• 제목/요약/키워드: pain assessment

검색결과 934건 처리시간 0.026초

슬관절의 등속성 최대 반복 신전시 Hilbert-Huang 변환과 AR 모델을 이용한 근피로 평가 (Muscle Fatigue Assessment using Hilbert-Huang Transform and an Autoregressive Model during Repetitive Maximum Isokinetic Knee Extensions)

  • 김효신;최승욱;윤애란;이소은;신기영;최재일;문정환
    • Journal of Biosystems Engineering
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    • 제34권2호
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    • pp.127-132
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    • 2009
  • In the working population, muscle fatigue and musculoskeletal discomfort are common, which, in the case of insufficient recovery may lead to musculoskeletal pain. Workers suffering from musculoskeletal pains need to be rehabilitated for recovery. Isokinetic testing has been used in physical strengthening, rehabilitation and post-operative orthopedic surgery. Frequency analysis of electromyography (EMG) signals using the mean frequency (MNF) has been widely used to characterize muscle fatigue. During isokinetic contractions, EMG signals present strong nonstationarities. Hilbert-Haung transform (HHT) and autoregressive (AR) model have been known more suitable than Fourier or wavelet transform for nonstationary signals. Moreover, several analyses have been performed within each active phase during isokinetic contractions. Thus, the aims of this study were i) to determine which one was better suitable for the analysis of MNF between HHT and AR model during repetitive maximum isokinetic extensions and ii) to investigate whether the analysis could be repeated for sequential fixed epoch lengths. Seven healthy volunteers (five males and two females) performed isokinetic knee extensions at $60^{\circ}/s$ and $240^{\circ}/s$ until 50% of the maximum peak torque was reached. Surface EMG signals were recorded from the rectus femoris of the right thigh. An algorithm detecting the onset and offset of EMG signals was applied to extract each active phase of the muscle. Following the results, slopes from the least-square error linear regression of MNF values showed that muscle fatigue of all subjects occurred. The AR model is better suited than HHT for estimating MNF from nonstationary EMG signals during isokinetic knee extensions. Moreover, the linear regression can be extracted from MNF values calculated by sequential fixed epoch lengths (p> 0.0I).

암의 종류 및 증상에 따른 삶의 질 평가 척도에 관한 연구 현황 분석 (Analysis of Studies on Quality of Life according to Cancer Types and Symptoms)

  • 이남헌;조정효;손창규;유화승;이연월;윤담희;이종훈;방선휘;조종관
    • 대한한방내과학회지
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    • 제27권3호
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    • pp.555-560
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    • 2006
  • Objectives : The objective of this study is to analyze what quality of life(QOL) scales are frequently used in cancer patients and lay a cornerstone to develop new QOL scales adequate for oriental medical anti-cancer treatment in the future. Methods : We searched 151 articles concerned with 'QOL and scale and cancer' from PubMed and classified them according to periods. nations. cancer types and symptoms. Results: 138 articles(91%) were published after 1996. 65 articles(43%) were published in USA. For breast. lung, prostate. esophageal cancer and melanoma. European Organization for Research and Treatment of Cancer-quiality of life questionaire(EORTC-QLQ) was used most frequently to evaluate quality of life. Functional Assessment of Cancer Treatment(FACT) for bladder cancer. Hospital Anxiety and Depression Scale(HADS) for colorectal cancer and of Washington Quality of Life questionnaire(UW-QOL) for Head & Neck cancer were used repeatedly. And for the patients with the symptoms such as bone marrow depression. depression. pain. dyspnea. nausea & vomiting and voice change. the investigators used EORTC-QLQ mainly to evaluate QOL. FACT-An(anemia) for anemia. FACT-BMT(bone marrow transplant) for bone marrow depression were applicated generally. Conclusions It is anticipated that further investigations will be performed to develop adequate QOL scales for oriental medical anti-cancer therapy.

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요추부 협착증 치료를 위한 극돌기 삽입술의 생체역학적 효과 분석 (A Biomechanical Analysis of an Interspinous Distraction Device for Treatment of Lumbar Spinal Stenosis)

  • 이희성;첸웬밍;송동률;권순영;이권용;이성재
    • 대한의용생체공학회:의공학회지
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    • 제27권5호
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    • pp.210-217
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    • 2006
  • Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

일부 전문대 응급구조학생의 응급구조전문직관의 변화에 대한 연구 (A study on the change of the views on E.M.T. profession of the E.M.T. college students)

  • 김학수;최은숙;김진회;신동민;이인수
    • 한국응급구조학회지
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    • 제1권1호
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    • pp.28-41
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    • 1997
  • The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionaire from November 25 to November 29, 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summerized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, P<.05) 2. The view on competence as a E.M.T. was a statistically significant differncein sufficient professional knowledge on the E.M.T. (t=-1.144, P<.001), own's health (t=-0.808, P<.001), sincerity and responsibility (t=-1.429, P<.01), satisfaction and effort (t=-1.335, P<.01), boundary of affairs (t=-1.356, P<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, P<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, P<.001), ACLS (t=1.678, P<.001), hemorrhage & shock (t=-3.252, P<.001), trauma (t=-4.284, P<.001), cardiopulmonary disturbance (t=-2.897, P<.001), acute abdomen (t=-4.284, P<.001), neonatal disease (t=-4.032, P<.001), OBGY disease(t=-4.151, P<.001), emergency delivery (t=-2.825, P<.001), infectious disease (t=-2.930, P<.001), environmental emergency (t=-3.123, P<.05), recording(t=2.22, P<.05) 5. The view on ideology of E.M.T. was a statistically significant difference in belief & faith (t=-2.344, P<.001), knowing of own (t=-2.142, P<.01), humanity (t=-2.581, P<.05), knowing of patient (t=-2.079, P<.05).

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Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

Analysis of the annual changes in dental institutions that claimed dental sedatives in Korea and the types of sedatives using health care big data

  • Minjae Lee;Seong In Chi;Hyuk Kim;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권2호
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    • pp.101-110
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    • 2023
  • Background: Dentists make various efforts to reduce patients' anxiety and fear associated with dental treatment. Dental sedation is an advanced method that dentists can perform to reduce patients' anxiety and fear and provide effective dental treatment. However, dental sedation is different from general dental treatment and requires separate learning, and if done incorrectly, can lead to serious complications. Therefore, sedation is performed by a limited number of dentists who have received specific training. This study aimed to investigate the proportion of dentists who practice sedation and the main sedatives they use in the context of the Republic of Korea. Methods: We used the customized health information data provided by the Korean National Health Insurance. We investigated the number of dental hospitals or clinics that claimed insurance for eight main sedatives commonly used in dental sedation from January, 2007 to September, 2019 at the Health Insurance Review and Assessment Service. We also identified the changes in the number of dental medical institutions by region and year and analyzed the number and proportion of dental medical institutions prescribing each sedative. Results: In 2007, 302 dental hospitals prescribed sedatives, and the number increased to 613 in 2019. In 2007, approximately 2.18% of the total 13,796 dental institutions prescribed sedatives, increasing to 3.31% in 2019. In 2007, 168 institutions (55.6%) prescribed N2O alone, and in 2019, 510 institutions (83.1%) made claims for it. In 2007, 76 (25.1%) hospitals made claims for chloral hydrate, but the number gradually decreased, with only 29 hospitals (4.7%) prescribing it in 2019. Hospitals that prescribed a combination of N2O, chloral hydrate, and hydroxyzine increased from 27 (8.9%) in 2007 to 51 (9%) in 2017 but decreased to 38 (6.1%) in 2019. The use of a combination of N2O and midazolam increased from 20 hospitals (6.6%) in 2007 to 51 hospitals (8.3%) in 2019. Conclusion: While there is a critical limitation to the investigation of dental hospitals performing sedation using insurance claims data, namely exclusion of dental clinics providing non-insured treatments, we found that in 2019, approximately 3.31% of the dental clinics were practicing sedation and that N2O was the most commonly prescribed sedative.

Assessment of In vitro Antioxidant, Antidiabetic and Cytotoxic Activities of Sphaeranthus africanus Extracts

  • Tran Thi Huyen;Julien Dujardin;Nguyen Thi Thu Huong;Chung Thi My Duyen;Nguyen Hoang Minh;Ha Quang Thanh;Dao Tran Mong;Ly Hai Trieu;Nguyen Mai Truc Tien;Mai Thanh Chung;Nguyen Nhat Minh;Nguyen Thi Ngoc Dan;Huynh Loi
    • Natural Product Sciences
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    • 제29권2호
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    • pp.98-103
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    • 2023
  • Sphaeranthus africanus is commonly used as a traditional remedy for sore throats and pain treatment in Vietnam. The aerial parts have been studied for its anti-inflammatory and anti-proliferative properties. However, the antioxidant and antidiabetic potential of the plant has not been explored. In this work, hydrophilic extracts of the plant's aerial parts were prepared in order to investigate its antioxidant and anti-diabetic properties. Also, the cytotoxicity of the root was evaluated and compared to that of the aerial parts. All of the extracts inhibited lipid peroxidation with IC50 values ranging from 2.05 to 3.56 ㎍/mL, indicating substantial antioxidant activity. At an IC50 value of 4.80 ㎍/mL, the 50% ethanol extract exhibited the most potent inhibition of α-glucosidase. The cytotoxic activity of root extracts is 2 to 5-fold less than that of the aerial parts. Nevertheless, dichloromethane and ethyl acetate extracts of the root demonstrated a selective effect on leukemia cells, with no harm towards the normal HEK-293 cell line. This work provides a scientific support for the antioxidant and antidiabetic activity of the plant. Hence, it may find a promising material for the development of novel antioxidant and antidiabetic agents. More research can be conducted on the phytochemistry and anticancer activities of the plant's root.

Use of custom glenoid components for reverse total shoulder arthroplasty

  • Punyawat Apiwatanakul;Prashant Meshram;Andrew B. Harris;Joel Bervell;Piotr Lukasiewicz;Ridge Maxson;Matthew J. Best;Edward G. McFarland
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.343-350
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    • 2023
  • Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

흡연이 구강 건강에 미치는 영향 : 구강 위생이 양호한 집단의 장기적 연구를 위한 예비 평가 (Effects of Smoking on Oral Health : Preliminary Evaluation for a Long-Term Study of a Group with Good Oral Hygiene)

  • 이현석;김미은
    • Journal of Oral Medicine and Pain
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    • 제36권4호
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    • pp.225-234
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    • 2011
  • 흡연은 전신건강 뿐 아니라 구강건강에도 유해하여 구강암과 치주염의 발생, 창상치유 지연, 치아상실 등과 관련성을 가지는 것으로 알려져 있다. 이미 흡연과 구강건강의 관련성에 대한 연구가 많이 있지만, 구강건강에 대한 인식도나 위생관리 등 흡연 외의 다양한 요소가 구강건강에 영향을 줄 수 있으며 타액 분비나 구취처럼 흡연과의 관련성이 확실히 밝혀지지 않은 부분도 존재한다. 그러므로 구강위생에 대한 인식 수준이 상대적으로 높고 추적조사가 용이한 치과대학생이라는 집단에서 흡연자와 비흡연자의 구강건강을 상태를 장기적, 포괄적으로 비교한다면 흡연이 구강건강에 미치는 영향을 보다 명확하게 확인할 수 있을 것이다. 본 연구는 장기적 연구에 앞서 치과대학생 중 흡연자들의 흡연 특성을 파악하고, 흡연자들과 비흡연자들의 전반적인 구강건강상태를 비교하여 보고하고자 하였다. 2010년 4월 21일부터 2011년 4월 20일까지 단국대학교 치과대학 치의학과에 재학 중인 1학년부터 4학년까지의 남학생 224명 중 지원자 192명(85.7%)을 대상으로 하여 설문지 조사와 임상검사를 시행하였다. 설문지조사에는 흡연 양태, 음주, 니코틴의존도, 구강위생관리, 간이심리검사가 포함되었고 임상검사에는 치아 및 치주 상태, 니코틴 착색, 타액분비량, 전기 미각역치, 구취에 대한 평가가 시행되었다. 본 연구에서, 흡연자군은 금연자군, 비흡연자군에 비해 연령이 약간 높고, 음주를 하는 경우가 많았으며 알코올섭취량도 많았다(p<0.05). 세 군은 타액분비율, 구취, 전기미각역치 등의 임상조사에서는 유의한 차이를 보이지 않았으나, 양치질 횟수나 치과방문 횟수에 차이가 없음에도 불구하고 우식경험영구치율(DMFT rate), 치주가료필요 정도 및 니코틴 착색 정도에 있어서 흡연자군과 비흡연자군 사이에는 차이가 관찰되었다(p<0.05). 본 연구의 피검자들이 평균 25세로서 흡연자군이라 해도 흡연기간이 길지 않고 흡연량이나 니코틴의존도가 낮은 수준임에도 불구하고 치주조직에는 이미 유해한 효과를 주고 있다고 판단된다. 기초 자료 분석이지만 흡연은 치주조직에 신속히 영향을 미치므로 금연 치료를 조기에 시행할 필요가 있다.

서울시 간호사회 가정간호시범사업 서비스 내용 및 만족도 분석 (The Contents and Satisfation of Home Care Progral Delivered by Seoul Nurses Association)

  • 임난영;김금순;김영임;김귀분;김시현;박호란
    • 대한간호
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    • 제36권1호
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    • pp.59-76
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    • 1997
  • The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

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