• Title/Summary/Keyword: 통증 관리

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Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$ (자기공명분석기를 이용한 통증관리)

  • Park, Wook;Jin, Hee-Cheol;Cho, Myun-Hyun;Yoon, Suk-Jun;Lee, Jin-Seung;Lee, Jeong-Seok;Choi, Surk-Hwan;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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Psychology and Quality of Life in Cancer Patients on Radiation Therapy (방사선치료 중인 암 환자의 심리와 삶의 질)

  • Yang Jong-Chul;Chung Woong-Ki
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.271-279
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    • 2004
  • Purpose: The object of this study Is to investigate sociodemographic and clinical characteristics, psychology, self-esteem and quality of life in cancer patients on radiation therapy and to provide useful information for therapeutic approach to cancer patients on radiation therapy. Materials and Methods: The subjects were 36 patents who had been treated with radiation therapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients on radiation therapy were investigated, and symptom checklist-90-revised, Rosenberg Self-esteem Scale for self esteem, World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. And Spearman's correlation analysis was used among these. Result : The tendency of somatization, depression, anxiety and hostility in cancer group were significantly higher than normal group. Self esteem and quality of life in cancer group were significantly lower than normal group. No significant difference was found in comparison of psychology, self esteem and qualify on life according to sociodemographic variables. Among clinical characteristics, in the presence of metastasis in cancer patients, the scores of anxiety, phobia and paranoid ideation were higher In patients with pain, the score of somatization was higher And in case of weight loss, the score of somatization was higher. The higher score of depression, anxiety and hostility were significantly associated with lower self-esteem. And higher score of somatization, depression, anxiety and hostility were significantly associated with lower quality of life. Conclusion: Understanding and management of psychological symptoms, such as somatization, depression, anxiety, and hostility, and pain control are necessary to improve quality of life in cancer patients on radiation therapy.

Quality of life in patients with diabetes mellitus compared with non-diabetic subjects in Korea: The 5th Korea National Health and Nutrition Examination Survey (비당뇨병 환자와의 비교를 통한 우리나라당뇨병 환자의 삶의 질; 제5기 국민건강영양조사(2010-2012))

  • Shin, Hwan Ho;Han, Mi Ah;Park, Jong;Ryu, So Yeon;Choi, Seong Woo;Park, Seon Mi;Kim, Hyo Ju
    • Journal of agricultural medicine and community health
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    • v.40 no.1
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    • pp.21-31
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    • 2015
  • Objective: This study was to evaluate the health-related quality of life (HRQoL) among patients with diabetes in Korea and to compare them with the HRQoL of individuals without diabetes history. Methods: The study subjects were 17,655 adults aged over 19 who participated in the 5th Korea National Health and Nutrition Examination Survey (2010-2012). The EuroQoL-5Dimension was used to evaluate HRQoL. Chi-square test, t-test, ANOVA and multiple regression analysis were performed to test the difference of HRQoL in diabetic subjects and controls. Results: The mobility dimension was the highest reported problem: 36.4% for diabetic subjects. The proportion of any reported problem was significantly high among diabetic subjects compared with two controls in terms of mobility [reference group: diabetic subjects, chronic controls: adjusted odds ratio (aOR)=0.77, 95% confidence interval (95% CI)=0.66-0.91, healthy controls: aOR=0.61, 95% CI=0.50-0.75], self-care [reference group: diabetic subjects, chronic controls: aOR=0.68, 95% CI=0.55-0.83, healthy controls: OR=0.69, 95% CI=0.51-0.94]. and usual activities [reference group: diabetic subjects, chronic controls: aOR=0.85, 95% CI=0.72-0.99, healthy controls: OR=0.79, 95% CI=0.62-0.98]. Also, EQ-5D index were significantly low in subjects with diabetes compared to two controls. Conclusions: Subjects with diabetes had a significantly lower HRQoL compared with two controls. To improve the quality of life of diabetics, it is necessary to study various variables related to the quality of life, and develop and manage various health programs or welfare policies reflecting socio-demographic characteristics and health related features that affect the quality of life.

Unmet Medical Service Needs in Family Caregivers of Terminal Cancer Patients (말기암환자 가족간병인의 미충족 의료 분석)

  • Shin, Woong Jae;Hwang, Sun Wook;Hwang, In Cheol;Choi, Youn Seon;Lee, Yong Joo;Kim, Young Sung;Shin, Ji Sung;Choi, Young Ho;Rim, Da Won;Kim, Han Sook
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.163-169
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    • 2016
  • Purpose: The unmet medical service needs of caregivers critically influence their caring for terminal cancer patients, but not much research has been done in this regard. Thus, the purpose of this study is to investigate the association between caregivers' characteristics and their unmet medical service needs. Methods: The survey was conducted with 109 family caregivers of terminal cancer patients admitted to four hospice units. The data were collected from March 2014 through December 2014 using a structured questionnaire. The unmet medical service needs were measured using 14 items which were adopted and modified by authors. Results: Seven areas of unmet medical service needs were shown to be significant. A well-educated group showed stronger needs for counsel about cancer screening and complementary-alternative medicine and health supplement food. A never-smoked group was identified with less need for sexual dysfunction counsel. Counsel about family and personal relations was more necessary for current drinkers and current workers, and less necessary for the married. Insurance counsel was more needed for a no-religion group. Occupation counsel was less necessary for healthy patients. Financial support was less necessary for the married group. Conclusion: Based on the results, it is highly recommended to further investigate the unmet medical service needs of family caregivers for terminal cancer patients and causes of the unmet needs.

Oral Health Status and Dental Treatment Need of Liver Transplant Candidates (간 이식 예정 환자의 구강건강상태 및 치과치료 요구도에 관한 연구)

  • Park, Tae-Jun;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.1-9
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    • 2009
  • Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

Hepatic glycogenosis in a patient with poorly controlled type 1 diabetes mellitus (혈당 조절이 불량한 제1형 당뇨병 환자에서 발생한 간의 당원축적증)

  • Jin, Hye-Young;Kang, Dae-Young;Choi, Jin-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1279-1282
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    • 2009
  • Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report (체계적 분석, 진단, 치료 계획을 통한 전악 보철 재건 증례)

  • Kwon, Sooyeon;Paek, Janghyun;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.332-338
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    • 2013
  • Data collection including checking the problem list and analyzing the etiology cannot be overemphasized in full mouth rehabilitation cases. It is well reported that favorable prognosis of prosthodontic treatment depends on accurate diagnosis. Seventy seven year old female patient presented with chief complaints of chewing pain on maxillary and mandibular left premolars and unesthetic existing prosthesis. Clinical evaluation, radiographic examination and cast analysis were performed to gather comprehensive data and problem lists. Treatment planning was based on collected data and related articles. Abutment evaluation, prognosis depending on various types of prosthesis, and maintenance were considered as well. Occlusal vertical dimension was increased to solve esthetic dissatisfaction and insufficient interocclusal space. Patient adaptation was verified with provisional restorations followed by diagnostic wax up. Function, esthetics and occlusal stability were verified during 8 week follow-up period. Prosthodontic reconstruction based on systemic analysis, diagnosis, and treatment plan led to satisfactory result after delivery of definitive prosthesis.

Inpatient Dental Consultations to Pediatric Dentistry in the Yonsei University Severance Hospital (연세대학교 세브란스 병원 내 입원한 환자의 소아치과 의뢰 현황)

  • Joo, Kihoon;Lee, Jaeho;Song, Jeseon;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.145-151
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    • 2014
  • The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

Effect of Chamaecyparis obtusa tree Phytoncide on Candida albicans (편백 피톤치드가 Candida albicans에 미치는 영향에 대한 연구)

  • Kang, Soo-Kyung;Auh, Q-Schick;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.19-29
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    • 2010
  • Phytoncide, essential oil of trees, has microbicidal, insecticidal, acaricidal, and deodorizing effect. The present study was performed to examine the effect of phytoncide on Candida albicans, which is a commensal colonizer of the mucous membranes but has become an opportunistic pathogen. C. albicans was incubated with or without phytoncide extracted from Hinoki (Chamaecyparis obtusa Sieb. et Zucc.; Japanese cypress) and then changes were observed in its optical density, cell viability and morphology. As concentrations of phytoncide added to the culture medium increased, optical density and cell viability of C. albicans decreased. Minimum inhibitory concentration of phytoncide for C. albicans was observed to be 0.25%, and minimum fungicidal concentration was 0.5%. Numbers of morphologically atypical cells with electron-dense cytoplasm and granules and increased with increasing concentration of the phytoncide. At higher concentrations of phytoncide, compartments and organelles in the cytoplasm became indistinguishable. The overall results indicate that the phytoncide used for this study has a strong antimicrobial activity against C. albicans. Therefore, the phytoncide may be used as a candidate for prevention and therapeutic agent against oral candidiasis.

A Latent Class Analysis and Predictors of Chronic Diseases -Based on 2014 Korea National Health and Nutrition Examination Survey- (만성질환에 관한 잠재계층분석과 예측요인 -2014 국민건강영양조사를 중심으로-)

  • Kim, Woo-Jin;Lee, Song-Yi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.324-333
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    • 2018
  • The aim of this study was to investigate the latent classes and predictors of chronic diseases such as hypertension, dyslipidemia, arthritis, thyroid disease, depression, atopy, allergy, and diabetes. The subjects of this study were Korean citizens who participated in the Korea National Health and Nutrition Examination Survey in 2014. Stratified cluster sampling method was used with a sample size of 7,550. Latent hierarchy analysis was applied to this data. Four classes were identified. Class 1 consisted of participants with hypertension and diabetes. Class 2 consisted of participants with atopy and allergies. Class 3 consisted of participants with dyslipidemia, arthritis, thyroid disease, and depression. Class 4 consisted of participants without any chronic diseases. In comparing Class 1 to Class 4, age, physical activity, self-management, obesity, and presence of high cholesterol were found to be significant. In comparing Class 2 to Class 4, gender, age, and education level were significant. When Class 3 was compared to Class 4, gender, age, pain and discomfort, as well as high cholesterol were found to be significant. Diabetes and hypertension should be treated as comorbid conditions, applying integrated treatments involving effective drug treatment, diet, and physical activity programs. Atopy was found to be strongly correlated with allergies. Thyroid disease was found to coexist with dyslipidemia and arthritis, along with having a strong correlation to depression. Age-appropriate preventive measures can help reduce the risk of chronic diseases.