• 제목/요약/키워드: Severity of disability

검색결과 151건 처리시간 0.033초

The Characteristics of Sleep in Headache Patients

  • Yoon, Seung Hyun;Choi, Young-Chan;Kwon, Jeong-Seung;Ahn, Hyung Joon
    • Journal of Oral Medicine and Pain
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    • 제40권2호
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    • pp.63-71
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    • 2015
  • Purpose: To investigate the relationship between headache and sleep by evaluating sleep quality, daytime sleepiness, and specific features related to sleep-disordered breathing (SDB). Methods: One hundred one subjects with headache and 118 healthy controls were enrolled. To collect various information on headache attacks, headache group completed self-reported questionnaire about the characteristics of headache attacks and the migraine disability assessment (MIDAS) questionnaire. The subjective quality of sleep was evaluated in all of the subjects using the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). In addition, the following specific features of sleep were evaluated in 28 subjects selected randomly from each group: apnea-hypopnea index (AHI), prevalence of SDB, nocturnal oxygen saturation (SaO2), and oxygen desaturation index (ODI) as measured using a portable monitoring device. Results: The global PSQI and the prevalence of poor sleeping (global PSQI >5), ESS scores and the prevalence of daytime sleepiness (ESS score >10) were significantly higher in the headache group (both p<0.0001, respectively). The mean scores on the numerical rating scale and the MIDAS were significantly higher in the poor-sleeper group than in the good-sleeper group (p=0.0347 and p=0.0016, respectively). The global PQSI and prevalence of daytime sleepiness were significantly higher in the chronic-headache group than in the acute-headache group (p=0.0003 and p=0.0312, respectively). Conclusions: There is a significant association between headache and sleep. Especially, severity and chronicity of headache were significantly associated with sleep quality and daytime sleepiness.

Randomized controlled clinical trial of oral health-related quality of life in patients wearing conventional and self-ligating brackets

  • Othman, Siti Adibah;Mansor, Noorhanizar;Saub, Roslan
    • 대한치과교정학회지
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    • 제44권4호
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    • pp.168-176
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    • 2014
  • Objective: The aim of this randomized controlled clinical trial was to compare oral health-related quality of life (OHRQoL) of patients treated with conventional, active self-ligating (ASL), and passive self-ligating (PSL) brackets in different therapeutic phases. Methods: Sixty patients (mean age 18.3 years; 29 males and 31 females) requiring orthodontic treatment were randomly and equally assigned to receive conventional (Victory Series), ASL (In-Ovation R), or PSL (Damon 3MX) brackets. OHRQoL was measured with a self-administered modified 16-item Malaysian version of the Oral Health Impact Profile for immediate (soon after the visit) and late (just before the subsequent visit) assessments of the bonding and activation phases. Data were analyzed with the Kruskal-Wallis and chi-square tests. Results: The PSL and ASL groups showed more immediate and late impacts in the bonding phase, respectively; the conventional group was affected in both the assessments. The first activation phase had similar impacts in the groups. After the second activation, the conventional group showed more immediate impacts, whereas the PSL and ASL groups had more late impacts. The commonly affected domains were "physical disability," "functional limitation," "physical pain," and "psychological discomfort." No significant differences in the prevalence and severity of immediate and late impacts on OHRQoL of the patients were noted in any therapeutic phase. Conclusions: No bracket system seems to ensure superior OHRQoL. This information could be useful for explaining the therapeutic phases, especially the initial one, and selecting the optimal bracket system based on the patient's preference.

만성 두통 환자에서 Botulinum Toxin Type A 치료 (Botulinum Toxin Type A Therapy in Chronic Headache Patients)

  • 문동언;문영은;김시현;김은성
    • The Korean Journal of Pain
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    • 제18권1호
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    • pp.29-33
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    • 2005
  • Background: Chronic headache (CH) constitutes a significant public health problem, impacting on both the individual sufferer and society. Patients with CH, unresponsive to drug therapy or nerve block, suffer considerable disability due to the frequency and severity of attacks; therefore, they should be considered for novel therapy. Botulinum toxin type A (BoNT-A) has shown significant promise in the management of CH. In this paper, we review recent evidence on the efficacy of BoNT-A, and also report our experience with this treatment in CH patients. Methods: BoNT-A was used to treat 69 CH patients, including 47 in a chronic migraine group and 22 in a non-migraine CH group, who showed therapy-resistance to palliative drug or nerve block. We investigated the demography, dosage and site of BoNT-A injection, and used a visual analogue scale (VAS) for pain and the degree of satisfaction. The data were analyzed using t-tests and a Friedman repeated measures analysis of variance on ranks. Results: Significant decreases in the VAS for pain were found in both the chronic migraine and non-migraine CH groups, from 2, 4 and 12 weeks and from 4 and 12 weeks, respectively, after BoNT-A administration (P < 0.05). The chronic migraine group showed significantly lower VAS scores for pain than the non-migraine CH group from 2, 4 and 12 weeks after the BoNT-A administration (P < 0.05). Twenty eight patients (59.2%) in the chronic migraine group and eight (36.4%) in the non-migraine CH were satisfied with the BoNT-A treatment. Conclusions: This clinical study revealed that the use of BoNT-A demonstrated efficacy for CH patients resistant to drug therapy or nerve block. Moreover, BoNT-A proved itself more effective in the chronic migraine than non-migraine CH group.

Mortality and Epidemiology in 256 Cases of Pediatric Traumatic Brain Injury : Korean Neuro-Trauma Data Bank System (KNTDBS) 2010-2014

  • Jeong, Hee-Won;Choi, Seung-Won;Youm, Jin-Young;Lim, Jeong-Wook;Kwon, Hyon-Jo;Song, Shi-Hun
    • Journal of Korean Neurosurgical Society
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    • 제60권6호
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    • pp.710-716
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    • 2017
  • Objective : Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods : We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery). Results : Among all the 2617 THI patients, total number of pediatric patients was 256. The average age of the subjects was 9.07 (standard deviation${\pm}6.3$) years old. The male-to female ratio was 1.87 to 1 and male dominance increases with age. The most common cause for trauma were falls and traffic accidents. Age (p=0.007), surgery (p<0.001), mechanism of trauma (p=0.016), subdural hemorrhage (SDH) (p<0.001), diffuse axonal injury (DAI) (p<0.001) were statistically significant associated with severe brain injury. Conclusion : Falls were the most common cause of trauma, and age, surgery, mechanism of trauma, SDH, DAI increased with injury severity. There is a critical need for effective fall and traffic accidents prevention strategies for children, and we should give attention to these predicting factors for more effective care.

A Case of Constitutional Trisomy 8 Mosaicism

  • Cho, Hee-Soon;Lee, Chae-Hoon;Kim, Kyoung-Dong;Lee, Eun-Sil
    • Journal of Yeungnam Medical Science
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    • 제22권2호
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    • pp.241-246
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    • 2005
  • 체질성 8세염색체는 비교적 드문 염색체 이상으로 신생아 25,000-50,000명당 한 명 정도의 출생빈도를 보이며 여아보다 남아에서 발생 빈도가 높다. 순수한 8세염색체는 생존이 어려운 것으로 보이며 보고된 대부분의 증례는 섞임증이다. 저자들은 뇌량 무발생, 선천성 심장질환과 소악증을 가진 신생아에서 말초혈액 T림프구 핵형분석 및 형광동소교잡법을 통해 체질성 선천성 8세염색체 섞임증을 진단하였다. 체질성 8세염색체 섞임증의 표현형은 거의 정상에 가까운 형태에서 심한 신체적 혹은 지능 장애까지 매우 다양하지만 그 표현형의 정도가 전체 핵형에서 8세염색체 핵형이 차지하는 비율, 즉 섞임증의 정도와 비례하지는 않는다. 또한 조직마다 섞임증의 정도가 매우 다양하여 그 예후를 예측하기는 매우 어렵다. 8세염색체 세포에서 골수성 혈액질환의 발생빈도가 높은 것으로 알려져 있으므로 향후 주의깊은 추적관찰이 필요하다.

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슬관절 후외방 불안정성의 치료 (Treatment of Posteolareral Rotatory Instability of the Knee)

  • 김진구
    • 대한관절경학회지
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    • 제15권2호
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    • pp.146-154
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    • 2011
  • 슬관절 후외방부 구조의 손상은 흔치 않으나 심한 불안정성과 관절 연골의 손상을 초래하여 심각한 장애가 생길 수 있다. 그러나 아직까지 이에 대한 해부학적 구조 및 진단과 치료 방법이 확실하게 정립되어 있지 않다. 후외방부 구조의 손상은 주로 십자인대 손상과 동반되어 나타나며 후외방 불안정성을 치료하지 않고 그냥 두었을 경우에 십자인대 재건술의 결과에 영향을 미쳐 실패에 이르게 하는 주요한 원인으로 인식되고 있다. 후외방부 구조의 손상의 진단은 신체 검진, 방사선 소견, 자기공명영상 및 관절경 소견을 종합하여 이루어 진다. 후외방부 구조 손상의 치료 방법은 손상 시기 및 손상 정도에 따라서 정해지게 된다. 최근의 해부학적 재건술은 다양한 결과를 보이던 이전의 비해부학적인 재건술에 비하여 임상적인 측면에서 대부분에서 좋은 임상 결과를 보이고 있으나 장기 추시를 시행한 임상 연구들의 뒷받침이 필요하다. 저자는 후외방부 구조와 관련되어 최근까지 발표된 문헌들을 정리하고 진단과 치료에 대하여 알아보고자 한다.

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족근-중족 관절 골절 탈구의 치료경험 (Treatment for Tarsometatarsal Fracture-Dislocation)

  • 정영기;유정한;박용욱;노동근;하성한
    • 대한족부족관절학회지
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    • 제1권2호
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    • pp.112-118
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    • 1997
  • Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

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흰쥐의 전층피부상처 동물모델에서 소풍산(消風散)이 VEGF 및 TGF-β1발현에 미치는 영향 (Sopung-san Extract Enhances healing potential on Full-thickness Skin Wound in Rats: Role of VEGF and TGF-β1)

  • 김범회
    • 대한한의학방제학회지
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    • 제25권2호
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    • pp.123-134
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    • 2017
  • Wounds are commonly created during almost every kind of surgery, trauma and skin diseases. Delayed wound healing affects a plenty of patients and requires prolonged treatments that seriously reduce the quality of life for patients. Skin damage involving large areas or great severity can lead to disability or even death. Wound healing involves a complicated series of actions, of various tissues and cell lineages, concerning inflammation, migration, proliferation, reepithelialization, and remodeling. Sopung-san is reported to have anti-inflammatory effect and has been used for various skin diseases such as allergic dermatitis and atopic dermatitis. In this study, the hypothesis that oral treatment with Sopung-san could enhances healing potential on rat full thickness skin wounds was tested. Twenty young male Sprague-Dawley rats were used for the studies. A full-thickness skin wound was made on the dorsal skin of the rats. Either Sopung-san water extract (SPS) or saline (Control) was orally administrated every day. The wound area was measured and the percentages of wound contraction, wound healed and wound epithelization were calculated. Wound tissue samples were excised following injection for histopathological and immunohistological examination. Wound area in rats of SPS group significantly was decreased compared to Control. SPS group showed significant promotion of wound healing compared to Cotrol group in the percentages of wound contraction, wound healed and wound epithelization. Histopathological examination revealed that SPS induces neo-vascularization potential in wound healing process. SPS treatment in rats significantly accelerated cutaneous wound healing in the neo-vascularization process by increasing VEGF and $TGF-{\beta}1$ synthesis. The results suggest that Sopung-san affects key cellular processes responsible for wound repair and point to a unique potential for this molecule in the therapy of skin wounds, particularly as an angiogenic agent.

국내 만성질환 노인환자의 한의과 진료서비스 이용과 사망률 및 파킨슨병 발생률의 관계연구 (The Relation of Korean Medicine Services Use on the All-cause Mortality and Incidence of Parkinson's disease and Elderly Patients with Chronic Disease in Korea)

  • 우연주
    • 대한예방한의학회지
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    • 제25권3호
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    • pp.25-37
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    • 2021
  • Objectives : To investigate the effectiveness of Korean Medicine services use on the all-cause mortality and incidence of Parkinson's disease(PD) in elderly patients with chronic disease based on the National Health Insurance Service Corhort Database (elderly), called as the NHIS-senior. Methods : This study was a retrospective cohort analysis conducted using the NHIS-senior. Patients with chronic diseases over 65 years old who were not diagnosed PD during 2007-2009 were identified. The case group was defined as patients who used both Korean Medicine and Western Medicine services and the control group consisted of patients who used Western Medicine service only. The all-cause mortality and incidence of PD was analyzed using the Cox proportional hazard model after a propensity score matching(PSM) with a 1:1 ratio. Results : After PSM, the cohort included 47,546 subjects (23,773 in the case group, 23,773 in the control group). Sex, age, comorbidity, severity of disability, and neurology medical service utilization were adjusted in both groups. The mortality was 0.668 times (95% C.I.: 0.646-0.690) lower in the case group than the control group, which was statistically significant (p<0.001). The incidence of PD was 1.051 times (95% C.I.: 0.962-1.148) higher in the case group than the control group, which was not statistically significant(p=0.272). Conclusion : It was not obvious that the use of both Korean Medicine service and Western Medicine services for prevention of PD is benefitial than using only Western Medicine. But it would be possible that using both Korean Medicine and Western Medicine services decreases the mortality than using Western Medicine alone.

DASH로 평가한 상지 근골격계 질환자의 기능 제한 (Determining the Degree of Disability in Workers with Upper Limb Musculoskeletal Disorders using DASH)

  • 김규상;장기언
    • 대한인간공학회지
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    • 제29권3호
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    • pp.311-320
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    • 2010
  • This study aimed to examine the development and characteristics of the workers with upper limb musculoskeletal symptoms and disorders and to analyze the upper limb musculoskeletal symptoms and disorders for its relationship with the individual socio-demographic characteristics. This study investigated the effect on the limitations of physical activities using standardized surveillance tool and clinical diagnosis. Musculoskeletal symptoms and the limitations of physical activities were examined. The clinical diagnosis of musculoskeletal disorders were carried out by physical examination, radiological examination and electromyography-electroneuronography for 22 workers in kitchen hood assembly process and 50 workers in toggle process of leather product manufacturing. The proportion of workers with musculoskeletal disorders was higher and the DASH score was also statistically higher in female and aged workers with longer working hours, longer household working hours, less leisure/hobby activity and higher physical load. Physical activities component score increased in the following order: workers in normal health, workers with musculoskeletal symptoms, and workers with musculoskeletal disorders as clinically diagnosed. Score for each DASH component increased in the following order: sports/performing arts ability, social activities, specific physical functional activities, work or other regular daily activities, work ability, psychological activities, insomnia and upper limb symptoms. The overall and each component DASH scores were higher in workers with symptoms of status praesens and of more severity, and receiving medical intervention. Musculoskeletal symptoms and disorders are associated with individual socio-demographic characteristics, and DASH score for physical activities of upper limb was higher in workers with musculoskeletal disorders. Musculoskeletal symptoms and disorders have a remarkable epidemiological significance for physical activities, social activities, work or other regular daily activities, upper limb symptoms and insomnia, where work ability, sports/performing arts ability and preventive measure is needed.