• 제목/요약/키워드: pain and suffering

검색결과 486건 처리시간 0.02초

말기 암 환자에서 완화적 진정 증례 토론 (Palliative Sedation for Terminal Cancer Patient)

  • 김도연
    • Journal of Hospice and Palliative Care
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    • 제11권2호
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    • pp.106-110
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    • 2008
  • 완화적 진정은 임종이 임박한 불응성 증상을 가진 환자들에게 고려될 수 있는 치료이지만 부적절한 진정으로 인한 윤리적인 문제가 쟁점이 된다. 본 증례는 수차례항암화학요법과 완화적 방사선 치료에도 불구하고 진행되는 다발성 뼈 전이를 동반한 전이성 위암을 가진 50세 남자에게 완화적 진정을 시행했던 예를 권고안에 비추어 후향적 검토하였다. 환자는 표준적인 통증경감치료에 불응성으로 판단되었고 환자의 의사결정능력 부족으로 환자보호자에게 완화적 진정에 대한 치료 목적 및 예견되는 부작용을 설명한 후 midazolam으로 완화적 진정을 시작하였다. 본 증례에 통하여 완화적 진정의 적응, 완화적 진정의 시작 전 의사 결정, 완화적 진정 시작, 완화적 진정 시작 후의 돌봄에 대한 토의를 하였고 국내실정을 반영한 권고안 마련을 제의하는 바이다.

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근육 강직 증후군: 진단적 어려움 (Stiff-Person Syndrome: Diagnostic Difficulty)

  • 이정길;강찬;김상범;안병국;이기수
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.131-134
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    • 2019
  • Stiff-person syndrome is a rare disorder, and the natural history of the syndrome has not been completely ascertained. The symptoms range from mild to severe and can progress over time: the final result can be significant disability. However, this syndrome is often misdiagnosed due to a lack of understanding of the clinical manifestations. We report the case of a patient who presented with slowly progressing gait disturbance and lower extremity pain and was later diagnosed as suffering from stiff-person syndrome. The patient experienced symptomatic improvement after the administration of benzodiazepines. No recurrence of symptoms has been reported. If the characteristic clinical features and electromyography findings of the syndrome are accurately interpreted, diagnosis of patients with abnormal muscle tension can be effectively done.

다루기 힘든 만성창상의 치료에 구더기를 이용한 임상적 적용 (Clinical Application of Maggots in Chronic Difficult Wounds)

  • 김석원;강태조
    • Archives of Plastic Surgery
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    • 제35권4호
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    • pp.400-406
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    • 2008
  • Purpose: Since ancient times, larval therapy has been applied to help wound healing. Its use has recently been rediscovered, and the interest in this therapy has been increased in clinical practice, as well as in research. The objective of this study is to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds. Methods: Twenty patients, suffering mostly from chronic wounds were treated using maggots of greenfly (Phaenicia sericata). Sterile maggots were administered to the wound twice a week. The causes of the development of wounds were diabetic foot(14), trauma(3), plate exposure(1), and unknown origin(2). Results: Complete debridement was achieved in 10 wounds; in 8 wounds, the debridement was partially achieved; 2 patients escaped. Four patients were healed without any additional surgical procedures but fourteen patients were treated with skin graft. Pain, reported by six patients, was relatively well controlled with oral analgesics. Conclusion: We found larval therapy to be effective for chronic wounds. Maggot therapy is a relatively rapid and effective treatment, particularly in necrotic wounds or the wounds resistant to conventional treatment.

MCU와 나선형 코일을 이용한 촛점식 체외 충격파 전립선 치료 장치에 관한 연구 (The study on Focused Extracorporeal Shock Wave Prostate Therapy Apparatus using MCU and Spiral Coil)

  • 유희수;손병래
    • 한국전자통신학회논문지
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    • 제16권1호
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    • pp.203-210
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    • 2021
  • 만성 전립선 염 치료의 어려움은 치료 의사뿐만 아니라 환자에게도 육체적 고통과 정신적 문제를 유발한다. 본 연구의 장치는 외부 충격파의 열적 및 기계적 상호 작용으로 인한 충격파 에너지의 진동 효과로 인해 전립선 증상으로 고통받는 환자를 돕기 위해 연구되었다. MCU와 나선형코일을 활용하여 집중된 에너지의 열 및 진동 효과를 발생시키고 이 파동을 효과적으로 적용하는 체외 충격파 치료 장치를 고안하여 전립선 염 및 전립선비대증(BPH, Benign prostatic hyperplasia)에 대한 효과적인 치료 수단을 제공하는 구조를 구현하였다.

두침(頭鍼)을 시행한 요추간판탈출증 환자 30례에 대한 임상고찰(臨床考察) (A Clinical Report on 30 Cases with H.I.V.D by Scalp Acupuncture)

  • 장석근;김영화;강재희;김정호;임윤경;이현;이병렬
    • Journal of Acupuncture Research
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    • 제20권5호
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    • pp.252-260
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    • 2003
  • Objective : The purpose of this report is to examine the effects of Scalp Acupuncture therapy in the H.I.V.D patients. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Cheonan O. M. hospital from Aug. 1, 2001 to Jan. 31. 2002. 30 patients had a diagnosis of herniated lumbar intervertebral disc by Lumbar-C.T or Lumbar-M.R.I. we treated 30 patients by Scalp Acupuncture therapy. Results : 1. We operated Scalp Acupuncture on the foot-motion sensory area(족운동감각구), the sensory area(감각구) 2. In the result of treatment due to clinical symptoms, leg radiating pain was more effective than any other clinical symptoms. 3. The efficacy of Scalp Acupuncture therapy was 83.3%(when we set a standard things more than fair) and 63.3%(when we set a standard things more than good). Conclusions: The Scalp Acupuncture therapy is effective of H.I.V.D patients, but we thought that it needed to prove effects of Scalp Acupuncture therapy for efficient application by more clinical reports.

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A형 독감을 동반한 쇼그렌 증후군 환자에 대한 한의치료 1례 (A Case Report of Sjögren's Syndrome with Influenza A Virus Infection Treated with Korean Medicine)

  • 이기향;전상우;강세영
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.1007-1013
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    • 2019
  • Objectives: The purpose of this study was to report the treatment of a patient suffering from $Sj{\ddot{o}}gren^{\prime}s$ Syndrome with influenza A virus infection with Korean medicine. Methods: We used herbal medicine, acupuncture, and moxibustion to treat a patient during hospitalization. We observed the changes in symptoms using the European League against Rheumatism $Sj{\ddot{o}}gren^{\prime}s$ Syndrome Patient Reports Index (ESSPRI) and a visual analogue scale (VAS). Results: After treatment for 17 days, the patient's symptoms showed improvement in joint pain, dry eye, and dry mouth. The ESSPRI score was decreased from 10 to 5.3. The VAS for dry mouth and dry eye were decreased from 10 to 6 and from 10 to 5, respectively. Conclusion: This clinical case study suggests that Korean medicine treatment that includes Insamyangyoung-tang-gami could be effective in the treatment of $Sj{\ddot{o}}gren^{\prime}s$ Syndrome.

침치료로 임상증상이 호전된 진성적혈구증가증 환자 치험 1례 (A Case Report on Symptom Improvement in a Polycythemia Vera Patient Treated with Acupuncture)

  • 김어진;허소영;황조현;장은경;이장훈;김영철
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.976-981
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    • 2021
  • Objectives: This study investigated the effectiveness of acupuncture for improving polycythemia-vera-related symptoms and quality of life. Methods: A 56-year-old woman diagnosed with polycythemia vera received acupuncture treatment between February 19, 2021, and August 26, 2021. We observed the changes in subjective symptoms and conducted myeloproliferative neoplasm symptom assessment form total symptom score (MPN-SAF TSS) questionnaire. Results: After 13 acupuncture treatment sessions over six months, symptoms of polycythemia vera, such as fatigue, bone pain, itching, and headache, improved. Conclusion: This study suggests that acupuncture may be a helpful treatment strategy for polycythemia vera patients suffering from significant symptom burdens and reduced quality of life.

말기 폐림프관 평활근종증 환자에서의 단측 폐이식술 (Single Lung Transplantation in the Patient with End-stage Lymphangioleiomyomatosis -Report of 1 case-)

  • 양희철;최용수;김진국;심영목;김관민
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1015-1018
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    • 2004
  • 폐림프관 평활근종증은 주로 가임기 여성에서 발병하며 점진적으로 호흡부전에 이르게 하는 드문 질환이다. 폐의 혈관, 림프관 그리고 기관지를 구성하는 평활근 세포의 비정상적 과오종성 증식으로 인해 기관지 폐쇄, 낭성 기포로의 변환, 림프관 폐쇄 등의 특징이 있으며 대부분 호흡곤란, 기흉, 기침, 흉통, 객혈, 유미흉 등을 동반한다. 호흡부전을 동반한 말기 페림프관 평활근종증은 페이식이 유일한 치료법으로 국내에서 시도된 적은 있으나 아직 성공사례에 대한 보고가 없었다. 본원에서는 폐림프관 평활근종증을 앓고 있던 말기 호흡부전의 40세 여자 환자에게 좌측 단일 페이식술을 시행하여 좋은 결과를 얻었기에 이를 보고하는 바이다.

손해배상액 산정에 관한 최근 10년간 판례의 동향 (상)(上) (The Trend of Precedents about Calculation of Damage Compensation for Last Decade)

  • 박영호
    • 의료법학
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    • 제10권2호
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    • pp.11-36
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    • 2009
  • This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

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만성두통을 호소하는 공황장애 환자의 두통 치험 1례 (A Case Report of a Panic Disorder patient suffering from a Chronic Headache)

  • 차혜진;이지원;곡경내;김효주;서영민;박세진
    • 동의신경정신과학회지
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    • 제19권2호
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    • pp.279-288
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    • 2008
  • In this case, a 33 year-old female patient had a chronic headache with Panic disorder, and accompanied gastroenteric troubles(vomiting, nausea, dyspepsia and abdominal discomfort), for fifteen years. It may be the symptoms of Phlegm-syncope headache, and we treated this disease with oriental medical treatment, including the Banhabaekchulcheonma-tang, Breathing retraining and Cognitive retructuring. The effects of treatment were measured by were using BPI(Brief Pain Inventory), VAS(Visual analog scale). In Conclusion, Chronic headache with panic disorder was improved by our treatment.

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