• 제목/요약/키워드: Spontaneous pain

검색결과 279건 처리시간 0.025초

Lumbar herniated disc: spontaneous regression

  • Altun, Idiris;Yuksel, Kasim Zafer
    • The Korean Journal of Pain
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    • 제30권1호
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    • pp.44-50
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    • 2017
  • Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

비가역성 치수염의 임상증상에 따른 임파구 분포에 관한 연구 (LYMPHOCYTES POPULATION IN RELATION TO CLINICAL SYMPTOMS IN IRREVERSIBLE PULPITIS)

  • 이우철;임성삼
    • Restorative Dentistry and Endodontics
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    • 제20권1호
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    • pp.235-249
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    • 1995
  • This study was designed to identify the lymphocytes present and to examine the relation between lymphocytes population and clinical symptoms of the pulps clinically diagnosed as normal and irreversible pulpitis. We recorded the history and severity of the pain and performed several clinical tests, before extirpation of vital, irreversibly inflamed pulps in routine endodontic treatment. Then the teeth were divided into two groups. Five teeth, categorized in acute symptom group, had severe spontaneous pain, particularly at night and were extremely sensitive to cold and heat. The other 15 teeth with history of mild to moderate pain and with or without cold or heat responses were categorized as chronic symptom group. Inflamed pulps were also classified into 8 minor groups by presence or absence of signs or symptoms related to the involved teeth, including the presence of pain on percussion, pain on heat and cold stimuli and the periodontal pocket depth. All extirpated pulps were immediately immersed in ultra low-temperature freezer($-74^{\circ}C$), and they were sectioned $6{\mu}m$ in thickness. Specimens were stained using three-stage indirect immunoperoxidase techniques(DAKO, LSAB kit) and monoclonal antibodies for detecting the presence of T lymphocytes(T), B lymphocytes(B) and helper(T4) and suppressor(T8) lymphocytes. Following results were obtained; 1. All the examined normal and inflamed pull) tissues had positive staining for T lymphocytes and T helper and T suppressor cells. But B cells were observed only in inflamed pulp. 2. Statistically more T and B cells were observed in acute symptom group as compared with chronic symptom group(p<0.05). 3. Cell ratio of BIT in acute symptom group were significantly higher than that of chronic symptom group(p<0.05). 4. Only B cells were significantly increased in the percussion positive group than the number of B cells in percussion negative group(p<0.05). 5. No differences were observed in the number of different cell types among other minor groups.

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자발성 혈흉을 동반한 후종격동 신경섬유초종 (Spontaneous Hemothorax in a Patient with Posterior Mediastinal Neurilemmoma -A case report-)

  • 김혁;양주민;정기천;김영학;강정호;정원상
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1019-1021
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    • 2004
  • 신경종은 후종격동 종양의 흔한 형태이며 주로 증상 없이 단순흉부촬영상 우연히 발견되거나 흉통이나 요통 등의 신경압박증상이나 기관지를 압박하여 나타나는 증상 등에 의해 발현되기 쉽다. 하지만 본 증례와 같이 자발성 혈흉을 일으키는 경우는 극히 드물다. 환자는 45세 남자로 갑자기 생긴 흉통 및 호흡곤란을 증상으로 타 병원 응급실 내원하여 시행한 단순흉부촬영상 우측 늑막삼출이 의심되어 폐쇄성 흉관삽입술 후 혈흉으로 진단되었고 흉부 전산화단층촬영상 후종격동 종양 소견 보여 본원으로 전원되었다. 전원 후 시행한 흉추 자기공명영상촬영상 아령모양의 신경종 의심되어 수술적 절제를 시행하였고 병리조직검사상 신경섬유초종으로 판명되었다.

원발성 자연기흉의 폐기포절제술시 정중액와개흉술과 비디오흉강경수술의 임상적 비교 (A Comparison of Clinical Evaluation for the Management of Primary Spontaneous Pneumothorax Using the Video-Assisted Thoracic Surgery and Mid-Axillary Thoracotomy)

  • 서성구
    • Journal of Chest Surgery
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    • 제28권5호
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    • pp.471-474
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    • 1995
  • A total of 20 patients underwent bullectomy in the spontaneous pneumothorax between October 1993 and August 1994. The patients were divided into two groups: Control group; the patients who received with mid-axillary approach[n=10 , Experimental group; the patients who received with video-assisted thoracic surgery [n = 10 . The results were as follows; 1. The total sex distribution was male predominence [M :F=6:1 . Mean age of control group was 31.6$\pm$ 10.1 age and experimental group was 24.3$\pm$ 5.5 age. 2. The operative times were 117.0 $\pm$ 32.6min in control group and 102.5$\pm$ 38.4min in experimental group [not significant . 3. The indwelling period of postoperative chest tube and hospital stay were 4.5$\pm$ 2.6 days and 8.3 $\pm$ 1.8 days in control group, $1.5\pm$ 0.5 days and 3.1 $\pm$ 0.3 days in experimental group[p=0.0018, < 0.0001 . 4. In control group, injection times of pain-killer were 1.7$\pm$ 0.7 times/day at operative day and 0.4$\pm$ 0.6times/day at postoperative 1 day. In experimental group, there were 0.3$\pm$ 0.7times/day at operative day and 0.1 $\pm$ 0.3times/day at postoperative 1 day[p=O.O002 at operative day, not significant at postoperative 1 day .

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외측 반월상 연골에서 발생한 외상성 완전 방사상 파열 자가 치유의 자연 경과: 증례 보고 (Natural History of Spontaneous Healing of a Traumatic Radial Tear of the Lateral Meniscus: A Case Report)

  • 심재앙;윤용철;이신우;이범구
    • Journal of Trauma and Injury
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    • 제28권1호
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    • pp.21-26
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    • 2015
  • Complete radial tears of the lateral meniscus are relatively rare. Once torn, the injury can be debilitating due to disruption of the circumferential fibers of the meniscus. We experienced a case of a lateral meniscus with a complete radial tear at the midbody, where the two torn ends were displaced more than 1 cm and could not be approximated during arthroscopy. Thirteen months after surgery, follow-up MRI and second-look arthroscopic findings showed that the complete radial tear has healed spontaneously. However, twenty nine months after the second-look arthroscopy, the patient complained of severe knee pain during exercise. On follow-up MRI, increased sclerosis and newly developed bone marrow edema were observed in the lateral femoral condyle, compared with previous MR images. Finally, we performed meniscal allograft transplantation due to the defective properties of the completely healed lateral meniscus.

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원발성 흉골결핵의 외과적 치험 -1례 보고- (Primary Sternal Tuberculosis with Spontaneous Fracture Treated by Resection and Reconstruction -A Case Report-)

  • 배상일;김미혜;오태윤;장운하
    • Journal of Chest Surgery
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    • 제31권2호
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    • pp.190-193
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    • 1998
  • 본 강북삼성병원 흉부외과에서는 병적골절이 동반된 원발성 흉골결핵을 치험 하였다. 22세된 여자환자가 특별한 외상이없이 발생한 흉골부위의 통증 및 골절로 입원 하였다. 입원당시 시행한 흉부단순촬영 및 전산화단층촬영상 흉골의 괴사소견과 연부조직의 부종이 관찰되었다. 세침세포검사상 냉농양을 동반한 결핵성 골수염으로 진단되어 술전 항결핵 치료후 수술을 시행하였다. 수술시 흉골중앙부위의 골괴사 및 다발성 누공을 확인하였으며, 골괴사 부위를 제거한후 환자의 장골능을 골이식 하였다. 병리조직학적 결과는 결핵성 골수염의 소견 및 치즈양괴사를 보였다. 술후 경과는 양호 하였으며, 2개월동안의 추적검사상 흉골의 불안정은 관찰되지 않았다.

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Spontaneous Intraorbital Hemorrhage : A Case Report

  • Kwon, Jae-Hyun;Song, Young-Jin;Choi, Sun-Seob;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • 제44권3호
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    • pp.156-158
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    • 2008
  • Intraorbital hemorrhage is a rare clinical condition caused by orbital trauma, surgery around the orbit, intraorbital vascular abnormalities, and neoplasm. It was reported to occur spontaneously without any known causes and in association with orbital pseudotumor in a very few cases. A 59-year-old, female patient admitted with sudden onset of severe exophthalmos and pain on the left eye. Orbital CT and MR imaging suggested hemorrhage in the upper part of retrobulbar area of the left orbit. Cerebral angiography was taken to rule out any possible vascular abnormalities. On the left carotid cerebral angiography, the run-off of the distal ophthalmic artery was not seen and the engorgement of the supraophthalmic artery was noted. Systemic administration of corticosteroid did not improve the clinical status and craniectomy was done and retrobulbar hematoma was removed, and the clinical symptoms and signs were improved. Authors report a case of spontaneous intraorbital hemorrhage with the clinical features similar to those of orbital pseudotumor, requiring surgical decompression.

식도 자연파열[Boerhaave 증후군]의 외과적 치료;2례 보고 (Surgical Treatment of Spontaneous Rupture of the Esophagus [Boerhaave`s Syndrome])

  • 김근;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • 제25권8호
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    • pp.812-818
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    • 1992
  • The spontaneous rupture of the esophagus is an uncommon disease, but without early diagnosis and treatment, the mortality rate is high. This report is on the two cases treated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyu-ngpook National University. The first patient, after heavy drinking, had vomiting followed by chest pain, dyspnea and subcutaneous emphysema. After diagnosis using an esophagogram, an operation was perfomed. About a 4cm rupture was found at the lower left part of the esophagus and was primarily sutured with the intercostal muscle. The patient was weaned from the ventilator after 40 hours. The second patient had symptoms the same as the first case. Six days after the app-earence of the symptoms, the patient was treated by the Thais onlay gastric patch method. The leakage happened after the surgery and he received a conservative treatment. After discharge no abnormalities, such as leakage and stricture, were found on the eso-phagogram The two patients now live a normal life.

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자연성 기흉으로 인한 대량의 혈흉 (Massive hemothorax resulting from spontaneous pneumothorax)

  • 홍지연;김수완
    • Journal of Medicine and Life Science
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    • 제17권1호
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    • pp.16-20
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    • 2020
  • Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.

자발성 혈흉을 동반한 제1형 신경섬유종증 (Spontaneous Hemothorax in a Patient with Type I Neurofibromatosis)

  • 장원채;정인석;이교선;오봉석
    • Journal of Chest Surgery
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    • 제40권2호
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    • pp.140-142
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    • 2007
  • 제1형 신경섬유종증에서 혈관 병변은 드물지만 매우 치명적일 수 있다. 환자는 제1형 신경섬유종증 가족력이 있는 28세 여자로 갑자기 생긴 배부 통증과 호흡곤란을 주소로 내원하였다. 흉부 전산화단층 촬영상 우측에 다량의 혈흉을 동반한 늑간 동맥류 파열이 발견되었고 생체징후가 불안정하여 응급수술을 시행하였다. 저자들은 자발성 혈흉을 동반한 제1형 신경섬유종증 1예를 치험하였기에 증례보고를 하는 바이다.