• 수면정신생리
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• 제8권1호
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• pp.22-29
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• 2001

목 적 : 폐쇄성 수면무호흡증의 진단에 있어 야간 수면다원검사가 중요함에도 비용이나 시간의 문제로 임상의들이나 환자들이 이 검사의 시행을 주저하는 측면이 있다. 만약 진찰로 어느 정도 수면호흡장애의 정도를 가늠할 수 있다면 수면다원검사를 포함하는 다음 단계 진단과정 선택이나 경과의 관찰에 중요한 길잡이가 될 수 있을 것이며 환자들을 이해시키는 일도 좀 더 쉬워 질 것이다. 이에 저자는 Simmons등이 처음 제안한 턱 압박술을 이용해 체계화한 새로운 호흡장애지수(이하 CPS)를 고안하고 진찰시 이것을 측정하여 야간 수면다원검사로 나타나는 여러 호흡장애 변수들과의 상관관계를 분석함으로써 이 지수의 타당도를 검토하고자 하였다. 방 법 : 임상적으로 폐쇄성 수면무호흡증(이하 OSA)이 의심되어 수면다원검사실에 의뢰된 환자들 중 검사 결과 폐쇄성 수면호흡장애로 최종 진단된 43명을 연구 대상으로 하였다. 이 중 상기도 저항증후군(이하 UARS)이 15명, OSA가 28명이었다. CPS(범위 $0{\sim}6$)범주와 진단 범주간의 카이제곱 검정을 실시하여 상관성을 검토한 뒤 이 지수와 수면무호흡지수(이하 AHI), 수면 시간당 산소포화도 저하 건수(이하 SaO2 dips) 등의 기존 수면무호흡 관련 변수와 상관분석을 시행하였다. 결 과 : 연구 대상의 평균연령은 $45.95{\pm12.47$세(범위 $14{\sim}76$세)였고 BMI의 평균은 $25.98{\pm}3.61$(범위 19.65${\sim}$37.64)였다. OSA군과 UARS군 사이에 나이, 성별, BMI에 유의한 차이는 없었다. 두 진단군 사이에 호흡장애지표와 ESS에서는 유의한 차이가 있었으나(p<0.05) 수면 변수에는 차이가 없었다. 전체 대상의 CPS 구간 중앙값 평균은 4.14(범위 $1{\sim}6$)이었다. 진단범주와 CPS범주간의 카이제곱 검정 결과 진단에 따라 CPS의 차이가 있었다(Likelihood Ratio $X^2$ test ; $X^2=17.41$, df=5, p=0.004). 결합도 Somers'd는 0.65로 나와($0.65{\pm}0.12$, t=4.83, p=0.000) CPS가 OSA군에서 뚜렷이 높아지는 양상을 보이고 있다. Spearman 상관관계분석에서 CPS가 AHI(r=0.77), SaO2 dips(r=0.83)와 좋은 정 상관관계를 보여주었다(p<0.001). 그 외에 90%이하 산소포화도 누적시간 백분율(r=0.76), Epworth 졸음척도치(r=0.57), 일 단계 수면의량(r=0.55)과도 강하거나 뚜렷한 정 상관관계를 보였으며 (p<0.05), 동맥혈 최저 산소포화도(r=-0.69)하고는 뚜렷한 역 상관관계를 보였다(p<0.05). 그러나 동맥혈 산소포화도 저하 건의 평균 지속시간과는 상관관계가 약했다. CPS와 AHI에 대한 회귀 분석 결과 턱 압박시 약간 호흡장애를 느끼는 수준(CPS가 3) 이상의 경우 수면다원검사를 시행하면 AHI가 5이하로 나올 확율은 약 3분의 1이하로 나왔다. 결 론 : CPS가 AHI, SaO2 dips 등 기존의 수면 무호흡 지수들과 뚜렷한 정 상관관계를 보여 턱 압박술은 수면무호흡증의 진단시 그 정도를 예측하는데 있어 유용하다.

• 대한간호학회지
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• 제25권2호
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• pp.372-389
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• 1995

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

• 혜화의학회지
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• 제9권1호
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• pp.547-594
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• 2000

I. Introduction The essence of Oriental medicine consists of ancient books, experienced doctors and succeeded skills of common society. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. $\ll$DangDaeMyeongIImJeungJeongHwa(當代名醫臨證精華)$\gg$ written by SaWoogWang(史宇廣) and DanSeoGeon(單書健) has many medical experience of famous doctors. So it has important historical value. Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. So I studied ${\ll}BiJeungJuJip{\gg}$. II. Final Decision Following decisions of Chinese doctors of 20th century are as follows ; 1. JuYangChun(朱良春) emphasized on IkSinJangDok(益腎壯督) to treat BiJeong. And he devided WanBi(頑痺) as PungHanSeup(風寒濕), DamEo(痰瘀), YeolDok(熱毒), SinHeo(腎虛). He used insects for medicine. 2. ChoSuDoek(焦樹德) introduced past prescription. He used ChiBiTang(治痺湯) to treat HaengBi(行痺), TongBi(痛痺), ChakBi(着痺). He insisted that Han(寒; coldness) and Seup(濕; dampness) be Eum(陰) and Pung(風; wind) can change his character to be Eum. After all BiJeung is usually EumJeung. So he used GaeJi(桂枝) and BuJa(附子). By the way he used ChungYeolSanBiTang(淸熱散痺湯) for YeolBi, BoSinGeoHanChiWangTang SaBok(王士福) emphasized on the importance of medicine. He introduced many treatments like CheongYeol(情熱) for YeolBi and YiO(二烏) for HanBi. And he divided BiJeung period for three steps. At 1st step, we must use GeoSa(祛邪), at 2nd step, we must use BuJeong(扶正) and at 3rd step, we must use BoHyeol(補血), he insisted. And he introduced many herbs to treat BiJeung. 4. JeongGwangJeok(丁光迪) said that GaeJi(桂枝), MaHwang(麻黃), OYak(烏蘖) and BuJa(附子) are very important for TongRak(通絡). And pain usually results from Han(寒), so he liked to use hot-character herbs. 5. MaGi(馬志) insisted that BiJeung usually result from ChilJeong(七情). And he liked to use insects for treatment of BiJeung. 6. WeolSeokMu(越錫武) introduced 8 kinds of treatments and divided BiJeung period. Also he divided BeJeung for PungBi(風痺), HanBi(寒痺) and SeupBi(濕痺). 7. SeoGeaHam(徐季含) observed many patients and concluded that 86.7% of BiJeung is HeuJeung(虛症). 8. YuJiMyeong(劉志明) said that YeolBi is important and CheongYeol is also important. So he emphasized on DangGyuiJeomTongTang(當歸拈痛湯) and SeonBiTang(宣痺湯). 9. WangLiChu(汪履秋) studied cause of WanBi. Internal cause is GiHyeolHeo(氣血虛) and GanSinHeo(肝腎虛) and external cause is SaGi(邪氣) he insisted. 10. WangSaSang(王士相) said that YeolBi can be SeupYeolBi or EumHeuYeolBi(陰虛熱痺) and HanSeupBi(寒濕痺) is rare. He use WooBangJaSan(牛蒡子散) and BangPungHwan(防風丸) for SeupYeolBi, DangGyuiSaYeokTang(當歸四逆湯) for HanSeupBi. 11. JinTaekGang(陳澤江) treated YeolBi with BaekHoGaGyeJiTang(自虎加桂枝湯) and SaMyoSan(四妙散). If they don't have effect, he tried to cure BiJeung step by step. And he used e term of GeunBi(筋痺) and BangGiMogwaEIInTang(防己木瓜薏苡仁湯) was good for GeunBi. 12. MaSeoJeong(麻瑞亭) said that PungSeupYeokJeul(風濕歷節) is BiJeung and it is related to GanBinSin(肝脾腎; liver, Spleen, Kindey). And he emphasized on balance WiGi(衛氣) and YoungHeul(營血). 13. SaJeJu(史濟桂) said that GeunGolBi(筋骨痺) is similar to arthritis and sometimes called ChakBi. And SinBi(腎痺) is terminal stage of ChakBi, he said. He also used insects for treatment. 14. JeongJeNam(丁濟南) tried to cure SLE and used GyeJi, CheonCho(川椒), SinGeunCho(伸筋草), SunRyeongBi(仙靈脾), HyconSam(玄蔘) and GamCho(甘草). 15. JinGYungHwa(陳景和) emphasized on diagnosis of tongue. If the color of tongue is blue, it usually has EoHyeol(瘀血), for example. And he also used insects. 16. JuSongI(朱松毅) tried to devide YeolBi with OnByeong(溫病), Wi(衛), Gi(氣) and Hyeol(血). 17. RuDaBong(蔞多峰) said that JyeongHeo(正虛), OiSa(外邪) and EoHyeol are closely related. And he explained BiJeung by deviding the body into the part, for example head, neck, shoulder, waist, upper limb and lower limb. 18. YuMuBo(劉茂甫) defined PungHanSyubBi as chronic stage and YeolBi as acute stage.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.669-671
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• 2006

Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

• 사상체질의학회지
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• 제12권1호
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• pp.265-270
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• 2000

뇌졸중을 일으키는 환자들에서 있어서 심폐의 기능적 및 기질적 이상이 선행요인으로 작용하거나 질병을 악화시키는 요인 및 합병증으로 병발되는 경우가 많다. 심폐질환이 동반된 경우 병의 진행과정이 급격히 악화될 가능성이 크며 예후가 불량한 경향을 띠므로 심폐질환에 주안점을 두어 급히 치료해야 한다. 상지대학교 한방병원 입원환자 중 뇌경색과 함께 울혈성 심부전으로 인하여 폐부종을 동반한 소음인 부종환자를 사상의학적으로 변증하고 치료하는 과정 중에 좋은 결과를 얻었기에 이에 증례보고를 하고자 한다. 68세 여환으로 우반신불수(右半身不遂) 연부장애(嚥不障碍) 어순(語純)의 중풍으로 내원하였으며 병의 진행 과정에 울혈성 심부전으로 진단되었고 폐부종의 소견과 함께 전신부종이 심하였다. 이를 소음인 부종이 태음증(太陰證)에 속한다고 하였으나 식(食) 변(便) 면(眠) 맥(脈) 설태(舌苔) 증상(症狀) 등을 종합하여 소음증(少陰證)으로 변증하고 건비이강음(建脾而降陰)의 치법(治法)에 준하여 궁귀총소이중탕(芎歸蔥蘇理中湯)을 투여하여 증상의 호전을 확인하였다.

• 사상체질의학회지
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• 제21권1호
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• pp.150-164
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• 2009

1. Objectives This study was to designed investigate the relationship between hypertension and its risk factors and the prevalence of hypertension according to Sasang Constitution. 2. Methods Five hundred and twenty six people were subjects out of 666 people, over 40 years old, who participated in the community-based cohort in Wonju, South Korea from July 2nd to August 30th in 2006. Hypertensive group was 263 peoples and normal group was 263 people, selected randomly among non hypertensive people who had same age and sex with hypertensive groups. Sasang Constitutional Diagnosis was carried out using PSSC(Phonetic System of Sasang Constitution), face and tongue photos and a checkup list. Risk factors from blood samples, physical measurements and social indices were analyzed using SPSS. 3. Results The prevalence of hypertension in Taeeumin was 63.1%(N=166), that of Soeumin was 22.4%(N=59) and that of Soyangin was 14.4%(N= 38). Considering risk factors of hypertension, there weren't any differences between two groups in social support indices and Framingham type A score. But scores of Soeumin's and Soyangin's were significantly high compared with that of Taeeumin in female normal group. There were significantly high results in Adiponectin of Soeumin's and HDL-cholesterol of female Soyangin's and HOMA-IR of Taeeumin's than any other groups. Crude OR of Taeeumin was 2.18 as compared with that of Soeumin in terms of risk of hypertension, and OR of Taeeumin was 2.02 as compared with that of Soeumin after drinking, smoking, total cholesterol, fasting blood sugar and HOMA-IR were adjusted. But after BMI was adjusted there wasn't a significance between Soeumin and Taeeumin and the OR of more than 25 was 2.42 as compared with that of less than 23 in BMI. 4. Conclusions Sasang Constitution is thought to be the reasonable variable to control hypertension in terms of prevention, treatment and regimen. And constitution is needed as a good variable to make a cohort study concerning chronic diseases, especially hypertension.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.26-35
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• 2010

Objective : The aim of this study was to examine the characteristics of the acute stroke patient who take Gwakhyangjeonggisan, and provide the basis of Gwakhyangjeonggisan prescription Method : We studied hospitalized patients within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Oriental Medical Center, Semyung University Oriental Medical Center from February 2010 to July 2010 We compared the general characteristics of acute stroke patient according to herb medicine Result : The patient who take Gwakhyangjeonggisan show significant difference for sex, family history of Stroke, Face color, Tongue color, Pulse condition, HDL Cholesterol, Fastfood eating, Waist circumference. Conclusion : The above result show that Gwakhyangjeonggisan can be prescribed to stroke patient whose complaining gastrointestinal symptoms, & Oriental Medical Diagnosis is Cold & Deficiency type. Further studies will be needed to better understand the difference between Gwakhyangjeonggisan group and Other herb medicine among acute stroke patients.

• 대한한방내과학회지
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• 제43권6호
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• pp.1105-1121
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• 2022

Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

• 대한핵의학회지
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• 제38권1호
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• pp.52-61
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• 2004

목적: 두경부암의 중요한 예후인자인 경부림프절 전이의 수술전 진단은 최근 기능보존적 수술이 증가함에 따라 그 중요성이 증가되고 있다. 이 연구에서는 경부 림프절군의 전이에 대한 FDG-PET의 진단적 정확도를 평가하고 이를 CT/MRI와 비교하고자 하였다. 방법: 조직학적으로 두경부암(상부성문암 16, 설암 9, 기타 7)이 확인된 32명의 환자(남/녀=27/5, $56{\pm}10$세)를 대상으로 FDG-PET과 CT의 수술전 진단성적을 비교하였다. FDG-PET과 CT/MRI는 1개월 이내에 시행되었고 병리적 소견을 토대로 경부림프절군 단위로 예민도와 측이도를 구하였다. 결과 32명의 환자에서 153개의 림프절군이 절제되었고 이중 19명의 환자에서 32개의 림프절군이 조직학적으로 전이양성이었다. 전체적인 FDG-PET의 민감도와 예민도는 각각 88% (28/32)와 93% (113/121)이었고 CT/MRI의 민감도와 예민도는 각각 56% (18/32)와 92% (112/121)로 FDG-PET이 CT/MRI보다 예민도가 유의하게 높았다. (p=0.002) 개별 림프절군에서의 진단성적은 그 위치에 따라 서로 달랐으며 가장 낮은 민감도와 특이도를 보인 림프절군은 편측 제II 림프절군이었고 반대측 림프절군과 인두후부 림프절군 등에서 가장 높은 예민도와 특이도를 보였다. 결론: 두경부암에서 경부림프절전이를 발견하는데 FDG-PET이 CT/MRI보다 더 민감하였으며 FDG-PET은 경부절제술의 범위를 결정하는데 유용할 것으로 생각된다.

• 구강회복응용과학지
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• 제31권2호
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• pp.86-95
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• 2015

목적: 이 연구의 목적은 다양한 종류의 악기연주자를 대상으로 설문지검사, 임상검사 및 방사선검사를 시행하여 측두하악장애와 관련된 주관적 증상 및 임상적 징후를 평가하고, 이를 토대로 악기 연주와 측두하악장애의 연관성에 대해 알아보는 것이다. 연구 재료 및 방법: 803명의 악기연주자를 대상으로 측두하악장애에 대한 설문지검사를 시행하여 대상자가 느끼는 주관적 증상의 유병률과 분포를 살펴보고, 그 중 한가지 이상의 측두하악장애와 관련된 증상을 보고한 사람들 중 70명의 자원자를 진료실에 내원시켜 임상검사 및 방사선검사를 시행하여 임상적 징후의 유병률과 분포를 살펴보았다. 70명의 대상자는 목관악기 연주자, 금관악기 연주자 그리고 현악기 연주자의 세 군으로 나누어 각 군에 따른 질환 분포를 살펴보고 비교평가 하였다. 결과: 803명의 악기연주자 중 610명(75.97%)이 한가지 이상의 측두하악장애 관련 증상을 가지고 있었다. 설문지검사에서 가장 많이 보고된 증상은 단순관절음으로 전체 증상의 29.68%를 차지했다. 지원자 70명의 객관적인 임상검사 및 방사선검사 결과 가장 많은 진단명은 근막동통으로 전체 진단의 30.53%를 차지하였다. 악기종류에 따라, 비교 시, 객관적 임상 징후에서는 유의할 만한 차이가 발견되지 않았으나 주관적 증상에서는 근육통에서 현악기 연주자가 유의성 있게 높게 나타났다(P = 0.024). 70명의 임상검사 결과 66명(94.3%)에서 이갈이나 이악물기 같은 부기능성습관의 징후를 보였다. 결론: 악기연주자에서 측두하악장애가 높은 유병률을 보였으며 측두하악장애를 가진 악기연주자들은 대부분 이갈이나 이악물기 같은 부기능성습관을 가지고 있었다.