• 제목/요약/키워드: Sensation disorders

검색결과 49건 처리시간 0.02초

성인 식도이물의 내시경적 치료 (Endoscopie Removal of Adult Esophageal Foreign Bodies)

  • 장민희;이숭
    • 대한기관식도과학회지
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    • 제10권1호
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    • pp.46-50
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    • 2004
  • The majority of esophageal Foreign body ingestions occur in the pediatric population. In adults, true foreign object ingestion occurs more commonly among those with psychiatric disorders, mental impairment. The management of esophageal foreign bodies is influenced by the age, clinical condition of ingested material, anatomic location and technical abilities of the endoscopist. Recently the therapeutic endoscopy is becoming wider and more rational in application. We evaluated the role of endoscopy for removal of esophageal foreign bodies during the period of 4 years from January 2000 to December 2003 at the Department of Otolaryngology and Gastroenterology, Seonam University Hospital. The results were as follow, 1) The age ranged from 21 to 74 years old (mean 50.5), most frequent age group was between 61-70 years old and male to female ratio was 1:1.4. 2) Fish bone was the most frequent foreign body in the esophagus ($47.1\%$), food material ($23.5\%$) and meats ($17.6\%$) were next frequent foreign bodies. The most frequent site of lodgement was the first ($78.4\%$), second ($17.6\%$) and third narrowing ($3.9\%$) in order. 3) The most common symptom was foreign body sensation (28.6%). the next common symptoms were chest discomfort($23.8\%$) and dysphagia($19\%$). 4) In duration of lodgement, 49cases ($96.1\%$) were lodged for less than one day. 5) The foreign bodies of esophagus were removed successfully by flexible endoscope with basket, snare, forceps, overtube and endoscopic variceal ligation cap. There were only 3 cases of minimal complications, esophageal mucosal tearing. In conclusion, endoscopic esophageal foreign body removal is useful and safe with minimal or no complications.

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기능성 상부 위장관 증상을 호소하는 환자의 스트레스, 불안 및 우울 (Stress, Anxiety, and Depression of the Patients Who Complained of Functional upper Gut Symptoms)

  • 이상열;신성훈;최석채
    • 정신신체의학
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    • 제6권1호
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    • pp.3-12
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    • 1998
  • Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

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시기능 훈련 시스템을 이용한 훈련 효과에 관한 연구 (The Study on the Effect of Vision Training System)

  • 이창선;손정식;김인수;강성수;이동희;김기홍
    • 한국안광학회지
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    • 제14권1호
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    • pp.81-86
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    • 2009
  • 목적: 본 연구는 새롭게 개발한 MYSTERY CIRCLE, Anaglyphs 및 Block string을 이용하여 양안시 기능적, 감각적, 증상 변화에 대해 비교 관찰하고, 훈련방식별 개선효과와 실용 가능성을 알아보고자 하였다. 방법: 대상자는 T안경원의 75명의 시기능 훈련 대상자(남자 40명, 여자 35명)이며 7주(49일)동안 시기능 훈련을 실시하였다. 결과: 모든 훈련방식(MYSTERY CIRCLE, Anaglyphs, Block string)에서 시기능 훈련자의 양안시 개선에 도움이 되었으나, 정상화 성공기준에 포함된 대상자수를 비교한 결과 MYSTERY CIRCLE훈련이 유의수준 0.05에서 다른 훈련방식과 유의한 차이를 보였다. 결론: 본 연구에서 MYSTERY CIRCLE 훈련이 양안시 이상자의 시기능 개선 및 정상화에 우수한 개선효과가 있는 것으로 나타났다.

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Determinants of depression in non-cardiac chest pain patients: a cross sectional study

  • Roohafza, Hamidreza;Yavari, Niloufar;Feizi, Awat;Khani, Azam;Saneian, Parsa;Bagherieh, Sara;Sattar, Fereshteh;Sadeghi, Masoumeh
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.417-426
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    • 2021
  • Background: Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients. Methods: The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression). Results: Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47-4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients. Conclusions: Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

  • Chandan, SN;Shetty, Sujeeth Kumar;Shetty, Sahith Kumar;Shah, Anjan Kumar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권3호
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    • pp.183-189
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    • 2021
  • Objectives: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. Materials and Methods: This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. Results: A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. Conclusion: This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

Post-COVID-19 pain syndrome: a descriptive study in Turkish population

  • Topal, Ilknur;Ozcelik, Necdet;Atayoglu, Ali Timucin
    • The Korean Journal of Pain
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    • 제35권4호
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    • pp.468-474
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    • 2022
  • Background: The new type of corona virus has a wide range of symptoms. Some people who have COVID-19 can experience long-term effects from their infection, known as post-COVID conditions. The authors aimed to investigate prolonged musculoskeletal pain as a symptom of the post-COVID-19 condition. Methods: This is a descriptive study on the patients who were diagnosed with COVID-19 in a university hospital, between March 2020 and March 2021. Patient records and an extensive questionnaire were used to obtain relevant demographic and clinical characteristics, including hospitalization history, comorbidities, smoking history, duration of the pain, the area of pain, and the presence of accompanying neuropathic symptoms. Results: Of the diagnosed patients, 501 agreed to participate in the study. Among the participants, 318 had musculoskeletal pain during COVID-19 infection, and 69 of them reported prolonged pain symptoms as part of their a post-COVID condition which could not be attributed to any other cause. The mean duration of pain was 4.38 ± 1.73 months, and the mean pain level was 7.2 ± 4.3. Neuropathic pain symptoms such as burning sensation (n = 16, 23.2%), numbness (n = 15, 21.7%), tingling (n = 10, 14.5%), stinging (n = 4, 5.8%), freezing (n = 1, 1.4%) were accompanied in patients with prolonged musculoskeletal pain. Conclusions: Patients with COVID-19 may develop prolonged musculoskeletal pain. In some patients, neuropathic pain accompanies it. Awareness of prolonged post-COVID-19 pain is crucial for its early detection and management.

뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고 (Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report)

  • 이꽃님;김미애;황인경;박지현;마연주
    • 대한소아치과학회지
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    • 제43권3호
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    • pp.327-333
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    • 2016
  • 틱이란 불수의적이고 갑작스러운 소리냄과 리듬이 없는 근육의 움직임을 말한다. 다수의 운동틱과 한 가지 이상의 음성틱이 모두 존재하는 경우 뚜렛 증후군으로 분류되며, 운동틱에 의한 자해 행위는 뚜렛 증후군 환자에서 흔히 나타나는 증상 중 하나이다. 본 증례에서 9세 소년이 혀의 심각한 궤양을 주소로 신경정신과로부터 의뢰되었다. 두 달 전부터 시작된 반복적인 혀 씹기에 의해 궤양은 빠르게 진행되었으며, 환아는 그로 인한 식이 및 연하의 어려움을 호소하였다. 우리는 부드러운 실리콘 재질을 이용하여 상, 하악이 분리된 가철성 장치를 제작하기로 결정하였다. 장치의 지속적 사용이 고통을 줄일 수 있는 방법임을 강조하였기 때문에, 환아는 장치 장착에 동의하였으며 잘 적응하였다. 3주 후 혀의 병소가 상당히 개선된 것을 확인할 수 있었다. 현재 구강 내 자해 행위를 치료하기 위한 표준화된 지침은 없다. 따라서 임상가는 약물 치료를 비롯하여 구강 내 장치 적용이나 관련 치아의 연마 등 다양한 접근 방법을 고려하여야 한다.

척골 지단 신경의 전기생리학적 연구 (An Electrophysiologic Study on the Ulnar Digital Nerves)

  • 김종순;이현옥;안소윤;구봉오;남건우;김호봉;류재관;류재문
    • 대한정형도수물리치료학회지
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    • 제11권2호
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    • pp.13-18
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    • 2005
  • The ulnar nerve extends down the arm, across the elbow, and into the hand. It provides sensation to the little and ring fingers and activates many of the small muscles in the hand. The determination of peripheral nerve conduction velocity is an important part of ulnar nerve evaluation. The electrodiagnostic value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. The purpose of this investigation was to measure the digital nerve conduction velocity of ulnar nerve for obtain clinically useful reference value and compare difference in each fingers and then compare with the other countries. 71 normal Korean volunteers (age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II (EMG machine) was use for detected conduction velocity and amplitude of digital nerves in ulnar nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation and independent t-test was used to compare with ring and little finger. Conduction velocity of the right ring finger was 57.44m/sec and little finger was 55.32msec. The left ring finger was 55.55msec and little finger was 54.11msec. Amplitude of the right ring finger was $30.28{\mu}V$ and little finger was $48.36{\mu}V$. The left ring finger was $30.67{\mu}V$ and little finger was $52.76{\mu}V$. There were significantly difference between ring and little in amplitude (p<.05) but there were no statistically difference between conduction velocity of ring and little finger (p>.05). The amplitude of little finger are greater than ring finger. The present results revealed that electodiagnosis can easily perform in little finger for digital nerve of ulnar nerve study.

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폐쇄성 수면 무호흡 증후군 치료에서 구개수구개인두성형술의 임상적 유용성 (The Clinical Efficacy of Uvulopalatopharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome)

  • 문화식;최영미;박영학;김영균;김관형;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제44권6호
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    • pp.1366-1381
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    • 1997
  • 연구배경 : 구개수구개인두성형술(uvulopalatopharyngoplasty : UPPP) 은 폐쇄성 수면 무호흡 증후군 환자에서 가장 보편적으로 시행되고 있는 외과적 치료법이지만 치료 효과에 대하여는 논란의 여지가 많으며, 국내 연구 자료는 매우 부족한 실정이다. 방 법 : UPPP를 시행한 폐쇄성 수면 무호흡 증후군 환자들 중에서 일차 추적 수면다원검사가 가능했던 26명을 대상으로 단기 치료 효과를 관찰하였다. 치료 효과는 두가지 기준에 의해 평가하였다. 첫 번째는 일반적인 평가 기준으로써, UPPP 시행으로 무호흡지수(apnea index : AI) 혹은 무호흡-저호흡지수(apnea-hypopnea index : AHI)가 50% 이상 감소한 경우 혹은 UPPP 시행 후의 AI가 10 미만이거나 AHI가 20 미만인 환자들을 효과가 있는 경우 즉 반응군으로 정의하였고, 두 번째는 저자들이 설정한 평가 기준으로써, UPPP 시행 전의 AI 혹은 AHI와 관계없이 UPPP 시행 후의 AI가 5 미만이거나 AHI가 10 미만인 환자들을 단기적으로 폐쇄성 수면 무호흡 증후군이 치유된 경우 즉 치유군으로 간주하였다. 비만도, AI 및 AHI와 UPPP 시행에 의한 AI 및 AHI 감소율과의 관련성을 관찰하였고, 수면 구조를 비교함으로써 UPPP의 시행으로 수면의 질이 개선될 수 있는지 여부를 분석하였다. UPPP 시행 후 10일 이내에 발생한 문제점을 조기 합병증으로 정의 하였고, 10일 이후에 발생한 부작용은 후기 합병증으로 분류하였다. 결 과 : 26명의 환자 중에서 반웅군은 18명(69.2%) 이었고, 10명(38.5%)은 단기적으로 폐쇄성 수면 무호흡 증후군이 치유된 소견을 보였으며 5명(19.2%)은 UPPP 시행 후에 AI 혹은 AHI가 오히려 증가되었다. UPPP 시행 전의 비만도는 AI 감소용 및 AHI 감소율과 상호 관련성이 없었고, UPPP 시행 전의 AI는 AI 감소율과 상관관계가 없었으며, AHI 역시 AHI 감소율과 관련성이 없었다. 전체 대상 환자, 반웅군 및 비반웅군, 치유군 및 비치유군 각각에서 UPPP 시행 전후 수면 구조의 유의한 변화는 없었다. UPPP 시행에 따른 조기 합병증으로 비교적 심한 수술 부위의 통증, 음식물의 비역류, 기침이나 호흡곤란 등의 호흡기 증상, 수술 부위의 출혈, 연하곤란, 귀의 통증 혹은 봉합 부위 파열 등이 전체 환자(100%)에서 발생하였고, 후기 합병증으로 인후의 건조감, 비역류, 음성의 변화, 연하곤란, 인후의 이물감 혹은 미각변화 등이 22명(84.6%)의 환자에서 관찰되었으나, 합병증은 모두 경미한 것이었다. 결 론 : 폐쇄성 수면 무호흡 증후군 환자의 약 70%가 UPPP의 시행으로 호전을 보이지만, 치료 효과가 충분한 경우는 약 40%에 불과하였다. 치료 효과를 높이기 위해서는 엄격한 기준에 의한 적응증의 결정과 더불어 적절한 수술 방법이 필요할 것으로 생각한다.

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