• 제목/요약/키워드: Spontaneous pain

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폐쇄식 흉강삽관술 후 발생한 호너 증후군 - 치험 1예 - (Horner's Syndrome: A Rare Complication of Tube Thoracostomy - A case report -)

  • 최재웅;김주현;유병수;강창현;김영태
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.816-819
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    • 2010
  • 호너 증후군은 폐쇄식 흉강삽관술 후 발생할 수 있는 드문 합병증으로 이를 치험하여 보고하고자 한다. 17세 여자 환자로 2번째 발생한 좌측 기흉으로 폐쇄식 흉강삽관술 시행 후 수술 위해 입원하였다. 입원 후 우측 중이염 발생으로 항생제 치료 중 폐쇄식 흉강삽관술 후 3일째 흉관 삽입한 동측 동공 축동과 눈꺼풀 처짐을 증상으로 하는 호너 증후군이 발생하였고, 즉시 흉관을 2~3 cm 잡아 빼서 흉관의 위치를 교정하였다. 폐쇄식 흉강삽관술 후 5일째 기흉에 대한 낭포 절제술과 기계적 흉막 유착술을 시행하였고, 특별한 문제 없이 수술 후 7일에 퇴원하였다. 수술 후 호너 증후군으로 인한 증상은 점차 호전되었고, 2달만에 완전히 회복하였다.

하악 구치부에 발생한 Bisphosphonate Related Osteonecrosis of Jaw의 치험례 (Bisphosphonate Related Osteonecrosis of Jaw on Mandibular Molar Area: a Case Report)

  • 박재안;윤규호;정정권;배정호;유경하;조규홍;신재명;백지선
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권5호
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    • pp.478-483
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    • 2010
  • Bisphosphonates are synthetic analogue and have high affinity on bone remodeling site. Since they have a long half-reduction time, they accumulate at bone and act for a long time. They are widely used in osteo-porosis derived from imflammatory bowel disease or postmenopausal osteoporosis patient for bone mineral density improvement. In addition, they neutralize hypercalcemia owing to bone metastasis of malignancy. However, a jaw bone necrosis was recently reported in some patients who have taken bisphosphonates for a long time. It is called Bisphosphonate Related Osteonecrosis of Jaws (BRONJ). It can come spontaneous-ly, but more often after oral surgery including tooth extraction. In this case, a 80-year-old woman was treated with bisphosphonate (sodium alendronate) for 2 years to improve bone mineral density. She had her left lower second molar tooth extracted at local clinic. After extraction, she had inflammatory symptoms like a pain, a cheek swelling, and a discharge of pus. She was referred to our clinic for treatment. We treated meticulously from dressing to surgery. After following up about 1.5 years, the jaw lesion was successfully healed. So we report this case.

하대정맥의 혈전증을 동반한 인지질항체 증후군의 수술적 치료 - 1예 보고 - (Inferior Vena Cava Thrombectomy in a Patient with Antiphospholipid Syndrome - A case report -)

  • 장재석;권오춘;이섭;김석
    • Journal of Chest Surgery
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    • 제42권3호
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    • pp.371-374
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    • 2009
  • 36세의 여자환자가 복부통증 및 하지부종소견을 주소로 내원하였다. 과거력상 자연유산의 경험이 있고 광과민성, 수관절 통증을 간헐적으로 호소하였으며, 입원당시 시행한 컴퓨터 단층촬영상 하대정맥에 혈전이 관찰되었으며, 혈액검사상 자가항체의 상승이 동반되어 인지질항체 증후군으로 진단되었다. 헤파린 및 이뇨제등의 약물치료를 유지하는 동안 폐동맥색전증이 관찰되어 혈전제거 술을 시행하였으며 현재 환자는 특별한 재발의 소견 없이 항응고요법을 시행하며 외래에서 추적관찰중이다.

자하거 약침으로 호전된 방아쇠 수지 환자의 증례 보고 (The Case Report of Trigger Finger Improved with Hominis Placenta Pharmacopuncture Treatment)

  • 김정원;김주영;최승범;한상욱;이재철;김동훈
    • 대한약침학회지
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    • 제13권4호
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    • pp.139-147
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    • 2010
  • 본원에서 방아쇠 수지 환자 3례를 자하거 약침으로 5-7회 치료한 결과 유의한 효과가 있었다. 그러나 연구자의 치료예가 부족하여 4도 정도로 굴건의 걸림이 심한 경우나, 양방의 보존적 치료 후 재발되는 경우, 증상이 오래된 경우에 대한 연구와 1년 후의 재발율에 대한 추적 조사가 더 필요한 것으로 생각된다. 그리고 방아쇠 수지를 급성기, 결절형의 염증상태와 만성기, 미만형 퇴행상태로 정확하게 구분하여 염증상태에는 봉약침을 사용하고, 퇴행화 상태에서는 자하거 약침을 사용한다면 좋은 효과를 볼 것으로 기대된다. 앞으로 각종 수지관절 및 건의 질환에 대한 치료방법에 대한 연구가 더욱 더 필요할 것으로 생각된다.

시상 증후군에 동반된 대뇌 피질 혈류 변화에 대한 $^{99m}Tc-HMPAO$ Brain SPECT (Thalamic Syndrome with Related Cortical Hypoperfusion on $^{99m}Tc-HMPAO$ Brain SPECT)

  • 김은경;정태섭;서정호;김동익;이종두;박창윤;홍용국;이명식
    • 대한핵의학회지
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    • 제26권1호
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    • pp.33-39
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    • 1992
  • Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

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식도 천공의 임상적 고찰 (A Clinical Evaluation of the Esophageal Perforation)

  • 김재학;오덕진
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.759-762
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    • 1996
  • 충남대학교 병원 흉부외과에서 1985년 6월부터 1995년 10월까지 식도 천공 15례를 경험하였다. 남녀 비는 9 대 6 이 었으며, 연령 분포는 19세 에서 71세 (평균 49세)까지 였다. 식도 천공 원인은 다양하여, 특 발성 및 식도이물 섭취로, 천공된 례가 각각 4례, 기구 조작에 의한 경우 3례, 흉부 둔상 1례, 약물(클로 르칸키) 섭 취 1례, 기관 절개술시 식도 손상 1례, 원인 불명의 천공 1례가 있었다. 천공 부위는 흉부 식도 9례, 경부 식도 6례 였다. 증상은 동통 11례, 발열 9례, 연하 곤란 Bfl, 호흡 곤란 5례 등이었다. 수술은 경 부 식도 천공의 경우 절개 및 배액술, 단순 봉합, 위루술등, 흉부 식도 천공의 경우 단순 봉합, 단순 봉합 및 흥막 보강술, 위루술 등을 시행하였다 1례가 사망하였으며, 사인은 패혈증이 었다.

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텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화 (Visualization of unstructured personal narratives of perterm birth using text network analysis)

  • 김증임
    • 여성건강간호학회지
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    • 제26권3호
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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.

The Effectiveness of Osteoplasty System (Vertebroplasty using Large Cannula-low Pressure Delivery System) in Compression Fracture and other Spinal Pathology

  • Kang, Jeong-Han;Kuh, Sung-Uk;Shin, Zun-Zae;Cho, Yong-Eun;Yoon, Young-Sul;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제38권4호
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    • pp.259-264
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    • 2005
  • Objective : The vertebroplasty is an excellent procedure in spine compression fracture, but there are some problems such as cement leakage and difficulties in bone biopsy. Recently, the osteoplasty system is developed to solve these problems, so we will report the usefulness of the osteoplasty system. Methods : From January 2003 to November 2003, there are 9patients with simple osteoporotic spine compression fracture, 2 compression fracture patients combined with suspicious spinal metastasis, 1patient with suspicious primary bone tumor, and 2patient with infection on spine. All patients were treated using the osteoplasty system. Results : All 11 compression fracture patients were relived the back pain after the osteoplasty and there is no complication. The bone biopsies in 3 suspicious cancer patients were also effectively performed using the osteoplasty system; negative result in 2patients and positive result in 1patient. The culture result of spontaneous discitis was no growth for 48hours. The spine tuberculosis was confirm using the osteoplasty system. Conclusion : The osteoplasty system has distinguished advantages in comparison with the vertebroplasty. That is, the risk of cement leakage is lower than vertebroplasty because of low pressure delivery system. And we can obtain the specimen effectively in bone biopsy because of large cannula. In conclusion, we emphasize that the osteoplasty system is a more useful procedure in spine compression fracture especially in the patient needed bone biopsy for diagnosis.

뇌혈관질환 환자를 돌보는 가족원의 신체증상과 스트레스 (Actual Physical Symptom and Stress in Caregivers of Patients with Cerebrovascular Disease)

  • 김희승;박현애;오미정
    • 대한간호학회지
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    • 제28권3호
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    • pp.695-704
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    • 1998
  • This study aims for examines the actual physical symptom and stress in caregivers of patients with cerebrovascular disease. The data were collected by a survey conducted from August to September, 1997 which included 65 caregivers of cerebrovascular disease patients in 4 hospitals located in Seoul. The caregiver's stress was measured by Choi (1992)'s instrument and the actual physical symptoms were investigated. The data were analyzed using ANOVA, Scheffe test, Pearson correlation coefficient and stepwise multiple regression. The results were as follows : 1. The mean number of caregiver's physical symptom was 3.5. There were significantly higher number of physical symptom in women, those of who have a religious affiliation, those of who perceive their own health status perceived as bad, and those of who perceived their patients disease condition as serious than in their counterparts. Also, the number of caregiver's physical symptom was significantly higher in caregivers whose patients have a paralysis sypmtom and the disease onset as accident than in caregivers whose patients have no paralysis symptom and the disease onset as spontaneous. 2. The average of caregiver's stress was 57.9. The caregiver's stress was the highest in between the ages of 50 and 59. There were also significantly higher level of stress in women, those of who perceived the disease condition of their patients as serious than in their counterparts. 3. The most common caregiver's physical symptom was fatigue(87.7%). This was followed by insomnia(58.5%) and muscle pain(47.7%). 4. Caregiver's physical sypmtom was positively correlated with caregiver's stress and negatively correlated with patient's activity of daily life. 5. The most important vairable affecting the caregiver's physical symtom was patient's activity of daily life which accounted for 12.7% of the total variance in stepwise multiple regression analysis. The most important vairable affecting the caregiver's stress was the patient disease condition perceived by the caregiver that accounted for 12.1% of the total variance.

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하악골 골절에 대한 수술 시 예방적 항생제 사용과 술후 항생제 투여의 효율성 (ANTIBIOTIC PROPHYLAXIS IN THE OPERATION OF THE CLOSED MANDIBULAR FRACTURES AND THE EFFICACY OF POSTOPERATIVE ANTIBIOTICS)

  • 강상훈;최영수;변인영;김문기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권1호
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    • pp.31-34
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    • 2009
  • Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.