• Journal of Korean society of Dental Hygiene
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• v.12 no.3
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• pp.563-576
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• 2012

목적 : 본 연구는 업무형태에 따른 측두하악장애의 유병률과 업무 시 노출되는 직무스트레스 및 구강 내 악습관이 측두하악장애와 어떠한 연관성이 있는지 알아보아 보건학적 기초자료를 제공하고자 실시되었다. 방법 : 본 연구의 자료 수집을 위하여 서울과 경기 일부지역에 근무하고 있는 일반사무직, 서비스직, 교직원으로부터 편의 추출된 452명을 대상으로 2010년 1월부터 2010년 4월까지 설문조사를 실시하였고, 수거된 353명을 연구대상으로 하였다. 설문지는 측두하악장애의 증상, 하악사용에 관한 구강 내 악습관, 직무스트레스, 인구사회학적 특성으로 구성되었다. 측두하악장애의 증상의 정도를 구분하기 위해 설문지의 양성응답 수의 빈도에 따라 무증상인 1단계에서 양성응답 수가 가장 많은 4단계 까지 총 4그룹으로 나누었다. 측두하악장애의 유병률을 알아보기 위하여 빈도분석을 시행하였고, 측두하악장애의 증상의 정도에 따른 여러 요인들 간의 연관성 및 관련요인을 알아보기 위하여 교차분석 및 경향성 분석과 다항로지스틱회기 분석을 시행하였다. 결과 : 측두하악장애의 유병률은 75.4%였고, 측두하악장애에 대한 주관적 증상으로는 관절잡음이 56.4%로 가장 주된 증상 중 하나였으나 남녀 간의 차이는 통계적으로 유의하지 않았다. 다음으로는 두통이나 목의 통증이 36.5%이었고, 귀, 관자놀이, 볼 주위의 통증이 22.1%로 높았다. 측두하악장애의 주관적인 증상 수에 따른 인구사회학적 특성은 증상이 없는 경우 여성에서 19.1%, 남성에서 36.6%로 여성에서 더 높은 유병률을 보였다. 연령별로는 40세 이상의 그룹보다 20 - 30대그룹에서 측두하악장애 증상수가 높아지는 경향을 보였다. 하악 사용과 관련된 악습관 및 직무스트레스는 측두하악장애 증상수와 유의한 관련성이 있는 것으로 나타났는데, 하악 사용과 관련된 습관의 개수가 많아질수록 측두하악장애의 증상의 개수도 많아졌고, 습관이 한 가지씩 늘어날수록 측두하악장애 증상이 없는 1단계보다 3단계가 될 위험이 1.45배, 4단계가 될 위험이 1.57배 높아졌다. 스트레스 수준도 가장 하위단계에서 한 단계 높아지면 측두하악장애 1단계에서 4단계가 될 위험이 2.49배, 두 단계 높아지면 3.43배 높아졌다. 결론 : 본 연구의 결과 측두하악장애와 업무특성에 따른 연관성은 설명하지 못하였지만, 직무스트레스가 높은 경우 측두하악장애 증상의 개수 또한 높아짐을 확인할 수 있었다. 이는 측두하악장애의 주관적인 증상을 발생시키는데 있어서 업무형태 보다는 심인적인 부분이 더 중요한 인자임을 의미한다. 그러므로 측두하악장애 평가 시 신체적인 문제뿐 아니라 행동적, 심리 사회적 문제로 예측인자를 폭넓게 인식함으로써 다각적인 접근을 하는 것이 필요하며, 측두하악장애 증상이 발생된 경우 임상적 치료뿐 아니라 행동요법 및 심리 치료와 자가 관리 등이 함께 수반되어 기여요인 조절을 조절하는 것이 중요하다 하겠다.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.200-204
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• 1999

Background: Patient-controlled analgesia (PCA) has proven to be safe and effective in children from age 5 years, and older and compares favourably with continuous morphine infusion in the older child. We compared fentanyl and butorphanol for opioid use in PCA with ketorolac to determine a suitable drug combination for post-tonsillectomy pain control. Methods: We studied 60 patients, aged 5~12 yrs, undergoing tonsillectomy with or without adenoidectomy under general anesthesia using $N_2O-O_2$-enflurane. Patients were randomly assigned to receive fentanyl $250\;{\mu}g$ (Group 1: n=30) or butorphanol 5 mg (Group 2: n=30) mixed with ketorolac 90 mg and ondansetron 4 mg diluting 100 ml of 5% D/W solutions intravenously via PCA pump after operation. PCA pump were programmed to deliver a 0.05 ml/kg loading dose, 0.01 ml/kg/hr basal infusion, 0.01 ml/kg on demand bolus, 6 min lockout intervals between doses and 4 bolus hourly limit. Total infusion dosage of PCA drug, VAS pain scores, side effects and satisfaction score of both groups were monitored for 48 hrs. Results: Total infusion dosages were fentanyl $170.6\;{\mu}g$ with ketorolac 61.4 mg (Group 1) and butorphanol 2.8 mg with ketorolac 50.4 mg (Group 2). Total infusion dosage, quality of analgesia, side effects and overall satisfaction didn't differ between two groups. Conclusions: Both fentanyl and butorphanol mixed with ketorolac were effective for post-tonsillectomy pain control using PCA pump in children as young as 5 years old.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.211-216
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• 2008

Background: Postoperative pain after bilateral total knee replacement (TKR) is expected to be more severe than unilateral TKR. Intravenous patient-controlled analgesia (IV PCA) is less effective than other methods of pain management especially immediately after an operation even though it is an easily controlled method for managing pain. This study was designed to evaluate the effect of femoral nerve blocks combined with IV PCA after bilateral TKR for postoperative pain control. Methods: The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) were given bilateral femoral nerve blocks with 12 ml of 0.25% bupivacaine and epinephrine 1 : 400,000 before extubation followed by an IV PCA. Main outcome measures included numerical rating pain score, cumulative opioid consumption, hourly dose during each time interval, and side effects. Results: The pain score in group II was significantly lower than that in group I immediately after recovery of awareness and at 3, 6, 12 hours postoperatively. Cumulative opioid consumption was significantly decreased in group II during the first 48 hours postoperatively. The hourly dose in group II was also significantly lower than that in group I until 12 hours postoperatively. There was no difference in side effects between the groups. Conclusions: We concluded that bilateral femoral nerve blocks improve analgesia and decrease morphine use during IV PCA after bilateral TKR.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.54-58
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• 1999

Background: We studied 150 patients who received intravenous patient controlled analgesia (PCA) after total abdominal hysterectomy to evaluate pain relief, analgesic consumption, patient's satisfaction and side effects. Methods: We made total 40 ml of analgesic mixture with morphine 40 mg, ketorolac 120 mg, droperidol 3 mg and normal saline. Loading/bolus/basal infusion dose and lockout interval was 2 ml, 1.5 ml, 0.5 ml/hr and 10 min, respectively. Numerical rating scale (NRS) pain score, cumulative analgesic consumption, degree of satisfaction, and incidence of side effects were evaluated. Also, correlation of age and edu ion with analgesic consumption were evaluated. Results: The average pain scores using NRS were $3.1{\pm}1.7$ (6 h), $2.1{\pm}1.5$ (24 h), $1.7{\pm}1.5$ (48 h). The average cumulative analgesic consumption were $11.7{\pm}5.0$ ml (6 h), $23.0{\pm}6.7$ ml (24 h), $32.1{\pm}3.7$ ml (48 h). The degree of satisfaction in postoperative pain control was good in 94% of patients. There was no correlation between degree of satisfaction and analgesic consumption. Also age and level of edu ion did not correlated with analgesic consumption. Conclusions: Intravenous PCA with morphine, ketorolac, and droperidol is an effective method of postoperative pain control because it provides adequate pain relief and a few side effects with high patient's satisfaction. However, age and level of education did not correlated with analgesic consumption.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.153-168
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• 2004

Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.382-387
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• 1999

The concept of PCA(Patient Controlled Analgesia) was first described in 1968, by Sechzer. The earliest descriptions of actual self-administered PCA machines were by Forrest et al. In gastric bypass surgery, cesarian section, orthopedic surgery etc, PCA is widely used in the control of postoperative pain. Previous Studies have shown that PCA provides effective pain-control for the postoperative patient. The postoperative pain-control is a problem that should be solved in surgery. Especially in orthognathic surgery, it is not same as in the case of maxillofacial trauma surgery or of tumor surgery: most orthognathic surgery patients are under operation not accustomed to pains, and difficulties in pain-complaint due to IMF(Intermaxillary fixation), postoperative nausea, and vomiting are additional problem. In this study, we have compared PCA and IM analgesics with respect not only to time request but also to the quality of postoperative pain control.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.95-105
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• 2001

제 4형 콜라젠을 분해하는 MMP-9은 조직 재생에 중요한 역할을 하기 때문에 주목받아 왔는데, 이전의 문헌들에서 PMA에 의해 이 유전자 발현이 강하게 상승발현된다고 알려져 있다. 비록 MMP-9 발현을 조절하는 PMA의 기전이 잘 밝혀지지는 않았지만, 다른 유전자발현에서의 이 phorbol ester의 효과는 c-raf-1-ERK 신호전달통로의 활성에 관해 연구되어 오고 있다. 하지만 이번 연구에서 저자는 MMP-9 발현에서 PMA의 상승효과에는 대개는 스트레스성 자극과 관련된 JNK1 의존성 신호전달과정이 또한 필요하다는 다른 가능성을 조사하였다. 그 결과 JNK 억제재중 하나인 SP 600125가 UM-SCC-1세포주에서 PMA에 의해 유도된 MMP-9 상승발현을 용량의존적으로 억제하는 것으로 나타났고 72시간동안 전처치를 한 경우에 그의 억제효과가 최대이었다. phorbol ester로 처리한 세포에 GAL4 luciferase reporter와 vector를 주입해서 조사한 결과 PMA가 c-Jun transacting 활성을 상승시켰다. 그뿐 아니라 PMA에 의한 MMP-9 촉진자 활성에는 AP-1 motif가 필요하며 이 motif에 c-Jun이 결합하는 것을 EMSA를 통해 확인하였다. 결론적으로 UM-SCC-1 세포주에서 PMA에 의한 MMP9의 증가된 발현은 이미 밝혀진 ERK 경로뿐 아니라 JNK 경로를 통한 결과임이 밝혀져 이 경로를 차단하는 방법이 또하나의 암치료 방향을 제시해주고 있다.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.114-122
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• 2014

The purpose of this study was to analyze the effect of mediating variables on the relationship between job stress and stress response. A survey was conducted to 243 clinical dental hygienists from January 15, 2013 to March 20, 2013 and the data were analyzed using t-test, one-way ANOVA, Pearson's correlation analysis, and hierarchical multiple regression analysis. The subjects who worked in poor working environment, had high level of role conflict and overload and aggressive nature showed high stress responsivity (p<0.01). The variable that showed mediation effect on the relationship between job stress and physical discomfort, depression was shown to be personality type (p<0.05). Also, the variable that showed mediation effect on the relationship between job stress and turnover intention was social support (p<0.05). According to the results, personality type and social support were shown to be important parameters when it came to the relationship between job stress and stress response. Therefore, in order to reduce negative outcomes caused by stress, it is suggested to provide an educational opportunity on self-control management while increasing social support from the organizational and structural level. Especially, it is asked to expand the system that provides encouragement and recognition to feel the sense of achievement in the course of their duty execution.

• Journal of Life Science
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• v.21 no.6
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• pp.893-900
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• 2011

Prostatic acid phosphatase (PAP) is one of the widely used biomarkers in the diagnosis of prostate cancer. It was initially identified in 1935 and is the most abundant phosphatase in the human prostate. PAP is a prostate-specific enzyme that is synthesized in prostate epithelial cells. It belongs to the acid phosphatase group that shows enzymatic activity in acidic conditions. PAP is abundant in prostatic fluid and is thought to have a role in fertilization and oligospermia. It also has a potential role in reducing chronic pain. But one of the most apparent functions of PAP is the dephosphorylation of macromolecules such as HER-2 and PI3P that are involved in the ERK1/2 and MAPK pathways, which in turn leads to inhibition of cell growth and tumorigenesis. Currently, clinical trials using PAP DNA vaccine are underway and FDA-approved immunotherapy using PAP is commercially available. Despite these clinically important aspects, molecular mechanisms underlying PAP regulation are not fully understood. The promoter region of PAP was reported to be regulated by NF-${\kappa}B$, TNF-${\alpha}$, IL-1, androgen and androgen receptors. Here, the features of PAP gene and protein structures together with the function, regulation and roles of PAP in prostate cancer are discussed.

• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.423-432
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• 2010

Purpose: This study was done to examine effects of Nei-Guan acupressure on nausea, vomiting and level of satisfaction for gynecological surgery patients who were using a patient-controlled analgesia (PCA). Methods: For this study, 51 patients were assigned to one of three groups, a control group (17 patients), experimental group 1 (finger acupressure group) (17 patients), and experimental group 2 (relief band group) (17 patients). The data were collected for 24 hr in the recovery room of a university hospital located in Seoul. The 6 hr-intervals including the time of leaving the recovery room were taken into consideration. Results: The occurrence of nausea between the experimental group with Nei-Guan acupressure treatment and the control group was different. However, there was no difference in nausea and vomiting control or level of patient satisfaction between the finger acupressure group and the relief band group. Conclusion: Nei-Guan acupressure is recommended for nursing practice as a way for alleviating the opioid-induced nausea and accelerating the recovery of patients who are using PCA after surgery.