• Title/Summary/Keyword: Hand edema

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High prevalence of musculoskeletal pain in individuals with severe obesity: sites, intensity, and associated factors

  • Mendonca, Carolina Rodrigues;Noll, Matias;Santos, Annelisa Silva e Alves de Carvalho;Rodrigues, Ana Paula dos Santos;Silveira, Erika Aparecida
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.245-257
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    • 2020
  • Background: Musculoskeletal pain is associated with obesity; however, information on factors associated with pain in adults with obesity and severe obesity is limited. The purpose of this study was to assess the prevalence of musculoskeletal pain by site and intensity of pain and associated factors in individuals with severe obesity (body mass index ≥ 35.0 kg/㎡). Methods: Baseline data from the DieTBra Trial study evaluating pain symptoms in nine body regions over the last seven days using the Nordic Questionnaire on Musculoskeletal Symptoms and Numerical Pain Scale. The variables analyzed using multiple Poisson regression with hierarchical analysis were: sociodemographic, lifestyle, food consumption, clinical, and anthropometric, and the outcome was moderate and intense pain. Results: In 150 participants, there was a high prevalence of ankle and foot pain (68.7%), lower back pain (62.7%), pain in the knees (53.3%) and upper back pain (52.0%), with a predominance of intense pain. Factors associated with pain according to specific sites were: type 2 diabetes with hand/wrist pain; sedentary time with hip pain; insomnia with pain in the hip and knee; edema in the lower limbs with pain in the lower back and ankles/feet; degree of obesity with ankle/foot pain; and percentage of total fat with ankle/foot pain. Conclusions: There was a high prevalence of pain and intense pain in individuals with severe obesity and an association with clinical variables, the degree of obesity, and sedentary lifestyle.

Resurfacing of the Open Wound of the Hand With Free Arterialized Venous Flap (유리 동맥화 정맥피판을 이용한 수부의 재피복술)

  • Woo, Sang-Hyun;Kim, Seong-Eon;Jeong, Jae-Ho;Lee, Kyung-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.303-313
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    • 1994
  • Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages: (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operarive field. But, we also have some disadvantages of difficult handling of the pliable veins and the uncertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.

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Evaluation of Blood Volume State Using the Quotient of Urine Sodium and Potassium Excretion in Primary Nephrotic Syndrome in Children (일차성 신증후군 환아에서 소변 나트륨과 칼륨 농도를 이용한 저혈량증 평가)

  • Choi, Jung-Youn;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.9-15
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    • 2007
  • Purpose : Edema is one of the cardinal features of nephrotic syndrome. Although the pathogenesis of edema is not entirely understood, it is caused by hypovolemia or hypervolemia by different mechanisms. Accordingly it is important to evaluate the volume status of patients in order to treat the edema, but it is difficult to evaluate the patient's volume status only by clinical parameters. The quotient of urine sodium and potassium excretion $U_K/(U_{Na}+U_K)$ is introduced as a more useful way to evaluate volume status. In this study we will propose the usefulness of $U_K/(U_{Na}+U_K)$ in evaluating the volume status of children with nephrotic syndrome. Methods : Primary nephrotic syndrome patients at Yeungnam University Hospital since January 1995 to June 2005, were included in the study. We analyzed clinical parameters such as tachycardia, cardiomegaly, pleural effusion, blood chemistry and urinalysis prospectively. We defined hypovolemia when $U_K/(U_{Na}+U_K)$ exceeded 60%. Intravenous albumin and diuretics were administered to hypovolemic edematous patients. On the other hand, hypervolemic edematous patients were treated only with diuretics. Results : There were 50 cases of primary nephrotic syndrome patients(hypervolemia: 29 vs hypovolemia: 21). There were no significant differences in clinical symptoms and laboratory findings except for FeNa While $F_eNa$ and $U_K/(U_{Na}+U_K)$ had a significant negative correlation, BUN and $U_K/(U_{Na}+U_K)$ had a significant positive correlation. Urine output after edema treatment was effective and there were no treatment-related side effects in both groups. Conclusion : FeNa, BUN and $U_K/(U_{Na}+U_K)$ are a useful parameters for evaluating volume status of edematous nephrotic syndrome patients. We could suggest a therapeutic option for using albumin and/or diuretics according to volemic status by means of measured $U_K/(U_{Na}+UK)$.

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Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary? -A case report- (복합부위통증증후군 제I형 환자에서 조기 척수자극술이 필요한가? -증례보고-)

  • Min, Hyoung Ki;Han, Kyung Ream;Lee, Sang Eun;Kim, Kyoung Tae;Kim, Chan
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.223-227
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    • 2006
  • Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

The effects of complex decongestive therapy on pain and functionality in individuals with breast cancer who developed adhesive capsulitis due to lymphedema: an evaluation by an isokinetic computerized system

  • Tatar, Konca Kaya;Turhan, Begumhan
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.280-290
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    • 2022
  • Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

Use of a semitendinosus myocutaneous flap for the coverage of hindlimb full-thickness skin defects in cats

  • Eleftheria Dermisiadou;Ioannis Panopoulos;Dimitra Psalla;Stefanos Georgiou;Aikaterini Sideri;Apostolos Galatos;Vassiliki Tsioli
    • Journal of Veterinary Science
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    • v.24 no.1
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    • pp.14.1-14.15
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    • 2023
  • Background: The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported. Objectives: To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects. Methods: In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively. Results: Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon. Conclusions: An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery (유방암 수술 후 발생한 림프부종과 말초신경병증에 대한 도침술과 정맥자락술 집중치료 증례보고)

  • Jang, Eun-Ha;Kim, So-Yeon;Kim, Hyun-Sik;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.12 no.4
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    • pp.119-126
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    • 2009
  • Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

Angiographic embolization for hemorrhage control after dental implantation

  • Hwang, Hee-Don;Kim, Jin-Wook;Kim, Yong-Sun;Kang, Dong-Hun;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.27-30
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    • 2013
  • Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.

Studies on the Concurrent Administration of Medicines(I) -Anti-inflammatory and Analgesic Actions of Galgun-tang and Aspirin- (의약품(醫藥品)의 병용(倂用) 투여(投與) 효과에 관한 연구(硏究)(I) -갈근탕(葛根湯) 엑기스와 Aspirin의 병용(倂用) 투여(投與)가 항염(抗炎) 및 진통작용(鎭痛作用)에 미치는 영향(影響)-)

  • Cho, Eui-Hwan;Kim, Il-Hyuk
    • Korean Journal of Pharmacognosy
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    • v.16 no.1
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    • pp.7-11
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    • 1985
  • The extract of Galgun-tang at oral doses of 200 and 400 mg/kg showed remarkable inhibition of 42.5% and 45.0%, respectively, on the carrageenin edema in rat paw. In case of combined oral administration of the extract at each dose of 100, 200 and 400mg/kg with 100mg/kg of aspirin, the inhibitions were 70.5%, 83.6% and 80.7% respectively. These results showed the remarkable effects as compared with those of aspirin which showed 50.3% and 69.4% of inhibition at doses of 100 and 200mg/kg, respectively. On the other hand, on the writhing syndrome in mice induced by 0.7% acetic acid solution, the oral administration of the extract showed remarkable inhibition of 18.5 and 47.7% at doses of 200 and 400mg/kg, respectively. In case of combined oral administration of the extract at each dose of 100, 200 and 400mg/kg with 100mg/kg of aspirin, the inhibition percentages of writhing syndromes were 66.6, 72.3 and 80.8, respectively, whereas the inhibition at doses of 100 and 200mg/kg of aspirin showed 59.9 and 69.5%, respectively.

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A Practical Application on the External Treatment of Acne (A Focus on the Medical Herbs Published in the Woman's Monthly Magazines) (여드름 외용약의 실제적 응용에 관한 고찰(여성 월간지에 여드름 미용도포제로 소개된 본초를 중심으로))

  • Yu Hyun-jung;Choi In-hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.1
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    • pp.34-44
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    • 2004
  • Objectives: The objective of this study was to teach patients clinically useful external application of acne. Methods: We investigated the effects and manufacturing methods of the medical herbs published in the woman's monthly magazines according to "Zhong-Yao-Da-Ci-Dian(中藥大辭典)". Results: We investigated that Saururus chinensis Baill.(三白草), Houttuynia cordata Thunb.(魚腥草), Coix lachrymajobi L.(薏苡仁) were discovered 3 times, Brassica oleracea L.(甘藍), Raphanus sativus L.(래복), Daucus carota L. var. Sativa DC.(홍래복), Oryza sativa L.(米皮糠), Spinacia oleracea L.(파래), Cucumis sativus L.(黃爪) 2 times, and Glycyrrhiza uralensis Fisch.(甘草), Gallus gallus domesticus Braisson.(?子白), Aloe vera L.(노회), Phascolus radiatus L.(綠豆), Prunus persica Batsch.(桃葉), Lycopersicon esculentum Mill.(番茄), Taraxacum mongolicum Hand.-Mazz.(蒲公英), Prunus armeniaca L.(杏仁), Musa paradisiaca L. var. Sapientum O. ktze.(香蕉) and Malus pumila Mill.(평과) were discovered once in woman's monthly magazine during last two years. According to the effects, we classificated four groups which were defervescence(淸熱), subsidence of edema(消腫), pyorrhea(排膿) and gloss(滋潤) group. Conclusion & discussion : We suggested the use of each medical herbs on the Consensus conference on acne classification. We needed the further study on the manufacturing method, the time of use and the dose

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