• Journal of TMJ Balancing Medicine
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• v.12 no.1
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• pp.28-31
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• 2022

위에서 살펴본 바와 같이 나는 급성 턱관절장애의 경우, 첫번째 유형은 주로 턱관절 디스크공간의 문제와 하악의 위치를 바로잡아주는 근육의 문제가 주 원인일 것으로 추정하고 있다. 만약 턱관절 디스크공간이 정상공간이라면 턱의 지그재그 움직임이나 턱관절잡음, 턱통증, 턱탈구, 그리고 개구장애 등이 발생할 수 없기 때문이다. 그리고 근육의 문제 중에서는 턱관절 디스크원판을 양측에서 잡아주는 내외측 익돌근의 문제가 가장 많은 영향을 미치고 있다. 특히 내측 익돌근의 긴장 및 수축이 디스크 원판을 내측으로 빠져나가게 함으로써 하악의 좌우 지그재그 움직임을 야기시키고 턱관절잡음이나 턱통증 및 개구장애를 유발하기 때문이다. 나머지는 저작에 관여하는 근육들이 그 다음으로 영향을 미치는 것으로 예측하고 있다. 그러나 제2형 급성 턱관절장애의 경우는 제1형 급성 턱관절장애가 한단계 더 발전하여 이와 연관된 근육이나 인대의 긴장수축이 오랜 시간 진행되어, 이들이 다시 상부 경추의 아탈구와 두개골의 비정상적 움직임에까지 영향을 미쳐 나타나는 것으로 생각된다. 그렇게 되면 뇌에서 필요 충분한 뇌혈액공급이나 뇌척수액순환의 문제를 일으킬 수 있기 때문이다. 그리고 제1형 만성 턱관절장애의 경우는 제2형 급성 턱관절장애가 좀 더 진행되면서 척추 및 근골격계의 구조변화, 교합 및 턱의 구조변화 그리고 안면구조의 변화에 이르기까지 점점 진행되어 나타나는 것으로 보인다. 따라서 각종 척추 디스크질환, 관절질환을 비롯해서 두개천골계의 순환문제, 부정교합 및 턱 비대칭, 안면 비대칭의 문제를 유발하게 된다고 추정된다. 그러나 두번째 유형의 만성 턱관절장애는, 턱에서 지속적이고 반복적인 그리고 과다한 부정적 자극들이 오랜 기간 누적되면서 턱에 분포된 C 섬유를 비롯한 3차신경의 가소성변화를 유발하면서 결국 중추신경계를 포함하여 전체신경계의 회로망에까지 파급되어 다양한 만성질환 또는 난치성 질환들이 양산되는 것으로 추정하고 있다. 아마도 지금까지 서양의학에서 아직 밝혀내지 못한 대부분의 질병들이 여기에 포함되지 않을까 하는 것이 나의 생각이다.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.1
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• pp.18-26
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• 2002

Objectives : The object of this study was to investigate the relationship between coping strategies and perceived stress or pain discomfort in patients with chronic low back pain. 80 patients with chronic low back pain and 100 normal controls participated in this study. Methods: Global assessment of recent stress (GARS) scale and Stress Response Inventory (SRI) were used to measure perception for stressors and stress responses. Coping scale and pain discomfort scale were used to measure coping strategies and pain perception. Results : Scores of perceived stress related to work or job, interpersonal relationship, changes in relationship, sickness or illness and the total scores on the GARS scale were significantly higher in those with chronic low back pain than normal controls. Scores of the SRI fatigue subscale scored significantly higher in those with chronic low back pain than normal controls. No significant difference was found on total scores of the pain discomfort scale between those with chronic low back pain and normal controls. The patients with chronic low back pain scored significantly higher on planful problem solving and positive reappraisal than normal controls. In the patient group, pain perception had significant positive correlations with total scores of the SRI and scores of stress perception related to illness or injury. The extent of escape-avoidance showed significant negative correlations with age, whereas the extent of distancing or escape-avoidance had significant negative correlations with the level of education. Significant difference was also found in accepting responsibilities between male subjects and females. However, no significant correlations were found between coping strategies and perceived stressors, stress responses or pain perception. Conclusion : The results suggest that patients with chronic low back pain were more likely to use more active coping strategies than normal controls, though the former had more perception for stressors than the latter. It was also found that coping strategies used by the patients were associated with sociodemographic factors, but that they were not associated with perceived stressors, stress responses or pain perception.

• Journal of Digital Convergence
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• v.16 no.8
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• pp.243-252
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• 2018

The purpose of this study was to examine relationships among disease-related characteristics, symptom stress, quality of life in women with endometriosis, and then to identify predictors of quality of life in them. The self-reported questionnaires were administered to 99 women in one general hospital. As results of multiple regression analysis, the factors affecting quality of life in women with endometriosis were sick leave (${\beta}=-.27$, p=.000) and symptom stress (${\beta}=.59$, p=.000), explained women's quality of life with 57.0% (F=11.39, p<.001). Based on the findings, there is a need to develop a self-care program for chronic pain and a nursing intervention for enhancing a quality of life in women with endometriosis.

• Journal of the Institute of Electronics and Information Engineers
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• v.51 no.1
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• pp.185-194
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• 2014

One in every 10 persons suffer from chronic gastritis in Korea. Endoscopy is most commonly used to diagnose the chronic gastritis. Endoscopic diagnosis is precise but it is accompanied with pain and high cost. According to pulse diagnosis in Traditional East Asian Medicine, health problems in stomach can be diagnosed with radial pulse signals in 'Guan' location in the right wrist, which are non-invasive and cost-effective. In this study, we developed a classification model of chronic gastritis using pulse signals in right 'Guan' location. We used both linear discrimination method and logistic regression model with respect to pulse features obtained with a peak-valley detection algorithm and a Gaussian model. As a result, we obtained sensitivity ranged between 77%~89% and specificity ranged between 72%~83% depending on classification models and feature extraction methods, and the average classification rates were approximately 80%, irrespective of the models. Specifically, the Gaussian model were featured by superior sensitivities (89.1% and 87.5%) while the peak-valley detection method showed superior specificities (82.8% and 81.3%), and the average classification rate (sensitivity + specificity) of the Gaussian model was 80.9% which was 1.2% ahead of the peak-valley method. In conclusion, we obtained a reliable classification model for the chronic gastritis based on the radial pulse feature extraction algorithms, where the Gaussian model was featured by outperformed sensitivity and the peak-valley method was featured by outperformed specificity.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.259-264
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• 2010

The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.253-263
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• 1997

농촌지역은 도시지역에 비하여 의료자원의 부족으로 보건의료자원의 이용 접근성이 낮다고 할 수 있다. 따라서 일부 농촌지역주민의 질병이환과 이환시 보건의료자원의 이용양상을 분석하는 것은 매우 의의가 있다고 하겠다. 본 연구방법은 포천군 주민의 보건의료자원의 이용과 치료원의 이용 양상을 분석할 목적으로 1995년 8월 4일~20일까지 1,200가구를 대상으로 가구 면접조사를 실시하였다. 분석대상 가구수는 1,019가구였으며 훈련받은 조사원에 의하여 조사되었으며 경기도 포천군 지역은 연세대학교 보건대학원 및 간호대학의 연구사업지역으로 본 분석 자료는 연세대학교 연구자료의 일부를 사용하였다. 연구 결과는 다음과 같다. 성별인구분포는 남자가 49.9%, 여자가 50.1%이고 연령별 분포는 60세 이상이 16.5%로써 전국의 노인인구 비율보다 높았다. 교육상태는 13년 이상 교육이수율이 남자가 여자보다 높았으나 전체 조사 대상 인구는 교육수준이 높았다. 가족 형태는 핵가족이 70.9%로써 농촌지역임에도 매우 높았다. 지난 15일간의 이환상태를 조사한 결과 급성이환율은 5.4%(54/1,000)이며 3개월 이상 만성이환율은 130/1,000으로 나타났다. 급성이환시 증상별 분포는 호흡기계질환이 36.4%, 소화기계가 20.9%, 여러 가지 복합 증상이 33.0%을 나타낸 반면 만성이환율은 관절염 및 류마티즘이 21.2%, 기타 골격계가 12.6%로서 높았다. 급성 이환시 의료이용양상은 포천군관내의 의료기관이용이 62.6%, 약국이용이 15.2%, 보건소 이용이 4.0%였으며 의료기관이 주요 이용자원이었다. 아무 조치를 취하지 않은 비율은 6.1%로서 높지 않았다. 즉 극성질환인 경우 전체이환자의 76.5%가 1회 방문으로 문제를 해결한 것으로 나타난 반면 나머지 23.5%가 2회 이상 의료자원을 이용한 것으로 나타났다. 3개월이상 만성이환자는 포천군관내 의료기관의 이용율이 56.3%, 관외의료관 이용이 19.3%인 반면 한방기관이용이 7.6%로서 급성이환시 한방이용비율인 4.0%보다 높았다. 1회 방문이 67.4%인 반면 2회 이상 보건의료자원을 이용한 비율이 33.6%로서 만성질환 이용시 보건의료자원의 이용 빈도가 높은 것으로 나타났다. 본 분석결과 포천군 주민의 주요 보건의료자원의 이용은 의료기관으로 나타났고 미치료율이 타농촌지역에 비하여 낮았으며 만성질환시 급성이환시보다 한방의료이용이 높았음을 나타났다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.324-333
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• 2018

The aim of this study was to investigate the latent classes and predictors of chronic diseases such as hypertension, dyslipidemia, arthritis, thyroid disease, depression, atopy, allergy, and diabetes. The subjects of this study were Korean citizens who participated in the Korea National Health and Nutrition Examination Survey in 2014. Stratified cluster sampling method was used with a sample size of 7,550. Latent hierarchy analysis was applied to this data. Four classes were identified. Class 1 consisted of participants with hypertension and diabetes. Class 2 consisted of participants with atopy and allergies. Class 3 consisted of participants with dyslipidemia, arthritis, thyroid disease, and depression. Class 4 consisted of participants without any chronic diseases. In comparing Class 1 to Class 4, age, physical activity, self-management, obesity, and presence of high cholesterol were found to be significant. In comparing Class 2 to Class 4, gender, age, and education level were significant. When Class 3 was compared to Class 4, gender, age, pain and discomfort, as well as high cholesterol were found to be significant. Diabetes and hypertension should be treated as comorbid conditions, applying integrated treatments involving effective drug treatment, diet, and physical activity programs. Atopy was found to be strongly correlated with allergies. Thyroid disease was found to coexist with dyslipidemia and arthritis, along with having a strong correlation to depression. Age-appropriate preventive measures can help reduce the risk of chronic diseases.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.1
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• pp.8-14
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• 2009

Objectives : The purpose of this study was to investigate the various aspects of stress in patients with chronic prostatitis. Methods : Thirty two chronic prostatitis patients meeting the criteria of NIH-category III were compared with sixty four controls. Data pertaining to the source of, response to, and coping with stress, as well as chronic prostatitis symptom index were collected using a self-report questionnaire. The questionnaire consisted of a Global Assessment of Recent Stress(GARS), Stress Response Inventory(SRI), Ways of Coping Checklist(WCC), in addition to the NIH-CPSI. Results : From the results of GARS subscales, the scores of changes in relationship, sickness or injury and financial were significantly higher in patients with chronic prostatitis than normal controls. Chronic prostatitis patients had greater amplification of somatization, depression and anger in SRI and significantly lower score in ways of coping checklist compared with controls. In the NIH-CPSI of chronic prostatitis patients, the degree of symptom played a role in depression as stress response item and significant negative correlationship between the symptom point and problem focused, seeking social support coping strategy was observed. Conclusion : These results show that patients with chronic prostatitis have greater stress, higher stress response and insufficient coping strategy. Therefore, these efforts should be considered that enhancing healthier coping strategy and evaluation and management of stress experienced by chronic protatitis patients

• Tuberculosis and Respiratory Diseases
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• v.60 no.4
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• pp.397-403
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• 2006

Background: Chronic obstructive pulmonary disease(COPD) is categorized by the percentage of the predicted $FEV_1$(Forced expiratory volume in 1 second) result which is highly correlated with disease severity(morbidity and mortality). In COPD patients, dyspnea seems to be different from disease severity. We investigated whether dyspnea is correlated with disease severity, as measured by $FEV_1$, quality of life(QoL), occupation, and supporting level of family members and neighbors. Method: Thirty-six clinically stable patients with chronically irreversible airflow limitation were enrolled. We used the Medical Research Council(MRC) dyspnea scale to assess the level of dyspnea and the Korean St. Goerge's respiratory questionnaire(SGRQ) as measure the QoL. Result: The mean percentage of the predicted $FEV_1$ was 32.0%. Dyspnea was not correlated with GOLD stage using $FEV_1$(p=0.114). With deteriorating level of dyspnea the scores of symptoms(p=0.041), activity(p=0.004), impact(p=0.001), and total SGRQ score(p<0.001) were significantly increased. Dyspnea was not correlated with the level of occupation(p=0.259). The supporting level of family members and neighbors was significantly negatively correlated with dyspnea scale(p=0.011). Conclusion: In the management of COPD patients, we have to remember that the level of subjective dyspnea is correlated with QoL(symptom, activity and impact on society) and social supporting level as well as GOLD stage($FEV_1$).

• Journal of agricultural medicine and community health
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• v.34 no.3
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• pp.334-345
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• 2009

Objectives: This study was performed to investigate the management status of chronic disease at community health centers. Methods: The study subjects were 450 employed persons at community health centers in Jeonlanamdo. General characteristics, status of chronic disease management and health education were collected for statistical analysis. The differences on management status among working areas were assessed with chi-square test and ANOVA. Results: The mean values of work duration were 18.7 years in rural, 14.4 years in fishing village, and 17.4 years in urban-rural, respectively. The number of management registration was highest in hypertension. The ways of disease management were medication check-up, diet stopping smoking. The contents of group health education were exercise, diet and prohibition of smoking. The place of health education was town assembling hall. The fields which officials wanted to be educated were symptom, diagnosis, treatment and complication. The most important field was early detection of chronic disease patients and health education. Finally, the field requiring support was work standardization. Conclusions: Community health workers have worked positively in chronic disease management. The barriers to work were the lack of professional and preliminary data. The support system with other health organ and health education were needed for the improvement of working ability.