• Title/Summary/Keyword: lower abdominal pain

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Effects of Continuous Epidural Infusion of Buprenorphine for Postoperative Pain Management (수술후 통증관리를 위한 Buprenorphine의 지속적 경막외 투여효과)

  • Yoon, Hee-Dong;Park, Young-Cheol;Lim, Hae-Ja
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.151-158
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    • 1996
  • Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid $\mu$-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can possibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and side effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg morphine (M group), 0.15 mg buprenorphine (0.15B group), 0.3 mg buprenorphine (0.3B group) combined with 0.25% bupivacaine 10ml, and subsequent continuous infusion doses were 6 mg morphine plus 0.125% bupivacine 100 ml (M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml (0.15B, 0.3B, group) during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group (P<0.05). Conclusion: The above results suggest that continuous epidural infusion of buprenorphine combined with low-dose bupivacaine is an advisable method of postoperative analgesia.

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A Literatural Study on the Traditional Korean Medical Physiotherapy (한방물리요법에 대한 문헌적 고찰)

  • Choi, Bo-Mi;Hong, Seo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.211-226
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    • 2011
  • Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology (소양인체질병증 임상진료지침: 음허오열병)

  • Yu, Jun-Sang;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.272-280
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    • 2014
  • Objectives This research was carried out to establish the clinical practice guideline(CPG) for Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Methods Dongeuisusebowon(sinchuk edition) and several kinds of literatures including journal articles concerning this symptomatology of Soyangin disease were collected and classified. Sasang constitutional specialists' conference was held to make an agreement on the conflicting issues as well. Consensus was drawn as a result of the conference. Results & Conclusions 3 papers were selected as an inclusion and exclusion criteria for the relevant articles to Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology consists of two aspects : Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern. In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern contains 1 disease, namely, Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern). In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern contains 2 diseases, Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology has several kinds of symptoms like dry mouth, disliking to drink much water, diurnal body fever, coldness on the back and nausea as well as body fever, chest discomfort, constipation or dry stool as a common symptoms of Interior Heat disease. Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern) has above mentioned symptoms and much urine/turbid urine, thin thigh and knee joints and twinge of joint pain over the body. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern has symptoms like indigestion and epigastric discomfort, abdominal pain and vomiting in addition. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern has symptoms like hematemesis as well.

Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

Analysis on Outpatients with Postpartum Disease at the Korean Gynecology Clinic of Traditional Korean Medicine Hospital (한방병원에 내원한 산후병 환자의 특성 및 증상에 대한 분석)

  • Hwang, Young-Sik;Park, Nam-Chun;Lee, Jin-Wook;Yang, He-Rynn;Park, Seung-Hyeok;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.61-78
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    • 2018
  • Objectives: The purpose of this study was to analyze the current characteristics of outpatients with postpartum disease and provide a treatment instruction in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, We searched medical records from January 1, 2015 to December 31, 2017 using Z34 (Supervision of normal pregnancy), O94 (Sequelae of complication of pregnancy), U327 (産後風) and 388 postpartum patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $33.73{\pm}3.62$ years old, 356 (91.75%) patients are full term pregnancy, 201 (51.81%) patients are first delivery, 79 (20.36%) patients had past history of abortion and 63 (16.24%) patients had past history of gynecologic disease. 2. The most subjects visited in April (10.31%). The mean duration from delivery date to visiting date was $131.5{\pm}214.6$ days. The mean number of visits after the initial visit was $1.91{\pm}1.7$. 3. The characteristics related with pregnancy and delivery are as follows. The number of subjects taken assisted reproductive technology was 19 (4.9%) and suffering from gestational disease was 28 (7.22%). The mean body weight difference between full term pregnancy and visiting date was $-8.24{\pm}3.57kg$. The number of subjects discharging lochia on visiting date was 167 (43.04%) and breastfeeding was 262 (67.53%). 4. The most chief complaint was arthralgia in 217 (55.93%) followed by general weakness, cold sensation, edema, sweating disorder, dizziness, lower abdominal pain, digestion disorder, heat sensation, defecation disorder and urination disorder. 5. The most accompanied symptom was arthralgia in 322 (82.99%), followed by sleep disorder, cold sensation, general weakness, sweating disorder, defecation disorder, edema, dizziness, digestion disorder, urination disorder, lower abdominal pain and heat sensation. 6. A total of 356 subjects were taken herbal medicine. The most prescribed herbal medicine to subjects was Gungguijohyeol-eum-gamibang (29.59%). Conclusions: These results could be helpful to diagnose and treat postpartum patients in Korean gynecologic clinical fields.

Histopathological Study of Carcinoma of the Colorectum in the Taegu Area (대구지방의 장암에 대한 병리조직학적 검색)

  • Nam, Hae-Joo;Choi, Won-Hee;Lee, Tae-Sook;Hong, Suk-Jae
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.33-39
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    • 1986
  • A clinical and statistical study was done for 123 patients with histologically proven colorectal malignant tumor from 1983 to 1986 at the department of anatomical pathology. Yeung Nam University Hospital. The results were as follows: 1. Ratio between male and female was 1.6:1 and incidence was most prevalent in 7th decades comprising 29.3%. 2. Location of tumor was the most frequent in rectum(65%). 3. Frequent symptoms and signs in case of right colon were pain, abdominal mass and bowel habit change. In left colon, they were pain, bowel habit change and bloody stool or melena. In rectum, they were bloody stool or melena, bowel habit change and pain. 4. Duration of symptom was 1 to 3 months(33.3%). 5. The most frequent histological type was adenocarcinoma(82.9%). 6. According to Dukes's classification, 32.9% of the tumor were stage $C_2$. 7. Operative procedures were Mile's operation(47.0%), right hemicolectomy(19.8%) and lower anterior resection(11.7%). 8. Polyps were the most frequent associated disease. 9. The most common complication was wound infection(11.1%).

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The relationship between the development of musculoskeletal disorders, body mass index, and academic stress in Bahraini University students

  • Tantawy, Sayed A;Rahman, Asma Abdul;Ameer, Maryam Abdul
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.126-133
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    • 2017
  • Background: There are many mechanisms in which stress can lead to weight gain thus high a BMI. The endocrine and inflammatory pathway can directly increase abdominal adiposity. Another way in which stress leads to weight gain is through changes in health behaviors. The study aimed to investigate the prevalence of musculoskeletal disorders (MSDs) among healthy students of Ahlia University, and to determine the relationship between the development of MSDs and academic stressors and body mass index. Methods: Self-administered questionnaires were distributed to 94 students aged 18-26 years who were enrolled at various Ahlia University colleges and met other inclusion criteria. The students responded to the standardized Nordic musculoskeletal questionnaire and the modified College Student Stress Inventory regarding musculoskeletal symptoms and academic stressors. Height and weight measurements were also obtained to determine body mass index. Results: A total of 77.66% reported MSDs in one or more body part, with the prevalence being higher among women than among men. The 7-day prevalence of MSDs severe enough to interfere with activities of daily living was 60.64%, and 44.68% by female and male students, respectively. There was a significant relationship between academic stress and MSDs in the neck, shoulders, lower back, and hips, while the relationship between MSDs, and body mass index, academic stress, and grade point average was not significant. Conclusions: The prevalence of MSDs among Ahlia University students was found to be high. Apart from the positive correlation between academic stress and MSDs in certain body parts, other correlations were not significant.

Studies on the Similar Effects between Jwahun(坐薰) and Sojucheon(小周天)_Practice (좌훈(坐薰)과 소주천(小周天) 수련의 상관성에 관한 연구)

  • Huh, Ji-In;Lee, Jae-Heung;Choi, Hyeong-Il;Lee, Gye-Seung
    • Journal of Korean Medical Ki-Gong Academy
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    • v.11 no.1
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    • pp.144-172
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    • 2009
  • objectives : This research aimed to study the similar effects between Jwahun and Sojucheon_practice, as both Induces to SooSengg-HwaGang(the coordination of water and fire). methods : 141 recipients of the survey was conducted in the Jwahun room of Korean medicine Hospital, which contained to body reaction between the moment of the Jwahun and after the Jwahun. And the result of them compared with the body's response of Sojucheon_practice results : 1. In a survey, 78% of the patients had responses that were sweating. The area sweating a lot in the survey is the face, abdomen, chest and was, in this order, the ratio was high. About feeling of warmth and coolness, survey of those who felt the warmth ratio was 79%, those who did not feel the coolness ratio was 77%, most of the responses were warm bodies. 46% of patients replied that feels warm in the belly. It said the fact that Jwahun directly to the lower body is to warm. 2. Symptoms of congestion of the head on the survey, 78% of investigators did not appeal. Other investigators were responding they were dizzy. Research on pain and itching, but no response was at 84%. Among the responses to the itchiness, itching perineum was 11% of the respondents. The rest was weak. 3. Associated with defecation in the survey, the investigators found that 33% of respondents said fart. Urine is 22% of respondents said. Abdominal reactions, 33% of respondents answered was taking a tone in the abdomen. In response to the whole body reaction, the most relaxing 39% of the respondents said, 22% of respondents replied that the body feel lighter. 4. After Jwahun, belly is warm and cathartic reactions were the most responsive. This said that Jwahun even after, in the lower abdomen lasting warmth as can be seen. Smooth bowel movements disproves the abdominal organs is a good move. It will also be seen in the same context of bowel movements, abdominal response when just doing Jwahun. conclusions : Jwahun activate the meridians and through the perineum stimulation induced imdokmaek(任督脈) SooSengg-HwaGang(水升火降) to enable the training and some Sojucheon can have similar effects.

MALT Lymphoma of Ocular Adnexa: A Case Report (안구 부속기의 점막연관 림프조직형 림프종의 증례보고)

  • Cho, Jeong Nam;Kim, Yoong Soo;Chung, Chan Min;Suh, In Suck;Cho, Ji Woong;Park, Hye Rim;Choi, Jae Gu
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.321-324
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    • 2008
  • Purpose: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. Methods: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass($1.9{\times}1.2{\times}0.9cm$ size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. Results: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. Conclusion: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.

The relationship between lowest bispectral index value and age in high spinal anesthesia (고위 척추마취에서 마취심도감시장치를 이용한 나이에 따른 진정 정도의 비교)

  • Hwang, Byeong-Mun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2322-2328
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    • 2013
  • The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.