• 제목/요약/키워드: patients with headache

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만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시 (A proposal of injection points of botulinum toxin into temporal region for chronic migraine)

  • 김영건;배정희;김성택
    • 구강회복응용과학지
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    • 제33권1호
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    • pp.1-6
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    • 2017
  • 보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애의 치료 등에 사용되어 왔다. 특히 보툴리눔 독소 주사는 만성편두통환자의 예방적 치료요법으로 현재까지 유일하게 승인된 요법이다. 기존에 잘 알려진 운동신경에서의 마비효과와는 달리, 편두통에 대한 작용기전은 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 본 논문에서는 보툴리눔독소가 갖는 진통효과에 대한 고찰과 함께 이를 통하여 추후 만성편두통환자에 대한 주사법 개발에 대한 방향성을 제시하고자 한다.

측두하악장애와 교합요인의 관계 (The Relationship between Temporomandibular Disorders(TMD) and Occlusion)

  • 김성택;이유식
    • 구강회복응용과학지
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    • 제21권1호
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    • pp.43-57
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    • 2005
  • Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory nuscles, and associated structures. There have been many different contributing factors of TMDs which were traumatic, occlusal, pathophysiological and psychosocial. Among there factors, the effect of occlusion on TMDs have been a controversy for a long time. The purpose of this study was to investigate the effect of occlusal factors and oral habits on TMDs. In this study, 140 subjects with signs and symptoms of TMDs and diagnosed of TMD in the Orofacial Pain clinic of Yonsei University Dental Hospital though March to July 2004 were selected for the TMDs group and 50 subjects without any signs and symptoms of TMDs as the control group. The subjects were evaluated clinically in TMDs' Occlusal and Prosthodontic Restoration examinations. TMDs' examination was composed of the TMJ pain, sound, locking, temporal or masseter muscle palpation, mandibular movement, oral habits and headache. Occlusal examination was made of overjet, overbite, lost teeth number, nonfunctional interference, midline shift, then pattern of lateral movement and attrition. prosthodontic restoration examination had the existence of restoration, placement, then number of crown or bridge and Satisfiable index which estimated the quality of occlusal state of prosthodontic restorations. Following results were obtained : 1. The prevalence of TMDs was higher in their 20s & 30s, female of the TMD patients group. 2. The clenching frequency in the TMDs group(40.71%) was higher than those in the control group(18.00%), and there was a significant statistical difference(p<0.05). 3. The frequency of Nonfunctional interference in the TMDs group(10.00%) was higher than those in then Control group(2.00%), and there was a significant statistical difference(p<0.05). The result of this study indicated TMDs prevalence was higher in their 20s, 30s, female group of TMDs patients similar to the previous studies. Clenching and nonfunctional interference were estimated as the contributing factors of TMDs.

임신 중 교통사고로 한방 치료를 받은 입원 환자에 대한 후향적 분석 (A Retrospective Analysis of Inpatients who Received Traditional Korean Medicine Treatment after a Traffic Accident during Pregnancy)

  • 윤희재;유정은
    • 대한한방부인과학회지
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    • 제34권2호
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    • pp.31-47
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    • 2021
  • Objectives: This study aimed to report the effectiveness and outcome on the prognosis of pregnancy of traditional Korean medicine treatment for inpatients who had a traffic accident during pregnancy. Methods: The study is conducted by analyzing the medical records of hospitalized patients in a Korean medicine hospital. Seventy-six pregnant patients who got into car accidents from March 2015 to February 2020 were included. We performed statistical analysis by using Statistical Package for the Social Sciences(SPSS) ver. 25.0. To verify the effect of traditional Korean medicine treatment for traffic accidents during pregnancy, we analyzed improvement of symptoms. Also, we analyzed the prognosis of pregnancy and signs of premature birth or miscarriage during treatment to verify the applicability of traditional Korean medicine treatment for traffic accidents during pregnancy. Results: Among the symptoms of pain, there was a statistically significant decrease in lower back pain, post neck pain, headache, pelvic pain, knee pain, lower limb pain, wrist pain, and upper limb pain. Other systemic symptoms showed statistically significant improvement in nausea, abdominal pain, dizziness, and lower limb numbness. All confirmed cases reported normal pregnancy maintenance and delivery, and no miscarriage was reported. Two cases that showed signs of premature birth or miscarriage during treatment were unrelated or unclear with traditional Korean medicine treatment. Conclusions: Traditional Korean medicine treatment is effective and applicable for pregnant women injured by traffic accidents. Further studies are needed to identify the effectiveness and safety of traditional Korean medicine treatment for the sequelae of traffic accidents during pregnancy.

방사선 치료를 받는 유방암 환자의 삶의 질에 관한 연구 (A Study on Quality of Life of Breast Cancer Patients Undergoing Radiation Therapy)

  • 노영희;한유정;양경미
    • 대한방사선치료학회지
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    • 제14권1호
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    • pp.187-199
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    • 2002
  • This descriptive study was undertaken to measure quality of life score and investigate the correlation between the demographic characteristics, the diagnostic related characteristics, physical symptom and quality of life of breast cancer patients undergoing radiation therapy as on attempt to provide basic data to help them attain better qualify of life. The subjects for this study were 74 out-patients undergoing radiation therapy at C University hospital in Gwangju, from June, 1998 to July, 2000. The data were obtained using a convenient sampling technique. The tool of this study was the quality of life scale developed by Ro Yoo Ja. The data were analyzed using the SAS program for percentage, mean, standard deviation, Pearson Correlation Coefficient, GLM. The results were as follows: 1. The total average score for quality of life of the subjects was 137.22 and the range was from 38 to 227, item mean score(range 1-5) was 3.15. For each factor in qualify of life of life score, the mean scores(range 1-5) were as follows; family relationship 3.69, relationship with neighbors factor 3.40, self esteem 3.10, physical state and function 2.95, economic life 2.91, emotional fate 2.88. 2. The incidence of physical symptoms was seen fatigue($82.4\%$), skin change($43.2\%$), alopecia($41.9\%$), pain($41.9\%$), anorexia($39.2\%$), anemia($39.2\%$), and headache($31.1\%$) in that order. 3. The result of the analysis of the relationships between the quality of life scores and demogaphic characteristics were as follows : there were significant differences, between age(F=3.44, p=0.013), educational level(F=3.84, p=0.007), duration of marriage((F=5.06, p=0.003) and monthly income(F=4.72, p=0.005). 4. The result of the analysis of the relationships between quality of life scores and diagnostic related characteristics was as follows: there was a significant difference between incidence durations(F=5.02, p=0.003). 5. The correlation of emotional state, economic life, self esteem, physical sate & function, relationship with neighbors, relationship with family in quality of life of cancer patients revealed a positive correlation.

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Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

  • Mitidieri, Andreia;Gurian, Maria Beatriz;Silva, Ana Paula;Tawasha, Kalil;Poli-Neto, Omero;Nogueira, Antonio;Reis, Francisco;Rosa-e-Silva, Julio
    • 대한약침학회지
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    • 제18권4호
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    • pp.26-31
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    • 2015
  • Objectives: This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Methods: Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

한국인 제2형 당뇨병 환자에 대한 디펩티딜 펩티다제 4 억제제 중 Sitagliptin과 Vildagliptin의 약물 사용 평가 (Sitagliptin and Vildagliptin Use Evaluation among Dipeptidyl Peptidase 4 Inhibitors in Adult Koreans with Type 2 Diabetes Mellitus)

  • 박현정;이옥상;임성실
    • 약학회지
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    • 제56권2호
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    • pp.136-143
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    • 2012
  • Type 2 Diabetes Mellitus (T2DM) is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary modification. As the condition progresses, medications may be needed such as oral sulfonylurea or others. Recently, dipeptidyl peptidase 4 (DPP- 4) Inhibitor is new drug which can control blood glucose by increasing the active levels of incretin hormone in the body. However, researches have been carried out for mostly Caucasian and Japanese, not for Koreans at all. Therefore, this study was to evaluate the efficacy and safety of DPP-4 inhibitor (Sitagliptin, Vildagliptin) in patients with T2DM in Koreans. This study was carried out retrospectively with reviewing of medical records from the 141 patients who received sitagliptin or vildagliptin over 24 week periods from January 2009, to December 2009. Information including demographics, concomitant medication, disease duration, and exercise was evaluated. $HbA_{1c}$, random blood glucose, post prandial 2 hour glucose, blood pressure, AST, ALT, serum creatinine, total cholesterol, triglyceride levels were also collected at baseline and endpoint (at 24 weeks). In each post-treatment group, $HbA_{1c}$, random blood glucose and post prandial 2 hour glucose levels were decreased significantly from baseline in the sitagliptin group (-0.82%, -28.76 mg/dl, -46.65 mg/dl) and vildagliptin group(-1.22%, -27.96 mg/dl, -67.2 mg/dl). Greater $HbA_{1c}$ mean reductions from baseline to 24 weeks were seen in patients with higher baseline values (>7.0%), with shorter disease durations (${\leq}1$ year) compared with those with lower baseline values (<7.0%), with longer disease durations (>1 year) in both sitagliptin and vildagliptin groups. The incidences of hypoglycemia, headache and upper respiratory infection were 0%, 8.7%, 5.8% in sitagliptin group and 2.8%, 8.3%, 6.9% in vildagliptin group. In conclusion, our results showed DPP-4 inhibitor provided similar efficacy compared with sulfonylurea after 24 weeks of treatment and were safer than sulfonylurea in hypoglycemia for Korean T2DM. Also vildagliptin was associated with significant improvement in $HbA_{1c}$ reduction in Korean patient with subgroup (body mass index<25 $kg/m^2$, metformin dose${\geq}$1000 mg, p<0.05) compared to sitagliptin. Therefore, even though DPP-4 inhibitor use for Korean needs to be studied more consistently in the future, DPP-4 inhibitor is a safe and effective drug for Korean T2DM based on our result.

척수손상 환자에 대한 전기자극 인공사정의 초기 경험 (An Early Experience of Electroejaculation in Anejaculatory Men with Spinal Cord Injury)

  • 강일규;조명관;오충환;문영태;김세철;최종한
    • Clinical and Experimental Reproductive Medicine
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    • 제19권1호
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    • pp.87-94
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    • 1992
  • From December 1991 to March 1992, 34 anejacuratory patients with spinal cord injury underwent 90 of electric stimulations with Seager NRH model 12. The average patient age was 43.5 years with a range of 23 to 48 years. The level of cord injury was cervical in 7, thoracic in 6, lumbar in 11, lumbosacral in 7 and conus medullaris in 3. The average number of electric stimulation per a patient was 2.65 with a range of 1 to 4. The average voltage and amplitude per a stimulation were 17.72 volts and 309. 89 mAmp with ranges of 5 to 25 volts and 50 to 500 mAmp. The total and motile sperm number were evaluated microscopically and analyzed statistically by paired t-test according to the frequency of electroejaculation, level of cord injury and voiding pattern. The results were obtained as follows. 1. An overall success rate of electroejaculation was 85.3% among 34 patients and 82.2% among 90 electric stimulations. 2. The total and motile sperm number per a stimulation were not correlated the frequency of electric stimulation, level of cord injury and voiding pattern. 3. Complications occured in 10 cases; severe low abdominal pain in 5, hypertension in 2, sweating in 1, headache in 1 and neck stiffness in 1. All the copmlications subsided spontaneously within 5 to 10 minutes after transient interruption of the electric stimulation. In summary, rectal probe electroejaculation is an accepted safe means of procuring sperm from spinal cord injury patients with ejaculatory incompetence. However very poor sperm motility was found and it was not related with the frequency of electroejaculation, level of cord injury and voiding pattern. Further investigation would be needed to conclude and to identify the reasons for impaired sperm motility.

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엔테로바이러스의 유무에 따른 수막염의 특성 (Characteristics of Meningitis with or without Enterovirus)

  • 조원제;권예림;차병호
    • 대한소아신경학회지
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    • 제26권4호
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    • pp.246-250
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    • 2018
  • 목적: 뇌수막염은 소아기 급성 감염의 일종으로 바이러스나 세균감염에 의해 발생한다. 본 연구의 목적은 엔테로바이러스 수막염과 비엔테로바이러스 수막염의 차이를 분석하여 임상적 특성 및 예후를 알아보고자 하였다. 방법: 2013년 1월부터 2016년 12월까지 원주세브란스기독병원에 내원한 303명의 무균성 수막염으로 진단받은 환자를 대상으로 후향적으로 연구를 진행하였다. 전체 환자의 일반적인 특성을 조사하고 혈청학적 검사 및 뇌척수액 검사, 임상 양상과 예후를 분석하였으며 원인에 따라 두 그룹으로 나누고 연령별 비교 분석을 시행하였다. 결과: 총 303명의 환자 중 남환은 197명(65.0%)이었고 여름, 가을 기간 동안 가장 많은 환자가 발생하였으며 빈도는 엔테로바이러스에 의한 수막염(65.0%)이 가장 많았다. 원인에 따라서는 엔테로바이러스 수막염 그룹에서 두통 및 위장관 증상이 더 많았으며 비엔테로바이러스 수막염 그룹에서 뇌척수액 내 백혈구 수치가 높고 1세에서 4세 그룹에서 경련이 많이 나타났으며 추후 뇌전증으로 진단받은 환자도 있었다. 결론: 이번 연구에서는 본 기관에 내원한 환자에서 엔테로바이러스에 의한 수막염이 가장 흔하며 예후는 양호하였고 그룹간 비교를 해 보았을 때 1세에서 4세 그룹에서 비엔테로바이러스 수막염 환자에게서 신경학적 증상이 빈번하고 예후가 좋지 않음을 알 수 있었다.

대전한방병원 한방안이비인후피부과로 내원한 돌발성 난청 환자 특성 분석 - 2013년 1월부터 2021년 12월까지 - (A Clinical Analysis on Outpatients with Sudden Sensorineural Hearing Loss of Korean Medicine Ophthalmology, Otolaryngology & Dermatology Department at Daejeon Korean Medicine Hospital - From January, 2013 to December, 2021 -)

  • 최윤영;변정아;백종찬;황미리;안재현;정현아
    • 한방안이비인후피부과학회지
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    • 제35권4호
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    • pp.31-46
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    • 2022
  • Objectives : The purpose of this study is to analyze outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. Methods : We retrospectively analyzed outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. according to year, season, gender, age, clinical symptoms, number of visits and initial degree of hearing loss. The statistical analysis performed using IBM SPSS 25.0 for Windows. Results : The results of analyzing the medical records of 194 patients are as follows. 1. The number of patients showed a gradual increase from 2014 to 2021 and spring was highest in season. Acc ording to gender, women visited more than men and the age group that visited the most was middle-aged, including 40s and 50s. 2. Patients experienced 13 symptoms and the average number was 4.06. In the analysis of the major symptoms according to gender, hyperacusis and headache were found to be more common in female. 3. The average of initial hearing loss was 52.54dB and was higher in male. The loss was relatively higher in 60s or older than in the younger age group. Conclusions : If treatment and management methods that reflect these symptoms are developed, it is thought that it will greatly helpful to improve the quality of life of patients with sudden hearing loss.

일개 병원의 뇌동맥류 파열의 위험요인 (Factors Associated with Ruptured Intracranial Aneurysm in a Hospital)

  • 이은하;윤소영;최자윤
    • 한국융합학회논문지
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    • 제10권1호
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    • pp.339-351
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    • 2019
  • 본 연구는 2016년 1월부터 12월까지 뇌동맥류로 진단받고 치료를 받고 있는 환자의 일반적, 입원관련, 임상적, 뇌동맥류 자체 및 생활습관 특성 중 위험요인을 확인하고자 의무기록지 검토를 통해 후향적으로 이루어졌다. 로지스틱 회귀분석결과 2개 이상의 경고증상(14.14 (CI: 1.25-159.40))이 뇌동맥류 파열에 대한 오즈비가 가장 높았고, 다음으로 3점 이상의 두통(13.95 (CI: 3.68-52.83)), 응급실을 통한 입원(13.62 (CI: 4.85-38.26)), 배우자가 없는 경우(9.72 (CI: 2.22-42.49)), 부정맥이 있는 경우(3.70 (CI: 1.22-11.22)), 1 mmHg 수축기압 증가(1.04 (CI: 1.01-1.08)), 1점 GCS 증가 (0.58 (CI: 0.37-0.90)), 1세 나이 증가(0.95 (CI: 0.91-0.99))순이었다. 뇌동맥류 파열이 발생하기 전에 일상적인 평가를 포함한 예방 활동을 수행해야하며 뇌동맥류 환자발견 시 뇌동맥류파열 위험요인에 대한 신속한 사정이 필요하다.