• Journal of Oral Medicine and Pain
• /
• 제32권4호
• /
• pp.441-447
• /
• 2007

악관절 내장증은 관절과두와 관절원판이 이루는 복합체의 기능적 관계가 파괴되어 관절원판이 변위되는 것이다. 관절원판의 변위는 전내방으로의 변위가 가장 흔하며, 정복성 관절원판 변위와 비정복성 관절원판 변위로 나뉘어진다. 악관절 내장증환자의 치료로는 교합안정장치, 물리치료, 운동요법, 행동요법 등의 보존적 치료법을 우선 고려하여야 하고, 충분한 기간 동안의 보존적 치료에도 증상의 변화가 적은 경우에 외과적 처치를 고려해 볼 수 있다. 악관절 수조작술은 앞서 언급한 보존적 치료법들과 함께 시행하는 보존적 술식으로 전방으로 변위된 관절 원판의 정복을 도모하고, 원판후조직의 적응을 유도하기 위해 시행한다. 전통적으로 Farrar의 방법을 널리 이용해왔으며, 이에 대한 많은 성공적 임상 사례들이 보고된 바 있고, 그 밖에도 몇몇 수조작법들이 소개된 바 있다. 그러나 전통적인 방법은 술자에 의해 이루어지는 것으로 환자가 병원에 내원할 경우에만 시행할 수 있어 수조작법의 치료 효과를 높이기 위해 환자가 스스로 시행할 수 있는 방법의 필요성이 제시되었다. Minagi, Mongini, Suarez 등은 환자 스스로 시행할 수 있는 수조작법을 소개한 바 있으나, 전통적인 수조작법과 비교한 자가 수조작법의 효과에 대한 연구는 현재까지 보고된 바가 없다. 본 연구에서는 Minagi, Mongini, Suarez 등에 의해 소개된 환자 스스로 시행할 수 있는 수조작법을 보완하여, 임상적으로 활용이 가능한 자가 수조작법을 소개하고 내원한 환자에 대하여 치과의사가 직접 실시하는 전통적인 수조작법과 환자의 교육을 통해 환자 자신이 일상에서 시행하도록 한 자가 수조작법이 악관절 자기공명영상검사로 확진된 비정복성 관절원판 전방변위로 인한 개구제한 환자들의 치료 성과에 어떠한 영향을 미치는지 알아보고자 하였다. 연구를 위해 구강내과에 2002년 12월부터 2004년 11월까지 측두하악관절장애로 진단 받은 환자 중 개구제한이 관찰되고 악관절 자기공명영상 검사에서 비정복성 관절원판 전방변위가 확진된 뒤 물리치료, 운동요법, 행동요법, 교합안정장치 및 수조작법을 시행하여 치료가 종결된 환자들을 대상으로 하였다. 초진시 환자는 개구제한과 함께 통증 등의 다양한 증상을 함께 호소하였고, 이에 따라 치료의 종결은 개구량의 증가와 더불어 환자의 주관적 불편감이 더 이상 존재하지 않아 내원을 중단할 수 있을 때로 결정하였다. 환자들의 의무 기록을 토대로 치료기간, 개구량의 증가, 주관적 증상의 개선 정도를 수조작법의 종류에 따라 후향 조사하였다. 전통적인 수조작법을 시행한 군과 변형된 자가 수조작법을 시행한 군의 차이를 분석하기 위하여 chi-squared test, Mann-Whitney U-test를 시행하였다. 치료 결과 개구량이 40 mm 이상으로 증가한 환자의 분포는 전통적인 수조작법을 시행한 군(42.9%)보다 자가 수조작법을 시행한 군(69.9%)에서 더 높은 경향을 보였으나, 그 차이가 통계적으로 유의하지는 않았다. 치료기간에 있어서는 치료의 종결 시점을 40 mm이상의 개구량이 확보되고 환자가 초진시 호소한 주관적 불편감이 해소된 때로 하였고, 이에 따라 치료가 종결된 환자의 치료기간은 전통적인 수조작법을 시행한 군($61.0{\pm}38.0$ 주)보다 자가 수조작법을 시행한 군($29.2{\pm}12.3$ 주)에서 통계적으로 유의한 수준으로 짧았다. (p<0.01) 결론적으로, 비정복성 관절원판 전방변위로 인한 개구장애 환자의 치료에 있어서 자가 수조작법의 시행은 환자가 수조작법을 교육받고 정해진 바에 따라 매일 시행하는 치료과정을 통해 개구량을 증가시킬 수 있고, 전통적인 수조작법에 비하여 전체적인 치료 기간을 단축시킬 수 있는 효과적인 치료법이라고 할 수 있다.

• 동의신경정신과학회지
• /
• 제24권1호
• /
• pp.45-62
• /
• 2013

Objectives : The purpose of this study was to compare the efficacy of Needle-Embedding Therapy with Acupuncture for Chronic Tension-type Headache (CTTH) patients. Methods : The study recruited Chronic Tension-type Headache patients. A total of twenty-six patients were divided into 2 groups. 13 subjects were placed into a needle-embedding therapy group and 13 subjects into an acupuncture therapy group by a randomization table. The needle-embedding therapy group was treated with needle-embedding at Fengchi (GB20), while the acupuncture therapy was acupunctured at Fengchi (GB20). Then, a comparative analysis was conducted by comparing the results with those measured by a Blood pressor, Heart rate variability (HRV), Henry Ford Headache Disablity Inventory (HDI) Internet Headache Impact Test (HIT), and Visual Analogue Scale (VAS). Results & Conclusions : As a result of evaluation by using the self-rating headache index (VAS, HDI, HIT), pain score declined in both groups. But they were not difference between the two groups.

• 한국치위생학회지
• /
• 제15권4호
• /
• pp.679-685
• /
• 2015

Objectives: The purpose of the study is to investigate the change of the salivary flow rate, xerostomia, and oral health-related quality of life in the elderly people after the application of oral massage. Methods: The subjects were 101 elderly people at two senior welfare centers in Mokpo from November, 2012 to January, 2013 by the application of oral massage. The final subjects were 56 elderly people who participated in the massage more than 15 times of 20. They were measured for saliva flow rate, xerostomia, and OHIP. On the first and the last day, a self-reported questionnaire was completed by the elderly people. The questionnaire consisted of general characteristics of the subjects, oral health related knowledge, symptoms and behavior of xerostomia, and OHIP. OHIP included functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap, and was measured by Likert 5 point scale. Results: The salivary flow rate of the elderly people increased after the implementation of the program. There was a significant improvement in xerostomia, functional limitation, physical pain, psychological discomfort, and social efficacy (p<0.001). Conclusions : The oral massage program enhanced the oral function of the elderly people, and had an influence on the improvement of oral health-related quality of life.

• Journal of Oral Medicine and Pain
• /
• 제41권1호
• /
• pp.7-15
• /
• 2016

Purpose: Mandibular advancement device (MAD) is widely recognized as an important treatment option for obstructive sleep apnea (OSA) and is readily accepted than any other treatment options owing to its simplicity and ambulatory nature. At this time, there are a multitude of MAD designs and their efficacies may be influenced by adjustment and retention mechanism. The MAD with the anterior connector (anteriorly adjustable mandibular advancement device, AAMAD) was newly developed in the Department of Oral Medicine, Dankook University Dental Hospital (Cheonan, Korea) and was prescribed for the OSA patients including snoring patients. Thus, this study was aimed to objectively investigate the effectiveness of the AAMAD on the OSA patients using the self-applied portable device (ApneaLink), and evaluate the treatment outcomes among patients with various severity of OSA level. Methods: Results of the treatment of fourteen patients (13 male, 1 female) with the AAMAD were retrospectively analyzed. Each patient underwent home sleep test before treatment and were divided into two groups, i.e., those with mild (apnea-hypopnea index [AHI] ${\geq}5$ and <15) to moderate OSA (AHI ${\geq}15$ and <30) and severe OSA (AHI ${\geq}30$). After treatment, home sleep test was conducted again and treatment outcomes were compared between mild to moderate and severe OSA patients. Results: Of all patients, 78.6% showed more than 50% AHI reduction. We found a significant reduction (85.3%) of AHI in the severe OSA patients. Patients with mild to moderate OSA showed the reduced AHI (56.1%). Conclusions: We concluded that AAMAD is an effective oral appliance for the majority of OSA patients.

• 기본간호학회지
• /
• 제6권3호
• /
• pp.559-569
• /
• 1999

The purpose of this study is to identify the effects of the supportive nursing care for arthritis patients enrolled in a rheumatoid clinic. To achieve this purpose, this study adopted a quasi-experimental, pre- and post-test research design, categorized subjects into experimental and control groups. Outpatient clinic nurse alloted the subjects by experimental and control groups and nurse researcher meets the experimental subject with in-depth, direct personal interview and advices via telephone for 8 weeks. During this pre and after the treatment period, the level of pain, uncertainty, self-efficacy, family support, and perception for health were measured. Analyses for the measured results for pre- and post-test showed that the supportive program conducted during this study decreased the level of uncertainty and increased the perception of family support in experimental group. So, the supportive healing interpersonal communication service proved to be effective and this result justifies the argument that the role of the nursing professionals at out-patient clinic should be extended for the more qualified care for the patient.

• Safety and Health at Work
• /
• 제13권2호
• /
• pp.201-206
• /
• 2022

Background: The present objective was to verify whether burnout (emotional exhaustion [EE], depersonalization [DP] and low professional efficacy [PE]) is a risk factor for long-term sickness absence (LTSA; 30 consecutive days) from the teaching role. Methods: This was a prospective cohort study with two years of follow-up that investigated 509 elementary and high-school teachers. Burnout was identified by Maslach Burnout Inventory. Poisson regression with robust variance was used to adjust for possible confounders. Results: The incidence of LTSA was 9.4%. High EE levels were associated with LTSA in the crude analysis, but the association lost statistical significance after adjustments (for sex, age, perception of work-life balance, general self-rated health, chronic pain and depression). High DP levels were associated with this outcome, even after all adjustments (relative risk = 1.80; 95% confidence interval: 1.05-3.09). Low PE levels were not related to LTSA. Conclusion: The results reinforce the need to improve teachers' work conditions to reduce burnout, particularly DP, and its consequences.

• 대한한방내과학회지
• /
• 제44권4호
• /
• pp.803-813
• /
• 2023

Objective: This case report outlines an investigation into the efficacy of Korean medicine treatment in a patient who presented with acute cholangitis accompanying common bile duct stones. The patient underwent percutaneous transhepatic gallbladder drainage and subsequently experienced resolution of the common bile duct stones. Methods: The patient was treated with Shihosogan-tang, general acupuncture, ear acupuncture, moxibustion, and cupping therapy. Changes in symptoms were evaluated using a self-reported numerical rating scale (NRS) score and a visual analog scale (VAS) score each morning. Laboratory tests were conducted to examine serum amylase, serum lipase, and liver function. Results: After 29 days, the NRS scores for indigestion and fatigue and the VAS score for abdominal pain all decreased. Additionally, the laboratory test results showed improvement. Discussion: The results suggest that Korean medicine could be effective in treating symptoms of acute cholangitis. However, further research is necessary.

• 대한간호학회지
• /
• 제28권2호
• /
• pp.244-255
• /
• 1998

The purpose of this study was to verify the reliability and validity of the Rosenbaum self-control schedule (SCS) for assessing resourcefulness in Korea and to explore the simplified scale. The study subjects consisted of 787 adults in a community. The data was collected during the period from Oct. to Dec., 1995 and analyzed as Cronbach α, item correlation with total, Pearson correlation and factor analysis with varimax rotation using SAS. Results were as follows : The mean SCS score for this sample was 17.2 and there were statistical differences for gender(men, 13.1 ; women, 20.0) on the SCS scores. The cronbachα of SCS with 36 items was .74 and when simplified with 30 items, it's coefficient alpha was .78. The translated content of the SCS was validated by two nursing faculty members and one professor of psychology. Factor analysis revealed the most parsimonious structure was obtained when six factors were extracted and subsequently rotated via the varimax criterion. There was 40.2% of total communality variance in the SCS with 36 items. The total communality variance was slightly increased to 43.4% with 30 items of the SCS. In order to reduce from 36 items to 30 items, the process excepted 6 items having low item correlation with total and low MSA(means of sampling adequacy) of factor analysis. According to factor analysis, there are six factors such as emotion control, impulse control, self-efficacy, coping with problems, pain control and satisfaction control, The SCS was found to have low, but statistically significant, correlations with social desirability and helplessness. From the above results, it can be concluded that the reliability of the SCS(inherent and simplified) was a acceptable level and its validity was reasonable when comparing it with other validity studies. To determine the usefulness the simplified scale, further study is necessary to simultaneously compare and analyze both scales for stability.

• 근관절건강학회지
• /
• 제17권1호
• /
• pp.79-88
• /
• 2010

Purpose: The purpose of this study was to analyze the published research in the Journal of Muscle and Joint Health and to suggest the future perspectives. Methods: In this study, we reviewed the contents of 195 articles published in this journal from the first issue of the year 1994 to 2007. Results: The majority of subjects were adult, mostly with arthritis. The position of the authors was mostly professor (73.3%). Most of studies did not clearly describe about ethical consideration. The data collection was mostly conducted in the hospital (53.8%) or community (36.9%), with the questionnaire (62.6%). The types of research design were correlational study (36.4%), experimental study (31.8%), survey (18.5%), and qualitative research (4.6%). Physical variables included pain, fatigue, activities of daily living, joint flexibility, muscle strength, etc., psychosocial variables were measured by self-efficacy, depression, quality of life, etc., and cognitive variables by knowledge, education, etc. The most utilized nursing intervention for experimental study were exercise, self-help, and education. Conclusion: Further research is needed to extend the target population research design from multidisciplinary perspectives.

• 지역사회간호학회지
• /
• 제16권4호
• /
• pp.446-457
• /
• 2005

Purpose: The purpose of this study was to analyse researches on nursing intervention for elderly health promotion. Method: A literature review of 38 researches was carried out using guidelines developed by the present researchers. Result: The research papers studied in this research were theses written for doctoral or master's degree and published between 1994 to 2004. These researches applied nursing intervention for health promotion of elders and used experimental study design. The average period of nursing intervention was about 9 weeks and the average frequency was three times per week. As for major characteristics of subject groups, most of them were over 65 years old (76.3%) and resided in community (65.8%), and each group consisted of 10 to 29 elders. The dependent variables used in these studies included physiological variables (blood pressure, blood cholesterol level, pulmonary function, fasting blood sugar, blood cortisol level, body mass etc.), psychologic variables (depression, quality of life, life satisfaction, loneliness, anxiety etc.), cognitive variables (perceived benefits, perceived barriers, self-efficacy, self-concept, subjective health status etc.), activities of daily livings, health promotion behavior, pain, risks of fall, and variables related to Trans Theoretical Model. The majority of these studies (78.9%) applied exercise programs for health promotion including exercise motivating programs (15.8%). Conclusion: We suggest that more various nursing interventions must be applied to promote elders' health and to take care of their chronic diseases.