• The Korean Journal of Pain
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• v.21 no.2
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• pp.159-163
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• 2008

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.85-96
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• 2021

Background: The purpose of this study was to effect of prenatal exercise program combined with Brugger's exercise on low back pain and balance in pregnant women. Design: A Single-Subject Study. Methods: This study was applied to 28 weeks of pregnant women who complained of low back pain for a total of 4 weeks. A total of 10 prenatal exercise programs in this study consists of sessions, and each session was applied with a Bruger exercise for 1 minute before the start. For the fatigue and safety of pregnant women, a break for 1 minute was provided for each session and was conducted under the supervision of the therapist The visual analogue scale (VAS), Oswestry disability index (ODI), and static balance (BT-4) were measured to evaluate the pregnant women's low back pain and balance ability before and after the intervention Results: The change in back pain after the intervention was VAS 5 before the intervention, but the VAS gradually decreased at 4 weeks after the intervention. Reduced to VAS 2 after 4 weeks of intervention. The Oswestry Disability Index (ODI) was 54%, which was at the level of severe disability, but the dysfunction index gradually decreased 4 weeks after intervention, reaching 19% in 4 weeks, and there were no problems with daily life. As for the static balance ability, the sway area and the sway distance values gradually decreased after the intervention in both the eyes open and closed state, showing an improvement in the static balance ability of pregnant women after the intervention than before the intervention. Conclusion: The prenatal exercise program combined with Brugger's exercise was effective to improve low back pain and static balance in pregnant women. The result of this study may helpful as basic data for obstetric physical therapy.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.207-213
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• 2017

Background: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. Methods: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit. Results: Surgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups. Conclusions: Magnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6033-6038
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• 2015

Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.4
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• pp.107-122
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• 2013

Objectives: This study was conducted to investigate the effectiveness and safety of acupuncture therapy for pregnant women. Researches on acupuncture therapy for pregnant women published since 2000 until 2013 were selected and analyzed. Methods: Bibliographic search was carried out using several online database systems using keywords like 'pregnancy', 'pregnant', 'acupuncture', 'forbidden points' within a 13-year time span (2000-2013). Results: 18 journal articles published in Korea and 22 journal articles published abroad were selected. It is reported that acupuncture has significant effect on low back pain and pelvic pain, depression, insomnia during pregnancy. Stimulation of acupuncture during pregnancy seems to be safe with respect to obstetric adverse effects. Conclusions: We can conclude that further investigation is needed to accumulate enough information to establish evidence for acupuncture therapy for pregnant women.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• Women's Health Nursing
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• v.26 no.3
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• pp.205-212
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• 2020

Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3129-3133
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• 2012

Diagnosis and treatment procedures in cancers and resulting anxiety negatively affect the individual and the family. Particularly treatment methods may generate psychological symptoms. The aim of this study was to determine the level of such symptoms in Turkish gynecologic cancer patients receiving chemotherapy. A total of 41 patients who were referred to our gynecologic oncology research clinic between January-March 2012, receiving 3 months or more chemotherapy and who agreed to participate were enrolled in study. All the data were collected using a personal information form, Edmonton Symptom Assesment System and State-Trait Anxiety Inventory. Patients received highest point average from fatigue symptom ($6.53{\pm}2.67$) and lowest point average from dyspnea ($1.53{\pm}3.03$) according to Edmonton Symptom Assesment System. The mean State Anxiety score of patients was $43.1{\pm}9.77$ and mean Trait Anxiety score was $46.7{\pm}7.01$. Comparing symptoms of patients and mean State Anxiety score it was found that there was a statistically significant corelation with symptoms like pain (p<0.05), sadness (p<0.001), insomnia (p<0.05), state of well being (p<0.001) and dyspnea (p<0.05). Similarly comparing symptoms of patients and mean Trait Anxiety score demonstrated significant correlations for fatigue (p<0.05), sadness (p<0.01), insomnia (p<0.01) and state of well-being (p<0.01). As a result, patients with gynecological cancers experienced symptoms related to chemotherapy and a moderate level of anxiety. In accordance, appropriate interventions should recommended for the evaluation and improvement of anxiety and symptoms related to treatment in cancer patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.22 no.3
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• pp.205-222
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• 2009

Purpose: The aim of this study was to review systemically journals on the studies for Complementary and Alternative Medicine in the treatment of breast cancer. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of breast cancer were searched. The cite used was http://www.Pubmed.gov. And then they were divided into three groups. Medication, Non-medication therapies and questionnaire reports. Results: 1. We researched 23 papers about herb medicines. Most of papers were about single herb and there were rarely about mixed composition. And there were papers about Ocimum gratissimum, elliptilimba, seeds of Livistona chinensis, golden feverfew which were not commonly used in Korea. 2. We researched 16 papers about acupuncture. Acupuncture had a possitive effect on such symptoms like flushing, nausea and vomitting and pain on upper limb caused by anticancer therapy or tamoxifen or surgery. 3. We researched 36 papers about questionnaire study. Most were about research for women who diagnosed as breast cancer or women after breast cancer surgery. Subjects were about proportion of using CAM, purpose of using it, most popular CAM therapy, satisfaction degree, and relation with age, aducation and social position. And most conclusion were that patient-doctor communication was needed. Conclusion: Afterwards we have to focus on realisitic clinical studies about breast cancer patients, especially postsurgery and people who takes anticancer therapy. And we have to be interest in acupuncture therapy on breast cancer patients.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.115-130
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• 1999

This study was conducted to investigate the prevalence of dysmenorrhea in women labor workers The subjects were 327 women labor workers in the area of Kyunggi. Kyungsang and Chunla Provinclils. The data were collected from 20. January to 20. February. 1999 by using self-administered structured questionnaires. The contents of, questionnaire were composed of demographic(3 items). work related(2 items). life style (6 items), obstetric-menstrual(8 items) characteristics. and experiences of dysmenorrhea(6 items). The results were as follows 1. Prevalence rate of dysmenorrhea was $76.8\%$. Among women who had dysmenorrhea. $52.0\%$ of them had family history on dysmenorrhea. $46.0\%$ of them experienced limitation of daily activities. $18.3\%$ of them have started the dysmenorrhea since their employment present company. and $8.8\%$ of them visited hospital due to dysmenorrhea of the subjects who took analgesics for relieving menstrnal pain. $7.2\%$ had no effect. 2. The frequency of dysmenorrhea was significantly different by educational level. working period. and the amount of mentrual flow.