• Title/Summary/Keyword: Acute pain

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Primary Pericardial Fibrosarcoma Presenting as Cardiac Tamponade - A case report - (심낭압전으로 발견된 원발성 심낭 섬유육종 - 1예 보고 -)

  • Lim, Ju-Yong;Sung, Kyu-Wan;Kang, Gil-Hyun;Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.574-577
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    • 2007
  • Primary malignant neoplasm of the pericardium is very rare, Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.

A Case of a Solitary Fibrous Tumor of the Pleura Presenting as Pneumonia and Acute Respiratory Failure (폐렴과 급성 호흡부전으로 나타난 흉막의 고립성 섬유성 종양 1예)

  • Park, Hye Sun;Kwak, Hyun Jung;Park, Dong Won;Koo, Tai Yeon;Kim, Hye Young;Park, So Yeon;Ahn, Seong Eun;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Chung, Won Sang;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.334-338
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    • 2008
  • Solitary fibrous tumors of the pleura (SFTPs) are relatively rare tumors that originate from the mesenchymal cells of the submesothelial tissue of the pleura. Patients with SFTPs are often asymptomatic, while some patients experience pleuritic chest pain, cough and/or dyspnea. We report here on a case of SFTP, and the patient presented with septic shock and respiratory failure that required mechanical ventilation. A 68-year-old woman was admitted for the evaluation of her dyspnea and generalized edema. Chest imaging studies showed an 18 cm-sized voluminous mass occupying the right thoracic cavity with anterior displacement of hilar structures and atelectasis of the right lung. Immediately after admission, she developed pneumonia and septic shock that required antibiotics and mechanical ventilation. She displayed a partial response to medical treatment, and then complete excision of the tumor was performed and the pathologic examination revealed benign SFTP. Afterward, she fully improved without evidence of recurrence until now.

Capsaicin Induces Acute Spinal Analgesia and Changes in the Spinal Norepinephrine Level (Capsaicin에 의한 척수 수준에서의 급성 진통효과와 Norepinephrine의 변화)

  • Park, Hyoung-SuP;Park, Kyung-Pyo
    • The Korean Journal of Pharmacology
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    • v.29 no.1
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    • pp.33-41
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    • 1993
  • Central analgesic effect of capsaicin was assessed by the tail flick reflex (TFR) test, using male Sprague-Dawley rats under anesthesia with pentobarbital sodium (induction with 40 mg/kg and maintenance with $4{\sim}8\;mg/kg/hr$). Level of norepinephrine in the spinal cord was also measured. Capsaicin, $35{\sim}150\;{\mu}g$, was injected intrathecally, and the TFR latency was measured before, 10, 30, and 60 minutes after the drug administration. TFR latency was increased 100% or more immediately by intrathecal capsaicin, from 2.9 seconds to the maximum of 7.0 seconds at 10 minute after the drug; P<0.01. The increase in TFR latency was maintained during the course of experiment of 2 hours. Concomitant reduction of NE content in the spinal cord was observed; from 16 ng/mg protein to 7 ng/mg protein. On the other hand, subcutaneous injection of capsaicin of 50 mg/kg did not change the TFR latency although the NE content reduced similarly to the case of intrathecal injection. Pretreatment of the animal with 0.5 mg/kg of MK-801 reversed the increase of TFR latency and NE reduction induced by intrathecal capsaicin. These results suggest that capsaicin causes analgesia at the spinal cord level by activating the excitatory amino acid-NE-dorsal horn interneurons axis of the descending inhibitory pain modulation pathway.

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Spinal Co-Administration of Ginsenosides with Morphine Prevents the Development of Opioid Tolerance and Attenuates Opioid Dependence

  • Choi Seok;Jung Se-Yeon;Nah Jin-Ju;Ahn Eun-Soon;Kim Yoon-Hee;Nam Ki-Yeul;Kim Seok-Chang;Ko Sung-Ryong;Rhim Hyewhon;Nah Seung-Yeol
    • Journal of Ginseng Research
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    • v.23 no.4
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    • pp.239-246
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    • 1999
  • The analgesic effect of ginsenosides or morphine was determined following intrathecal (i.t.) administration in rat tail-flick test. The effects of intrathecal co-administration of ginsenosides with morphine on the development of opioid tolerance and dependence were also examined using rat tail-flick test and naloxone-pre-cipitated withdrawal, respectively. Administration of ginsenosides (i.t.) produced a weak antinociception in a dose-dependent manner. Administration of morphine (i.t.) also produced antinociception in a dose-dependent manner. The $ED_50$ was $1.20\;{\mu}g\;(1.14\~1.29\;{\mu}g)$. However, the acute co-administration of $200{\mu}g$ ginsenosides with 0.1-1.0${\mu}g$ morphine did not show additive effect on morphine induced analgesia in rat tail-flick test. I.t. co-administration of 200 ${\mu}g$ ginsenosides with 10 ${\mu}g$ morphine for 7 days inhibited development of tolerance induced by 10 ${\mu}g$ morphine in rat tail-flick test, although i.t. co-administration of 50 or 100 ${\mu}g$ ginsenosides with morphine was without effect. I.t. co-administration of 200 ${\mu}g$ ginsenosides for 7 days also partially attenuated the development of morphine dependence as assessed by naloxone-precipitated withdrawal. In conclusion, these results suggest that i.t. administered ginsenosides produce a weak antinociception in rat tail-flick test and also prevent opioid tolerance and attenuate opioid dependence in chronic treatment with morphine at the spinal sites.

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Antioxidative Effects and Anti-proliferative Effects of MeOH, BuOH and Ethyl Acetate Fractionated from Stephania delavayi Diels (일문전(Stephania delavayi Diels.) 메탄올, 부탄올, 에틸아세테이트 분획물의 항산화 및 세포증식억제 효과)

  • Li, Yong-Chun;Kim, Kyoung-Hee;Xu, Hong-De;Park, Dae-Hun;Choi, Yeon-Shik;Hwang, Hye-Rim;Lee, Min-Jae;Choi, Jong-Jin;Kwon, Myung-Sang;Yook, Hong-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.297-301
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    • 2009
  • Stephania delavayi Diels. (S. delavayi Diels.) has been used as a drug for pain-relieving and acute gastroenteritis treatment in China. Because the major therapeutic mechanism of anti-inflammatory drug is to inhibit the cyclooxygenase (COX)-2 and because COX-2 proteins inhibit apoptosis, COX-2 inhibitor has been thought as the anticancer drug candidate. For this reason, we examined S. delavayi Diels. as an anticancer drug. S. delavayi Diels. was fractionated with methanol and then partitioned with ethyl acetate, n-butanol and water. The antioxidant activity was evaluated by 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity and reducing power. DPPH radical scavenging activities of the crude fractions at the concentration of $1,000{\mu}g/mL$ were 75.23% (n-butanol), 68.11% (methanol), 63.58% (ethyl acetate), and 50.13% (water). The reducing power increased according to the concentration in dose-dependent manner. Also, when the antiproliferation effects of each fraction against human breast cancer cell-lines MDA-MB-231 and MCF-7 were examined, methanol extract, n-butanol fraction and ethyl acetate fraction exhibited cell proliferative inhibition effects in both cell-lines whereas water fraction did not. Among the crude fractions, the n-butanol fraction exhibited the most potent anti-proliferation effect. In conclusion, fractions from S. delavayi Diels. are promising anticancer drug candidates.

Study of Medical Carein Health Subcenter (보건지소(保健支所) 진료활동(診療活動)에 관(關)한 연구(硏究))

  • Kim, Moon-Shik;Kim, Han-Joong;Kim, Young-Key;Kim, Il-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.109-116
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    • 1976
  • Reorganization of myun health care service is one of the main issues in health care delivery in rural Korea. The fundamenta, concept of the role and function of the myun health subcenter is that it is the basic unit of rural health care service and is to provide comprehensive health care service through the integration of curative and preventive services. The aim of this study is to analyze the patterns of curative activities in the myun health subcenter in terms of the most prevalent types of diseases, necessary diagnostic methods and required equipment, types of treatment, necessary drugs and materials, and finally the cost of curative services. The population on which this study was done was the 1596 patients who visited the two myun health subcenters (Sunwon Myun and Naega Myun) in Kang Wha County, the area of the Yonsei University Community Health Teaching Project, during period from May 1, 1975 to June 10, 1976. For the patient's record in the clinic, problem oriented medical records were used. Decisions regarding the disease classification, the diagnostic methods used and selection of the most appropriate and adequate medical treatment were made by a group of three experienced physicians after reviewing the medical records which had been written by public physicians who were treating patients in the study area. The records were reviewed by resident staff members of the Department of Preventive Medicine, of Yonsei University College of Medicine. A brief summary of results of the study is as follow: 1. 29.9% of the patients who visited the clinics were ages between 0-4. No sex difference was observed among patients less than 20 years of age. However, among patients over 20 years old, females predominated. Thus it is evident that the majority of patients were either children or mothers and grandmothers. 2. The distance from the individual villages to the myun health subcenter was one of important factors in determining the ratio of clinic visits. However, other factors such as the activities of the health workers also affected the rates substantially. 3. The most common 25 diseases comprised 90.2% of all the diseases recorded. Acute respiratory infection (25.5%), Skin (12.7%) , diarrheal diseases (6.8%), neuralgia and back pain (4.9%) and. all other injuries (3.9%) were the five most common diseases. 4. Of all the diseases diagnosed and treated, 9.2% required simple laboratory tests for diagnosis, 6.5% required X-ray examination, and altogether 13.6% required either laboratory test or X-ray examination. 5. Treatment and management of 42.0% of the cases could be accomplished with simple, inexpensive drugs, 12.8% required the use of more expensive drugs (mostly antibiotics) and injections were required in 19.7% of the cases. Minor surgery and referral were necessary in 5% of the cases. 6. The cost for diagnosis and treatment was estimated with a standard which was set by general concensus. The average cost of diagnosis was 144 per case and the cost of treatment was 726 per case, The Total average cost per visit was 870.

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A Case of Primary Antiphospholipid Syndrome with Pulmonary Thromboembolism (폐색전증을 동반한 원발성 항인지질증후군 1예)

  • Lee, Jae Beom;Sim, Yun Su;Noh, Young Wook;Park, Hye Sung;Tae, Chung Hyun;Lim, So Yeon;Jun, Yoon Hee;Ryu, Yon Ju;Chun, Eun Mi;Lee, Jin Hwa;Chang, Jung Hyun;Moon, Jin Wook
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.72-77
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    • 2007
  • Antiphospholipid syndrome (APS) causes recurrent thromboses and morbidity during pregnancy, including fetal loss. This malady is associated with the persistent presence of anticardiolipin antibody or lupus anticoagulant. The pulmonary manifestations of antiphospholipid syndrome include pulmonary thromboembolism, pulmonary hypertension, acute respiratory distress syndrome, etc. Pulmonary thromboembolism is often the initial manifestation of antiphospholipid syndrome and a timely diagnosis is critical due to the high mortality rate. We herein report on a 19-year-old man with pulmonary thromboembolism that was caused by primary antiphospholipid syndrome. He presented with blood-tinged sputum, fever and epigastric pain, and his chest computerized tomography showed pulmonary thromboembolism. The other possible causes of pulmonary thromboembolism were excluded and the diagnosis of primary antiphospholipid syndrome was confirmed by the lupus anticoagulant that was present on two occasions six weeks apart. We also discuss the nature and management of antiphospholipid syndrome, along with a brief review of the relevant literatures.

Effects of the Inspiratory Muscle Strengthening Training on the Respiratory Functions and the Quality of Life in Patients with Cervical Spinal Cord Injury Patients (들숨근 훈련이 경수손상환자의 호흡기능 및 삶의 질에 미치는 영향)

  • Shim, Yu-Jin;Moon, Ok-Kon;Choi, Wan-Suk;Kim, Bo-Kyung
    • The Journal of the Korea institute of electronic communication sciences
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    • v.8 no.11
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    • pp.1785-1792
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    • 2013
  • For patients suffering from spinal cord injuries, both of the possibility of having complications with the respiratory system and the related fatal rate are still high, while pneumonia is the most important cause of these fatalities. This research was carried out to find out what effects does a breathing exercise have on the respiratory functions and the improvement in the quality of life. The study was carried out for male patients suffering cervical spinal cord injuries for the purpose of inspiratory muscle strengthening. The objects of the study were 17 non-smoking-at-present male patients with C4 to C6 cervical spinal cord injuries. They had practiced inspiratory muscle strengthening training for three times a week for six weeks. The quality of life and the dyspnea (breathing difficulty) were self-measured before and after the training. As a result, the change in respiratory function was only significantly reduced (p<0.01) within the chronic group. In terms of the changes in the quality of life, the sub-acute group has only seen a significant improvement (p<0.05) for the VT(vitality), while the chronic group has seen significant improvements(p<0.05, p<0.01) in: GH(general health); BP(back pain); and VT(vitality). In this research, the inspiratory muscle strengthening has reduced the dyspnea (breathing difficulties) and improved the quality of life.

Inhibitory Effect of Stephanniae Tetrandrae Radix Extract on $TNF-{\alpha}$, $IL-1{\beta}$, IL-6 and Nitric Oxide Production in Lipopolysaccharide - Activated RAW 264.7 Cells (방기(防己) 추출물이 LPS로 유도된 Raw 264.7 cell에서의 $TNF-{\alpha}$, $IL-1{\beta}$, IL-6 및 Nitric Oxide Production에 미치는 영향)

  • Kim, Dae-Hee;Lee, Jong-Rok;Byun, Sung-Hui;Shin, Sang-Woo;Kwon, Young-Kyu;Kim, Sang-Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.902-908
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    • 2006
  • Tetrandra is the root of Stephania tetrandra 5. Moore (family Menispermaceae), or of Aristolochia frangchi Wu (family Aristolochiaceae). It is a Differ-flavored and cold-property herb acting on the urinary bladder, kidney and spleen meridiands. Known biological effects of this herb are expelling wind to relieve pain and inducing diuresis to alleviate edema. This herb also has anti-inflammatory and anti-hypersensitivity actions. Recent studies have shown that Stephanniae Tetrandrae Radix has antimicrobial effects, namely, a protective effect on acute renal failure induce by gentamicin sulfate and a suppressive effect against clostridium perfringes. However, there is a lack of studies concerning the immunological activities of this herb. The present study was conducted to evaluate the immunological activities of Stephanniae Tetrandrae Radix on the regulatory mechanisms of cytokines and nitric oxide (NO) in Raw 264.7 cells. Cell viability was measured by MTT assay after the treatment of Stephanniae Tetrandrae Radix extract (STRE) and NO production was monitored by measuring the nitrite content in culture medium. COX-2 and iNOS were determined by immunoblot analysis, and levels of cytokine were analyzed by sandwich immunoassays. Results provided evidences that STRE inhibited the production of nitrite and nitrate (NO), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) tumor necrosis $factor-{\alpha}\;(TNF-{\alpha})$, $interleukin-1{\beta}(IL-1{\beta})$ and interleukin-6 (IL-6) in Raw 264.7 cells activated with lipopolysaccharide (LPS). These findings showed that STRE could produce some anti-inflammatory effects which might play a role in adjunctive therapy in Gram-negative bacterial infections.

Variation of Indoor Average Ozone Concentration within the Radiation Therapy Room by High Energy Radiation (고 에너지 방사선에 기인된 방사선치료실 내 평균 오존 농도의 변화)

  • Lee, Jin-kook;Lee, Hyo-Yeong;Im, In-Chul;Yu, Yun-Sik
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.171-180
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    • 2016
  • This study was to evaluate the change in characteristics of concentration of ozone after exposure to high energy radiation in linac room. Background ozone concentration of linac room was measured and compared to ozone concentration around linac room. Background ozone concentration of linac room was mean $17.4{\pm}7.9ppb$. It was 50% of the ozone concentration($36.8{\pm}22.3ppb$) around linac room(p<0.05). The concentration of ozone after exposure to high energy radiation in linac room was elevated to double of background ozone level, intensity after exposure. with exposure time concentration of ozone increased proportionally. It showed maximum level at 130~180seconds and slowed a tendency to saturate. It required more than 10 minutes for ozone concentration in linac room to drop to ozone concentration around linac room. The concentration of ozone after exposure to high energy radiation is high enough to cause specific physical symptoms, such as acute dyspnea or chest pain due to dry cough. Exposure to high concentration of ozone in sealed linac room can aggravate pulmonary disease, so special attention is needed.