• 제목/요약/키워드: Somatic dysfunction

검색결과 29건 처리시간 0.027초

건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석 (Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99)

  • 신재권;주환수;이성엽;신예슬;고원일;박기병;김민규;하인혁
    • 척추신경추나의학회지
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    • 제11권1호
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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Relationships of autonomic dysfunction with disease severity and neuropathic pain features in fibromyalgia: is it really a sympathetically maintained neuropathic pain?

  • On, Arzu Yagiz;Tanigor, Goksel;Baydar, Dilek Aykanat
    • The Korean Journal of Pain
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    • 제35권3호
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    • pp.327-335
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    • 2022
  • Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

악관절 기능장애의 원인에 관한 연구 (A Study on the Background Variables in the Patients with TMJ Dysfunction)

  • 정성창;고명연;김연중
    • Journal of Oral Medicine and Pain
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    • 제8권1호
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    • pp.69-76
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    • 1983
  • Background variables in 203 patients with TMJ pain dysfunction showing no bony change, ranging from 11 to 76 of age, were studied by use of the modified form of self-administered questionnaires deviced by Carlsson et al intended to give a review of the patient's history. All the patients were identified in the Dept. of Oral Diagnosis and Oral Diagnosis and Oral Medicine, Seoul National University Hospital, during the period from Feb. 1983 to Nov. 1983. The questions concerning general somatic and psychic health, educational and social condition were dealt with in this article. The obtained results were as follows : 1. The main symptoms reported by 203 patients were difficulties in opening the mouth wide(74.4%), clicking of TMJ(70.9%), chewing difficulties(69.0%), and pain on movement of mandible(57.6%) 2. The most fequently reported medical symptoms or histories were stomach disease (21.2%), insominia(15.3%), ENT disease(13.8%) and skin disease (12.8%) 3. Seventy-eight percent of the patients denied having had a nervous or psychic disorders while 4% were currently under treatment for such disorders. 4. Eleven percent of 203 patients with TMJ dysfunction thought their family situation was distressing(8.4%) or very troublesome(3.4%).

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고유수용성 척수 반사(proprioceptive spinal reflex)를 응용한 근골격계 치료 기법의 고찰 (A Study of Manipulative Treatments for Musculoskeletal Problems Applying Proprioceptive Spinal Reflex)

  • 고은상;이종화;송윤경
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.81-92
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    • 2006
  • Objectives: To review recent findings from physiologic research about the nature of proprioceptive spinal reflex, proposed explanation for mechanisms of musculoskeletal problems associated with propriceptive dysfunction and techniques controlling this problem. Methods: MEDLINE databases were searched using various combinatins of the keywords proprioception, spinal reflex, somata-somatic reflex, spinal manipulation, muscle spindle, Golgi-tendon organ, along with searching the related articles and textbooks. Results and Conclusion: Proprioceptors(muscle spindle, Golgi-tendon organs) monitor the position of joints, tension in tendons and ligaments, and the state of muscular contraction. Disturbed activity of proprioceptive spinal reflex can cause chronic state of increased muscle stiffness, pain, deficiencies both in muscle coordination and propioception, and so on. All kinds of techniques that control proprioceptive primary afferent neurons can affect the motor control system and evoke changes in the neuromuscular system.

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신장 기능과 틸로미어 (Kidneys with bad ends)

  • 서동철
    • Childhood Kidney Diseases
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    • 제12권1호
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    • pp.11-22
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    • 2008
  • Telomeres consist of tandem guanine-thymine(G-T) repeats in most eukaryotic chromosomes. Human telomeres are predominantly linear, double stranded DNA as they ended in 30-200 nucleotides(bases,b) 3'-overhangs. In DNA replication, removal of the terminal RNA primer from the lagging strand results in a 3'-overhang of uncopied DNA. This is because of bidirectional DNA replication and specificity of unidirectional DNA polymerase. After the replication, parental and daughter DNA strands have unequal lengths due to a combination of the end-replication problem and end-processing events. The gradual chromosome shortening is observed in most somatic cells and eventually leads to cellular senescence. Telomere shortening could be a molecular clock that signals the replicative senescence. The shortening of telomeric ends of human chromosomes, leading to sudden growth arrest, triggers DNA instability as biological switches. In addition, telomere dysfunction may cause chronic allograft nephropathy or kidney cancers. The renal cell carcinoma(RCC) in women may be less aggressive and have less genomic instability than in man. Younger patients with telomere dysfunction are at a higher risk for RCC than older patients. Thus, telomeres maintain the integrity of the genome and are involved in cellular aging and cancer. By studying the telomeric DNA, we may characterize the genetic determinants in diseases and discover the tools in molecular medicine.

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해녀 우울장애 환자의 임상적 특징 (Clinical Characteristics of Haenyeo with Depressive Disorders)

  • 박준혁;전병선;이창인;김문두;정지운;정영은
    • 생물정신의학
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    • 제23권2호
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    • pp.63-68
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    • 2016
  • Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

좌상/역좌상기법에 대한 고찰 (Study of Strain/Counterstrain Technique)

  • 송윤경;임형호;박성호
    • 대한추나의학회지
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    • 제4권1호
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    • pp.99-109
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    • 2003
  • Dr. Lawrence H Jones developed innovative approach for the treatment of neuromuscular and musculo-skeletal disorders such as fibromyalgia, myofacial pain syndrome, any other muscle pain. This technique is called Strain/Counterstrain technique which uses effect of neuromuscular reflex for treatment of strain. First, Relieving spinal or other joint pain by passively putting the joint into its position of greatest comfort; secondly relieving pain by reduction and arrest of the continuing inappropriate proprioceptor activity. This was accomplished by markedly shortening the muscle that contains the malfunctioning muscle spindle by applying. mild strain to its antagonists. In other words, the inappropriate strain reflex is inhibited by application of counterstrain. Many other techniques have been developed for treating of muscle pain due to somatic dysfunction, but we want to introduce you to strain/counterstrain technique because this is basic concept and theory of Chum therapy for controling motor system.

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악관절증의 침치료에 대한 고찰 (근육장애을 중심으로) (Acupuncture Treatment for T.M.D.)

  • 김용석;김창환
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.36-50
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    • 1995
  • Acupuncture is so effective and simple to use in the pain and dysfunction syndrome of TMD. Acupuncture treatment is a point-specific. So, the selection of acupuncture point is very important. According to the traditional meridian theory, we select the points; local points around TMJ and mastication muscles(ST6, ST7, GB20, GB21) and remote point(LI4). And if there is another pain, one or two other points are added. Both neural and humoral mechanism play an important role in acupuncture analgesia. The discovery of spinal gate mechanisms shows somatic stimulation can induce pain inhibition. Humoral mechanism has been established from the discovery of opioid receptors and endogenous opioids. Acupuncture induces a relaxation in the patient, which further decreases the muscle tension.

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기울증을 교감단합항기탕으로 치료한 임상 1예 (The Clinical Report about the Stagnation Syndrome of Qi (기울증) Treated with Gyogam-dan plus Ganggi-tang)

  • 이진헌;조성은;우영민;김용호
    • 대한한의학회지
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    • 제22권4호
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    • pp.171-176
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    • 2001
  • The Stagnation Syndrome of Qi is the depressed and suppressed mental state caused by anxiety, unaccomplished desire, maintained thought, and emotional problems, resulting in a concomitant physiological somatic dysfunction. Although blood test, urine test, EKG, and gastric endoscopy showed normal finding. a patient complained of a group of symptoms, so we considered it as an unidentified clinical syndrome. This syndrome could be interpreted as the disconnection of Fire (Heart) and Water (Kidney) in Oriental medicine, and treated with the therapeutic method of 'Ascending Water-Descending Fire'. After the application of Gyogam-dan and Ganggi-tang for 18 days, symptoms and signs improved.

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Biolinkage System의 분석법 소개 (Introduction to the Analysis of the Biolinkage System)

  • 김규섭
    • 척추신경추나의학회지
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    • 제13권1호
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    • pp.45-53
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    • 2018
  • Objectives: This report aimed to provide an introduction to the analysis of the Biolinkage System. Methods: During diagnosis, the Biolinkage System was first classified into Type I & Type II according to the Patric's Test and the Pelvic Twist Analysis; the two types were then sub-classified into Step I, II, III according to the Thompson's sacrum test, Patrick's test, Scapular Fixation Test, and Pelvic Twist Analysis. During treatment, the sacrum-axis-temporomandibular joints were used in Step I, the hip joint-fourth cervical or scapular-occiput were used in Step II, and lastly the thoracic cage is used in Step III. Conclusions: The Biolinkage System is useful in the examination of somatic dysfunction.