• Journal of The Korean Dental Society of Anesthesiology
• /
• v.13 no.3
• /
• pp.127-131
• /
• 2013

We experienced failed airway management in a patient who had partial mandibulectomy and reconstruction with free-flap. 40 year-old man (height: 164 cm, body weight: 59 kg) with malignant melanoma on #38 tooth area of mandibular body was scheduled for partial mandibulectomy and reconstruction with free flap. Approximately fifteen-hours after surgery, the patient was extubated without complication. Seven hours after extubation, we experienced respiratory failure andfailed airway managementdue to airway edema and neck. We failed orotracheal intubation with direct laryngoscopy andlaryngeal mask airway, thus we tried tracheostomy but the patient was hypoxic state for more than 30 minutes. The patient had got hypoxic brain damage in whole cerebral cortex and basal ganglia. We should have the policy of airway management of the patients who have massive oro-maxillo-facial surgery and all medical personnel who treat these patients should be educated the policy and airway management methods.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.2
• /
• pp.173-179
• /
• 2001

Purpose : To assess therapeutic effects of percutaneous polymethylmethacrylate(PMMA) vertebroplasty on the pain caused by osteoporotic thoracic and lumbar vertebral body compression fractures in a large scale of a prospective clinical design, and to determine clinical factors influencing its therapeutic effects. Methods : A prospective clinical study was carried out in 349 vertebral levels of 159 patients between April 1998 and July 1999. The compression fractures were confirmed with bone scan and spine CT, and bone marrow density was measured. Visual analogue scale(VAS) score was used for pre- and post-operative assessments of the pain. All 159 patients were assessed immediately after surgery, and 140 patients of them were followed-up for about 6 months in average. Results : Partial and complete pain relief was sustained immediately after operation in 73%, through follow-up period in 88% of the patients. Pain relief was not proportional to the amount of PMMA or the rate of increase in the height of the compressed vertebral body. It appears that 3 to 6cc of PMMA was proper enough to sustain pain relief. Better clinical improvement was achieved in the patients treated within 6 months after occurrence of vertebral body fracture. The most frequent surgical complication was epidural leakage of PMMA, and the most serious complication was extravertebral leakage into the paravertebral muscles, which appeared to exert the worst influence on the outcome. However, surgery was not required in these patients. Conclusion : Therapeutic effects of PMMA percutaneous vertebroplasty on osteoporotic vertebral body compression fractures were confirmed in a relatively large scale of prospective clinical study. It appears that good outcome can be achieved in patients treated within 6 months after fracture, treated each level with 3 to 6cc of PMMA in amount. without serious complications.

• The Journal of Korean Physical Therapy
• /
• v.15 no.4
• /
• pp.431-441
• /
• 2003

Pregnancy and puerperium are associated with significant changes in pschological and physiologic health status. Back and pelvic pain is common in pregnancy with prevalence figures in the range of $48\%-90\%$. The pain starts during pregnancy and often disappears soon after childbirth. But the prevalence of such pain four to six months post postpartum is report to be $25-40\%$. In $10-15\%$ of the case the pain become chronics, that is persisting for more than three months after childbirth. Low back pain and pelvic pain maybe caused by several factors related to changes that occur naturally during pregnancy. Changes in the center of gravity can create a strain on weight-bearing structures in bone. Pregnancy related hormones, relaxin, create general laxity of collagenous tissue. Another factor found to be a possible primary or contributing cause for law back and hip symptoms are leg length inequality, weight gain and changes in foot function. This article outlines the physiological and biomechanical changes that occur during pregnancy which have been reported to be possible causes of low back and pelvic pain And then, examination, diagnosis, evaluation and treatment of the woman during pregnancy are described. Standard treatment for low back pain and pelvic pain in pregnancy includes education in anatomy and kinesiology, back-strengthening exercise, training of the abdominal muscles and body posture correction. So, most woman during pregnancy require individual consultation and physiotherapist.

• Journal of Korean Academy of Nursing
• /
• v.21 no.2
• /
• pp.230-246
• /
• 1991

Pain is a subjective and multidemensional concept. Therefore the patient's expression of pain have been referedl to the best believable indicator of pain condition but the support data obtained from the patient considered cultural difference is a deficient condition in determinded on the precise nursing diagnosis. The purpose of this reasearch was to understand multiple pain reponses in cultural difference and sensitivity, to encourage communication between medical teams, and to provide the foundation data of on data of precise nursing assessment for the patient in pain. The research problem was to grasp pain express pattern of Korean peptic ulcer patients. The subjects were 20 peptic ulcer patients in medical unit or OPD of twp university hospitals in Seoul. Data were collected from September 7th to 22nd, 1990 by intensive interviews. Interviews were done by the researcher and all were tape - recorded. The Data analysis was done by Phenomenological method from Van Kaam. Validity assured by confirmation of the internal consistency of the statements and catigory by nursing collegue in educational and clinicions in medical care. From the emic data, 96 descriptive statements were organized in 18 theme cluster. The results of study were summerized as follows. 1. Pain Express Pattern cluster of Peptic Ulcer Patients were “Pain as clogging”, “shallow pain”, “pain as pressing”, “nauseating pain”, “pain as smarting”, “pain as pulling”, “pain as pricking”, “pain as bursting”, “wrenching pain”, “excising pain”, “uncontrollable pain for mind and body”, “awakening pain”, “pain as hollowing” and the other cluster. As above mentioned, Pain Express Pattern of Peptic Ulcer Patient appeared diversely in verbal and they were propered to Korean culture. Therefore they will provide for the foundation data of precise nursing assessment.

• The Korean Journal of Pain
• /
• v.29 no.2
• /
• pp.123-128
• /
• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• Journal of Oral Medicine and Pain
• /
• v.25 no.4
• /
• pp.383-394
• /
• 2000

This study was performed to investigate the effect of change of body posture on the rest position and the rotational torque movement of the mandible. Thirty dental students without any signs and symptoms of temporomandibular disorders and with natural dentition were selected for this study. Cervical inclination and the amount of the mandibular movement on protrusion, on left and right excursion, and on tapping in three body postures such as sitting position, supine position without pillow, and supine position with pillow were measured by goniometer, Cervical-Range-of-$Motion^{(R)}$, and mandibular tracking device, $BioEGN^{(R)}$ with $Rotate!^{(R)}$ program. The data obtained were classified and processed according to body posture and type of lateral guidance with SPSS windows program and the results were as follows: 1. There was significant difference among the three cervical inclinations by body postures. 2. Comparison of mandibular rest positions among body postures showed significant difference only for lateral distance in frontal plane, but comparison between before and after swallowing showed significant difference except for the lateral distance, vice versa. 3. Distance and amount of the rotational torque movement on protrusion and/or lateral excursions didn't show any difference by body posture. But by both body posture and lateral guidance type, there were slightly significant difference for some items. 4. A significant difference was shown for the rotational torque movement in frontal plane on tapping by body postures, for the lateral distance in frontal plane on sitting position by lateral guidance type, and for the rotational torque movement in frontal plane by both body posture and lateral guidance type.

• Journal of Gastric Cancer
• /
• v.17 no.4
• /
• pp.342-353
• /
• 2017

Purpose: This study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact. Materials and Methods: This study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared. Results: Multiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22). Conclusions: Long-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

• Journal of Acupuncture Research
• /
• v.28 no.2
• /
• pp.1-11
• /
• 2011

Objectives : The aim is to comprehend the difference of moxibustion used according to applied body parts (knee pain, neck pain, back pain) to oriental doctors running clinic in Seoul. Methods : A sampling of 288 oriental doctors running clinic in Seoul was done and the doctors were asked to fill out 20 questions by interviewing directly from Nov. 23. 2009 to Jan. 9. 2010. Results : The result shows that moxibustion was used for knee pain and back pain more than neck pain. The type of moxibustion mostly used was sticker moxibustion for all three symptoms. Burn marks were left mostly in knee and back pain. Most large volume of moxa was used to back pain. More than half of the oriental doctors used 1-3 acupoints for one procedure and on average 2-3 sessions was done. Patients with knee pain and back pain had more than 4 sessions compared to neck pain. Treatments were mostly done 3 times a week, and as for total treatment period, it took less than 1 week for acute symptom, and it took more than 1 week and less than 5 weeks for chronic symptom. Conclusions : This research shows that the method of moxibustion used differs according to the area of treatment(knee pain, neck pain, back pain) by survey of oriental doctors through direct interviews.

• Journal of Korean Physical Therapy Science
• /
• v.31 no.2
• /
• pp.1-14
• /
• 2024

Background: Many patients with chronic low back pain have reduced movement due to pain. For that reason, muscle strength weakens, which leads to pain again. The pain caused by such a vicious circle is not only caused by structural problems, but also by physical function, activity disorder, or psychological depression due to biopsychosocial approaches and pain neuroscience education was applied as an intervention to find out its effect. Therefore, this study was experimented with to find out the effects of pain neuroscience education on pain, physical function, activity disorder, and depression in patients with chronic low back pain. Design: Randomized control trial Method: The study subjects were 39 patients with chronic low back pain, and the study subjects were randomized through computers to the experimental group applying pain neuroscience education and the control group applying only general physical therapy and myofascial release techniques, and the experiment was conducted for 4 weeks. Pressure Pain Threshold , Schober test, Korean Roland-Morris Disability Questionnaire, Korean Oswestry Disability Index, and Korean Depression Screening Assessment were measured. Results: As a result of the study, there was no significant difference in pain neuroscience education compared to the group that applied only general physical therapy and myofascial release techniques in both lumbar pressure pain thresholds, Schober test, Korean Roland-Morris disability questionnaire, and Korean Oswestry disability questionnaire. However, the Korean Depression Screening Assessment which is the result of measuring depression, showed significant results(p<0.05). Conclusion: Therefore, it is believed that it can be a way to mediate the psychological part through pain neuroscience education for patients with chronic low back pain in the future.

• The Korean Journal of Pain
• /
• v.9 no.2
• /
• pp.403-406
• /
• 1996

Total spinal block is used as final choice for chronic intractable pain which doesn't respond to other treatments. A 35 years old male patient was admitted to pain clinic due to severe cramping and throbbing pain of whole body, especially left lateral side since 1980. The result of cervical and lumbar epidural block was not good enough, so we decided to try total spinal block. At first, C7-T1 interspace was punctured and 2% mepivacaine 20 ml was injected, but the result was not satisfied. Next day, L3-4 interspace was punctured and 1.5% mepivacaine 40 ml was injected. The sensory block level was C6 and pain score on Visual Analog Scale, was changed from 9 to 4. In both trials, actually even though they were not complete total spinal block, the effect was good enough. If complete total spinal block had been accomplished, better result might be obtained in this chronic intractable pain.