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Correspondence between Temporomandibular Disorder Symptoms and Clinical Examination Findings (측두하악장애 환자에서 주관적 증상과 임상검사 소견 간의 일치성)

  • Im, Yeong-Gwan;Baek, Hey-Sung;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.83-91
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    • 2010
  • Objectives: This study aimed to assess the characteristics of temporomandibular disorder (TMD) symptoms and to determine the correspondence between TMD symptoms and clinical examination findings. Material and methods: A total of 218 patients (143 females and 75 males; age=$31.3{\pm}14.0$) were enrolled in this study who completed a questionnaire and underwent a clinical examination and radiographic assessment. Patients were asked about all the symptoms and complaints, including onset or duration, and locations of the symptoms. Clinical examination included amounts of mouth opening, palpable temporomandibular joint (TMJ) sounds, and tenderness to palpation of the TMJ and all masticatory muscles. Tenderness scores obtained from palpation of the masticatory system were summated to define the variables for further analysis. Results: Pain was the most frequently reported symptom (78.9%), followed by joint sounds (45.4%), and limitation in mouth opening (17.0%). Jaw pain comprised 91.9% of pain complaints. The subjective intensity of jaw pain was low to medium in most patients (93.7%), but it was poorly correlated with the sum of tenderness scores of the TMJ and masticatory muscles (Kendall tau = 0.084). In contrast, the side in which pain was reported by patients was well associated with the clinical examination results (pain of the right side, p < 0.001, and left side, p < 0.001). There was moderate agreement in TMJ sounds between the side identified by patients as symptomatic and clinical examination findings (kappa = 0.482). Finally, patients who complained of restricted mouth opening showed about a 10 mm less opening in all three measurements, compared to other patients (p < 0.001). Conclusion: The most frequent symptoms reported by TMD patients were jaw pain, TMJ sounds, and mouth opening limitation. The side of jaw pain, the side of TMJ sounds, and the presence of opening limitation were highly concordant between symptom reports and examination findings.

Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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The Benefit of KT-2000 Knee Ligament Arthrometer in Diagnosis of Anterior Cruciate Ligament Injury (슬관절 전방 십자 인대 파열의 진단에 있어서 KT-2000 기기의 유용성)

  • Park, Jai-Hyung;Kim, Hyoung-Soo;Jung, Kwang-Gyu;Yoo, Jeong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.82-88
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    • 2004
  • Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

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Development of the Anger Response Scale and its Application in Clinical Practice (분노반응척도의 개발과 임상적 적용)

  • Koh, Kyung-Bong;Park, Joong-Kyu;Kim, Chan-Hyung;Kim, Do-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.122-134
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    • 2004
  • Objective : The purpose of this study was to develop the Anger Response Scale(ARS), and then to use the scale in clinical practice. Methods First, a preliminary survey was conducted for 123 healthy adults to obtain 16 response items. Second, a preliminary questionnaire was completed by 258 healthy subjects. Third, a comparison was made regarding anger responses among 189 patients(59 with anxiety disorder, 72 with depressive disorder and 58 with somatoform disorder) and 258 healthy subjects. Results : Factor analysis yielded 4 subscales : aggression, irritability, avoidance and anger suppression. Reliability was computed by administering the ARS to 53 healthy subjects during a 2-week interval. Test-retest reliability for 4 subscales and the total score was significantly high, ranging between .53-.71. Cronbach's ${\alpha}$ for 4 subscales ranged between .62-.72, and .76 for the total score. Convergent validity was computed by correlating the 4 subscales and the total score with the total score of Aggression Questionnaire, State-Trait Anger Expression Inventory, anger and aggression subscale of Stress Response Inventory and hostility subscale of Symptom Checklist-90-Revised. The disorder group was significantly higher than normal group in scores of the avoidance and anger suppression subacale. The depressive disorder and somatoform disorder groups scored significantly higher on the avoidance subscale than the normal group. Conclusion : These results indicate that the ARS is highly reliable and valid. In addition, avoidance response is likely to be a characteristic anger response of the depressive disorder and somatoform disorder groups.

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The Effect of Social Capital on Health-related Quality of Life - Using the Data of the 2019 Community Health Survey - (노인의 사회적 자본이 건강 관련 삶의 질에 미치는 영향 - 2019년 지역사회건강조사를 중심으로 -)

  • Kim, Ji-Hee;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.280-294
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    • 2021
  • Objectives: The purpose of this study is to investigate the effects of social capital characteristics, socio-demographic characteristics, physical condition, and health behavior characteristics on health-related quality of life of the elderly in Korea. Methods: T-test, one-way ANOVA, and regression analysis were performed by applying a complex sample design to 57.787 people aged 65 and over using the 2019 Community Health Survey. Results: First, as a result of complex-sample T-test and ANOVA analysis, it was found that there were differences in health-related quality of life according to social capital characteristics, physical condition & health behavior characteristics, and socio-demographic characteristics. Complex Sample Regression Analysis Results, the explanatory power of the model was 28%. When living in the metropolitan area, living in an apartment building, having a spouse, having a higher household income, economic activity, higher educational attainment, increase sleeping time, walking time, frequent binge drinking, health checkup, networking, trust, and social participation showed higher health-related quality of life. When people were older, their gender was female, higher BMI, number of chronic diseases, and severe stress that showed lower health-related quality of life. Conclusions: It was proved that the factors affecting the health-related quality of life of the elderly are not only physical condition and health behavior factors, but also social capital and socio-demographic characteristics. It was found that the role as a member was important.

Effects of Visiting Prehabilitation Program against Functional Decline in the Frail Elderly: A Prospective Randomized Community Trial (허약노인을 위한 방문재활 프로그램의 장애발생예방 효과에 대한 연구)

  • Kim, Chang-O;Lee, Heeyeon;Ho, Seung Hee;Park, Hyunsuk;Park, Chulwoo
    • 한국노년학
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    • v.30 no.4
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    • pp.1293-1309
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    • 2010
  • This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

Autograft Versus Allograft Bone-Patellar Tendon-Bone in Anterior Cruciate Ligament Reconstruction - A Comparison Of Mid-Term Follow-Up Results - (자가 및 동종 골-슬개건-골을 이용한 전방 십자 인대 재건술 -중기 추시 결과의 비교-)

  • Cho, Sung-Do;Cho, Su-Hyun;Woo, Jong-Ken;Yoo, Chang-Hyun;Park, Moon-Su;Lew, Sog-U
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.14-18
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    • 2004
  • Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.

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Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

The Relationship of Stress Perception and Psychopathology with Intensity of Tinnitus in Patients with Tinnitus (이명환자들에서 스트레스지각 및 정신병리와 이명강도 간의 관계)

  • Koh, Kyung-Bong;Kim, Hee-Nam;Lee, Ho-Ki;An, Suk-Kyoon
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.151-157
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    • 1997
  • The relationship of stress and psychopathology with subjective or objective tinnitus intensity was investigated in 43 patients with tinnitus. Global assessment of recent stress scale, Beck depression inventory and symptom checklist-90-revision were used to measure stress perception and psychopathology. Subjective tinnitus intensity was assessed by subjective tinnitus severity inventory, whereas objective tinnitus intensity was assessed by tinnitogram. Scores of perceived stress related to interpersonal relationship and sickness or min had significantly positive correlation with subjective tinnitus intensity. In psychopathology, scores of somatization, interpersonal sensitivity, depression, anxiety, phobia, paranoid ideation, psychoticism had significantly positive correlation with subjective tinnitus intensity. However, stress perception and psychopathology did not significantly correlate with objective tinnitus intensity. These findings suggest that tinnitus may be associated with stress perception and multiple psychopathology including anxiety and depression. Thus, it is emphasized that Psychosocial intervention as well as effective consultation-liasion activity is needed for evaluation and treatment of patients with tinnitus.

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The Influences of Perceived Locus of Control to Patients with Pain (지각된 통제소재 (Locus of Control)가 통증환자의 심리상태에 미치는 영향)

  • Cho, Sun-Mi;Chin, Bum-Su;Song, Ho-Jeong;Kim, Chan;Han, Gyung-Lim
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.101-109
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    • 2002
  • Objectives: Cognitive-behavioral scientists have long been interested in how a pain patient's cognition such as locus of control relates to coping and adjustment. The present study examined the relationship of locus of control orientation to pain coping strategies, psychological distress and perceived pain intensity of patients with pain. Methods : Subjects were 96 patients with pain who visited pain clinic. All patients were administered the Multidimensional Health Locus of Control Scales, the Minnesota Multiphasic Personality Inventory, the Coping Strategies Questionnaire, and rating for perceived pain intensity, distress, and duration. Results : Correlational analysis revealed that patients who viewed outcomes as controlled by internality tended to have better ability to control and decrease pain. Also they tended to be less depressed and anxious. Regression analysis indicated that patients having a internal locus of control were more likely to use coping self-statement and reinterpreting pain sensation. Powerful others and chance locus of control orientation were predicted reliance on catastrophizing. Conclusion : The clinical implication of the present study is that cognitive factors of patients with pain such as locus of control influence emotional distress and coping. this study show that these factors should be applied to cognitive behavioral therapeutic intervention.

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