Purpose: Temporomadibular disorders (TMDs) can result in chronic pain, which is often associated with psychological and sleep disturbance. Increased levels of psychological and sleep impairments are often related with poor treatment outcomes. The purpose of the present study was to evaluate clinical features, psychological profiles and the prevalence of clinical insomnia in TMD patients with chronic pain and to suggest an effective treatment approach. Methods: A total of 200 TMD patients who had visited the Pusan National University Hospital dental clinic for treatment of their pain were recruited from June 2018 through December 2019. TMD patients were classified into an acute (n=100) and chronic (n=100) group and compared the clinical symptoms. The primary diagnosis of TMD were categorized as TMD with joint pain group (TMD_J), TMD with muscle pain group (TMD_M) and TMD with joint-muscle mixed pain group (TMD_JM). Self- report measures of sleep quality and psychological profiles were evaluated via the Insomnia Severity Index (ISI) and the Korean Stress Response Inventory (SRI). Independent t-tests, Mann-Whitney U-tests, and chisquared test were used for the statistical analysis. Results: Chronic TMD patients showed higher pain intensity, as well as higher prevalence of related symptoms (headache, musculoskeletal pain) and myogenous pain. They also had significantly higher scores in all SRI parameters and a higher percentage of clinical insomnia than acute TMD patients. Conclusions: Based on the above results, psychological profiles and sleep quality assessments are necessary to provide essential data that will allow for improved treatment of chronic TMD patients.
Objective: This study investigated the efficacy of using Nokyonggunbi-tang and other Korean medical treatments for a patient with consumptive disease and chronic fatigue. Methods: A 59-year-old female patient with fatigue, headache, dizziness, and neck pain due to consumptive disease and chronic fatigue was treated with herbal medicine (Nokyonggunbi-tang), together with acupuncture, pharmacopuncture, cupping, and chuna manual therapy, for 22 days. The treatment effects on the pain were evaluated using the scores for the Fatigue Severity Scale (FSS), European Quality of Life Five Dimensions (EQ-5d) Scale, Neck Disability Index (NDI), and Numerical Rating Scale (NRS). Results: Following treatment, the patient showed a decrease in the FSS, NDI, and NRS scores and an improvement in the EQ-5d score. Conclusions: Nokyonggunbi-tang and Korean medical treatment significantly improved fatigue symptoms in a patient with no substrate disease.
Objectives This study was designed to development the diagnosis indicators for the fatigue group without disease using analysis of questionnaire data. Methods The subjects were divided into three groups, the fatigue group with disease, the fatigue group without disease, non-fatigue group without disease. Thirteen kinds of questionnaire (Fatigue visual analogue scale, Fatigue severity scale, Pain visual analogue scale, Short-form McGill pain questionnaire score, Headache impact Test-6, Neck disability index, Oswestry low back pain disability questionnaire score, Blood stasis assessment scale, Physical activities questionnaire score, Beck depression inventory, Anger expression inventory score, Mood disability scale, Job stress scale) were carried out for the subjects. Results The results of this study are ; 1) The weight, the systolic and diastolic blood pressure were different among three groups. 2) Among nine questionnaires related to the physical or life conditions, the averages of eight questionnaires were not same one another. 3) Among four questionnaires related to the mental condition or autonomic nervous system, the averages of Beck depression inventory were not same one another. Conclusion The fatigue group without disease can be diagnosed through using the both the questionnaires related to the physical or life condition and the those related to the mental condition or autonomic nervous system.
Kim, Dong Shin;Choi, Hyuk Jai;Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung
Journal of Korean Neurosurgical Society
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제58권2호
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pp.131-136
/
2015
Objective : To investigate the incidence of corpus callosum injury (CCI) in patients with mild traumatic brain injury (TBI) using brain MRI. We also performed a review of the clinical characteristics associated with this injury. Methods : A total of 356 patients in the study were diagnosed with TBI, with 94 patients classified as having mild TBI. We included patients with mild TBI for further evaluation if they had normal findings via brain computed tomography (CT) scans and also underwent brain MRI in the acute phase following trauma. As assessed by brain MRI, CCI was defined as a high-signal lesion in T2 sagittal images and a corresponding low-signal lesion as determined by axial gradient echo (GRE) imaging. Based on these criteria, we divided patients into two groups for further analysis : Group I (TBI patients with CCI) and Group II (TBI patients without CCI). Results : A total of 56 patients were enrolled in this study (including 16 patients in Group I and 40 patients in Group II). Analysis of clinical symptoms revealed a significant difference in headache severity between groups. Over 50% of patients in Group I experienced prolonged neurological symptoms including dizziness and gait disturbance and were more common in Group I than Group II (dizziness : 37 and 12% in Groups I and II, respectively; gait disturbance : 12 and 0% in Groups I and II, respectively). Conclusion : The incidence of CCI in patients with mild TBI was approximately 29%. We suggest that brain MRI is a useful method to reveal the cause of persistent symptoms and predict clinical prognosis.
Objectives : The combined treatment (CT) with oriental herbal medicine and western biomedical medicine is prevalent in the world including Korea. But the clinical information on frequency, efficacy and safety of CT at lout cerebrovascular attack hat not known thoroughly yet. This study aimed to identify the status and adverse effects of CT for the treatment of stroke patients. Methods : A self-completed questionnaire survey and medical record survey by oriental medical doctors were performed in 20 Korean Oriental medical hospitals. Of the initial 1,000 in-patients through 2-stage sampling method, 883 were participated in this surrey, resulting in a response rate of 88.3%. Results : Among stroke patients, the proportion of CT was 94.1%. 156 respondents (18.8%): were experienced several adverse effects including headache, dizziness (fatigue), diarrhea, constipation, chest discomfort, etc. The severity of these adverse effects was generally mild to moderate. Although they quitted the CT, 9.8% of patients were not relieved from adverse effects. Conclusions : This study suggests that most patients in Korean Oriental medical hospitals used the combined treatment with oriental herbal medicine and western biomedical medicine for management of stroke. Therefore, the medical professionals should provide comprehensive and up-to-date clinical information about potential benefits and risks of CT to the stroke patients.
Kim, Yewon;Park, Susin;Kim, Eonjeong;Je, Nam Kyung
한국임상약학회지
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제31권1호
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pp.35-43
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2021
Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.
Calcitonin exerts a positive effects on bone pain. The relief of bone pain has been well known in Paget's disease and malignancy patients with bone metastasis who were treated with salmon calcitonin. We carried out a clinical study evaluating efficacy of salmon calcitonin in reducing bone pain and improving mobility of the postmenopausal osteoporosis women. Fifty women suffering pain from postmenopausal osteoporosis diagnosed by evidence of radiology and/or dual photon absorptiometry were treated with salmon calcitonin 50 MRC three times per week for 4 weeks. The severity of pain estimated by visual analogue scale(VAS) was reduced significantly in treated patients from $8.6{\pm}0.7$ on day 0 to $2.7{\pm}1.7$ on day 28. The mobility of the patients was improved in 2 weeks after salmon calcitonin treatment. Mild adverse effects were seen in 8(16%) patients; headache in 4(8%), sweating and dizziness in 2(4%), pain at the injection site in 1(2%), nausea and vomiting in 1(2%) patient. The treatment was stopped in 3 patients by their request. Salmon calcitonin was effective in 39(83%) of 47 patients above moderate degree. In conclusion, salmon calcitonin is useful in the treatment of patients with pain from postmenopausal osteoporosis.
Objective: The purpose of this study is to compare the improvement of Ramsay Hunt Syndrome and Bell's palsy after Oriental Medicine treatment Methods : Twelve patients with Ramsay Hunt Syndrome and twenty patients with Bell's Palsy who visited the Iksan Oriental Medical Hospital of Wonkwang University were evaluated. Evaluation was carried out by facial palsy grading system of Yanagihara. Results : 1. In the analysis of causes. the most common cause was 'none' with 14 cases(43.8%). stress with 8 cases(25.0%). fatigue with 4 cases(12.5%), cold and URI with 3 cases(9.0%) each. 2. In the analysis of prodrome, there was retroauricular pain in 16 cases(50.0%). headache and 'none' in 8 cases(25.0%) each. 3. There was no significant difference between RHS and Bell's palsy in evaluation score. Conclusions : RHS and Bell's palsy showed no statistical significant difference between severity of before treatment and that of after treatment.
Background: Herpes zoster is a common dermatologic disorder. However, it rarely occurs in children and adolescents in Gwangju-Jeonnam province. Objective: This study aimed to analyze the epidemiological features and clinical characteristics of herpes zoster in children and adolescents. Methods: A retrospective survey was conducted on patients who visited the department of dermatology of Chosun University Hospital in Gwangju-Jeonnam province within the past 8 years. The medical records of 103 patients aged <18 years were reviewed. We analyzed for age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment, and complications with serologic test. Results: The male-to-female ratio of the participants was 1.08:1, and their mean age was 13.0 years. Underlying diseases were observed in 3% (3/102) of the patients. The most common dermatomal distribution was thoracic dermatome (34%), followed by trigeminal (26%), cervical (20%), lumbar (15%), and non-skin (6%). The most common accompanying symptoms were headache (10%), fever (3%), and myalgia (3%). No difference was observed between patients who were varicella-zoster virus (VZV) IgM-positive and those who were VZV IgM-negative in terms of dermatome, visual analogue scale (VAS), severity, and body mass index (BMI). Conclusion: In children and adolescents with herpes zoster, the gender ratio and dermatomal distribution were similar to those previously reported, except for the low rate of underlying diseases. The incidence of herpes zoster in children was not significantly associated with immunosuppression and underlying diseases. Higher VZV IgM titer was not associated with dermatomal distribution, higher VAS score, or BMI. This study first compared the serological test results of children.
Objectives : The aim of this study is to review the instruments used to assess patient condition and the effects of Korean medical treatment for patients injured in traffic accidents in clinical studies in the Korean medical field published in South Korea. Methods : A literature study was performed, and clinical studies on patients injured in traffic accidents visiting Korean medical clinics or hospitals were examined. Data about chief complaints, tools used to assess either patients' condition or the effectiveness of Korean medical treatment, and time point of assessment were extracted. The studies were classified according to symptom. The use-frequency and the parent category of the assessment tools were also analyzed. Results : 78 studies were selected and classified into 5 categories based on the chief complaints, neck pain, lower back pain, headache, psychological symptoms and unspecified symptoms. Various scales were used to report the patient's pain severity, and functional or psychological status resulting from traffic accidents. Pain index, in particular VAS, was most frequently used and a few mechanical instruments and Korean medicinal assessment tools were mentioned. Conclusion : Most instruments used in Korean medicine clinical studies on patients injured in traffic accidents are self-reported tools. To assess both the patient's condition precisely and the effectiveness of Korean medical treatment on patients injured in traffic accidents, more appropriate and unified tools should be designed that consider pain, functional disability, psychological status and objective assessments measured by devices together.
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