• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.715-725
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• 1995

산업재해성 요부손상 환자의 심리적 증상은 산업재해성 비요추 환자에 비하여 신체화 증상, 우울, 공포증, 정신증의 항목에서 통계학적으로 유의하게 높은 점수를 나타냈고, 직업과 관련없이 발생되어 의료보험으로 치료를 받는 비산업재해성 요부손상 환자에 비하여 신체화 증상, 우울, 불안, 편집증, 정신증의 항목에서 통계학적으로 유의하게 높은 점수를 나타냈다. 산업재해성 요부손상 환자의 심리적 증상은 휴직 기간과, 작업복귀 여부, 그리고 이 둘의 교호 작용이 유의한 설명력을 가지는데, 휴직 기간이 길수록 또 현재 작업에 복귀하고 있지 않았을 경우에 심리적 증상은 더 높은 점수를 나타내었다. 산업재해성 요부손상 환자에서 사회심리적 증상은 질병의 발생과 그것의 만성화에 따라 심화되며, 조기 작업복귀를 포함한 다차원적이고 포괄적인 재활 치료가 산업재해성 요부손상 환자의 관리에 성공적일 수 있을 것으로 생각된다.

• 디지털융복합연구
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• 제13권10호
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• pp.445-458
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• 2015

본 연구는 65세 이상의 노인을 대상으로 만성통증과 사회적지지가 노인의 우울과 자살의도에 미치는 영향을 파악하고자 연구되었다. 연구대상은 복지관을 이용하는 만성통증이 있는 노인을 대상으로 자료수집기간은 2014년 4월 20일부터 5월 20일까지 시행하였고, 최종 178부를 자료를 분석하였다. 수집된 자료는 SPSS를 이용하여 실수와 백분율, 평균과 표준편차, t-test, ANOA, 상관관계, 다중회귀분석을 하였다. 연구분석 결과 만성통증은 우울과 자살의도에 유의한 정적 상관관계가 나타났으며 사회적지지는 우울과 자살의도에 유의한 부적 상관관계가 나타났다. 또한, 만성통증은 자살의도에 영향을 미치며 사회적지지는 우울에 영향 미치는 가장 강력한 변수로 확인되었다. 노인의 우울과 자살의도에 있어서 만성통증이 높을수록 우울과 자살의도는 높아지고 사회적지지가 낮을수록 우울과 자살의도가 높아지는 결과를 나타냈다. 따라서 노인의 우울과 자살을 예방하기 위해 가족과 사회적 관심과 사회적지지 서비스 개발이 필요하며만성통증을 경감시켜 줄 수 있는 다양한 프로그램 개발과 중재가 필요하다.

• Journal of Oral Medicine and Pain
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• 제34권4호
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• pp.429-433
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• 2009

구강 작열감 증후군은 혀나 구강점막에 객관적인 이상징후(abnormal sign)를 보이지 않으면서 혀 및 구강점막의 지속적인 통증을 보이는 만성 질환이다. 연관된 것으로 추정되는 요인이 다양하고 환자마다 통증 양상이 다소 다르게 나타날 수 있어 적절한 진단 및 효과적인 치료를 제공하기 어려운 경우가 많다. 혀나 구강점막의 작열감은 알러지, 캔디다감염, 부기능습관, 타액선 기능저하 등과 같은 국소요인과 당뇨병, 갑상선기능저하증, 영양결핍 등과 같은 전신적 요인, 그리고 우울증, 걱정, 암공포증 등과 같은 심인성 요인과 연관되어 발생할 수 있다. 그러므로, 임상가들은 작열감을 유발할 수 있는 원인들에 대하여 숙지하고 있어야 하며, 혈액검사 등의 관련 검사를 통한 적절한 평가를 정확하고 세심하게 시행하여 효과적인 치료를 제공할 수 있어야 한다. 이러한 구강 작열감 증후군의 치료에는 약물요법, 인지행동요법, 심리치료 등 다양한 치료들이 시도되어지고 있다. 현재 구강작열감 증후군의 치료에 이용되고 있는 약물에는 클로나제팜(clonazepam), 가바펜틴(gabapentin), 삼환성항우울제(amitriptyline), 알파리포산(alpha-lipoic acid), 캡사이신(capsaicin) 등이 보고되고 있으며, 이 중 클로나제팜을 국소적으로 적용하는 것이 전신 투여하는 다른 약물에 비해 부작용이 적으면서 효과도 상당히 좋은 것으로 보고되고 있다. 이에 구강 작열감 증후군 환자에게 클로나제팜을 국소적으로 적용한 증례를 통해 그 효과를 확인하고자 하였다.

• 한국치위생학회지
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• 제11권4호
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• pp.581-593
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• 2011

Objectives : The purpose of this study was to examine the relationship of the work environments of dental hygienists to their occupational diseases in a bid to provide some information on their health care, health promotion and the prevention of occupational diseases. Methods : The subjects in this study were 300 dental hygienists who worked in Seoul, urban communities involving large cities and rural areas. One-on-one interviews and a self-administered survey were implemented with their consent. Results : The findings of the study were as follows: 1. 60 percent of the dental hygienists investigated replied that they had occupation-related physical symptoms. By the length of service, the dental hygienists who worked for six to 10 years had the most symptoms. 2. Out of the occupation-related symptoms, the most prevalent symptom was a pain in the shoulders and neck(41%), followed by a pain in the lower back, a pain in the legs, a pain in the wrists and skin diseases. The most painful parts of the body were hands and arms. 3. In regard to the relationship between the general characteristics and the intensity of pain, the highest group of the dental hygienists in Seoul replied that they had a severe pain, and the lowest number of those in the large cities gave the same answer. 4. Concerning the cause of occupational diseases, 65.7 percent cited the wrong posture. 5. As to relationship between the general characteristics and regular hospital-visit experiences for the prevention of pain during work hours, many of the dental hygienists who were in their 40s and 50s visited hospitals from time to time, and many of those in their 20s never did that. 6. In regard to links between the general characteristics and an opinion on the necessity of regular education, many of the respondents from Seoul and urban regions involving large cities considered it necessary to receive education on a regular basis. By daily work hours, the highest number of those who worked for eight hours or less considered that necessary, and lots of those who worked for 11 hours didn't consent to that. The gaps between them were statistically significant(p<0.05). Conclusions : Given the findings of the study, daily work hours and length of service were two integral factors to affect the regular hospital-visit experiences and pain, and the wrong posture was identified as the most common cause of occupational diseases. To ensure the successful prevention of occupational diseases, dental hygiene students should be taught the importance of occupational disease before they start to work, and supplementary education should be provided for dental hygienists to work in the right posture.

• 대한치과의사협회지
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• 제56권1호
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• pp.42-48
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• 2018

INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator's and participant's overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine ($P{\leq}01$). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권4호
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• pp.213-221
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• 2020

Background: Complications following impacted third molar surgery significantly affect patients' quality of life during the immediate postoperative period. This study aimed to achieve the proper anesthesia method by comparing the effect of the application of lidocaine alone with the application of lidocaine and articaine simultaneously in reducing the complications during and following impacted mandibular third molar surgery. Methods: The study design was a split-mouth double-blind randomized clinical trial. The study was conducted on 13 patients (26 samples) referred for elective surgical removal of bilateral impacted mandibular third molar with similar difficulty on both sides. Each patient underwent similar surgical procedures on two separate appointments. Each patient randomly received 2% lidocaine for conventional inferior alveolar nerve block and 4% articaine for local infiltration before the surgery on one side (group A) and 2% lidocaine alone (for both block anesthesia and infiltration) before the surgery on the other side (group B). Intraoperative and postoperative variables for both groups were established and statistically analyzed. Results: The findings showed that pain on the first day after surgery in group A was significantly lower than that in group B. The patients in group A mentioned experiencing less discomfort following the surgery. The increased horizontal swelling on the first and third days following surgery and oblique swelling on the seventh day in patients in group B were statistically significant. Conclusion: Choosing an appropriate anesthetic drug for oral surgery, specifically impacted third molar surgery, is dependent on the clinician's opinion, however; it seems that the combination of lidocaine and articaine may control the patient's pain significantly better than lidocaine alone.

• 재활복지공학회논문지
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• 제12권1호
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• pp.29-37
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• 2018

본 연구에서는 독거노인과 비독거노인의 건강상태에 관하여 생활활동능력, 신체통증 그리고 정서상태의 3가지 요소로 나누어 그룹간에 차이를 비교하고 고령자의 건강상태에 관여하는 요인에 대한 관련성을 확인해 보았다. 연구에는 총 88명의 고령자를 대상으로 조사를 실시하여 분석에 사용하였다. 비독거노인에 비해, 독거노인의 경우 생활활동능력이 낮고, 신체적통증이 높으며, 정서상태가 부정적인 것으로 나타났다. 그리고 3요소간 유의미한 상관관계가 있었는데, 세부 분석 결과 이는 거주형태(독거/비독거)이외에도 생활활동패턴(실내/실외 활동)이 동시에 관여하고 있음을 확인하였다. 본 연구결과는 독거노인 돌봄서비스와 고령자의 건강상태를 객관적으로 측정하기 위한 생리학적 지표개발에 기초자료로 활용되어 질 수 있을 것으로 예상한다.

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.103-108
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• 2013

Pachyonychia congenita는 케라틴 유전자의 돌연변이로 발생하며, 상염색체 우성으로 유전되는 매우 드문 유전성 피부질환이다. 주로 손톱과 발톱, 발바닥, 구강점막 등에 이환되며, 주된 증상으로는 손발톱구만증, 손과 발의 과각화증, 소포성 각화증, 구강점막의 백색각화증 등이 있다. 구강점막의 조직학적 소견으로는 과각화증, 극세포증, 상피세포의 핵 주위 세포질내 공포 형성이 나타난다. 피부병소의 치료법으로는 수술적 요법, 기계적인 방법의 치료, 화학적 요법, 약물요법 등이 이용되고 있으며, 구강병소는 대개 치료를 필요로 하지는 않지만 환자의 불편함이 발생하면 대증요법을 시행한다. 피부병소와 구강병소가 동반되는 환자의 경우 면밀한 관찰을 통해 손톱과 발톱의 이영양증, 발바닥의 과각화, 구강점막의 백색각화증 등의 특징적인 병소가 나타나면 조직 생검을 시행하여 이를 확진할 수 있어야 하며, 환자가 호소하는 불편감에 따른 적절한 치료를 시행하여야 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.375-380
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• 2009

Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권1호
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• pp.39-47
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• 2022

Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, 𝛘² = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.