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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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Estimation of Adverse Events Scale relating Herbal Medicine in Korea (우리나라의 한약 부작용 규모 추정)

  • Woo, Yeonju
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.1
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    • pp.27-35
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    • 2020
  • Objectives : The purpose of study was estimation of adverse events [AEs] scale relating herbal medicine in Korea using Korean Medicine Utilization and Herbal Medicine Consumption Survey (National statistics No. 117087). Methods : Using microdata of Korean Medicine Utilization and Herbal Medicine Consumption Survey 2017, the number of inpatients and outpatients who experienced AEs was calculated. The microdata included AEs of all treatment methods that have been performed by visiting Korean medical institutions for one year, so set up the data into three models; model A (in case all treatments were only herbal medicine for one year), model B (in case herbal medicines were a part of all treatment methods in 1 year), model C (in case herbal medicines were a part of treatment methods at least one time in 1 year). The proportion of patients who experienced AEs during the last 1 year was calculated and then, the number of AEs relating herbal medicine was estimated. Results : A total of 1,010 outpatients and 904 inpatients were included in Korean Medicine Utilization and Herbal Medicine Consumption Survey 2017. The number of patients who had experienced AEs in the past 1 year was 0 in the model A, 9 in the model B (5 for outpatients, 4 for inpatients), and 19 in the model C (10 for outpatients, 9 for inpatients). By consideration for the complex sample survey, estimating the number of AEs relating herbal medicine, the model A was 0, the model B was 36,457 patients (0 to 75,526 patients), and the model C was 84,830 patients (26,314 to 143,347 patients). Conclusion : From the results of this study, it was possible to estimate the scale of AEs relating herbal medicines in Korea, suggesting that it is necessary to understand the actual condition of AEs and establish its management system.

Changes in the Oral Microflora in Patients with Acute Myeloid Leukemia during the Period of Induction Therapy (항암 화학요법중인 급성 골수성 백혈병 환자의 구강내 세균변화에 관한 연구)

  • Byul-Hee Lee;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.18 no.1
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    • pp.73-82
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    • 1993
  • To investigate the changes in aerobic and facultative anaerobic oral microflora during remission-induction chemotherapy in patients with acute myeloid leukemia, 10 consecutive patients were studied during a period of 28 days. One day before, during and after the induction therapy, patients were given 10% Betadine solution for mouthrinses after breakfast and kept from eating and drinking. After 3 hours, paraffin-stimulated whole saliva was obtained for 2 minutes and transported to the laboratory. The samples were dispersed and homogenized by use of vortex mixer for 20 seconds. From these samples 10-fold serial dilutions (from 10-1 through 10-3) were prepared. Each dilution of 0.1 ml was plated on duplicate set of one nonselective medium (Blood agar) and four selective media (Sabourauds dextrose agar, Mannitol salt agar, Mac-Conkey agar, SF medium ) using applicator woods. All agar plate were incubated at 37$^{\circ}C$ for 48 hours. The total number of microorganisms was calculated and the percentage distribution of the various microorganisms from each specimen was drawn. 1. The salivary flow rate decreased by 66%, going from 5.38 ml/2min to 1.81 ml/2min over two days during the chemotherapy. 2. The total number of microorganisms in saliva increased by 22%, going from 4.88$\times$105/ml to 6.00$\times$105/ml over two days during the chemotherapy. 3. The salivary flow rate and the total number of microorganisms in saliva were recovered within 28 days after the chemotherapy. 4. The quantitative alteration in oral Enterobacteria, Enterococci, Staphylococci, Cndida during the chemotherapy had no statistical significance. 5. In saliva of the patients with acute myeloid leukemia who ahd intraoral ulcer, Enterobacteria was quantitatively predominent. Our study suggests that chemotherapy-induced transient xerostomia may induce acute oral infection. Consequently, the use of saliva substitute, the removal of intraoral infection source and the consistent oral hygiene care seem to be required to avoid the transmission of potential pathogenes in this group of patients.

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The Effect of Postoperative Use of Teriparatide Reducing Screw Loosening in Osteoporotic Patients

  • Kim, Jae Wook;Park, Seung Won;Kim, Young Baeg;Ko, Myeong Jin
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.494-502
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    • 2018
  • Objective : The loosening of pedicle screws (PS) is one of the frequent problems of spinal surgery in the patients with osteoporosis. Previous studies had revealed that intermittent injection of teriparatide could reduce PS loosening by improving bone mass and quality when their patients took parathyroid hormone for a considerable duration before surgery. However, although the teriparatide is usually used after spine surgery in most clinical situations, there was no report on the efficacy of teriparatide treatment started after spine surgery. The purpose of this retrospective study was to examine the efficacy of teriparatide treatment started immediately after lumbar spinal surgery to prevent pedicle screw loosening in patients with osteoporosis. Methods : We included 84 patients with osteoporosis and degenerative lumbar disease who underwent transforaminal interbody fusion and PS fixation and received parathyroid hormone or bisphosphonate (BP) postoperatively. They were divided into teriparatide group (daily injection of $20{\mu}g$ of teriparatide for 6 months, 33 patients, 172 screws) and BP group (weekly oral administration of 35 mg of risedronate, 51 patients, 262 screws). Both groups received calcium (500 mg/day) and cholecalciferol (1000 IU/day) together. The screw loosening was evaluated with simple radiographic exams at 6 and 12 months after the surgery. We counted the number of patients with PS loosening and the number of loosened PS, and compared them between the two groups. Clinical outcomes were evaluated using visual analog scale (VAS) and Oswestry disability index (ODI) preoperatively, and at 12 months after surgery. Results : There was no significant difference in the age, sex, diabetes, smoking, bone mineral density, body mass index, and the number of fusion levels between the two groups. The number of PS loosening within 6 months after surgery did not show a significant difference between the teriparatide group (6.9%, 12/172) and the BP group (6.8%, 18/272). However, during 6-12 months after surgery, it was significantly lower in the teriparatide group (2.3%, 4/172) than the BP group (9.2%, 24/272) (p<0.05). There was no significant difference in the number of patients showing PS loosening between the teriparatide and BP groups. The teriparatide group showed a significantly higher degree of improvement of the bone mineral density (T-score) than that of BP group (p<0.05). There was no significant difference in the pre- and post-operative VAS and ODI between the groups. Conclusion : Our data suggest that the teriparatide treatment starting immediately after lumbar spinal fusion surgery could reduce PS loosening compared to BP.

The Study of Dosages of Herbal Medicine Including Aconiti Lateralis Preparata Radix and Aconiti Tuber on Aspartate Aminotransferase, Alanine Aminotransferase (부자(附子) 및 천오(川烏)를 포함한 처방이 혈중 Aspartate Aminotransferase, Alanine Aminotransferase 수치에 미치는 영향)

  • Han, Hyun-Young;Hwang, Won-Duk
    • The Korea Journal of Herbology
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    • v.24 no.4
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    • pp.87-93
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    • 2009
  • Objectives : Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏) are not commonly prescribed, but are necessary for some clinical conditions, despite of the fact that some negative effects have been known to occur with these medicines. This study shows the consequences for aspartate aminotransferase (AST), alanine aminotransferase (ALT) due to herbal medicines, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏). Methods : From 1st June 2007 to 10th May 2009, the results were analyzed for 64 patients belonging to the OO Oriental Medical Hospital who took herbal medicine, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏), more than 20 days. This is the study about the comparison and the investigation of AST, ALT. And the results were taken upon their hospitalization and to their departure. The Criteria of Diagnosis in Liver Injury of CIOMS was used as a standard for their examinations. Results : AST, ALT (total 64). The number of patients who were within normal reference value : 49. The number of patients who exceed the normal reference value after dosage, without satisfying the Criteria of Diagnosis in Liver Injury : 5. The number of patients who were recovered in normal reference value after dosage : 9. The number of patients who satisfying the Criteria of Diagnosis in Liver Injury after dosage : 1. Conclusions : This results suggest that these herbal medicines, including Aconiti Lateralis Preparata Radix (附子) and Aconiti Tuber (川烏), didn't cause adverse side-effects on AST, ALT of the patients who are taking them.

PARK Index and S-score Can Be Good Quality Indicators for the Preventable Mortality in a Single Trauma Center

  • Park, Chan Yong;Lee, Kyung Hag;Lee, Na Yun;Kim, Su Ji;Cho, Hyun Min;Lee, Chan Kyu
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.126-130
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    • 2017
  • Purpose: Preventable Trauma Death Rate (PTDR) using Trauma and Injury Severity Score (TRISS) has been most widely used as a quality indicator in South Korea. However, this method has a small number of deaths corresponding to the denominator. Therefore, it is difficult to check the change of quality improvement for annual mortality, and there is a disadvantage that variation is severe. Therefore, we attempted to improve the quality of the mortality evaluation by reducing the variation by applying the PARK Index (preventable major trauma death rate, PMTDR) which can increase the number of denominator significantly. And the Save score (S-score) was also examined as another quality indicator. Methods: In the PARK Index, the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths among these. The PARK Index includes only patients with ISS >15. The S-score is calculated in the same way as the W-score, but the S-score includes only patients with ISS >15, which is a difference from the W-score. Results: PARK Index decreased annually and was 12.9 (37/287) in 2014, 9.6 (33/343) in 2015, and 7.3 (52/709) in 2016. S-score increased annually and was -0.29 in 2014, 4.21 in 2015, and 8.75 in 2016. Conclusions: PARK Index and S-score improved annually. This shows that both quality indicators are improving year by year. PARK Index (PMTDR) has 9.5-fold increase in denominator overall compared to PTDR by TRISS. The S-score used only ISS >15 patients as a denominator. Therefore, there is an advantage that the numerical value change is larger than the W-score. In addition, S-score is not affected by the ratio of major trauma patients to minor trauma patients.

A Design of Application through Physical Therapy Big Data Analytics

  • Choi, Woo-Hyeok;Huh, Jun-Ho
    • Journal of Multimedia Information System
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    • v.5 no.3
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    • pp.171-178
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    • 2018
  • According to the National Health Insurance Corporation in 2008, there were 17,764,428 physical therapy patients, exceeding 31 percent for the population covered by health insurance. This means that three out of 10 Koreans received physical therapy. And now, 10 years later, due to the aging population and the increase in the sports population, the number of patients with physical therapy is expected to be much more than a decade ago. Among them, many physical therapy patients were orthopedic and neurologic disorder. However, in the medical field applied to physical therapy, it is widely applied across all medical fields, including orthopedics, neurosurgery, pediatrics, gynecology, thoracic surgery and dentistry. It is believed that various cases of patients receiving physical therapy will be secured. as mentioned earlier, there will be a large number of patients with physical therapy treatments, making big data analytics easier. based on this, physical therapy applications are thought to be helpful in the analogy of disease and the development of effective physical therapy and will ultimately promote the development of physical therapy.

Reproducibility of Statistical Motor Unit Number Estimate in Amyotrophic Lateral Sclerosis: Comparisons between Size-and Number-Weighted Modifications (근위축성 측삭 경화증에서의 Statistical Motor Unit Number Estimate 재연성: Size-and Number-Weighted Modifications간의 비교)

  • Kwon, Oh Yun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.27-33
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    • 2003
  • Background: Motor unit number estimation (MUNE) can directly assess motor neuron populations in muscle and quantify the degree of physiologic and/or pathologic motor neuron degeneration. A high degree of reproducibility and reliability is required from a good quantitative tool. MUNE, in various ways, is being increasingly applied clinically and statistical MUNE has several advantages over alternative techniques. Nevertheless, the optimal method of applying statistical MUNE to improve reproducibility has not been established. Methods: We performed statistical MUNE by selecting the most compensated compound muscle action potential (CMAP) area as a test area and modified the results obtained by weighted mean surface-recorded motor unit potential (SMUP). Results: MUNE measures in amyotrophic lateral sclerosis (ALS) patients showed better reproducibility with sizeweighted modification. Conclusions: We suggest size-weighted MUNE testing of "neurogenically compensated"CMAP areas present an optimal method for statistical MUNE in ALS patients.

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A Study of Activities of Daily Living and Its Influencing Factors in Patients with Chronic Arthritis (만성관절염 환자의 일상생활 기능에 영향을 미치는 요인에 관한 연구)

  • Sohng Kyeong Yae;Kang Sung Sil
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.342-354
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    • 2000
  • This study was conducted to identify the characteristics of activities of daily living(ADU) and its influencing factors in patients with chronic arthritis. The data were obtained from 104 patients with chronic arthritis in one university hospital from May to August. 2000. For analysing data. SAS program was used for t-test. ANOVA, Schefte test. Pearson correlation. and stepwise multiple regression. The results were as follows: 1. The variables which influenced self-efficacy were duration of disease. number of painful joint, quality of sleep and alcohol drinking. 2. The variables which influenced fatigue were diagnosis and number of painful joint. 3. The variables which influenced ADL were age. duration of disease. diagnosis. number of painful joint. number of exercise and alcohol drinking. 4. ADL was positive correlation with self-efficacy and negative correlation with fatigue. And self-efficacy was negative correlation with fatigue. 5. The predictors to explain ADL were self-efficacy. number of painful joint. lupus. duration of disease and religion. These predictors explained $66.01\%$ of the activites of daily living. According to these findings. the most significant influencing factor of ADL was self-efficacy. therefore the development of nursing intervention for enhancing self-efficacy would be needed. Also. it is suggested that an exercise program should be recommended as one of useful and appropriate nursing intervention for reducing fatigue and increasing ADL.

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Implant-Supported Fixed Prostheses for the rehabilitation of distal free end in periodontally compromised dentitions Number of fixtures affecting bone tissue change (치주질환에 이환된 환자에서 구치 상실 치열 수복을 위한 임플란트 수복)

  • Yi, Seung-Won;Kim, Young-Soo
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.53-63
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    • 2005
  • Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.