• The korean journal of orthodontics
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• v.23 no.4 s.43
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• pp.503-527
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• 1993

This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

• Journal of muscle and joint health
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• v.1 no.1
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• pp.31-47
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• 1994

The purposes of this research are to examine the effects of muscle relaxation to the rheumatoid arthritis patients' physiological, psychological, and social adaptation, and to verify that the technique Is an effective tool for improving the patients' adaptation. This research utilized a qusi-experimental design that compares the pre-experiment measures and the post-experiment measures. The subjects of this study were 37 out-patients who were diagnosed for rheumatoid arthritis in P university hospital and K clinic between September 12, 1993 and November 30, 1993. The experimental group consisted of patients treated on Monday, Wednesday and Friday. The control group consisted of patients treated on Tuesday, Thursday and Saturday The pre-experimental survey utilized the following tools. The physiological adaptation was measured by a graphic rating scale for pain and activity of daily living. The psychological adaptation was measured by Zung's depression scale and Rosenberg's self-esteem scale : and the social adaptation was measured by Derogatis' psychosocial adjustment scale. The experimental group received muscle relaxation treatment for 15 minutes per day for the period of 2 weeks, the control group received no treatment and had quiet time. The post-experiment measurement was carried out similar to the pre-experiment survey, SPSS $PC^+$ is used to analyze the collected data. The reliabilities of the measurement tools were examined by Cronbach's ${\alpha}$ coefficients. The homogeneities between the experimental and control groups were tested by t-test and chi-square test, hypotheses were tested by t-test. This research found that the general characteristics between the groups were statistically homogenious. The physiological, psychological, and social adaptation between the groups in the pre-experimental survey were also statistically homogenious. The results of this research can be summarized as follows : 1. Concerning the Physiological adaptation, the experimental group showed a statistically lower pain score than the control group. Thus, muscle relaxation was effective to relieve the pain of rheumatoid arthritis patients (t=-2.95, p=.006). 2. Concerning the psychological adaptation, the experimental group showed a statistically lower depression score than the control group. Thus, muscle relaxation was effective to reduce the patient's depression(t=-4.00, p=.001). 3. Concerning social adaptation, the experimental group showed a statistically higher score for the health maintenance and disease control than the control groups. Thus, muscle relaxation was effective for the health maintenance and disease control (t=2.09, p=.004). This research showed that the muscle relaxation is a nursing intervention that can promote the physiological, psychological and social adaptation of the rheumatoid arthritis patients in terms of short-term and cognitive changes. However, more fundomental changes in behavior and long-term physiology could not be found through such a short-term relaxation treatment.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Korean journal of food and cookery science
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• v.6 no.3 s.12
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• pp.85-94
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• 1990

The subject of this study was to yield data of dietetic education which could help the male teachers to live a desirable dietary life by analying the degree of balance of the diet, the interests in health and the subjective symptoms in disease, and finding the problem in the present dietary habit and the health state. Rusults were as follows: 1. The most regular meal in a day lunch and the most irregular was dinner. The sixties had meals most regularly. 2. The amount of smoking had influence on respiratory system and hepatobiliary system while daily amount of coffee intake influenced cardiobascalar system, diabetes mellitus and joint system. The amounts and the frequencies of alchol intake had no differences. 3. The factors which had meaningful relations with dietary habit were as follows; Salted food and so on had influences on cardiobascular system, spicy food on general disease, lipid intake including fried food, jun, bokchum on joint system, instant food and so forth on respiratory system. Fruit and so forth had influences on diabetes, salted food on hepatobilitary system.

• Physical Therapy Korea
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• v.18 no.1
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• pp.83-92
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• 2011

Osteoarthritis is a degenerative joint disease and is led to physical disability. Yet the development of effective disease-modifying treatments has lagged. In this study, I examined the effect of physical therapeutic intervention through microcurrent stimulation and attempt to find which degree of intensity, either 25 ${\mu}A$ or 500 ${\mu}A$ with a regular 5 pps pulse, is more effective in the osteoarthritis. Osteoarthritis was induced with a mixture of 2% carrageenan and 2% kaolin in 26 male Sprague-Dawley rats. The mixture (0.1 $m{\ell}$) was injected into the intra-articular capsule of knee joint once a week for three weeks. Five animals did not show degenerative changes by radiological findings and excluded in the following experiment. Osteoarthritic animals were randomly divided into 3 groups ($n_1$, $n_2$, $n_3$=7/each): untreated, treated with 25 ${\mu}A$, treated with 500 ${\mu}A$. All experimental groups received microcurrent stimulation for four weeks (15 min/day, 5 days/week). The ethological inspection of foot print analysis on the walking corridor was accomplished every week. Histological preparations and immunohistochemical staining with insulin-like growth factor-1 were also done in the articular cartilages. All of these parameters were compared with those of osteoarthritic control group (n=7). The ethological inspection of foot print analysis revealed that changes of walking track (paw width) and stride length was significantly increased in both experimental groups. The better results were observed in experimental group treated with 25 ${\mu}A$ intensity without significance than group treated with 500 ${\mu}A$. Histological preparations disclosed that routine hyaline cartilage of articular surface were altered to fibrous cartilage in untreated group and experimental group treated with 500 ${\mu}A$ intensity. But a little changes were seen in experimental group treated with 25 ${\mu}A$ intensity. Immunolocalization of insulin-like growth factor-1 was simultaneously decreased according to the duration of osteoarthritis, and did not show significant difference among the groups. In this study discovered that the microcurrent stimulation, especially 25 ${\mu}A$ intensity, had a positive effect by the ethological inspection, histological and immunohistochemical stainings. These results suggest that microcurrent stimulation with low-intensity might be effective in the promotion of healing process for the osteoarthritis.

• The korean journal of orthodontics
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• v.36 no.6
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• pp.402-411
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• 2006

Objective: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. Methods: Six thousand and seventy patients with TMD (temporomandibular cisorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. Results: The distribution. and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. Conclusion: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD.

• Journal of Oral Medicine and Pain
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• v.23 no.3
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• pp.289-294
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• 1998

본 증례는 측두하악관절의 퇘행성 변화를 보이는 환자에서 악교정 수술의 시행 전에 중심위교합장치를 통해 측두하악관절의 안정화를 유도하고, 또한 골스캔을 이용하여 장치의 치료효과를 평가한 임상증례이다. 환자는 24세의 여성으로 5년 전부터 전치부 개교합이 발생되기 시작하였고, 고형식 저작시 좌측 전이부에 간헐적인 통증이 발생한다는 주소로 본원에 내원하였다. 임상검사상 촉진시 양측 관절낭 후방부에 압통을 호소하였으며, 각각 50, 45mm의 최대개구량 및 최대무통성 개구량을 보였다. 좌측 악관절부에서 단순 관절 잡음, 우측 악관절부에서 염발음이 청취되었으며, 저항검사 및 부하 검사에서는 특기할 반응을 보이지 않았다. 약 7mm의 전치부 개교합의 소견을 보였으며, 파노라마 사진과 횡두개 방사선 사진 소견상 양측 과두의 크기 및 하악지의 높이가 다소 작은 소견이 관찰되었고 자기공명영상 소견상 양측성 비정복성 관절원판의 전방전위가 관찰되었다. 1997년 10월 27일 첫 번째 골스캔 소견상 양측성 비정복성 관절원판의 전방위가 관찰되엇다. 골스캔의 전방 사진에서 Densitometer를 이용하여 좌, 우측 과두부위와 상악 골부위의 가장 어두운 부분의 흑화도를 측정하였다. 각각 3회씩 구하여 평균을 구하고 좌, 우측 과두 대 상악골의 흑화도의 비율을 계산하였다. 첫번째 골스캔의 평균 흑화도는 우측 과두, 좌측과두, 상악골이 각각 0.88, 0.81, 1.32 였다. 1997년 11월 4일 중심위교합장치를 장착하였고 지속적인 물리치료를 시행하였다. 1997년 12월 10일 두 번째 골 스캔을 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.33, 0.37, 088 이었다. 1998년 1월 30일 세 번째 골스캔 소견상 두 번째 골스캔과 비교하여 활성도가 감소된 소견을 보였다. 임상검사시 무통이었다. 1998년 2월 25일 술 전 교정 위해 중심위교합장치의 장작을 중지시켰다. 1998년 6월 5일 네 번째 골스캔 소견상 이전 검사들과 비교시 흡수가 감소된 소견을 보였다. 네 번째 골스캔의 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.24, 0.19, 0.85 였다. 현재 지속적인 관찰 중이며 본원 교정과에서 악교정수술 위한 술 전 교장을 시행중이다. 결국 첫 번째 골스캔의 과두 대 상악골의 평균 흑화도의 비율은 우측과 좌측이 각각 0.66, 0.61이었고 두 번째 골스캔에서는 우측과 좌측이 각각 0.37, 0.42였고, 네번째 골스캔에서는 우측과 좌측이 각각 0.28, 0.23 이었다. 각 골스캔의 과두 대 상악골의 평균 흑화도의 비율 사이에 유의한 차이가 있는지 검증하기 위해 Standard t-test 와 ANOVA를 시행하였다. 이상의 결과에서 첫 번째, 두 번째, 네 번째 골스캔으로 갈수록 좌, 우측 과두 대 상악골의 흑화도의 비율이 유의하게 감소했음을 알 수 있었다. 결론적으로 본 증례에서는 전치부 개교합이 발생되어 악교정수술이 필요한 환자에게 측두하악관절의 안정화를 위해 중심위교합장치를 사용함으로써 퇴행성 관절질환의 진행을 억제시킬 수 있고, 퇴행성 관절질환의 활성도에 대한 평가시 골스캔이 유용할 수 있음을 보여주었다고 사료된다.

• Journal of Pathology and Translational Medicine
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• v.52 no.6
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• pp.396-403
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• 2018

Background: In the current American Joint Committee on Cancer staging system of breast cancer, only tumor size determines T-category regardless of whether the tumor is single or multiple. This study evaluated if tumor multiplicity has prognostic value and can be used to subclassify breast cancer. Methods: We included 5,758 patients with invasive breast cancer who underwent surgery at Samsung Medical Center, Seoul, Korea, from 1995 to 2012. Results: Patients were divided into two groups according to multiplicity (single, n=4,744; multiple, n=1,014). Statistically significant differences in lymph node involvement and lymphatic invasion were found between the two groups (p<.001). Patients with multiple masses tended to have luminal A molecular subtype (p<.001). On Kaplan-Meier survival analysis, patients with multiple masses had significantly poorer disease-free survival (DFS) (p=.016). The prognostic significance of multiplicity was seen in patients with anatomic staging group I and prognostic staging group IA (p=.019 and p=.032, respectively). When targeting patients with T1-2 N0 M0, hormone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-negative cancer, Kaplan-Meier survival analysis also revealed significantly reduced DFS with multiple cancer (p=.031). The multivariate analysis indicated that multiplicity was independently correlated with worse DFS (hazard ratio, 1.23; 95% confidence interval, 1.03 to 1.47; p=.025). The results of this study indicate that tumor multiplicity is frequently found in luminal A subtype, is associated with frequent lymph node metastasis, and is correlated with worse DFS. Conclusions: Tumor multiplicity has prognostic value and could be used to subclassify invasive breast cancer at early stages. Adjuvant chemotherapy would be necessary for multiple masses of T1-2 N0 M0, hormone-receptor-positive, and HER2-negative cancer.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.404-412
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• 2021

Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm²) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.

• Korean Journal of Oriental Medicine
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• v.3 no.1
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• pp.41-65
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• 1997

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.