• Title/Summary/Keyword: Acute pain

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Gastric anisakiasis cases in Cheju-do, Korea (고래회충유충증 107례 보고 및 어류감염 실태 조사)

  • 임경일;신호준
    • Parasites, Hosts and Diseases
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    • v.33 no.3
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    • pp.179-186
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    • 1995
  • Human anisakiasis may occur after ingestion of raw marine flesh infected with nematode larvae of Anlsi,hidae. Anisakiasis caused by the migration of the larva into the wall of stomach, small intestine and other portion has been reported in Korea. This prospective study was made of all cases referred to parasitological laboratory in Cheju-do between. Tune 1989 and June 1992. Gastric anisakiasis was confirmed if larvae invading the gastric wall were observed by gastrofiberscopy One hundred and seven cases were diagnosed, most of which were in 30-49 years old. Most of the patients complained acute epigastric pain with history of eating raw marine fish. This symptom usually occurred about 12 hours to 1 day after ingestion of infected marine fish. Edema, erosion or ulcer of the mucosa and hemorrhage from the gastric wall were observed in the involved areas. Ninety larvae removed from the stomach were identified; the larva of Anisqkis siwlex was the most prevalent species, and the Iarva of Pseudntewanoua decipien was also detected. The important species of marine fish from which the patients became infected was demonstrated as yellow corvina, sea eel, ling, cuttle fish, yellowtail and others. Five species of marine fish as a possible source of infection were examined, and Anisakis simplex larvae and Pseunotewqnoua decipirens larvae were collected from the mackerel and rock cod. This study demonstrates that anisakiasis is recognized as a public health problem in Korea.

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A study on the change of the views on E.M.T. profession of the E.M.T. college students (일부 전문대 응급구조학생의 응급구조전문직관의 변화에 대한 연구)

  • Kim, Hak-Soo;Choi, Eun-Sook;Kim, Jin-Hue;Shin, Dong-Min;Lee, In-Soo
    • The Korean Journal of Emergency Medical Services
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    • v.1 no.1
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    • pp.28-41
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    • 1997
  • The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionaire from November 25 to November 29, 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summerized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, P<.05) 2. The view on competence as a E.M.T. was a statistically significant differncein sufficient professional knowledge on the E.M.T. (t=-1.144, P<.001), own's health (t=-0.808, P<.001), sincerity and responsibility (t=-1.429, P<.01), satisfaction and effort (t=-1.335, P<.01), boundary of affairs (t=-1.356, P<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, P<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, P<.001), ACLS (t=1.678, P<.001), hemorrhage & shock (t=-3.252, P<.001), trauma (t=-4.284, P<.001), cardiopulmonary disturbance (t=-2.897, P<.001), acute abdomen (t=-4.284, P<.001), neonatal disease (t=-4.032, P<.001), OBGY disease(t=-4.151, P<.001), emergency delivery (t=-2.825, P<.001), infectious disease (t=-2.930, P<.001), environmental emergency (t=-3.123, P<.05), recording(t=2.22, P<.05) 5. The view on ideology of E.M.T. was a statistically significant difference in belief & faith (t=-2.344, P<.001), knowing of own (t=-2.142, P<.01), humanity (t=-2.581, P<.05), knowing of patient (t=-2.079, P<.05).

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Efficacy of ketamine in the treatment of migraines and other unspecified primary headache disorders compared to placebo and other interventions: a systematic review

  • Chah, Neysan;Jones, Mike;Milord, Steve;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.5
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    • pp.413-429
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    • 2021
  • Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

Preparation and Release Properties of Acetaminophen Imprinted Functional Starch based Biomaterials for Transdermal Drug Delivery (경피약물전달을 위한 아세트아미노펜 각인 기능성 전분 기반 바이오 소재 제조 및 방출 특성)

  • Kim, Han-Seong;Kim, Kyeong-Jung;Lee, Si-Yeon;Cho, Eun-Bi;Kang, Hyun-Wook;Yoon, Soon-Do
    • Applied Chemistry for Engineering
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    • v.32 no.3
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    • pp.299-304
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    • 2021
  • This study focuses on the preparation of acetaminophen (AP) imprinted functional biomaterials for a transdermal drug delivery using mung bean starch (MBS), polyvinyl alcohol (PVA), sodium benzoate (S) as a crosslinking agent, glycerol (GL) as a plasticizer, and melanin (MEL) as a photothermal agent. The prepared AP imprinted biomaterials were characterized using FE-SEM and their physical properties were evaluated. The photothermal effect and AP release property for functional biomaterials were examined with the irradiation of near infrared (NIR) laser (1.5 W/cm2). When the NIR laser was irradiated on functional biomaterials with/without the addition of MEL, the temperature of MEL added biomaterial increased from 25 ℃ to 41 ℃, whereas the biomaterial without MEL increased from 25 ℃ to 28 ℃. Results indicate that there is the photothermal effect of prepared biomaterial with the addition of MEL. Based on the results, AP release properties were evaluated using standard buffer solutions and artificial skin. It was found that AP release rates of MEL added AP loaded biomaterials were 1.2 times faster than those of MEL non-added AP loaded biomaterials when irradiating with NIR laser. We envision that the developed functional biomaterials can be utilized for an acute pain-killing treatment.

Anti-inflammatory effects of Lespedeza Cuneata in vivo and in vitro (야관문(夜關門)의 항염증효과(抗炎症效果))

  • Lee, Hoil;Jung, Ji Yun;Hwangbo, Min;Ku, Sea Kwang;Kim, Young Woo;Jee, Seon Young
    • The Korea Journal of Herbology
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    • v.28 no.4
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    • pp.83-92
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    • 2013
  • Objectives : Lespedeza Cuneata has been used to treat leukorrhea, asthma, stomach pain, diarrhea, acute mastitis, in Korean traditional medicine. According to recent studies, Lespedeza Cuneata has antioxidation, hypoglycemia, cell protective, insulin secretion, whitening, corpora cavernosa smooth muscle relaxation and antimicrobial activities, but it has been rarely conducted to evaluate the immuno-biological activity. The present study was examined to evaluate the anti-inflammatory effects of the Lespedeza Cuneata MeOH extract (LCE) in vivo and in vitro. Methods : In vitro, inflammatory mediators, such as cytokines, nitric oxide and prostaglandin $E_2$ were detected after the addition of LPS with or without LCE in Raw 264.7 macrophage cell line. In vivo, anti-edema effect of LCE was determined in the carrageenan-induced paw edema model in rats. Results : In vitro assay, LCE decreased release of nitric oxide (NO) and prostaglandin $E_2$ ($PGE_2$) via suppression of iNOS and COX-2 expression. LCE inhibited the phosphorylation of $I{\kappa}B$ indicating the suppression of NF-${\kappa}B$ pathway. In vivo assay, LCE significantly inhibited the formation of paw edema induced by carrageenan injection in rats. LCE effectively inhibited increases of hind paw skin thickness and inflammatory cell infilterations. Conclusion : These findings demonstrate that LCE has inhibitory effect on inflammatory mediators in LPS-activated Raw 264.7 cells and on paw edema in carrageenan-stimulated rats, showing the possibility of anti-inflammatory use of Lespedeza Cuneata.

Saudi Experts Consensus on Diagnosis and Management of Pediatric Functional Constipation

  • Alshehri, Dhafer B.;Sindi, Haifa Hasan;AlMusalami, Ibrahim Mohamod;Rozi, Ibrahim Hosamuddin;Shagrani, Mohamed;Kamal, Naglaa M.;Alahmadi, Najat Saeid;Alfuraikh, Samia Saud;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.163-179
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    • 2022
  • Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

Psychosomatic Symptoms Following COVID-19 Infection (코로나19 감염과 그 이후의 정신신체증상)

  • Sunyoung Park;Shinhye Ryu;Woo Young Im
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.72-78
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    • 2023
  • Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.

Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.172-178
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    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

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The Clinical Significance of Antiphospholipid Antibodies in Korean Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura (Henoch-$Sch{\ddot{o}}nlein$ 자반증에서 항인지질 항체의 임상적 의의)

  • Park, Eun-Jung;Baek, Ji-Young;Shin, Jae-Il;Lee, Jae-Seung;Kim, Hyon-Suk
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.146-152
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    • 2009
  • Purpose : We performed this study to evaluate the incidence and clinical significance of antiphospholipid antibodies (aPL Ab) in Korean children with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods : The medical records of 62 patients (31 boys and 31 girls) aged $46.0{\pm}3.1$ (1-16) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2009, the sera from children with acute HSP were tested for aPL Ab such as LA, anti-cardiolipin antibody and anti-${\beta}_2$ glycoprotein I antibody. Results : LA was positive in 18 (29%) of the 62 patients with HSP and We divided the patients into the two groups LA positive group (N=18) and LA negative group (N=44). There were no significant differences between the two groups with regard to abdominal pain, arthralgia and renal involvement, but LA positive group had significantly higher C-reactive protein ($4.3{\pm}7.2$ mg/dL vs. $1.3{\pm}1.8$ mg/dL, P=0.035), erythrocyte sedimentation rate ($37.5{\pm}26.2$ mm/hr vs. $25.1{\pm}22.6$ mm/hr, P= 0.039), IgM ($148.1{\pm}48.4$ mg/dL vs. $114.9{\pm}41.5$ mg/dL, P=0.024), C3 ($143.1{\pm}21.9$ mg/dL vs. $129.7{\pm}24.5$ mg/dL, P=0.048) and C4 levels ($30.9{\pm}6.3$ mg/dL vs. $24.9{\pm}7.8$ mg/dL, P=0.002) compared with LA negative group. Conclusion : We found that the incidence of positive aPL Ab tests was relatively higher in Korean children with HSP and the presence of aPL Ab was associated with acute inflammatory process of HSP. These results suggest that the aPL Ab are involved in the pathogenesis of HSP in children.