• 치위생과학회지
• /
• 제12권6호
• /
• pp.558-565
• /
• 2012

작업관련 근골격계 질환은 중요한 직업병 중 하나이며, 이는 치과의료 직종도 예외일수는 없다. 치과위생사는 주로 장시간 서서 진료를 하거나 머리와 목을 구부리고 어깨와 손을 많이 틀면서 움직이거나 부적절한 자세로 진료하는 경우가 많기 때문에 더욱 더 근골격계 질환에 대한 위험에 대한 노출도 크다. 따라서 본 연구는 작업과 관련하여 근골격계의 부위별 통증의 유무와 업무분야별 통증의 차이가 있는지를 알아보기 위하여 수도권 지역의 치과위생사 300명을 대상으로 설문조사를 하였고 이 중 268명이 설문에 응하였다. 본 연구의 결과는 다음과 같이 요약될 수 있다. 1. 연구대상자들의 신체부위별 근골격계 통증 정도를 분석해 본 결과, 어깨 90.3%, 목 89.2%, 다리 83.6%, 허리 81.7%, 손/손목/손가락 75.7%, 팔/팔꿈치 52.8%로 나타났다. 2. 연구대상자들의 업무영역에 따라서 근골격계 질환이 다르게 나타났으며 연구결과, 외과업무의 경우 목, 허리, 다리, 어깨, 손, 팔로 나타났으며 보철업무의 경우 어깨, 다리, 손, 목, 허리, 팔로 나타났다. 교정업무의 경우 목, 어깨, 손, 허리, 다리, 팔로 나타났고 접수의 경우 목, 어깨, 허리, 다리, 손, 팔로 나타났다. 모든 치료의 경우 어깨, 허리, 목, 다리, 손, 팔로 나타났다. 여기서 나타난 것처럼 연구대상자들이 주로 하는 진료에 대한 근골격계 통증이 신체부위별로 다르다는 연구결과가 나왔다. 3. 근골격계 질환의 주요변인에 대한 연구결과, 일반적 특성은 통계적으로 유의하지는 않았지만 신장이 큰 연구대상자들에게 허리와 어깨의 통증이 많았고 체중이 적게 나가는 연구대상자들은 목과 팔의 통증이 높았다. 연령은 29~33세는 어깨, 34세 이상에서는 팔/팔꿈치가 높았으며 이는 통계적으로 유의하였다(p<0.05). 근무환경은 경력이 높아질수록 손/손목/손가락은 통증이 증가하였고(p<0.05) 목과 어깨(p<0.05), 팔(p<0.01), 허리는 3~4년의 경력에서 가장 높았다. 그리고 다리/발은 1~2년의 경력에서 통증경험이 높았다. 근무시간은 시간이 증가함에 따라 목에 대한 통증이 높아진다고 하였으나 유의한 차이는 없었다. 그러나 손/손목/손가락에서는 근무시간이 적을 때 높은 통증경험을 나타냈으며 통계적으로 더욱 유의한 차이를 보였다(p<0.01). 근무처에 따라서 분과병원에서는 손/손목/손가락에서 높은 통증경험율을 나타냈고(p<0.05) 중소치과에서는 다리/발에서 높은 통증경험률을 나타냈다(p<0.05). 이와 같은 결과는 치과위생사의 근골격계 질환은 평균이상으로 많으며 이 질환에 대한 위험성을 인식하고 경각심을 느껴야 한다고 보여진다. 근골격계 질환은 초기에 발생되면 간단하게 치료받을 수 있지만 누적되어서 오랫동안 방치되었을 때는 이미 정상으로 되돌릴 수 없기 때문에 올바른 자세를 유지하고 통증이 나타나거나 피로가 쌓일 경우 즉시 치료를 하고 적극적인 자세로 응대하고 지속적인 노력이 필요하다고 보여진다.

• The Korean Journal of Pain
• /
• 제14권1호
• /
• pp.26-31
• /
• 2001

Background: Sympathetic blocks with local anesthetics are used to differentiate sympathetically- maintained pain (SMP) from sympathetically-independent pain (SIP). However, systemic lidocaine is also used in the management of neuropathic pain. Therefore, there may be possibility of a false positive response in relieving their pain by systemic absorption of lidocaine following a diagnostic sympathetic block in patients with SIP. In this study, we measured the plasma lidocaine concentrations after a stellate ganglion block (SGB) using three volumes of 1% lidocaine. Methods: This prospective, crossover study was performed in 3 patients who experience sudden hearing loss and in 4 volunteers. Each person received SGB three times using three different volumes (6 ml, 12 ml and 16 ml) of 1% lidocaine at one week intervals. SGB was performed using a 23 G butterfly needle via a paratracheal approach by two persons. Two ml of venous blood was obtained from a prepared contra-lateral sided venous route at 1, 3, 5, 7, 10, 20 and 60 min after SGB. Plasma lidocaine level was analyzed by immunoassay. Results: Mean plasma lidocaine concentrations correlated well with the volumes of 1% lidocaine used in SGB; larger volumes showed higher concentrations (P < 0.01). Mean peak plasma concentrations were $1.08{\pm}0.18$ in 6 ml, $1.90{\pm}0.47$ in the 12 ml and $2.74{\pm}0.67{\mu}g/ml$ in the 16 ml groups (P < 0.01). The mean time to reach peak plasma concentration was not significantly different between the three groups. Conclusions: The peak plasma lidocaine concentrations in SGB using large volume were found to be similar to that of IV lidocaine infusion in the management of neuropathic pain. These data suggest that diagnostic sympathetic block may result in many false positive responses for SMP. Part of its effect may be related to systemic local anesthetic absorption and not to a sympathetic block. Therefore, physicians may be required to use optimal volumes and minimal concentration of local anesthetic in diagnostic sympathetic block procedures and also make a careful assessment of the performance of a permanent sympathetic block.

• The Korean Journal of Pain
• /
• 제23권1호
• /
• pp.18-23
• /
• 2010

Background: Complications following lumbar transforaminal epidural injection are frequently related to inadvertent vascular injection of corticosteroids. Several methods have been proposed to reduce the risk of vascular injection. The generally accepted technique during epidural steroid injection is intermittent fluoroscopy. In fact, this technique may miss vascular uptake due to rapid washout. Because of the fleeting appearance of vascular contrast patterns, live fluoroscopy is recommended during contrast injection. However, when vascular contrast patterns are overlapped by expected epidural patterns, it is hard to distinguish them even on live fluoroscopy. Methods: During 87 lumbar transforaminal epidural injections, dynamic contrast flows were observed under live fluoroscopy with using digital subtraction enhancement. Two dynamic fluoroscopy fluoroscopic images were saved from each injection. These injections were performed by five physicians with experience independently. Accuracy of live fluoroscopy was determined by comparing the interpretation of the digital subtraction fluoroscopic images. Results: Using digital subtraction guidance with contrast confirmation, the twenty cases of intravascular injection were found (the rate of incidence was 23%). There was no significant difference in incidence of intravascular injections based either on gender or diagnosis. Only five cases of intravascular injections were predicted with either flash or aspiration of blood (sensitivity = 25%). Under live fluoroscopic guidance with contrast confirmation to predict intravascular injection, twelve cases were predicted (sensitivity = 60%). Conclusions: This finding demonstrate that digital subtraction fluoroscopic imaging is superior to blood aspiration or live fluoroscopy in detecting intravascular injections with lumbar transforaminal epidural injection.

• 한국항해학회지
• /
• 제23권2호
• /
• pp.67-79
• /
• 1999

The purpose of this study is to provide basic date on the causes and factors related with the workload on board for Korea Seaman's Low Back Pain. The date had been acquisited through the questionaires of those and analysed in Korea Institute of Maritime and Fisheries Technology from February 10 to April 10 in 1999. The results of this study are as follows: 1. The incidence of Occupational low back pain for the recent 12 months has been recorded as 56.2% of the subject. 2. The highter Occupational satisfaction has the lower incidence of low back pain(p＜0.01). and the person who takes a rest(p＜0.05) and physical exercise regularly(p＜0.01) has lower experience of the incidence. 3. The incidence of low back pain by charateristics of vessel was turn out as 59.3% of the fishing vessel, 55.3% merchantmarine and 52.9% of the vessel of special purpose. The incidence of each department of a ship has recorded as 54.3% of Deck Dept. 59.2% of engine Dept but there was little relationship between those. And the longer period of work and on-board service has the hither incidence of the higher incdence(p＜0.01). 4. The fittness of the working table (p＜0.01) and chair(p＜0.01) has affeced the incidence of low back pain significantly 5. The higher incidence of low back pain has been experienced in case of working: in back posture, and lifting up or carrying a heavy load(p＜0.01) 6. The major cause of low back pain was turned out as excessive workload(26.5%) and stress (18.5%) ; the stress(24.1%) and excessive overwork(22.4%) for Deck dept. and excessive workload(32.3%) and bad position(21.7%) for Engine Dept(P＜0.01)

• Journal of Acupuncture Research
• /
• 제27권2호
• /
• pp.71-78
• /
• 2010

Objectives : This survey was accomplished to find out how Korean medical doctors take Ojeok-san prescriptions for low back pain in clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. 306 persons having more than 5 years experience were randomly selected from a list of Korean medical doctors. Telephone interviews with them were conducted by the well-trained interviewers between March 21 and April 4 in 2009 and the computerized data were analyzed by STATA 9.0 SE version(Stata Corp, Colleg Station Tex, USA) statistical program. Results : 1. 192 out of 306(65.1%) Korean medical doctors taked Ojeok-san prescriptions for musculoskeletal disorders patients and 183 out of 192(95.3%) Korean medical doctors taked Ojeok-san prescriptions for low back pain treatment. 2. The rate of low back pain patients, '20~30%' was 99 people(33.6%) and the rate of Ojeok-san prescriptions for low back pain treatment, 'below 10%' was 65 people(35.5%). 3. In Ojeok-san effect of low back pain treatment, 'greate effects' 29.5%, 'tolerable effects' 66.7%, 'no effects' 3.8% were selected. In granule extracts effect, 'similar to Original herbs' 9.8%, 'unlike to Original herbs' 90.2% were selected. Conclusions : In our telephone survey, Korean medical doctors taked Ojeok-san prescriptions for low back pain treatment. Further research on this issue is needed.

• Journal of Oral Medicine and Pain
• /
• 제42권4호
• /
• pp.116-124
• /
• 2017

Purpose: Burning mouth syndrome (BMS) is a disabling pain that mostly occurs in elderly women, but rarely in men. It is characterized by an unremitting oral burning sensation and pain without detectable oral mucosal changes. We investigated the clinical and hematologic features of middle-aged men with BMS, and compared the results to those of men with oral mucositis. Methods: Five men with BMS ($48.60{\pm}6.19years$) and five age-matched controls with oral mucositis ($49.80{\pm}15.26years$) underwent clinical and psychological evaluations and blood tests. Psychological status was evaluated using the Symptom Checklist-90-Revised. Cortisol, estradiol, progesterone, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), adrenocorticotropic hormone (ACTH), and antidiuretic hormone (ADH) levels and erythrocyte sedimentation rate (ESR) were determined from the blood samples. Results: ADH level was significantly lower in men with BMS than in the controls. ADH levels correlated with testosterone (p<0.01), and ACTH levels strongly correlated with ESR (p<0.05). Progesterone level positively correlated with FSH and LH levels. Pain intensity on a visual analogue scale correlated with estradiol level only in men with BMS. Among psychological factors, the obsessive-compulsive disorder, interpersonal-sensitivity, and anxiety scores were higher in men with BMS than in the controls (p<0.05). However, no correlations were observed between the psychological and hematologic factors in both groups. The BMS symptoms presented only on the tongue, with the lateral border being the most prevalent area. Conclusions: Men with BMS may experience dysregulated endocrinologic or psychoneuroendocrinologic interactions, which might affect oral BMS symptoms, aggravating the severity of the burning sensation.

• 한국전문물리치료학회지
• /
• 제24권2호
• /
• pp.76-91
• /
• 2017

Background: Agricultural work is physically demanding and is associated with a high frequency of musculoskeletal disorders. It is challenging to comprehensively understand the present status of work-related diseases and injuries among farmers in underdeveloped countries. Objects: This study aimed to elucidate the current status of work-related musculoskeletal disorders in local farmers in Tigray, Ethiopia, and identify the agricultural factors associated work-related musculoskeletal pain (AFWMP) and healthy living and healthy behavior factors associated work-related musculoskeletal pain (HFWMP). Methods: The Institute for Poverty Alleviation and International Development at Yonsei University conducted a survey of 126 households in Tigray, Ethiopia in 2014. A total of 116 individuals (73 men, 43 women) representing each household answered the questionnaires. Results: 1) Work-related musculoskeletal pain (WMSP) most commonly occurred when performing heavy lifting and most frequently occurred in the lower back. 2) Age, self-perceived labor intensity, and months of farming work were significantly higher in the pain group than those in the non-pain group. 3) Overall work-related musculoskeletal pain intensity (WPI) showed positive and negative correlations with years of farming experience and self-perceived health status, respectively. 4) In binary logistic regression, the occurrence of WMSP showed significant associations with self-perceived labor intensity. 5) On multiple linear regression analysis, age, months of farming work, and self-perceived health status had a significant impact on overall WPI. Conclusion: The WMSP of farmers in Tigray, Ethiopia was related to the characteristics of farm working and health status. Furthermore, HFWMP and AFWMP were the chief factors affecting the occurrence of WMSP in farmers in Tigray. Therefore, both HFWMP and AFWMP should be considered for clinical health assessments of farmers with WMSP in underdeveloped African countries.

• Tuberculosis and Respiratory Diseases
• /
• 제62권2호
• /
• pp.140-143
• /
• 2007

심한 암통증을 호소하는 폐암 환자에서 고용량 펜타닐 첩포($600{\mu}g/hr$)를 이용하여 통증의 완화를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제19권5호
• /
• pp.261-270
• /
• 2019

Background: People with the Ehlers-Danlos Syndromes (EDS), a group of heritable disorders of connective tissue, often report experiencing dental procedure pain despite local anesthetic (LA) use. Clinicians have been uncertain how to interpret this apparent LA resistance, as comparison of EDS and non-EDS patient experience is limited to anecdotal evidence and small case series. The primary goal of this hypothesis-generating study was to investigate the recalled adequacy of pain prevention with LA administered during dental procedures in a large cohort of people with and without EDS. A secondary exploratory aim asked people with EDS to recall comparative LA experiences. Methods: We administered an online survey through various social media platforms to people with EDS and their friends without EDS, asking about past dental procedures, LA exposures, and the adequacy of procedure pain prevention. Among EDS respondents who both received LA and recalled the specific LA used, we compared agent-specific pain prevention for lidocaine, procaine, bupivacaine, mepivacaine, and articaine. Results: Among the 980 EDS respondents who had undergone a dental procedure LA, 88% (n = 860) recalled inadequate pain prevention. Among 249 non EDS respondents only 33% (n = 83) recalled inadequate pain prevention (P < 0.001 compared to EDS respondents). The agent with the highest EDS-respondent reported success rate was articaine (30%), followed by bupivacaine (25%), and mepivacaine (22%). Conclusions: EDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.

• 동서간호학연구지
• /
• 제21권2호
• /
• pp.110-118
• /
• 2015

Purpose: This study aimed to provide a basic resource for developing nursing interventions and educational programs for complementary and alternative therapies (CAT) by examining nursing students' perception, experience, and attitudes toward CAT. Methods: Data were collected targeting 230 nursing students from October 20 to November 10, 2014, and analyzed by using descriptive statistics, t-test, ${\chi}^2$-test, and ANOVA with SPSS/WIN 18.0. Results: Results showed that CAT were performed by CAT specialists in combination with hospital treatments for individuals suffering from chronic pain and musculoskeletal diseases. Nursing students obtained information on and experience of CAT through the Internet. CAT were used for psychological and mental stability as a supplementary treatment. The majority of the participants used Yoga followed by massage as a sub-therapy of the program. They said that openness of medical staff and active communication are important for having a positive attitudes toward CAT. There are differences in attitudes toward CAT according to gender, student levels, and previous experience on CAT. Conclusion: It is crucial for nursing students to have right perception, experience, and attitudes toward CAT in order to apply CAT to the clinical field.