SRRS를 이용한 측두하악장애환자의 생활변화에 관한 연구

박준상,고명연,Park, June Sang,Ko, Myung Yun 대한안면통증구강내과학회 1987 Journal of Oral Medicine and Pain Vol.12 No.1

The life changes of TMJ patients were evaluated through the Social Readjustment Rating Scale (SRRS) questionnaire. 61 female TMJ patients and 80 dental new female outpatients were studied at the TMJ Clinics, Department of Oral Diagnosis, PNUH from February to September 1987. The obtained results were as follows; 1. The life change unit (LCU) totals and number of life events in the TMJ patients were significantly higher than those in the control subjects, especially during the 1-6 months before presentation for the hospital. 2. There was no significant difference in the number of the high-scored (over 150 LCU totals) between the TMJ patients and the control subjects. 3. There was a significant difference in LCU totals and life events between the TMJ patients and the control subjects by age, despite no difference in LCU totals and life events between the young and the advanced subgroups. 4. The LCU totals and the number of life events in the TMJ patients over 13-year-school age were significantly higher than those in the control subjects over 13-year-school age and the TMJ patients under 12-year-school age. 5. The married subgroup in the TMJ patients showed no significant difference in LCU totals and life events as compared with the unmarried one. 6. Categorizing life events into 6 items (marital life, health, occupation, family, finances and social), the TMJ patients had the higher frequencies in marital life and occupation than the control.

삼차신경통의 임상양태와 보존적 치료결과에 관한 연구

남창옥,박준상,고명연,Nam, Chang-Ok,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 1999 Journal of Oral Medicine and Pain Vol.24 No.3

The 63 patients(20 males, 43 females) were treated for their trigeminal neuralgia at the Department. of Oral Medicine, Pusan National University Hospital from 1993 to 1998. All the patients were treated for their trigeminal neuralgia by conservative methods such as medication, and Electric Acupuncture Stimulation Therapy The obtained results were as follows: 1. Trigeminal neuralgia was mainly involved in the patients of past forties, women and acute group. 2. 50.8% of patients were related to maxillary branches of trigeminal nerves. The trigger points were on gingivae, cheeks, teeth, lips in order. 3. 55.6% of patients with trigeminal neuralgia had systemic diseases and 39.7% were related to dental practices. 4. Success rate of the treatments was 71.4% and the recurrence rate was 26.3%. 5. The refractory factors in improving symptoms were chronic history, involvement of complex branches, and experience of prosthodontic treatments.

SCL-90-R을 이용한 측두하악장애 재발환자의 심리학적 분석

차정현,박준상,고명연,안용우,Cha, Jeong-Hyun,Park, June-Sang,Ko, Myung-Yun,Ahn, Yong-Woo 대한안면통증구강내과학회 2006 Journal of Oral Medicine and Pain Vol.31 No.2

2005년 3월부터 2006년 2월까지 부산대학교병원 구강내과 구강안면통증 클리닉에 내원한 측두하악장애 재발환자 27명과 측두하악장애 신환 45명 및 부산지역 소재 치과의원에 내원한 일반치과환자 50명을 대상으로 SCL-90-R을 시행하여 심리학적으로 분석한 결과 다음과 같은 결론을 얻었다. 1. 측두하악장애 재발환자군(실험군)과 측두하악장애 초진군(대조군 I) 및 일반치과환자군(대조군 II)에서 9개 기본증상차원의 척도별 규준척 T점수 평균 값은 모두 정상범위 내에 있었다. 2. 재발환자군에 비해 일반치과환자군의 대인예민성 척도, 우울 척도, 공포불안 척도, 정신증 척도에서 유의한 차이를 보였다. 3. 측두하악장애 재발군과 초진군의 기본척도에서 성별에 따른 차이는 없었다. 4. 급성군과 만성군으로 구분하여 비교한 결과 재발환자에서는 특별한 차이점이 나타나지 않았으나 측두하악장애 신환군의 만성환자군에서 신체화 척도, 적대감 척도, 공포불안 척도, 정신증 척도의 평균 T점수가 유의하게 더 높았다.

기계적 자극에 의한 구강내 반응성 증식

김지현,박준상,고명연,Kim, Ji-Hyun,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

Intraoral soft tissue can easily be injured by weak mechanical irritation. Each symptom by irritation is various, but most of patients show chronic inflammatory lesion. The fibroma is the most frequent disease found in intraoral area followed by pyogenic granuloma, epulis fissuratum, palatal papillomatosis, and epulis granulomatosum. The inflammatory hyperplasia by mechnical irritation is easily different from other disease, but this shows similar to several benign and malignant tumors required differential diagnosis. By microscopic feature, the lesions is divided by granulatory stage, mixed stage, and fibrotic tissue stage. The inflammatory hyperplasia is differently treated by each clinical features.: only removal of cause or, and excisional biopsy is/are required. This is the cases report of reactive hyperplasia of intraoral soft tissue by mechanical irritation that suggests various treatments of each cases.

점막 유천포창의 진단 및 치료

민숙진,박준상,고명연,Min, Suk-Jin,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

측두하악장애 환자의 보존적 치료결과의 예측에 관한 연구

이혜진,박준상,고명연,Lee, Hye-Jin,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

This study was performed to predict the conservative treatment outcome of TMD patients by investigating the prognostic factors ; symptom duration, history of previous treatment, history of previous medication, history of trauma, disability of daily activity, severity of pain, noise, limitation of mouth opening(LOM) and maximum comfortable opening(MCO). Two hundreds and fifty-four subjects were selected for this study among the TMD patients who had visited the Dept. of Oral Medicine BNUH and been treated conservatively with medication, physical therapy, behavioral treatment, and splint therapy from 1991 to 2000. The subjects were divided into two groups improved or unimproved according to the treatment response following six months of conservative treatment. Those who showed less than 1 on NAS for pain, TMJ noise, and opening limitation belonged to the improved group and those who showed more than 2 on NAS belonged to the unimproved group. The two groups were compared with respect to symptom severity, number of diagnosis, history of trauma, previous treatment, previous medication, and disability of daily activity. A prognostic equation with the factors revealed to be significantly related to the prognosis of conservative treatment was obtained. The obtained results were as follows ; 1. In improved group, mean duration of history was 12 months, mean treatment duration of a patient was 4 months an mean number of treatment was about 10 times. In other words, in unimproved group, mean duration of history was 27.4 months, mean treatment duration of patient was 10.5 months and mean number of treatment was 19 times. 2. In unimproved group, multiple diagnosis, chronicity, disability of daily activity were significantly greater than that of the improved group. 3. Patients in unimproved group revealed severe noise at first visit and smaller maximum comfortable opening comparatively. 4. Prognostic factors such as duration of treatment, number of treatment, multiplicity, and chronicity and disability of daily activity showed a significant relation in prediction of improvement. 5. Prognostic equation with significant variables is as follows ; Y = 1.984 - 0.251Noise + 0.068MCO - 0.673Multiplicity. - 0.958Chronicity - 0.065Disability. Classification accuracy of 70.3 %, sensitivity of 71.4% and specificity of 66.7% were shown. 6. Prognostic equation with all factors is as follows : Y = 1.599 - 0.038Pain - 0.256Noise - 0.006Limitation + 0.068MCO - 0.580Multiplicity - 1.025Chronicity - 0.720Disability - 0.329Medication - 0.087Treatment + 0.740Trauma. Classification accuracy of 70.3 %, sensitivity of 73% and specificity of 64.3% were shown. 7. Prognostic value of the improved group with significant factors was $1.0446{\pm}1.0726$ and prognostic value of the unimproved group with significant factors was $-0.013{\pm}1.0146$. Prognostic value of the improved group with all factors was $1.0465{\pm}1.0849$ and prognostic value of the unimproved group with all factors was $-0.057{\pm}1.0611$.

안면신경마비의 치험례

조상훈,박준상,고명연,Cho, Sang-Hun,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

Facial nerve paralysis(or Bell's palsy) which commonly occurs unilaterally, gives rise to paralysis of facial expression muscle. This condition is classified into symptomatic facial nerve paralysis due to intracranial tumor, post operative trauma, etc. and idiopathic facial nerve paralysis. To explain the etiology of idiopathic facial nerve paralysis, many hypothesis including ischemic theory, viral infection, exposure to cold, immune theory etc. were suggested, but there is no agreement at this point. The method to evaluate the facial nerve paralysis, when it occurs, consists of three stage scale method, image thechnics like CT and MRI, laboratory test to examine the antibody titers of viral infection, neurophysiologic test to evaluate the degree and prognosis of paralysis. Treatment includes medication, stellate ganglion block(SGB), surgery, physical therapy and other home care therapy. In medication, systemic steroids, vitamins, vasodilating-drug and ATP drugs were used. SGB was also used repeatedly to attempt the improvement of circulation and to stimulate the recovery of nerve function. Physical therapy including electric acupuncture stimulation therapy(EAST) and hot pack was used to prevent the muscle atrophy. When No response was showed to this conservative therapies, surgery was considered. After treating two patients complaining of Bell's palsy with medication(systemic steroids) and EAST, favorable result was obtained. so author report the case of facial nerve paralysis.

전기미각측정기를 이용한 구강편평태선환자의 미각평가

김정우,박준상,고명연,안용우,Kim, Jung-Woo,Park, June-Sang,Ko, Myung-Yun,Ahn, Yong-Woo 대한안면통증구강내과학회 2006 Journal of Oral Medicine and Pain Vol.31 No.2

The purpose of this study was to investigate whether there were any changes in taste sensitivity with oral lichen planus (OLP). Sixty subjects (26 males and 34 females) were included for the study and they were categorized into 2 groups (oral lichen planus 30 persons,control 30 persons), oral lichen planus group was investigated in the department of Oral Medicine, College of Dentistry, Pusan National University from April, 2005 to February, 2006 and control group was investigated in the clinic at Cheongju City from february, 2006 to april, 2006. The electrical taste thresholds were measured using an electrogustometer of the 4 different sites (tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows; 1. The electrical taste threshold showed a tendency to decrease in the OLP group. 2. The electrical taste threshold showed a tendency to decrease in female group, but showed a tendency to increase in male group of the OLP group. 3. The electrical taste threshold showed a tendency to increase in tongue tip, tongue lateral of the multiple OLP group, but showed a tendency to decrease in circumvallate papilla, soft palate of the multiple OLP group. 4. The electrical taste threshold showed a tendency to increase in tongue tip, tongue lateral of the acute OLP group, but showed a tendency to decrease in circumvallate papilla, soft palate of the acute OLP group. 5. After treatment, electrical taste threshold was significant lower in soft palate of the OLP group than control group. 6. After treatment, NAS was significantly lower in soft palate of the OLP group than control group.

A Clinical Effect of Electro-Acupuncture Stimulation Therapy on TMD Patients

박태식,박준상,고명연,Park, Tae-Sik,Park, June-Sang,Ko, Myung-Yun The Korean Academy of Orofacial Pain and Oral Medi 2000 Journal of Oral Medicine and Pain Vol.25 No.3

측두하악장애의 치료에 이용되는 저주파 전자침 자극요법의 임상적 효과를 평가하기 위하여 치료를 시행한 28명과 치료를 전혀 시행하지 않은 10명의 대조군을 대상으로 치료전과 치료 2주 후에 경혈점의 압력통각역치와 임상지수를 측정하여 다음과 같은 결론을 얻었다. 1. 환자군에서 저주파 전자침 자극요법을 시행하기 전과 후의 임상지수가 유의하게 변화하였다(P<0.001). 2. 환자군에서 저주파 전자침 자극요법을 시행하기 전과 후의 압력통각역치는 G2, G21, Li4, S2, S3, S8, Si19 및 T17에서 유의하게 증가하였다(P<0.05). 3. 대조군에서 임상지수와 압력통각역치는 실험 전후에 차이가 없었다. 4. 환자군의 임상지수가 대조군에 비하여 유의하게 변화하였다 (P<0.05). 본 연구는 저주파 전자침 자극요법의 주관적 뿐만 아니라 임상적인 효과를 보여줌으로써 측두하악장애환자의 치료에서 저주파 전자침 자극요법이 유용한 방법임을 제시하였다.

코골이 환자의 처치

장동훈,박준상,고명연,Jang, Dong-Hoon,Park, June-Sang,Ko, Myung-Yun 대한안면통증구강내과학회 2000 Journal of Oral Medicine and Pain Vol.25 No.2

Snoring, the sign of obstructive sleep apnea may cause medical problems and also a serious problem in human relationship. Some of the treatment methods for snoring patients are drug therapy, intraoral appliance, surgical operation, etc. This is a case report of a 48 years old female patient who continuously complained about snoring after uvulopalatopharyngoplasty and a remarkable improvement of the symptom after the delivery of an oral appliance.