• Title/Summary/Keyword: 통증 양상

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Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease 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.

Case report: Full mouth rehabilitation for patient with heavy occlusal force and excessive abrasion (강한 교합력과 과도한 마모를 보이는 환자의 전악수복 증례)

  • Park, Ji-Hee;Vang, Mong-Sook;Yang, Hong-So;Park, Sang-Won;Yun, Kwi-Dug;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.119-124
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    • 2013
  • Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.

Evaluation of Nerve Conduction Study Result in Carpal Tunnel Syndrome before and after operation in eastern area of Jeonnam (전남 동부지역에서 손목터널증후군의 수술 전 후 신경전도검사 결과의 평가)

  • Seo, Choong-Won;Kim, Chul-Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5305-5310
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    • 2012
  • This study is Carpal tunnel syndrome(CTS) disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and Nerve Conduction Study(NCS). NCS of the median nerve before and after operation were compared in twenty four patient's with CTS, in order to seventeen patient's evaluate the prognostic value of that findings. Analysis result symptom profile of CTS in total number of patient's 17 (Female:17, Male:0), 21 hands (Rt:9, Lt:4, Both:4), Ages(31~60), Mean duration of symptom months($46.6{\pm}36.1$), Mean interval between 1st and 2nd NCS months($20.5{\pm}7.1$), Sensory symptoms(Tingling:21, Numbness:19, Noctunal paresthesia:17), Motor symptoms(Thenar atrophy:20, Trigger finger:2, Morning stiffness:3), Post-operative symptoms(Free:38.1%, >50% improve:52.4%, <50% improve:9.5%). NCS was normal range after operation than before in Sensory nerve conduction study 4 patients's and Motor nerve conduction study 5 patients. Surgery before and after Sensory nerve action potential (SNAP) responses showed improvement over the previous results. Forward by the patient's occupation and occupation patterns of CTS, other treatment methods and surgical treatment of CTS by comparing the degree of improvement to identify and correct nerve conduction study to judge whether the patient's operation.

Botulinum Toxin type A injection Versus Lidocaine Injection for Myofascial Pain Involving upper Trapezius (승모근 근막동통에 대한 보툴리눔 독소와 리도카인 주사의 치료효과 비교)

  • Ahn, Sung-Woo;Park, Eun-Hee;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.345-351
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    • 2005
  • The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.

Evaluation of Dental Terminology System Using GRAIL: A Pilot Study (GRAIL을 이용한 치의학 용어 체계의 평가)

  • Kim, Young-Jun;Lee, Jon-Ki;Kim, Myeng-Ki;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.189-204
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    • 2001
  • 본 연구는, 기존의 나열식 분류체계의 문제점을 극복할 수 있는 GRAIL을 이용하여 두경부의 해부학적 구조물들 및 구강 악안면 영역의 주요 질병들과 관련된 치의학 개념들의 모델을 구축한 뒤, 완성된 치의학 개념 모델이 두경부의 해부학적 구조물들 및 구강 악안면 영역의 주요 질병들을 잘 표현할 수 있는지와 기존의 GRAIL 모델이 지닌 특징에 잘 부합하는지를 평가하고자 시행되었다. 서울대학교 치과병원 내원 환자 중 포괄적인 치과 치료 병력을 지닌 환자 150명의 치과 의무기록을 내용별로 분석하고, 각종 치의학 교과서와 기존의 의학용어 분류체계에서도 모델 구축에 필요한 치의학 용어를 선택하였다. 이들 자료를 바탕으로, GRAIL 모델 구축을 진행하고 구축된 모델을 평가할 수 있는 소프트웨어 프로그램인 'KnoME'에서 치의학 개념 모델을 구축하고 평가하여, 다음과 같은 결론을 얻었다. 1. 환자 150명의 치과 의무기록을 내용별로 분석한 결과, 우선적으로 모델 구축이 필요한 치의학 용어로는, 해부학적 구조물의 경우 치아, 치은, 악관절, 입술, 턱, 혀 등의 순서로 나타났으며, 구강악안면 영역의 병소에서는 치아 우식증, 치주염, 치은염, 악관절 장애, 매복 지치, 치경부 마모 등의 순서로 나타났다. 2. GRAIL을 이용하여 치아, 치주조직, 구강점막조직, 치아 우식증, 치수 및 치근단 병소, 치주질환, 구강점막질환의 모델 구축을 시행한 결과, 치의학 개념간의 다양한 관계가 대다수 잘 표현되었다. 그러나, 구강 악안면 영역의 해부학적 구조물에 대한 공간 정의의 한계성과 구강 악안면 질환의 진행 양상에 있어서 표현의 어려움이 관찰되었다. 이러한 부분은 GRAIL을 치의학 분야에 적용할 때, 극복해야 할 한계로 나타났다. 3. 치의학 개념들에 관한 다양한 질의를 시행한 후 그 응답 내용을 평가한 결과, 완성된 모델 내에서 치의학 개념의 자동적인 분류가 이루어 졌으며, 다양한 목적의 검색이 가능하였다. 이와 같은 사실로 미루어 보아서, 완성된 모델은 기존의 GRAIL 모델의 특성에 잘 부합되는 것으로 생각되었다.

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Ultrastructural and Neurophysiological Changes Observed Following Injection of Morphine, Meperidine and Pentazocine in the Sciatic Nerves of Rabbits (가토의 좌골신경에 Morphine, Meperidine, Pentazocine을 주사한 후 미세형태학적 및 신경생리학적 변화)

  • Cheun, Jae-Kyu;Kim, Sae-Yune;Bae, Jung-In
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.213-220
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    • 1992
  • The sciatic nerves of anesthetized rabbits were exposed and stimulated by a nerve stimulator in order to observe the myoneural response. These rabbits were divided into three groups and respectively injected with morphine (Group 1), meperidine(Group 2) and pentazocine (Group 3). The sciatic nerves were stimulated periodically and gait changes were observed to see the myoneural activity after the injections. When the distal part of the sciatic nerves were stimulated by the nerve stimulator after the respective drug injections, the normal muscle twitch responses were observed in all the progressional stages of Group 1. However, in Group 2 and 3, the muscle twitch responses decreased gradually, finally disappearing after approximately 10 minutes in these two groups. Complete motor paralysis continued for about 60 minutes. The muscle reactions returned to normal approximately 90 minutes after injection. Specimens drug-injected tissues were severed 4 hours, 24 hours and 1 week after injection respectively. These tissue were investigated under light as well as electron microscopy. The tissue revealed rare to moderate vacuolizations scattered in the axons of the myelinated and unmyelinated nerves of some of the specimens; however, there were no significant pathologic lesions. These results provide evidence that neurophysiologically, meperidine and pentazocine have a local anesthetic-like effect such as motor paralysis, but morphine does not. In addition, the results indicated that neurohistologically, the three narcotics have no significant toxic effects on the nerve tissue.

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Descending Thoracic Aorto-bifemoral Artery Bypass Grafting in a Leriche's Syndrome (Leriche's 증후군에서 흉부하행대동맥-양측 대퇴동맥 우회술)

  • Chung, Jae Ho;Son, Ho Sung;Yi, Eun Jue;Son, Kuk Hui;Kang, Moon Chul;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.104-106
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    • 2009
  • Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.

Model on the Capillary Action-Induced Dynamics of Contact Lens (모세관 작용에 의한 콘택트 렌즈의 운동 모델)

  • Kim, Dae-Soo
    • Journal of Korean Ophthalmic Optics Society
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    • v.6 no.2
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    • pp.85-97
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    • 2001
  • A mathematical model was proposed to analyze the damped motion of contact lens which is initially displaced from the equilibrium position. The model incorporates the differential equations and their numerical solution program, based on the formulations of restoring force arising from the capillary action in the tear-film layer between the lens and cornea. The model predicts the capillary action induced surface tension, time dependence of displacement of lens when it is released from the equilibrium position. It seems that the motion of lens is similar to the typical over-damped oscillation caused by the large viscous friction in the liquid layer between the cornea and lens. The effect of variables such as base curves, lens diameters and thickness of tear film layer were illustrated by the computer simulation of the derived program. The time required for the lens to return to the original position increases as the liquid layer thickness increases and it decreases as the diameter of lens increases. With the certain value of base curve the time interval is found to be minimum. The free vibrations of lenses were also simulated varying the parameters such as base curve, diameter, layer thickness. The resonant frequencies are inversely proportional to the liquid layer thickness and it increases as the lens diameter increases. The resonant frequency of lens has a maximum when the diameter is of certain value. If the external impulse or force of the same frequency as the natural frequency of contact lens acted on the cornea in vivo it may cause an excessive movement and thus it might cause the distortion 10 the lens or be pulled off the eye.

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Effect of a Mouthwash Containing Cetylpyridinium and Zinc Chloride on Oral Malodor (세틸피리디늄(Cetylpyridinium) 및 염화아연(Zinc chloride)을 함유한 구강 양치액의 구취제거 효과에 대한 연구)

  • Kim, Ju-Sik;Park, Ji-Woon;Kim, Dae-Jung;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.245-252
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    • 2011
  • The aim of this study is to clinically evaluate the effect of a mouthwash containing cetylpyridinium and zinc chloride on reduction of morning oral malodor in healthy subjects measured by organoleptic measurement and a portable sulfide monitor. A total of 8 healthy non-smoking male volunteers were enrolled in this study of crossover design consisting of two experimental phases. The subjects were instructed to rinse the mouth with 10 mL of the experimental mouthwash containing cetylpyridinium and zinc chloride for 30 seconds at the first phase. At the second phase after a one-week washout period, each subject rinsed with distilled water as a control. All experiments were conducted at around 8:30 a.m. and oral malodor was measured using organoleptic measurement and a portable sulfide monitor just before rinsing with the experimental mouthwash or control (baseline), 1 hr, 2 hrs, and 3 hrs after rinsing. The mouthwash containing cetylpyridinium and zinc chloride reduced morning oral malodor up to 3 hrs after rinsing. Organoleptic score and concentrations of volatile sulfur compounds after use of the experimental mouthwash significantly decreased with time, and the decreases were significantly different between the mouthwash and control. In conclusion, the mouthwash containing cetylpyridinium and zinc chloride is significantly effective on reduction of morning oral malodor in healthy subjects by 3 hrs.