• Title/Summary/Keyword: chronic pain

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Solitary Juvenile Polyps and Colonoscopic Polypectomy in Children (연소성 대장 용종의 내시경적 용종 절제술)

  • Cheon, Kyoung Whoon;Kim, Jae Young;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.236-241
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    • 2003
  • Purpose : This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. Methods : This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. Results : The mean age of the 19 cases was $4.7{\pm}2.8year$. The male to female ratio was 1 : 1.1. Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. Conclusion : Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.

The Ability of Cervus Elaphus Sibiricus Herbal Acupuncture to Inhibit the Generation of Inflammatory Enzymes on Collagen-induced Arthritis Mice (녹용약침(鹿茸藥鍼)이 CIA 모델 생쥐의 염증인자 생성억제에 미치는 영향)

  • Hwang, Jong-Soon;Hwang, Ji-Hye;Lee, Hyun-Jin;Lee, Dong-Gun;Kang, Min-Joo;Back, Song-Ook;Cho, Hyun-Seok;Kim, Kyung-Ho;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.1-14
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    • 2007
  • Backgrounds : Rheumatoid Arthritis(RA) is known as the chronic inflammatory diseasethat induces persistent inflammation in the joint cavity. The destruction of cartilage occurs as the result of bones destoyed by pannus, several influential cytokines induced by the synovial capsulitis, varieties of proteinases, $O_2$ radicals, and the secondary degenerative changes of articular cartilage. The type 2 collagen-induced arthritis model is used in recent experimental research on rheumatoid arthritis. Cervus elaphus sibiricus (Nockyong) has the effect of relieving pain by nourishing the muscles, joints, and bones. It is also known to be efficacious in promoting and enhancing the immune system. The objective of this study was to investigate the effect of Cervus elaphus sibiricus herbal acupuncture to inhibit the generation of proinflammatory enzyme on type 2 collagen-induced arthritis. I investigated the inhibition of mRNA transcription of MIF(macrophage migration inhibitory factor), $TNF-{\alpha}$(Tumor necrosis $factor-{\alpha}$) and MMP-9 (matrix metalloproteinase-9) of Cervus elaphus sibiricus herbal acupuncture using an in vitro test. Also investigated was the inhibition of differentiation of Th 1 cells and activation of cytokines(MIF, $TNF-{\alpha}$, IL-6, MMP-9), which are known to cause initial RA ,and are also related to the morphology of the synovial membranes of the joint capsule, by an in vivo test, using CIA(collagen induced arthritis) model mice. Materials & methods : The laboratory animals used in this experiment were 4 week-old DBA female mice, weighing approximately 20 grams, and adjusted to the laboratory environment. The experiment was divided into the normal group(NOR)-no treated group, control group(CON)-CIA induced group, and sample group(SAM)-Cervus elaphus sibiricus herbal acupuncture treated group. RA was induced in the mice via injection of $50{\mu}{\ell}$ C II mixed CFA. The Cervus elaphus sibiricus herbal acupuncture solution was applied on $GB_{35}$(陽陵泉) for 26 days from the 3rd day of RA inducement. The concentration of the solution was determined via a MTT assay. To research the effect on the expression of MIF, $TNF-{\alpha}$ and MMP-9 mRNA, RT-PCR was performed on synovial membrane cells from the knee joint of CIA mice. C II induced RA knee joint's histo-chemical synovial membrane was observed using a specimen model via the Hematoxilin and Eosin dying technique. Results : The expression of mRNA of RA-related cytokines such as MIF, $TNF-{\alpha}$, and MMP-9 dosedependently decreased in the cell from the synovial membranes of the joint, which is treated with Cervus elaphus sibiricus herbal acupuncture solution. In mice treated with Cervus elaphus sibiricusherbal acupuncture, the damage of synovial membranes of the joint was lessened, and differentiation of Th 1 cells was suppressed. The activation of RA-related cytokines such as MIF was suppressed, and the generation of $TNF-{\alpha}$ and MMP-9 showed a statistically significant decreas. Conclusions : It is speculated that Cervus elaphus sibiricus herbal acupuncture has the therapeutic effect of palliating the damage of the tissue impaired by RA by inhibition of the initial RA progression and by regulating excessive differentiation of Th 1 cell as it suppresses the generation of RA-related cytokines during the highest stage of RA by acting on pro-inflammatory enzymes.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Transcatheter Arterial Embolization for Hemoptysis (객혈환자에서 동맥 색전술의 효과)

  • Yoo, Byung-Su;Ryu, Jeong-Seon;Lee, Won-Yeon;Song, Kwang-Seon;Ahn, Kang-Hyun;Yong, Suk-Joong;Shin, Kye-Chul;Kim, Young-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.50-57
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    • 1995
  • Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

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A Comparison Study on the Internet Addiction and Health Problems of Middle School Students between Urban and Rural Area (도농간 중학생의 인터넷 중독과 건강문제 비교연구)

  • Yeon, Mi-Jung;Kim, Keon-Yeop;Lee, Moo-Sik;Hong, Jee-Young;Bae, Seok-Hwan;Hwang, Hye-Jeong
    • Journal of the Korea Convergence Society
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    • v.1 no.1
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    • pp.41-47
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    • 2010
  • This study was conducted to investigate determinent factors of the internet addiction that have influenced on middle school students. We randomly selected each one middle school in urban and rural areas, and conducted survey in 862 students of 2nd and 3rd grade from September 1 to 15, 2005. By using a statistical program called SPSS10.0, the data collected thereby were analyzed through a series of statistical methods including $x^2$-test, logistic regression analysis. The result of logistic regression analysis showed that the significant variables in urban area were resting time and using time a day. In rural area, sex, economic level, resting time and using time a day were significant variables. Higher status of internet addiction showed significant relationship with physical problems, anxiety, maladjustment to school, insufficient sleep time, fatigue in eyes, headache, pain in neck or shoulder, chronic fatigue, reduced vision, weight reduction, indigestion, xeroderma and adjustment to school. Especially, resting time and using time a day have dominant influence on internet addiction. And in case that the groups who showed high addiction tendency, there were negative health problem by physical, mental and social problem. To prevent internet addiction health education programs of right internet use and time, importance of rest, and health problems must be considered in internet addiction prevention policy.

Comprehensive Geriatric Assessment for Community Living Elderly in a Rural Area (일부 농촌지역 거주 노인들에 대한 포괄적 노인평가)

  • Rhee, Jung-Ae;Shin, Hee-Young;Chung, Eun-Kyung;Shin, Jun-Ho
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.21-31
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    • 2002
  • The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

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Factors Contributing to Treatment Outcome of Functional Constipation in Children (소아 기능성 변비의 치료에 영향을 미치는 인자)

  • Kim, Hyung-Seok;Hong, You-Rha;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.36-43
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    • 2010
  • Purpose: The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children. Methods: We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively. Results: Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2${\pm}$37.9 months. The duration of symptoms was 32.6${\pm}$33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later. Conclusion: Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.

BTEX Exposure and its Health Effects in Pregnant Women Following the Hebei Spirit Oil Spill (허베이 스피릿호 유류유출사고 지역 산모의 BTEX 노출과 건강영향)

  • Kim, Byung-Mi;Park, Eun-Kyo;LeeAn, So-Young;Ha, Mi-Na;Kim, Eun-Jung;Kwon, Ho-Jang;Hong, Yun-Chul;Jeong, Woo-Chul;Hur, Jong-Il;Cheong, Hae-Kwan;Yi, Jong-Heop;Kim, Jong-Ho;Lee, Bo-Eun;Seo, Ju-Hee;Chang, Moon-Hee;Ha, Eun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.96-103
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    • 2009
  • Objectives : We evaluated the health effects of exposure to BTEX(Benzene, Toluene, Ethylbenzene, m,p-Xylene, o-Xylene) in the Taean area after the Hebei Spirit oil spill. Methods : We used a questionnaire survey to look for health effects among 80 pregnant women 2 to 3 months following the Hebei Spirit oil spill. Their BTEX exposures were estimated using the CALPUFF method. We then used a multiple logistic regression analysis to evaluate the effects of BTEX exposure on the women s health effets. Results : Pregnant women who lived near the accident site reported more symptoms of eye irritation and headache than those who lived farther from the site. There was a trend of decreasing symptoms with an increase in distance from the spill site. Pregnant women exposed to higher ambient cumulative levels of Xylene were significantly more likely to report symptoms of the skin(OR 8.01 95% CI=1.74-36.76) in the first day after the accident and significantly more likely to report abdominal pain(OR 3.86 95% CI=1.02-14.59 for Ethylbenzene, OR 6.70 95% CI=1.82-24.62 for Xylene) during the 1st through 4th days following the accident. Conclusions : This study suggests that exposure to BTEX from an oil spill is correlated with an increased risk of health effects among pregnant women. This implies the need to take proper measures, including the development of a national policy for environmental health emergencies and a plan for studying the short- and long-term chronic health effects associated with such spills.

Urinary Lithiasis in Children : A Single Center Study (소아 요로 결석 : 단일 기관 연구)

  • Lee, Hyun-Kyung;Lee, Sung-Ha;Han, Kyoung-Hee;Lee, Beom-Hee;Choi, Hyun-Jin;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.280-287
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    • 2007
  • Purpose : Urinary lithiasis is uncommon in children, however, it may lead to chronic renal insufficiency and even end stage renal disease. The etiology of stone formation in children is largely unknown; although the most common causes are known to be associated with congenital anomalies of the genito-urinary(G-U) tract, urinary tract infections(UTI), and metabolic diseases. Methods : A total of 73 children(male:female=42:31, mean age $6.6{\pm}5.3$ years) presented with urinary lithiasis between Sep. 1998 and Jul. 2007 at Seoul National University Children's Hospital. The medical records were reviewed retrospectively. Results : The most common presenting symptoms were gross hematuria(28/73, 38%) and flank or abdominal pain(23/73, 32%). The stones were located in the upper urinary tract in 48 patients(66%), in the bladder in 18(24%), and in both the bladder and upper urinary tract in 2 (3%). Congenital anomalies of the G-U tract with/without UTI were detected in 30 children (41%), hypercalciuria with/without hypercalcemia in 15(20%), and other metabolic diseases in 8(11%). In 17 patients(23%), no underlying cause of stone formation was detected. The majority of stones were infected stones(24/36, 67%), which were followed by calcium stones(8/36, 22%), uric acid stones(3/36, 8%). and cystine stones(1/36, 3%). Thirty-four patients(46%) underwent surgical procedures and/or extracorporeal shockwave lithotripsy for stone removal, and 13(18%) passed stones spontaneously with/without medical management. Stones recurred in 6 patients(8%): 4 with neurogenic bladder augmented by ileocystoplasty, 1 with cystinuria, and 1 with unknown etiology. Conclusion : The common causes of urinary lithiasis in children were congenital anomalies of the G-U tract with/without UTI and metabolic disorders including hypercalciuria/hypercalcemia. For the management of stones, minimally invasive procedures should be chosen on the basis of accompanying symptoms and the composition, locations and etiology of stones.

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Anti-Obestic Effects of Artemisiae Capillaris Herba, Artemisia Capillaris Stem Aqueous Extracts on the High Fat Diet Supplied Mice (고지방 사료 급여 마우스에서 인진쑥 추출물의 항비만 효과)

  • Kim, Hong-Tae;Kim, Dae-Dong;Ku, Sae-Kwang;Kim, Ju-Wan;Jang, Kwang-Ho;Oh, Tae-Ho;Lee, Keun-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.348-365
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    • 2010
  • Artemisia capillaries THUNB is a perennial herb that belongs to the family compositae spp. and the most common plant among the various herbal folk remedies used in treatment of abdominal pain, hepatitis, chronic liver disease, jaundice and coughing in Korea. The object of this study is to observe the dosage-dependent anti-obestic effects of an aqueous extracts of dried aqueous extracts of stems of Artemisia capillaris Thunberg. [Artemisiae capillaris Herba, In-Jin in Korean, INJ] on 45%/Kcal high fat diet (HFD) supplied mice. 45%/Kcal rodent HFD are supplied to ICR mice from 1 week before initiation of INJ administration throughout the 12 weeks, and after the end of 12 weeks of 62.5, 125 and 250 mg/kg/day of INJ administration, the efficacy was divided into five categories 1) hypoglycemic, 2) hepato-protective, 3) nephroprotective, 4) hypolipemic, and 5) anti- obesity effects. The effects were compared to those of simvastatin (for hypolipemic activity), silymarin (for hepatoprotective and free radical scavenger effects) and metformin (for hypoglycemic and related anti-obesity effects). 7 animals per group (8 groups; total 56adapted mice on HFD were selected base on the body weight at 6 days after initiation of HFD supply) were used in this experiment. INJ and all three different reference drugs were directly suspended or dissolved in distilled water, and administered at a volume of 10 mL/kg, once a day for 84 days from 1 week after HFD supply. As results of 91 days of continuous HFD supply, mice showed marked obese states, hyperglycemia, hyperlipemia, liver damages and kidney damages. These mean the obesity, diabetes, diabetic hepatopathies, nephropathies and hyperlipemia were induced by HFD supply. After end of 84 days of continuous treatment of three different dosages of INJ, all diabetes related complications were inhibited; relatively favorable anti-obesity, hypolipemic, hepatoprotective, hypoglycemic and nephroprotective effects. These favorable effects showed relatively good dose-relations between all three different dosages of INJ treated, and INJ 250 mg/kg showed enough favorable effects on diabetes and related four complications tested as compared with one of each three different references. Otherwise, the efficacy of 62.5 and 125 mg/kg of INJ was somewhat slighter than those of all three reference drugs. Therefore, the suitable effective dosage of INJ is considered as 250 mg/kg/day in the present study. The overall anti-obesity effects of INJ 250 mg/kg-treated group was similar or more favorable than those of metformin 250 mg/kg-treated group, and INJ 250 mg/kg showed slighter hypoglycemic effects with silymarin 100 mg/kg and metformin 250 mg/kg, similar hypolipemic effects with simvastatin 10 mg/kg, and similar hepatoprotective effects with silymarin 100 mg/kg, and similar nephroprotective effects with that of silymarin 100 mg/kg and metformin 250 mg/kg, respectively. Obese, hyperglycemia, hyperlipemia, steatohepatitis and related nephropathies induced by HFD supply were dramatically inhibited by 84 days of continuous treatment of all three different dosages of INJ. It is, therefore expected that INJ extracts will be a favorable alternative agent for diet-related diabetes and complications.