• Title/Summary/Keyword: Subjective Pain

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Open Versus Arthroscopic Technique in the Traumatic Recurrent Anterior Dislocation of the Shoulder (견관절 전방 재발성 탈구에 대한 관혈적 술식과 관절경적 술식의 결과 비교)

  • Kyung, Hee-Soo;Jeon, In-Ho;Kim, Sung-Jung;Yeo, Jun-Young
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.110-117
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    • 2002
  • Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

Suffering and Hospice Care (고통과 호스피스 케어)

  • Kim, Myung-Ja;Jung, In-Sook
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.21-28
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    • 2007
  • Although hospice care includes palliative care technology in terminally ill person for pain, it is much more holistic including emotional, spiritual and other life dimension. Human suffering that experiencing the hospice client must be reconsidered whether one starts with an objective side or a subjective side of suffering, the strategies about the expanded consciousness is important. In the hospice caring perspectives, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially dying person, family member, and the hospice team.

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Hook Plate Fixation for Isolated Greater Tuberosity Fractures of the Humerus

  • Lee, Kyoung-Rak;Bae, Ki-Cheor;Yon, Chang-Jin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.222-229
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    • 2017
  • Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

Clinical Evaluation of Primary Lung Cancer (III) (폐암의 임상적 고찰 (III))

  • Hur, Y.;Yu, H.K.;Ahn, W.S.;Kim, B.Y.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.73-80
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    • 1990
  • A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].

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Rupturing in the Plaza: Teens in the Candle Demonstrations (광장에 균열내기 촛불 십대의 정치 참여에 대한 문화적 해석)

  • Kim, Ye-Ran;Kim, Hyo-Sil;Jung, Min-Woo
    • Korean journal of communication and information
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    • v.52
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    • pp.90-110
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    • 2010
  • This study problematizes the youth‘s politico-cultural process of identification as becoming in the context of candle demonstration in Seoul, 2008. We examine their ethical subjectivity, communicative subjectivity and political subjectivity based on our analysis of depth interviews of teenage activists in the candle demonstrations. It is suggested that instead of naming the teens as the historical consequence of so-called 386 generation, or social product in the neo-liberal economic and educational conditions, we need to understand the complexities and dynamics of the youth’s practice of identity politics: subjective pain and anxiety in daily life, creation and sharing of pleasure and fun of peer group comunication are mixed into the pursuit of justice in their social activation of generation/gender politics.

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ASSESSMENT OF INFERIOR ALVEOLAR NERVE DAMAGE USING DIGITAL INFRARED THERMOGRAPHIC IMAGING (디지털 적외선 체열 검사를 사용한 하치조 신경 손상의 평가)

  • Lee, Ji-Yeon;Lee, Jae-Hoon;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.488-496
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    • 2004
  • Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

Mid to Long-term Outcome of Vascularized Pronator Quadratus-wrapped Radial Bone Flap Arthroplasty for Advanced $Kienb{\ddot{o}}ck's$ Disease (진행된 키엔벡 병에서의 방형회내근 유경 요골 피판을 이용한 관절성형술의 중장기 결과)

  • Gong, Hyun-Sik;Baek, Goo-Hyun;Lee, Young-Ho;Kim, Sae-Hoon;Cho, Young-Jae;Chung, Moon-Sang
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.101-106
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    • 2006
  • The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.

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The Combined Effect of Autologous Fat Injection and Liposculpture for Gluteal Reshaping in Koreans (한국인에 있어 둔부몸매교정(Gluteal Reshaping)을 위한 자가지방주입술 및 지방흡입술의 효과)

  • Kim, Jee-Hoon;Hong, Jin-Joo
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.861-866
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    • 2011
  • Purpose: Together with the breast, buttocks are an important element of attractive body contour. To make a beautiful buttocks, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. The authors investigated characteristic features of buttocks in Koreans and report about the results of liposculpture and autologous fat injection for improving buttock's contour. Methods: We performed a retrospective study of 21 patients who would like to gluteal reshaping. We checked about buttock's ptosis, projection, depression, gluteal retraction and excessive fat accumulation around buttocks. Depending on it, we performed liposculpture and autologous fat injection. Under general anesthesia, we harvested fat from excessive fat accumulation areas around buttocks, and injected into buttocks medio-superiorly. Postoperatively, pillows were positioned on the bed not to press the buttocks which were injected with the fat. Results: Based on the shape of buttocks, A-shape is seen in 4 cases (19%), V-shape 3 cases (14%), squareshape 9 cases (43%), round-shape 5 cases (24%). Based on the Gonzalez's ptosis grading method, 1 degree ptosis is 1 case (4%), 2 degree ptosis is 6 cases (29%), 3 degree ptosis is 8 cases (38%), 4 degree ptosis is 6 cases (29%). There were no complications such as infection, hematoma, pain, dysparethesia. The subjective assessment of surgical results by patients was excellent. Conclusion: To make a beautiful buttock, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. Liposculpture and autologous fat grafting are very safe, useful and easy methods for improving buttock's contour.

Meta Analysis of the Effects of Massage Intervention for the Laboring Women (산부를 위한 마사지 중재 효과에 대한 메타분석)

  • Yeo, Jung-Hee;Choi, Hwan-Seok
    • Journal of Society of Preventive Korean Medicine
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    • v.13 no.3
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    • pp.87-99
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    • 2009
  • Objectives : The study was to examine the empirical evidence concerning the effects of massage intervention for the laboring women and to investigate the effect sizes related to the characteristics of intervention. Methods : Meta analysis was performed. A total of 11 trials related to massage intervention between 2000 and 2007 were reviewed. Results : Massage intervention showed a beneficial effect on length of labor(1st stage : U=46.75, p=0.00, 2nd stage : U=6.13, p=0.01), perception of childbirth experience(U=12.57, p=0.00), intensity of uterine contraction at the active(U=6.34, p=0.01) and the transition phases(U=24.83, p=0.00), and interval of uterine contraction at the active phase(U=4.83, p=0.03). Massage decreased systolic(U=10.81, p=0.00) and diastolic blood pressure at the transition phase(U=10.60, p=0.00). However, massage had no effect on subjective and objective labor pain and anxiety. No differences were found in effectiveness of massage according to characteristics of intervention(massage material, massager, and massage site) except for anxiety(QB=4.82, p=0.03) and diastolic blood pressure at the active phase by massage site(QB=4.52, p=0.03). Conclusions :We found that massage intervention for the laboring women had an empirical evidence on improving perception of childbirth experience and shortening length of labor. These results should be interpreted with caution due to the lack of studies. More full-scale randomized clinical trials with reliable designs are recommended to further warrant the effectiveness of massage.

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The Clinical Analysis of Patent Ductus Arteriosus (동맥관개존증의 임상적 고찰)

  • 박상섭
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.510-517
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    • 1988
  • With the ligation of a patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease, and treatment of the patent ductus is representative of the rapid advance made in thoracic surgery in the last 40 years. We have had clinical experiences about 36 cases of this in the department of Thoracic & Cardiovascular surgery, Pusan Paik Hospital, Inje medical college from March 1891 to June 1987. And the results were summarized as follows. 1. There were 11 males, 25 females. The age range of the patients were from 8 months to 36 years with the mean age of 7.9 years. 2. The chief complaints of the patients on admission were frequent URI[50%], dyspnea on exertion[29.8%], chest pain[11.1% k 1%], growth retardation[2%], cough[2.8%], anorexia[2.8%]. But there were 11 patients[30.6%] having no subjective symptoms. 3. In auscultation, the usual continuous machinery murmur was noticed in 30 patients[83.3%], only systolic murmur in 6[16.7%]. 4. In the preoperative chest P-A views, there were noticed cardiomegaly in 20 cases, enlarged pulmonary conus and / or pulmonary plethora in 22 patients[61.1%]. 5. In the preoperative EGG findings, there were noticed pattern of LVH in 8 patients[22.2`], RVH in 2[5.6%], BVH in 4[11.5%] and normal in 19[52.89o]. 6. The size of PDA[mean] was 9.5 mm[length] and 8.8 mm[width], the range of length was from 4 to 29 mm and the range of width was from 4 to 18 mm. 7. There were noticed 6 cases which were combined with other anomalies[VSD in 2 cases, Coarctation of aorta in 2, Mitral regurgitation in 1, and AP window in 1]. 8. On operation, simple ligation of the ductus was performed in 30 cases[83.3%], division and suture-ligation in 5[13.9%]. 9. Postoperative complications were noticed in 4 cases[pneumonia in one case, wound infection or disruption in 3], but there were no mortality.

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