• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제2권1호
• /
• pp.116-122
• /
• 1999

저자들은 복통, 구토, 혈변을 주소로 입원한 6세 여아에서 allergic purpura에 급성 췌장염이 병발된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Childhood Kidney Diseases
• /
• 제1권1호
• /
• pp.82-85
• /
• 1997

The incidence of nephritis associated with Henoch-Sch nlein purpura varies, but glomerulonephritis consistently accounts for most of the associated morbidity and mortality. A very small number of Henoch-Sch nlein purpura develop rapidly progressive glomerulonephritis. A three-year old male patient who showed acute nephritic nephrotic syndrome developed abdominal pain, arthralgia and multiple purpurae on lower extremities later. Peritoneal dialysis was done at the 6th hospital day and continued for 7 months. Renal biopsy disclosed crescentic glomerulonephritis (with 81% crescent formation) and methylprednisolone pulse therapy was done. These days, his general condition is good, but serum creatinine levels are 1.2-1.3 mg/dL. This case was reviewed briefly with the literatures.

• 대한한방내과학회지
• /
• 제42권2호
• /
• pp.104-113
• /
• 2021

Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

• 대한족부족관절학회지
• /
• 제24권1호
• /
• pp.1-8
• /
• 2020

Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.

• The Korean Journal of Pain
• /
• 제19권2호
• /
• pp.181-186
• /
• 2006

Background: Although cervical epidural block can be a useful therapeutic treatment for head, neck and upper extremities pain, there is no consensus regarding the volume of injection required for pain management. Herein, the spreading in the vertebral segments after a cervical epidural injection of either a 5 or 10 ml volume was studied. Methods: A total of 78 patients, suffering from head, neck and upper extremity pain, were selected. Cervical epidural blocks were performed consecutively with 5 ml (n = 42) and 10 ml (n = 36) of 0.4% mepivacaine and 222 mg I/ml iopamidol at the C7⁣-T1 levels. Both anteroposterior (AP) and lateral radiographs were obtained under fluoroscopy, and the upper and lower epidural spreading of the contrast media in relation to the vertebral level was evaluated. Results: The cervical epidural blocks were performed without complications. The rostral spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.6{\pm}1.1$ and $6.1{\pm}1.1$, respectively. The caudal spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.4{\pm}3.4$ and $7.2{\pm}3.9$, respectively. The total numbers of segments with vertebral spreading of the contrast media in both directions showed significant differences between the two groups. The numbers of patients who showed spreading of the contrast media up to C2 vertebral segment showed no significant differences between the two groups. Conclusions: 5 and 10 ml epidural injection volumes may be adequate for the spread of contrast media to the entire cervical spine. A 5 ml epidural injection volume, compared to a 10 ml volume, may be ample when considering the possibility of unnecessary caudal spreading of drugs and volume related complications in the management of head, neck and upper extremity pain.

• Journal of Acupuncture Research
• /
• 제39권2호
• /
• pp.134-138
• /
• 2022

Distal femur osteotomy (DFO) is a controlled surgical break of the femur performed to allow realignment of the limb. Redistribution of the load aims to correct the abnormal mechanical weight-bearing axes in patients with abnormal alignment of the lower extremities, and degenerative changes in the knee joint. This report describes a complex Korean medicine treatment for a patient complaining of knee pain and stiffness following a DFO. Post-operative care for the patient lasted 78 days with treatment including pharmacopuncture, acupuncture, herbal medicine, cupping therapy, and physiotherapy. The effectiveness of the treatments was evaluated using the numerical rating scale, range of motion of the knee, and by physical examination. After treatment, these evaluation indicators improved, suggesting that the complex Korean medicine treatment received by the patient was an appropriate treatment for knee pain and stiffness following a DFO.

• 대한물리의학회지
• /
• 제17권3호
• /
• pp.23-30
• /
• 2022

PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.

• The Korean Journal of Pain
• /
• 제2권1호
• /
• pp.21-25
• /
• 1989

For the simple operations of the perineal region, caudal, epidural and saddle blocks of analgesia are preferable anesthesia techniques in men. But, if the operations shoud be delayed or the physicians are willing to observe and manipulate the patients for a couple of days, as in the ureteral stone manipulation, continuous epidural analgesia will be a reliable method. The authors have observed 36 male patients of ureteral calculi with continuous lumbar epidural analgesia for the purpose of elimination of an undesirable pain sensation which was associated with the transurethral cystoscopic manipulation. The results were as follows: 1) In most cases, the anesthetics used were 1% lidocaine 20 ml through the $L_{3-4}$ and $L_{4-5}$ interspace with 4~6cm of catheter tip advancement mainly to cephalad. 2) There was no motor weakness or paralysis in the lower extremities except some numbness and paresthesia on the perineal area. 3) Besides the various minor complications, there were no problems in respiration with small doses of morphine extradurally. 4) Among them, four cases of ureteral calculi dropped into the bladder spontaneously due to the epidural technique during transportation of the patients from the pain clinic to the urology out-clinic. One case of calculi was dropped by the aid of instrumentation at the ward, and twelve cases of calculi were removed directly by Dormia stone basket in the scopic room. For the remaining patients, we deduced that their calculi was be evacuated out because there were no complaints were notified after discharge.

• Journal of Chest Surgery
• /
• 제25권4호
• /
• pp.391-397
• /
• 1992

Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

• Journal of Chest Surgery
• /
• 제30권2호
• /
• pp.172-178
• /
• 1997

인제대학교 서울 백병원에서 실시한 말초동맥 색전제거술을 후향적으로 분석하였다. 1987년 3월부터 1996년 2월까지 26명의 환자가 색전제거술을 시술받았고 남자는 18명 여자는 8명이였으며 평균연령은 56.8세 였다. 24명의 환자에서 휴식시 동통이 주소였고 2명의 환자에서 급성 증상의 회복후 장기간의 간헐적 파행을 호소하였으며 10명의 환자에서만 신경/근육 증상을 보였다. 대부분의 색전은 심인성으로 빈도가 높은 원인질환으로8명의 환자는 허혈성 심질환, 11명의 환자는 심장판막질환이 있었다. 동맥색전 부위는 상지동맥이 6명, 안장색전증이 2명, 하지동맥 18명이였고 대퇴동맥이 11명으로 가장 많았다. 술전 동맥조영술은13명의 환자에서 진단과 수술계획을 위해 실시하였으나 나머지 환자에서는 실시하지 않았다. 2명만이 6시간이내 색전제거술을 실시하였으나 나머지 환자는 모두 6시간 이후에 수술하였 다. 모든 환자에서 우회로 조성술 엄이 포가티 색전제거 카테터를 사용하여 색전제거술을 하였는데, 상지동맥 색전증은 상완동맥 절개로 수술하였고, 안장색전증의 경우 양측 서혜부 절개로 접근하였으며, 하지동맥 색전증은 경대퇴동맥 접근을 하 느립\ulcorner3명의 원위부 슬와-경골동맥 색전증 환자에서 재수술시 경술와 동맥 색전제거술을 시행하였다. 수술 전후로 18명의 환자가 헤파린이나 푸락시파린으로 항응 고제 요법을 받았고 17명의 환자에서 퇴원시 와파린을 투여하였으며 항응고제 투여의 적응증은 심판막 질환, 심방세동, 말초동맥 죽상경화증, 재발색전 등이었다. 색전제거술후 14명의 환자에서 좋은 결과가 있었고, 5명에서 재수술후 증상 호전되었으며, 심한 하지동맥 죽상경화증을 보인 환자 1명에서 슬관절 이하 하지절단을 시행하였다. 색전재발은 1명, 사망 환자는 2명이 였는데, 사인은 각각 급성 신부전과 뇌동맥 혈전증이였다. 색전제거술 합병증으로 재관류 손상, 가성동맥류, 내막박리 등이 각각 1례 발생하였다. 결론적으로 사지동맥 색전증치 진단이 지연되고 있고, 허혈성 심질환을가진 고령환자가 증가되고 있는 경향이었다. 술전 동맥조영술은 항상 진단과 수술을 위해 필요하지 않으며 항응고제는 적응증에 따라 선택적으로 투여하여 색전재발을 방지할 수 있다. 원위부 슬와-경골동맥 색전증의 경우, 경대퇴동 맥 접근으로 선택적인 경골동맥 색전제거에 어려움이 있었다.