• Journal of the Korea Convergence Society
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• v.10 no.5
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• pp.85-94
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• 2019

This study was aimed to identify a study on the effect of chest compressions combined with abdominal drawing-in technique on prevention of back pain and chest compression quality. We tested motion analysis, electromyography, and chest compression quality of 15 paramedics. Data were normalized to SPSS 21.0 (Kolmogorov-Smirnov and Shapiro-Wilk test). The paired t-test was used for the pre- and post-test chest compressions, the one-way ANOVA was used for the analysis of the measurement point-in-time differences, and LSD was used for the post-test. The results of the study showed significant difference in muscle activity and chest compression success rate when the chest pressure was applied with abdomen drawing-in. Therefore, it is necessary to study cardiopulmonary resuscitation education which can increase the chest compression success rate while preventing the back pain of the paramedics in the future.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.1
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• pp.27-44
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• 2002

The main purpose of this study was to identify the effect of hand massage on pain and anxiety related to chest tube removal in patients with a lobectomy. The research design of this study was a nonequivalent control group non-synchronized design. Of the twenty nine adult subjects, fourteen were assigned to the experimental group and fifteen to the control group. The data were obtained over 3 months from a medical center in Seoul. The instruments used to assess trait state anxiety was the Spielberger Trait-State anxiety Inventory. For pain and psychological anxiety. The Visual Analogue Scale was used. Hiko analogue sphygmo-manometer(2001) was used to check blood pressure and pulse rate as indicators of physiological anxiety Subjects in the experimental group received hand massage for 5 minutes just before chest tube was removed, and subjects assigned to the control group did not receive hand massage. Data were analysed with $x^2$-test and Mann-Whitney U test using the SPSSWIN 10.0 program. The results of the study are as follows : 1. Hypothesis 1: 'there will be a significant difference between two groups in the level of pain after chest tube removal' was supported (u = 23.00, p < 0.001). 2. Hypothesis 2: 'there will be a significant difference between the two groups in the level of psychological anxiety after chest tube removal' was supported (u = 3.00, p < 0.001). 3. Hypothesis 3: 'there will be a significant difference between the two groups in physiological anxiety(systolic, diastolic blood pressure and pulse rate) after chest tube removal' was supported(u =55.50, p = 0.01 ; u = 41.50, p = 0.01 ; u = 20.50, p < 0.001, relatively). The findings of this study indicate that hand massage is effective for pain and anxiety related to chest tube removal in patients with lobectomy. Therefore, hand massage is recommended as an effective nursing intervention for relieving pain and anxiety in patients undergoing chest tube removal. Further research is needed to identify the proper duration and timing to achieve the optimal effect of hand massage. A larger subject population is required to apply the current findings to the general population. Further research is also needed to assess the effects of hand massage in other patient subsets. Finally, it would be interesting to see if the effects of hand massaging would be attenuated when performed by a non-medical specialist.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.51-56
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• 2013

Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures. Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected. Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians. Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

• Journal of Chest Surgery
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• v.3 no.1
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• pp.17-20
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• 1970

Six cases of broncho-pleural fistula due to complicated liver abscess were experienced at the department of chest surgery, Seoul National University Hospital from October 1967 to March 1970. Amebic liver abscess was the primary cause in the 5 cases and the remaining one case was due to pyogenic liver abscess. Involved lung was right side in all case. The clinical manifestation was fever,chill,cough, sputum, dyspnea, chest pain, hemoptysis and shoulder pain. The methods of the treatment employed were closed thoracotomy [1], thoracotomy & drainage [2],decortication [1],and right lower lobectomy[3]. The average duration of the post-operative course was 19.6 days. There was no operative mortality.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.185-188
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• 2016

The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.109-116
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• 2009

Objective: The objective of this study is to observe the effect of anti-inflammatory herbal acupuncture on the Complex Regional Pain Syndrome Methods : Anti-inflammatory herbal acupuncture, A-Shi Point, Sa-am acupunture were used to treat shoulder pain & ROM(range of movement)disorder, chest pain, finger's causalgic pain. We evaluated the patient through VAS(Visual Analog Scale) daily and Physical Examinations Results & Conclusions : After 42days of treatment, shoulder pain was decreased from VAS10 to VAS3, chest pain was decreased from VAS10 to VAS1.5, finger's causalgic pain was decreased from VAS10 to VAS2.5. and the patient showed that the ROM(range of movement) of shoulder was better, oriental treatment is good method for pain relief and better movement.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.120-126
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• 2012

Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.

• Journal of Korean Neurosurgical Society
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• v.43 no.3
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• pp.169-171
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• 2008

Giant lymph node hyperplasia (Castleman's disease) is a nonneoplastic lymphoproliferative disorder of unknown etiology that usually occurs in the chest. Its morphological recognition is based on a composition of various histological features. The mass is often asymptomatic, but it can cause nonspecific thoracic symptoms, such as regional pain. This disease can be found wherever lymph nodes are present, but two-thirds of these tumors are found in the chest, along the tracheobronchial tree in the mediastinum or lung hilus. However, we experienced an unusual case of Castleman's disease as a cause of back pain that was localized in the posterior mediastinum bordering the chest wall.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.286-289
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• 2010

A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from $500{\mu}g/hr$ to $3,650{\mu}g/hr$, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl $4,050{\mu}g/hr$ for more than 16 months.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.12-24
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• 2014

Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport. Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods. Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement. Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.