• 대한치과의사협회지
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• 제49권2호
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• pp.72-76
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• 2011

Temporomandibular disorders refer to a large group musculoskeletal disorders that originate from the masticatory structures. The AADR recognize that temporomandibular (TMDs) encompass a group of musculoskeletal and neuromuscular conditions that involve the temporomandibular joints (TMJs), the masticatory muscles, and all associated tissues. The signs and symptoms associated with these disorders are diverse, and may include difficulties with chewing, speaking, and other orofacial functions. They also are frequently associated with acute or persistent pain, and the patients often suffer from other painful disorders. The chronic forms of TMD pain may lead to absence from or impairment of work or social interactions, resulting in an overall reduction in the quality of life. However, the consensus of recent scientific literature about currently available technological diagnostic devices for TMDs is that, except for various imaging modalities, none of them shows the sensitivity and specificity required to separate normal subjects from TMD patients or to distinguish among TMD subgroups. This article reviews the various instruments to aid in the diagnosis of TMDs, and the overall validity and practical use of the Electromyography.

• 한국정밀공학회지
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• 제31권4호
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• pp.359-364
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• 2014

This paper describes the development of needle type probe that measures temperature and injects medicine for both diagnosis and treatment of musculoskeletal pain syndrome (MPS). The size of trigger points is from several micrometers to millimeter. Therefore, it is required to develop a medical device that is capable of not only finding the trigger points by temperature measurement, but also injecting medicine at the exact location for treatment. To challenge these difficulties, thermocouple was fabricated on the surface of a needle using metal deposition process. Special type of stainless-constantan thermocouple was achieved from the stainless body of a needle itself and deposited constantan metal film. In particular, parylene coating enables to limit the temperature sensitive area to the end of the needle tip. Fabricated needle type probe produces $3.25mV/^{\circ}C$ of thermoelectric sensitivity and compared its performance with commercial T-type thermocouple in animal muscle sample.

• Imaging Science in Dentistry
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• 제34권2호
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• pp.91-97
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• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5759-5765
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• 2014

Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of $1.51{\pm}0.75$ whereas mammography scored $4.15{\pm}0.87$ (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.

• 대한물리의학회지
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• 제10권4호
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.

• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.48-53
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• 2016

Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.

• Restorative Dentistry and Endodontics
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• 제40권2호
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• pp.155-160
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• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.15-21
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• 2019

Objective: The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention (MI) increases the trigger point threshold of the same spinal segment as well as to investigate the relationship between the amounts of change in CS pressure pain thresholds (PPT). Design: Randomized controlled trial. Methods: Thirty-nine persons with myofacial pain (MFP) were recruited in this experiment. The subjects consisted of 20 men and 19 women (age 20-39). MI was applied on the subjects using the Graston technique for 5 minutes to induce CS changes. The CS changes were measured with sensory tests by using the Von Frey Filament, and PPT changes were estimated by using the pressure threshold meter. For the observation of sensory and PPT changes with time, the test was conducted for 15 minutes including a pre, post, and after intervention session. Results: CS threshold increased significantly when MI was applied (p<0.001). On the same spinal segment, changes in the right infraspinatus PPT was observed (p<0.001) but the PPT changes in other muscles were not significantly different. Furthermore, the control group CS and PPT were not significantly different. In addition, regression analysis showed that the CS changes have a larger impact on PPT in the same spinal segment (p<0.001). Conclusions: CS changes induced by MI make to change PPT on the same spinal segment. In other words, it is possible to identify PPT changes following CS changes except for the muscle which belongs to a different spinal segment. Therefore, application of MI is necessary for the CS changes in the same spinal segment. Furthermore, it can be useful in the clinical fields as a method of providing pain control and increasing the PPT.

• Restorative Dentistry and Endodontics
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• 제23권1호
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• pp.461-467
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• 1998

A survey has been made of the reasons for the replacement of 318 resin restorations in selected dental practices in Korea. Secondary caries and discoloarations were the main reason for replacement of composite restorations, followed by discoloration, fracture of restoration, loss of anatomic form and pain sensitivity. The estimated 50% survival time for the surveyed restorations was 3.3 years.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.283-295
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• 1999

1997년 1월 1일부터 12월 31일까지 영남대학교 의과대학 부속병원 응급의료센터에 내원한 비외상성 흉통 환자에 대한 임상적 연구를 시행하여 다음과 같은 결과를 얻었다. 응급의료센터를 내원한 총환자 25,583명 중 비외상성 흉통을 주소로 내원한 경우는 488례였으며 남녀비는 1.9:1로 남자에게서 많이 발생하는 것으로 조사되었다. 흉통의 원인별 분류를 보면 심인성인 경우가 320례(65.6%)로 가장 많이 발생하였으며 심인성의 경우를 다시 나누어 보면 협심증이 140례(28.7%), 심근경색증이 128례(26.2%)였다. 흉통의 발생시간별 비교에서 심인성군이 비심인성군에 비해 오전에 더 많이 발생하는 것으로 나타났다(p<0.05). 내원 시간별 비교에서는 6시간내 도착한 경우가 심인성에서 60.0%, 비심인성에서 45.2%로 가장 많았으며, 6시간 이후에 도착한 경우는 심인성 40.0%, 비심인성 54.8%였다. 평균 소요시간은 비심인성군에서 $1,848.9{\pm}4,384.6$분, 심인성군에서 $1,454.5{\pm}3,219.1$분, 심근경색증군에서 $1,230{\pm}2780.6$분으로 심인성군, 심근경색증 환자군에서 소요시간이 짧은 것으로 나타났다. 흉통의 양상은 쥐어짜는 듯한 양상이 256(52.5%)례로 가장 많았고, 다음이 둔한 양상의 순으로 나타났으며, 심인성의 경우 쥐어짜는 듯한 양상이, 비심인성의 경우 둔한 양상이 가장 많이 나타났다. 연관된 증상의 경우, 호흡 곤란이 가장 많았으며, 증상의 평균개수는 비심인성군에서 $1.1{\pm}0.9$개, 심인성군에서 $1.4{\pm}1.1$개, 심근경색증군에서 $1.7{\pm}1.1$개로 나타나 심근경색증의 연관 개수가 의의있게 많았다(p<0.05). 심효소 검사에서 troponin-T rapid assay의 심근경색증 진단에 대한 민감도(sensitivity)는 59.2%, 특이도(specificity)가 95.0%, 양성 예측도86.0%, 음성 예측도 81.9%였으며. CK-MB 검사는 민감도 46.4%, 특이도 95.4%, 양성 예측도 84.1%, 음성 예측도 77.1%였으며 myoglobin 검사는 민감도 45.1%, 특이도 92.1%, 양성 예측도 74.3%, 음성 예측도 76.7%로 나타났다. 급성심근경색증군을 대상으로 한 경우 모두 90% 이상에서 시행되었으나 민감도는 45-59%에 불과했지만 심전도 검사의 경우 민감도가 96.1%로 나타났다. 입원율은 심인성군에서 229례(71.6%)로 비심인성군의 85례(50.6%)에 비해 높게 나타났으며 전체 응급의료센터의 입원율 35.2%에 비해서도 높았다(p<0.01). 사망률은 심인성군에서 13.8%로 전체 흉통환자의 8.8%보다 더 높았으며 비심인성군의 0.6%에 비해 20배 이상의 높은 수치를 보였다(p<0.01). 심인성군중에서도 특히 심근경색증이 원인인 경우에는 사망률이 28.1%에 달했다. 결론적으로 비외상성 흉통을 호소하는 환자의 경우 심인성 질환에 의한 경우가 가장 많고 이중 허혈성 심질환이나 심근경색증이 그 원인인 경우가 많은 것으로 나타났고, 임상양상을 비교해 볼 때 심인성질환 특히 심근경색증의 경우 연관 증상이 더 많은 것으로 나타났으며 쥐어짜는 듯한 양상이 가장 많았고 사망률 또한 가장 높았다. 그러나 정확한 진단이 되지 못한 상태에서 퇴원되는 경우도 있어 초기에 자세한 병력 청취를 통해 연관증상이 많은 경우 심질환을 의심하고, 심전도 검사를 시행하여 이를 통한 환자의 분류를 통해 조기에 심인성 질환을 감별하고 처치할 수 있는 방법이 모색되어야 할 것이며 특히 흉통진료실과 같은 특수한 제도를 도입함으로써 심근경색증 환자에 대한 집중적인 관리와 아울러 저위험군의 진료에도 좀 더 개선된 결과를 가져올 수 있도록 하는 것이 필요할 것으로 사료된다.