints by clinical trial. In addition, we suggest the continuous development of assessment endpoints on other carcinomas except of hepatocelluar carcinoma and lung cancer in future.

Connections of Preventive Actions against Musculoskeletal Diseases by Dental Hygiene Students according to the Health Belief Model (치위생과 학생들의 건강-신념 모형에 의한 근골격계 질환 예방 행위 관련성)

  • Jung, You-Sun
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.545-550
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    • 2009
  • This study set out to examine the knowledge about and preventive actions against musculoskeletal diseases among dental hygiene students according to the Health Belief Model, suggest a need for programs to promote health and prevent those diseases, and investigate their relations, A survey was taken among 83 sophomores and 114 juniors at the dental hygiene major of a college in Gyeonggi Province. Analyzed by using SAS 8.0 version. The findings are as follows: 1. The sophomores and juniors scored $22.50{\pm}2.37$ and $22.29{\pm}3.01$ points, respectively, on susceptibility of the Health Belief Model with significant differences between the two groups(P < 0.01). Significant differences were also found between the sophomores that scored $18.82{\pm}2.60$ points and the juniors that scored $18.64{\pm}2.77$ points on benefit(P < 0.05). 2. The juniors experienced a higher level of pain than the sophomores with statistical significance observed on the neck, shoulder, lower back, knee, foot, and ankle(P < 0.05). 3. Of the Health Belief Model, severity had significant positive correlations with 'Placing frequently used tools near the dental technician' and 'Trying to avoid repeating the same task and diversify tasks'(P < 0.01). And benefit was positively correlated with 'Trying to reduce the frequency of bending and stretching out during treatment, 'Trying not to lean much with the neck, back, arm, and wrist' and 'Trying to maintain the torso in the neutral position'(P < 0.01). The results suggest that there should be some instructions to help dental hygiene students practice the preventive actions against musculoskeletal diseases and further prevention programs against those diseases.

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Abdomino-perineal Organ Injuries Caused by Cultivators (경운기 사고에 의해 발생한 복부 및 회음부 장기 손상)

  • Yeo, Kwang Hee;Park, Chan Yong;Kim, Ho Hyun;Park, Soon Chang;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.60-66
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    • 2015
  • Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

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Toxic Megacolon as a Complication of Infectious Colitis Caused by Salmonella enteritidis Group D in a Previously Healthy Child (건강한 소아에서 살모넬라 장염의 합병증으로 발생한 독성거대결장)

  • Jeon, Sung Bae;So, Cheol Hwan;Jo, Young Min;Yu, Seung Taek
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.110-117
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    • 2021
  • Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease. Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

Relationship Between Work Ability, Self-efficacy, Work Satisfaction, Sequelae and Workplace Relationships of Reemployed Workers Who Experienced Industrial Accidents (재취업한 산재 노동자의 업무능력, 자기효능감, 직무 만족, 후유증, 동료관계의 구조적 관계)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.463-477
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    • 2022
  • The current study examined the mediating effect of self-efficacy (SE) in the relationship between work ability (WA) and work satisfaction (WS) perceived by reemployed workers who have experienced industrial accidents based on social cognitive career theory (SCCT), and investigated the effect of Industrial accident sequelae and workplace relationships (WR) on these variables. The data of 976 newly employed workers were selected from the data of the Panel Study of Worker's Compensation Insurance collected in 2018. The data were analyzed by Structural Equation Modeling through SPSS and AMOS programs. It was found that WA had a positive effect on WS through SE. In addition, it was found that the level of pain, the severity of the disability, and the activities of daily living had a negative effect on WS through WA and SE sequentially. Meanwhile, it was found that the WR was affected by the activities of daily living, and had a positive effect on WS through WE. These results emphasize that it is important to provide support to manage sequelae and increase SE in order to help victims of industrial accidents return to the job market and live satisfactorily. It also suggests that SCCT is useful in explaining WS of industrially injured workers.

Evaluation of the clinical and radiographic effectiveness of treating peri-implant bone defects with a new biphasic calcium phosphate bone graft: a prospective, multicenter randomized controlled trial

  • Jae-Hong Lee;Hyun-wook An;Jae-Seung Im;Woo-Joo Kim;Dong-Won Lee ;Jeong-Ho Yun
    • Journal of Periodontal and Implant Science
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    • v.53 no.4
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    • pp.306-317
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    • 2023
  • Purpose: Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 60% β-TCP and 40% HA compared to demineralized bovine bone mineral (DBBM). Methods: This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ2 test. Results: Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. Conclusions: The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM.

The Effects of Spousal Bereavement and Complicated Grief on Death Anxiety among Older Adults (배우자 사별여부와 복잡성비애 수준이 노인의 죽음불안에 미치는 영향)

  • Kim, Kyung Hee;Lyu, Jiyoung
    • 한국노년학
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    • v.39 no.1
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    • pp.21-35
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    • 2019
  • The purpose of this study was to empirically verify the effects of spousal bereavement and complicated grief level on death anxiety of the elderly. The sample consisted of 1,998 adults who were aged 65 or older. Dependent variable was measured with the Death Anxiety Scale-Korean version (DAS-K). Independent variable was measured with both spousal bereavement and the Inventory of Complicated Grief-Korean version (ICG-K). Multiple regression analysis was performed using SPSS 23.0, adjusting for demographics, psycho-social and health variables. The results indicated that death anxiety level was lower among the bereaved with normal grief (p<.01) than non-bereaved. In contrast, death anxiety level was higher among the bereaved with complicated grief than non-bereaved (p<.01). The study result suggests that the most risky factor for death anxiety is complicated grief rather than the bereavement. Although the bereavement can be a universal experience, the severity and duration of symptoms after the bereavement may not be general. The unhealed emotional and physical pain after the bereavement stimulates death anxiety, and senior citizens who suffer from complicated grief often fail to integrate the bereavement and loss into reality, therefore, may not accept the death phenomenon itself. Anxiety and fear of death can emerge when they cannot acknowledge the bereavement. To manage complex sorrows and mitigate death anxiety, intervention programs should be provided to increase adaptability to the bereavement.