• 제목/요약/키워드: CRPS

검색결과 93건 처리시간 0.026초

복합부위통증증후군의 작업치료적 접근에 관한 고찰 (A Review of Occupational Therapy Approach for Complex Regional Pain Syndrome)

  • 최유임;박수현
    • 한국콘텐츠학회논문지
    • /
    • 제10권1호
    • /
    • pp.286-294
    • /
    • 2010
  • 복합부위통증증후군은 외상, 신경 손상, 골절, 뇌졸중, 척수 손상과 수술 등에 의해 부적합하게 발생하는 만성 신경병성 통증증후군으로, 질환의 경과, 치료법 등 모든 면에서 생물심리사회적 요인의 영향을 받는다. 작업치료에서는 생물학적, 심리적, 사회적 요소를 고려한 다학제적인 치료적 접근이 유용할 것이다. 생물학적 치료는 모든 영역에서의 독립성을 향상시키기 위해 사지의 기능적 사용을 증가시키는 것이다. 심리적 치료는 이완/바이오피드백 훈련과 인지행동치료를 제공하고, 사회적 치료는 레크리에이션 치료와 직업 재활을 실시할 수 있다. 복합부위통증증후군에 대한 작업치료는 다양한 전문 분야의 협조적인 치료과정을 통해 기능 회복과 통증 관리, 심리적 요인들의 회복을 이끌어 내야 할 것이다.

동상의 임상적 분석 (Clinical Analysis of Frostbite)

  • 최장규;김현철;신홍경
    • Journal of Trauma and Injury
    • /
    • 제28권3호
    • /
    • pp.158-169
    • /
    • 2015
  • Purpose: Frostbite can affect still soldiers. Initial clinical manifestations are similar for superficial and deep frostbite, so early treatment is identical. It is under-estimated by physicians. We try to identify the challenges of managing these complex tissue injuries. Methods: A retrospective analysis of 84 patients hospitalized at AFCH from 2009 to 2015 was conducted. We investigated differences of epidemiological characteristics, identification of soft tissue injury, treatment and complications between superficial (SF: 43; 51.2%) and deep (DF: 41; 48.8%) frostbite. Results: The major (94.0%) developed frostbite in dry circumstances (89.3%). Wet circumstances (66.7%) were more susceptible to DF rather than dry (46.7%). The 38 (45.2%) arrived to specialist within 7days. Most prone sites were feet, followed by hands. Toes had more deep injuries. DF presented more increased levels of ALT, CPK, CKMB, CRP. The bone scan of W+S+ was 48.3%, 87.1% and W+S- was 20.7%, 12.9%, respectively. The treatment resulted in improved or normalized perfusion scan with matching clinical improvement. It was a good tool to assess treatment response. Eighteen normal and 8 stenotic type of PCR resulted in normal with matching clinical improvement. One continuous obstructive waveform led to minor amputation. Twelve underwent both PCR and MRA. Among 6 normal PCR, 5 showed normal and one stenosis in MRA. All 5 stenosis and one obstruction showed the same findings in MRA. It was a good tool to evaluate vascular compromise. They were treated with rapid rewarming (11.6%, 22.0%), hydrotherapy (16.3%, 29.3%), respectively. Six (14.6%) underwent STSG, 2 (4.9%) had digital amputation in DF. Berasil, Ibuprofen, Trental were commonly administered. PGE1 was administered selectively for 6.8, 10.8 days, respectively. Raynaud's syndrome (16.3%), CRPS (4.7%), LOM (14.6%) and toe deformity (4.9%) were specific sequelae. Conclusion: We should recommend intensive foot care education, early rewarming and evacuation to specialized units. The bone scanning and PCR should allow for a more aggressive and active approach to the management of tissue viability.

  • PDF

복합부위통증증후군 환자에서 척수자극술과 교감신경 고주파열응고술 -증례 보고- (Thoracic Spinal Cord Stimulation and Radiofrequency Thermocoagulation of Lumbar Sympathetic Ganglion in a Patient with Complex Regional Pain Syndrome in the Lower Extremity -A case report-)

  • 김시현;문동언;박종민;유건희;서경수;유시현
    • The Korean Journal of Pain
    • /
    • 제18권2호
    • /
    • pp.240-245
    • /
    • 2005
  • Herein is described the successful treatment of complex regional pain syndrome type II with the combination treatment of spinal cord stimulation and radiofrequency thermocoagulation of the lumbar sympathetic ganglion. A 62 years old male patient, suffering from CRPS type II in his left lower extremity, visited our pain clinic. Medication and nerve blockade produced only slight improvement in his symptoms and signs. Therefore, a linear type spinal cord simulator was inserted into the thoracic epidural space, using a non-surgical percutaneous approach, with the cephalad lead located at the T11 level. Two months later, the repositioning of the electrode to the T12 level for more effective pain control, with radiofrequency thermocoagulation of lumbar sympathetic ganglion also performed at the left L2 and 3 levels for the control of trophic change. These resulted in significant pain relief and decreased trophic change, with no complications, after which the patient was able to resume a normal life.

신경병증성 통증 치료시 Gabapentin 투여에 따른 제통 효과와 체열상의 변화 -증례 보고- (Thermographic Changes by Administering Gabapentin in Neuropathic Pain -A report of three cases-)

  • 이장원;김정순;배덕구;박욱
    • The Korean Journal of Pain
    • /
    • 제14권1호
    • /
    • pp.98-103
    • /
    • 2001
  • Neuropathic pain originating from multiple condition of nerve cell injury is common, but is difficult to treat. Even though many drugs such as anti-convulsants, anti-depressants, NSAIDs, opioids have been used, their clinical analgesic action were not satisfactory due to occur severe side effects. Gabapentin was introduced in 1994 as a novel antiepileptic drug and has been used to treat partial seizure. After 1995 gabapentin treatment for reflex sympathetic dystrophy (RSD) started, 45% of the reports about the analgesic efficacy of gabapentin were restricted to the treatments of non-epileptic pain syndrome. This drug is preferred to treat neuropathic pain because of a lower incidence of its side effects than those of other anti-convulsants and anti-depressants. For evaluating it's analgesic efficacy, the changes in the patients' subjective pain intensity was measured by the score on the visual analogue scale (VAS) and patient's objective pain intensity by measuring the skin temperature via infrared thermography were investigated respectively. Side effects of gabapentin were look into. We observed successful relief of neuropathic pain in the three patients which included post-herpetic neuraligia, complex regional pain syndrome (CRPS) and diabetic neuropathic pain, and the side effects of gabapentin were at acceptable levels.

  • PDF

EEDI 개선을 위한 상반 회전 프로펠러 단독성능 분석용 수치해석과 모형시험에 대한 연구 (A Numerical and Experimental Procedure for the Open Water Characteristics of Contra-Rotating Propellers for EEDI Improvement)

  • 김문찬;송무석;강현지;김동언
    • 한국해양환경ㆍ에너지학회지
    • /
    • 제16권4호
    • /
    • pp.248-254
    • /
    • 2013
  • IMO가 도입한 Energy Efficiency Design Index (EEDI)의 강제로 최근 관심이 증가되고 있는 상반회전 프로펠러(Contra-Rotating Propeller, CRP)의 단독 상태에서의 성능평가를 위한 보오텍스격자법(Vortex Lattice Method) 기반의 포텐셜 수치해법과 모형시험법을 확립하고 이를 특정 CRP에 적용하여 유용성을 검증하였다. 대상 CRP는 EEDI 개선을 목적으로 설계된 것으로 그 성능을 본 연구의 수치 및 실험 해석을 바탕으로 분석하였다. CRP의 설계점을 포함한 주 작동 영역에 대해 계산과 실험이 좋은 일치를 보임을 확인하였고, 본 연구를 통하여 제안된 기법은 향후 CRP 설계 및 성능해석에 유용하게 사용될 수 있으리라 생각된다.

반사성 교감신경이영양증후군(RSDS)으로 내원한 환자 1례에 대한 보고 (A Case Report of Reflex Sympathetic Dystrophy Syndrome)

  • 문형철;김성남;이성용;김성철;이상민;임정아
    • Journal of Acupuncture Research
    • /
    • 제22권6호
    • /
    • pp.241-249
    • /
    • 2005
  • Objectives : The purpose of this case is to report the improvement after treatment about patient with Reflex sympathetic dystrophy syndrome. Methods : We treated the patient with acupuncture therapy and Herbal medication from 12th October 2004 to 20th June 2005 by evaluating shoulder function with VAS score, shoulder joint ROM and mannual muscle test(MMT). Results : After treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as like pain, swelling, paresthesia, color tone change was almost disappeared, and there was improvement of ROM and MMT Conclusion : Reflex Sympathetic Dystrophy Syndrome (RSDS) also known as Complex Regional Pain Syndrome (CRPS) is a chronic neurological syndrome characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling, extreme sensitivity to touch. Oriental medical treatment for Reflex Sympathetic Dystrophy Syndrome resulted in satisfactory results by diminishing the symptoms progressively during the thirty two weeks of treatment. Differential diagnosis was based on careful physical examination. More research of Reflex Sympathetic Dystrophy Syndrome is needed.

  • PDF

복합부위통증증후군의 침구치료 효과에 대한 연구동향 고찰 (A Review of Research on the Effects of Acupuncture and Moxibustion Treatment to Complex Regional Pain Syndromes)

  • 김호선;배영현;김해솔;서창용;김노현;양규진;이기범
    • Journal of Acupuncture Research
    • /
    • 제33권4호
    • /
    • pp.137-148
    • /
    • 2016
  • Objectives : This study was performed to review articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Methods : On-line databases including PubMed, Cochrane Library, Ovid-EMBASE, NDSL and OASIS were searched to find articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Several overlapping articles and those not relevant to the topic were excluded, as well as review articles and commentaries. Results : 16 case reports were selected through the procedure, all of which presented successful treatment cases of Complex Regional Pain Syndromes with acupuncture and moxibustion. Most of them presented one single patient case and were published in Korea. However, almost half of them were printed in English, and had been continuously published since 2005. It was remarkable that pharmacopuncture was predominantly used to treat Complex Regional Pain Syndromes. Also, we noted that Chinese scalp acupuncture needs to be studied further as two successful cases were presented from the U.S army. Conclusion : The results show that several case reports have been published regarding Complex Regional Pain Syndromes treated with acupuncture and moxibustion. However, all of them were case reports which are given low status in Evidence-Based Medicine. We expect that a more diverse range of articles, including case control studies, cohort studies and randomized controlled trials will be performed in the near future, and that a unified outcome measure will be developed for Complex Regional Pain Syndromes.

Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

  • Kim, Sei-Kyoung;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제38권3호
    • /
    • pp.152-159
    • /
    • 2012
  • Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

PUF를 이용한 OTP 기반 거래 검증 프로토콜 (OTP-Based Transaction Verification Protocol Using PUFs)

  • 이종훈;박민호;정수환
    • 한국통신학회논문지
    • /
    • 제38B권6호
    • /
    • pp.492-500
    • /
    • 2013
  • One-Time Password(OTP) 발생기는 현재 은행이나 증권 회사에서 전자금융 거래 시에 안전한 거래를 보장하기 위해 multi-factor 인증으로 사용되고 있다. 국내 OTP 기반 전자금융 거래 검증 프로토콜은 OTP 인증 정보를 통해 사용자에 대한 신원을 확인함으로써 안전한 거래를 보장하며, 또한 Man-in-the-Browser(MITB) 공격, 메모리 해킹 공격 등에 대처하기 위해 사용된다. 하지만 지능적인 피싱, 파밍, 사회공학 공격들을 통해 OTP 생성 단말에 대한 정보를 수집하여 활용한다면 동일한 OTP 값을 생성할 수 있는 가능성이 있다. 그러므로 이와 같은 위협에 대응할 수 있는 대책이 필요하며 본고에서는 앞에서 언급한 문제점을 해결하기 위해 Physical Unclonable Functions(PUFs)을 이용한 새로운 기법을 제안한다. 먼저, 물리적으로 PUFs를 복제할 수 없는 특성은 동일한 OTP 값을 생성하는 것을 불가능하게 만든다. 또한 하드웨어적으로 OTP 발생기를 복제하는 것이 불가능하다. 결론적으로 제안된 프로토콜은 PUFs를 추가함으로써 이전 프로토콜보다 강력하고 안전한 인증 프로토콜을 제공한다.

Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment

  • Seo, Yu-Mi;Kang, Hyun-Mi;Lee, Sung-Churl;Yu, Jae-Won;Kil, Hong-Ryang;Rhim, Jung-Woo;Han, Ji-Whan;Lee, Kyung-Yil
    • Clinical and Experimental Pediatrics
    • /
    • 제61권5호
    • /
    • pp.160-166
    • /
    • 2018
  • Purpose: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Methods: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). Results: The mean fever duration was $6.6{\pm}2.3days$, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. Conclusion: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.