• 제목/요약/키워드: Acute pain

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흉부 손상의 임상적 고찰 (Clinical Evaluation of Chest Trauma)

  • 김용한
    • Journal of Chest Surgery
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    • 제25권9호
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    • pp.968-975
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    • 1992
  • A clinical analysis was performed on 404 cases of the chest trauma who were admitted and treated at department of thoracic and cardiovascular surgery, Chung Ang University, Yong San Hospital during the past 8 years from July 1984 to April 1992. The results were as follows. 1. The sex ratio was 3: 1 with male predominence. 2. The common age groups were 3rd, 4th, 5th and 6th decades. 3. The most common chief complaint was chest pain[58.2%]. 4. Of 404 cases of chest trauma, 50 cases were resulted from penetrating injuries whereas 354 cases were from non penetrating injuries. The most common cause of the non penetrating injuries was traffic accident[234/354, 66.1%] and of the penetrating injuries were stab wound[47/50, 94%]. 5. The left thorax was the preferred site of chest trauma. 6. The range of hospital stay was from less than 1 week to over 6 weeks and the average duration was about 2 weeks. 7. The common chest trauma was rib fracture[51.6%] and others were simple contusion [18.8%], hemothorax[14.6%], hemopneumothorax[14.9%] and pneumothorax[8.7i]. The rib fracture was prevalent between 4th to 9th rib laterally. 8. There were 92 cases of associated injuries which were bone fracture[66/92, 71.7%], head injury[17/92, 18.5%] and abdominal injury[9/92, 9.8%]. 9. The methods of treatment were conservative management[58.6%], closed tho-racostomy[23.3%], open thoracotomy[3.4%] and others. 10. There were 28 cases[6.9%] of complication, such as pneumonia, atelectasis, emp-yema, respiratory failure and others. 11. The overall mortality was 2.5%[10 cases] and causes of death were hypovolemic shock, acute renal failure, adult respiratory distress syndrome, sepsis and multiple organ failure.

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외상성 횡경막 허니아 (Traumatic Diaphragmatic Hernia)

  • 장봉현;한승세;김규태
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.839-846
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    • 1987
  • The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

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Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

  • Kim, Du-Han;Kim, Beom-Soo;Baek, Chung-Sin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • 제23권1호
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    • pp.20-26
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    • 2020
  • Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

야교등의 항산화 및 간보호효과 (Effect of Polygoni Multiflori Ramulus extract against arachidonic acid and iron-induced oxidative stress in HepG2 cell and CCl4-induced liver injury in mice)

  • 전창권;정지윤;박정아;지선영;김상찬
    • 대한한의학방제학회지
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    • 제25권2호
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    • pp.155-166
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    • 2017
  • Objectives : Polygoni Multiflori Ramulus has been widely used as a traditional medicinal herb for the treatment of insomnia, limb pain and itch. The extract of Polygoni Multiflori Ramulus (PMRE) is known to have a modulatory effect of many inflammatory responses. This study was performed to investigate the hepatoprotective effect of PMRE against arachidonic acid (AA) + iron-induced oxidative stress on HepG2 cell and carbon tetrachloride ($CCl_4$)-induced liver injury on mice. Methods : The effects of PMRE on cell viability was assessed by MTT assay. And flow cytometric analysis was performed to estimate the effects on mitochondrial function. To investigate its underlying mechanism, apoptosis-related proteins were analysed by using immunoblot analysis. In addition, ICR mouse were administrated (po) with the PMRE (30, 100 mg/kg) for 3 days and then, injected (ip) with $CCl_4$ (0.5 ml/kg body weight) to induce acute liver damage. The level of pro-caspase-3 was measured. Results : Treatment of PMRE increased relative cell viability, prevented a cleavage of poly (ADP ribose) polymerase and pro-caspase-3, and also reduced mitochondrial membrane permeability against AA + iron-induced oxidative stress. In addition, PMRE treatment decreased liver injury induced by $CCl_4$, as evidenced by increases in pro-caspase-3 level. Conclusions : These results demonstrate that PMRE has an ability to anti-oxidant and hepatoprotective effect against AA + iron-induced oxidative stress and $CCl_4$-induced liver injury.

방사선 피부염 치료법에 대한 문헌고찰 (A Literature Review of Management on Radiodermatitis)

  • 권미혜;윤지현;김은혜;이지영;윤성우
    • 대한암한의학회지
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    • 제25권1호
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    • pp.11-24
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    • 2020
  • Objective : Radiodermatitis is a common sequelae in 95% of patients receiving radiation therapy, which is important to be well managed as it can affect the patient's quality of life as well as the cancer treatment schedule. The aim of this study is to review and summarize the interventions available for the treatment of acute radiodermatitis, including traditional Korean medicine, and to propose treatment algorithms for clinicians. Methods : To collect studies about managements for radiodermatitis, domestic and foreign database were used such as Korean journal of traditional knowledge portal (KTKP), Korean studies information service system (KISS), national discovery or science leaders (NDSL), and oriental medicine advance searching integrated system (OASIS), Pubmed, Google scholar and Scopus. Results : Thirty-two studies were selected. There were nine studies on usual care and dressing, eleven studies on chemical agents, two studies on biological preparations, and ten studies on herbal medicines. Conclusion : Hygienic options and dressings have proved to be useful in the management of radiodermatitis. Chemical agents such as corticosteroid, statin, and topical antibiotic agent have proved to alleviate symptoms and severity, regenerate damaged skin, and prevent secondary infection. In biological preparations, EGF (epidermal growth factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) could be used to protect skin and prevent radiodermatitis. For herbal medicines, Calendula, catechin, β-sitosterol, and Jaungo (紫雲膏) may be effective for symptoms including pain, itching, and burning sensation induced by radiation therapy. Because of some research with conflicting results, further studies are needed to propose an algorithm for more optimal treatments.

Severe ileus after colonoscopy in a patient on peritoneal dialysis

  • Kim, Sang Un;Kim, Su Hee;Hwang, So Yoon;Kim, Ryang Hi;Choi, Ji-Young;Cho, Jang-Hee;Kim, Chan-Duck;Kim, Yong-Lim;Park, Sun-Hee
    • Journal of Yeungnam Medical Science
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    • 제34권1호
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    • pp.119-122
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    • 2017
  • Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.

볼거리 고환염에 따른 무정자증: 2례 (Azoospermia Following Mumps Orchitis:2 Case)

  • 심현선
    • 한국콘텐츠학회논문지
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    • 제16권11호
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    • pp.767-775
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    • 2016
  • 볼거리(mumps)는 타액선을 비롯한 전신에 침범하는 급성 바이러스성 염증 질환으로 일측성 또는 양측성 이하선의 종창과 통증을 동반한다. 볼거리 바이러스는 공기, 타액, 소변으로 다른 사람들에게 전파 되고, 학교, 군대 등 인구밀도가 높은 집단에서 발생하며 양측 고환에 침범하는 경우는 10-60% 정도이다. 사춘기 이후에 남성 볼거리 고환염(mumps orchitis)에 이완되는 경우 1-2개월 후에 감염자의 50%에서 심한 고환 위축과 같은 합병증이 발생한다. 볼거리 고환염은 정자 수, 형태, 운동성 등에 영향을 미치고 정자감소증과 드물게 무정자증으로 인한 불임이 발생한다. 볼거리 고환염이 의심되는 경우 초기 대증적 치료를 적극적으로 함으로써 장차 성인이 되었을 때 무정자증으로 인한 불임을 예방할 수 있을 것으로 생각된다. 본 증례에서는 볼거리 고환염을 앓은 후 무정자증을 보인 2례를 경험하였기에 초음파검사와 정액검사에 대해 참고문헌과 함께 보고하고자 한다.

간호 대학생의 간호과정 앱 사용의도 및 적용 평가 (Evaluation of Adaption and Intent to Use Smartphone Application for Nursing Process of Nursing Student)

  • 조훈;홍성정;김화선
    • 한국산학기술학회논문지
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    • 제14권12호
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    • pp.6403-6412
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    • 2013
  • 본 연구는 임상실습을 하는 간호학생들의 간호과정 스마트폰 애플리케이션의 사용의도를 조사하고, 이 프로그램의 적용효과를 평가하기 위해 시도되었다. 연구대상자는 대구 지역 일개의 간호대학 3학년 학생으로, 2012년 9월부터 2013년 9월까지 외과 병동 성인간호학 실습을 나가는 60명이다. 연구결과 간호과정 스마트폰 사용의도는 학습의 용이성, 사회적 영향, 자기효능감과 유의한 관계가 있었다. 그리고 대상자에게 적용된 간호과정 앱 애플리케이션은 급성통증에 대한 진단, 중재, 결과에 대한 목록이 가장 많았고, 프로그램 사용 만족도는 4.35점이었다. 이 연구결과를 통해 간호과정 앱은 임상실습 현장에서 간호과정 앱 사용에 대한 더 많은 기회와 교육을 제공하고, 그것의 활용에 관하여 손쉽게 적용될 수 있는 방안이 마련되어야 할 것이다.

비확장성 요관결석에 대한 컬러 도플러의 유용성 (Usefulness of Color Doppler for Non-dilatational Ureteral Stone)

  • 심현선
    • 한국콘텐츠학회논문지
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    • 제17권1호
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    • pp.120-128
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    • 2017
  • 요로결석증으로 인한 급성 옆구리 통증은 환자들이 응급실로 방문하는 가장 흔한 질병이다. 연구의 목적은 수신증이 동반되지 않은 환자에서 컬러 도플러를 이용하여 요관결석 검출의 유용성에 대하여 알아보고자 한다. 신장, 요관, 방광의 단순 x-ray 검사에서 요로결석 의심 소견자 또는 소변검사에서 혈뇨 양성반응을 보인 161명의 환자를 대상으로 초음파 검사를 시행하고 후향적으로 분석하였다. 초음파검사에서 진단된 요관결석은 161명 환자 중 154례 (95.6%) 이었다. 수신증이 없고 컬러 도플러 초음파검사에서 섬광인공물(TA)을 동반한 요관결석은 21명 중 18례 (85.7%)이었다(p<0.001). 초음파는 비교적 저렴하고, 보편적으로 사용하므로 옆구리 통증을 갖는 환자의 요로결석 진단에 우선적으로 이용할 수 있다. 컬러 도플러를 이용하여 구분되지 않은 결석, 비확장성 요관결석, 중간요관 결석 검출에 높은 진단 효과를 갖는다.

복방홍등패장산(復方紅藤敗醬散)의 항혈전(抗血栓) 및 항염작용(抗炎作用)에 대한 실험적(實驗的) 연구(硏究) (The Experimental Study on Anti-thrombotic and Anti-inflammatory Effect of BokbangHongdeungPaejangSan (BHPS))

  • 임동욱;유동열
    • 대한한방부인과학회지
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    • 제19권3호
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    • pp.151-173
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    • 2006
  • Purpose : This study was performed to evaluate anti-thrombotic and anti-inflammatory effects of BokbangHongdeungPaejangSan water extract (BHPS). Methods : BHPS was investigated using cultured cells and a murine models. As for the parameters of inflammation, levels of several inflammatory cytokines and chemical mediators which are known to be related to inflammation were determined in mouse lung fibroblast cells (mLFC) and RAW 264.7 cells. Results : In experiment of anti-thrombotic effect, BHPS inhibited the platelet aggregation induced by ADP and epinephrine, and inhibited pulmonary embolism induced by collagen and epinephrine. BHPS increased Platelet number and fibrinogen amount, and shortened PT and APTT in thrombus model induced by dextran. In experiment of anti-inflammatory effect, BHPS inhibited IL-1${\beta}$, IL-6, TNF-${\alpha}$, COX-2 and NOS-II mRNA expression in a concentration-dependent manner in RAW 264.7 cell line, and inhibited significantly NO production at 50, 100 ${\mu}g/ml$, and also inhibited ROS production in a concentration-dependent manner. BHPS inhibited IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production significantly in serum of acute inflammation-induced Balb/c mice, and decreased IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production in spleen tissue, but increased IL-1${\beta}$, IL-6 and TNF-${\alpha}$ production in liver tissue. BHPS increased survival rate at the 3th day in ICR mice with lethal endotoxemia induced by LPS. Conclusion : These results suggest that BHPS can be used for treating diverse female diseases caused by thrombosis and inflammation such as endometriosis, pelvic pain, cervicitis, pelvic inflammatory disease and pelvic tuberculosis and so forth.

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