• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.1
• /
• pp.28-42
• /
• 2016

Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.3
• /
• pp.271-280
• /
• 2021

Purpose. The aim of this study was to evaluate the relationship between the patient's occlusion and a cracked tooth by using T-scan occlusal analysis and a quantitative light-induced fluorescence (QLF) technology. Materials and methods. This study was carried out on 51 patients having cracked teeth between January, 2019 and December, 2020. The tooth crack was determined with a Q-ray pen and QLF parameters (ΔF_max and ΔR_max) were obtained by a Q-ray software. T-scan tests were conducted to all subjects and then, the occlusal force and disclosing time were analyzed. Mann-Whitney U test was performed to compare the occlusal force and disclosing time between cracked teeth groups and contra-lateral normal teeth groups (α = .05). Mann-Whitney U test was performed to compare ΔF_max and ΔR_max according to the results of cold/bite tests (α = .05). A Spearman correlation analysis was run to determine the relationship between ΔF_max or ΔR_max and occlusal force or disclosing time (α=.05). Results. The mean occlusal force and disclosing time were significantly higher on cracked teeth than on normal teeth (P < .05). The ΔF_max or ΔR_max were not significantly different according to the results of cold/bite tests (P > .05). There was no correlation between ΔF_max or ΔR_max and occlusal force or disclosing time (P > .05). Conclusion. There was a significant relationship between occlusion and cracked tooth syndrome. QLF has the potential to be a valuable tool for the diagnosis of tooth crack in clinical practice.

• Korean Journal of Medical Ethics
• /
• v.21 no.4
• /
• pp.360-376
• /
• 2018

Nursing students experience ethical conflicts that lead to moral distress and moral sensitivity in clinical practice. Most nursing students have some difficulty in speaking up when faced with morally challenging situations. Hence, increasing moral courage of these students is important to improve the quality of practice, and carry out nursing responsibilities. However, research on the moral distress, moral sensitivity, and moral courage of nursing students has not been reported in South Korea. The purposes of this study were to (a) identify the levels of moral distress, moral sensitivity, and moral courage of nursing students and (b) examine the influence of moral distress and moral sensitivity on moral courage. Data were collected through a survey using self-reported questionnaires sent to senior nursing students at two nursing colleges in Seoul and Gyeonggido. A total of 138 senior nursing students participated in the survey. The data were analyzed using the IBM SPSS Statistics 23 program by Pearson's correlation coefficients and multiple regression analysis. The mean scores of the moral distress thermometer, moral distress, moral sensitivity, and moral courage were $3.53{\pm}2.18$, $57.33{\pm}43.35$, $134.98{\pm}13.98$, and $56.33{\pm}12.75$, respectively. The significant factors influencing moral courage were the moral distress thermometer and patient-centered nursing, which was a subcomponent of moral sensitivity. The explanatory power of the model was 5%. This study confirms that nursing students, like nurses, experience moral distress. It is therefore important to create organizational environments that support the moral courage of nursing students.

• Journal of the Korean Society of Radiology
• /
• v.15 no.2
• /
• pp.201-210
• /
• 2021

This study was conducted not only to find out the effect of straight body exercise on neck pain, necks disability and neck length change of turtle neck syndrome patients but also to provide fundamental data for this field in the future. Number of 60 persons were selected by pre-test and divided to 21 persons in straight body exercise group, 19 persons in exercise group and 20 persons in control group(non-exercise group). 5 kinds of straight body exercise were applied in straight body exercise group, 8 kinds of strengthening cervical vertebral exercise were applied in exercise group and no exercise was applied in control group. Neck pain, necks disability index and neck length were measured before and after exercise and 10 weeks later as well. The data were analyzed by SPSS(v18.0). In straight body exercise group and exercise group, neck length, neck pain and necks disability index were significantly decreased after eight weeks of exercise and there was no significant difference in control group. Neck length which was checked every week in straight body exercise group and exercise group was significantly decreased and there were significant differences after 3 weeks.. After 2 weeks of 8 weeks exercise, neck length, neck pain and necks disability were checked again in post test and those results were maintained just like 8 weeks exercise status. As above results, it was more efficient in the straight body exercise group than exercise group and control group to decrease neck pain, necks disability and neck length of turtle neck syndrome patients. Furthermore, after 2 weeks of 8 weeks exercise, the results were maintained just like 8 weeks exercise status. Therefore, the author consider that straight body exercise will be effective exercise for turtle neck syndrome patients, and this study would provide fundamental data for this field in the future.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.1
• /
• pp.20-25
• /
• 2022

Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst^®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst^® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst^® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst^® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst^® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst^® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst^® treatment as a standard treatment for globus.

• The Korean Society of Law and Medicine
• /
• v.23 no.3
• /
• pp.3-44
• /
• 2022

As a result of a close review focusing on the case of obstruction of epidemiological investigation by a religious group A in Daegu, which was a problem when the pandemic of Covid-19 infection began in Korea around February 2, 2020, when an epidemiological investigator requested a specific group to submit a list, While there have been cases where an act of not responding or submitting an edited omission list was sentenced to the effect that the act did not fall under an epidemiological investigation, in the case of non-submission of the visitor list for the B Center, even though a 'list of visitors' was requested. Regarding the fact of refusal without a justifiable reason, 'providing a list of persons entering the building is a key factual act that forms a link between epidemiological investigations accompanying an epidemiological investigation, and refusing to do so is also an act of refusal and obstruction of an epidemiological investigation. There are cases where it is possible to demand criminal punishment. Regardless of whether the request for submission of the membership list falls under the epidemiological investigation, there are cases in which the someones' actions correspond to the refusal or obstruction of the epidemiological investigation. A lower court ruling that if an epidemiological investigation is rejected or obstructed as a result of interfering with factual acts accompanying an epidemiological investigation, comprehensively considering whether or not the list has been diverted for purposes other than epidemiological investigation, the logic is persuasive. Epidemiological investigations such as surveys and human specimen collection and testing are conducted for each infectious disease patient or contact confirmed as a result of the epidemiological investigation, but epidemiological investigations conducted on individual individuals cannot exist independently of each other, and the This is because the process of identification and tracking is essential to an epidemiological investigation, and if someone intentionally interferes with or rejects the process of confirming this link, it will result in direct, realistic, and widespread interference with the epidemiological investigation. In this article, ① there are differences between an epidemiological investigation and a request for information provision under the Infectious Disease Control and Prevention Act, but there are areas that fall under the epidemiological investigation even in the case of a request for information, ② Considering the medical characteristics of COVID-19 and the continuity of the epidemiological investigation, the epidemiological investigator the fact that the act of requesting a list may fall under the epidemiological investigation, ③ that the offense of obstructing the epidemiological investigation in certain cases may constitute 'obstruction of Performance of Official Duties by Fraudulent Means', and ④ rejecting the request for information provision under the Infectious Disease Control and Prevention Act from September 29, 2020 In this case, it is intended to be helpful in the application of the Infectious Disease control and Prevention Act and the practical operation of epidemiological investigations in the future by pointing out the fact that a new punishment regulation of imprisonment or fine is being implemented.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.2
• /
• pp.150-156
• /
• 2021

Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.2
• /
• pp.125-133
• /
• 2021

Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

• 한국노년학
• /
• v.31 no.1
• /
• pp.129-141
• /
• 2011

This study aims to find out effects of a tailored occupational activity program(TOAP) on the activities of daily living(ADL), cognitive function, depressive mood, and caregiver burden, who live in the community. Method : From October 2009 to May 2010, the TOAP was applied to 15 dementia patients and 15 of their caregivers, who was visitors of the Y-city Center for Managing Dementia in Gyunggi-do. The TOAP was designed for habituating patients and caregivers to the techniques acquired through goal activities and task and making it capable of being routinized regularly. The TOAP was applied to dementia patients and their cvaregivers twice a week for 7 weeks(one-time home visit, one-time phone inspection), a total of 14 times. Results: Significant differences among pre-test and post-test were found in the AMPS motor skills(1.10±1.14 and 1.34±1.2 respectively) scores, AMPS process skills(0.32±0.55 and 0.77±0.66 respectively) scores, ACL(3.86±0.65 and 4.17±0.64 respectively) scores, MMSE-KC(17.33±4.6 and 19.33±4.97 respectively) scores, GDS(11.73±6.87 and 8.53±7.09 respectively) scores, and caregiver burden(31.80±20.06 and 26.13±18.07 respectively) scores(p<0.05). A significant effect was confirmed from the TOAP which ADL, cognitive function, reduced patient's depression and caregiver burden(p<0.05). Conclusion: From the above results that a TOAP has an effect on the improvement of the ability to ADL, cognitive function and reduced depression and caregiver burden of dementia patients living in community. The present author hopes that, in the future, more diverse community based on tailored occupational activity programs will be developed to improve the functions of dementia patients living in community.

• The Journal of Korean Society for Radiation Therapy
• /
• v.35
• /
• pp.7-13
• /
• 2023

Purpose: In this study, we evaluated the effect of using a customized bolus on dose delivery in the treatment plan when cervical cancer protruded out of the body along with the uterus and evaluated reproducibility in patient set-up. Materials & Methods: The treatment plan used the Eclipse Treatment Planning System (Version 15.5.0, Varian, USA) and the treatment machine was VitalBeam (Varian Medical Systems, USA). The radiotherapy technique used 6 MV energy in the AP/PA direction with 3D-CRT. The prescribed dose is 1.8 Gy/fx and the total dose is 50.4 Gy/28 fx. Semiflex TM31010 (PTW, Germany) was used as the ion chamber, and the dose distribution was analyzed and evaluated by comparing the planned and measured dose according to each position movement and the tumor center dose. The first measurement was performed at the center by applying a customized bolus to the phantom, and the measurement was performed while moving in the range of -2 cm to +2 cm in the X, Y, and Z directions from the center assuming a positional error. It was measured at intervals of 0.5 cm, the Y-axis direction was measured up to ±3 cm, and the situation in which Bolus was set-up incorrectly was also measured. The measured doses were compared based on doses corrected to CT Hounsfield Unit (HU) 240 of silicon instead of the phantom's air cavity. Result: The treatment dose distribution was uniform when the customized bolus was used, and there was no significant difference between the prescribed dose and the actual measured value even when positional errors occurred. It was confirmed that the existing sheet-type bolus is difficult to compensate for irregularly shaped tumors protruding outside the body, but customized Bolus is found to be useful in delivering treatment doses uniformly.