• 제목/요약/키워드: pain clinic

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Smith-Magenis Syndrome (SMS) 환아의 증례 보고 (SMITH-MAGENS SYNDROME (SMS) : A CASE REPORT)

  • 김은영;이긍호;최영철
    • 대한소아치과학회지
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    • 제30권3호
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    • pp.341-347
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    • 2003
  • Smith-Magenis syndrome(이하 SMS)은 제 17번 상염색체의 부분적 결손으로 발생하는 다발성 선천적 기형 및 정신지체를 특징으로 하는 증후군으로 1 : 25,000의 빈도로 발생하는 것으로 알려져 있다. 이 증후군은 작은 키와 단두증(brachycephaly)을 동반한 편평한 중안면, 처진 입, 종종 두드러지게 붉은 뺨, 성인에서 돌출된 턱 등의 특징적인 얼굴 생김새, 만성이염, 청각 손상, 사시와 근시를 포함한 눈의 이상, 목 쉰 소리, 짧은 손가락과 발가락, 심장 질환, 비뇨기 질환, 척추 만곡, 비정상적 걸음걸이, 통각에 둔감함 등의 신체적 특징을 지닌다. 특히 유아기에는 토실토실한 아기 얼굴, 행복한 기분, 드문 울음소리, 낮은 근 긴장도, 섭식 장애 등의 특징이 있다. 수면 장애를 포함하여 언어 지체 및 발음 장애, 발달지체, 학습 장애, 정신지체, 활동항진과 자해, 폭발적 분노, 지속되는 짜증, 파괴적이고 공격적인 행동, 흥분성, 흥분시에 팔로 안거나 손을 끼우는 행동 등의 행동 발달적 특징을 나타낸다. 본 증례는 3세 3개월된 남아로 생후 10개월에 SMS를 진단받은 환자로 상악 좌측 제 1유구치의 통증을 주소로 본과에 내원하였으며, 임상 및 방사선학적으로 다발성 우식증을 보였으며, 소아과 주치의에게 의뢰한 결과 심내막염의 예방을 위한 항생제의 처치를 처방 받고, 환아의 행동 발달적 문제로 인해 물리적 속박의 방법 하에 외래에서 치료되었다. 이 증례를 통해 SMS라는 희귀한 증후군에 관하여 보고하고자 한다.

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미소안면침의 얼굴 축소 및 피부상태 개선 효과 (The Effect of Miso Facial Acupuncture on Facial Reduction and Improvement of Skin Condition)

  • 권기순;김정희;이경아;이수정;송정화;송춘호;윤현민;장경전;김철홍
    • Journal of Acupuncture Research
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    • 제29권4호
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    • pp.7-18
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    • 2012
  • Objectives : The purpose of this study is to evaluate the effects of Miso facial acupuncture on facial reduction and improvement of skin condition. Methods : From March to May 2012, 20 women in their twenties to forties with no facial diseases were recruited. Miso facial acupuncture was performed on the both side of their face twice a week, total seven times. The 3D face photographs of each participant were checked 5 times ; before treatment, after 1st treatment, 4th treatment, 7th treatment and 10 days from the last treatment using RS-400FL(Morpheus Co. Korea) and REAL FACE. The surface distances of the 4 lines on the face were measured using Renai MEF program. The improvement of skin condition was evaluated by water content, trans epidermal water loss(TEWL), erythema index and melanin index using MPA 5. They were checked 4 times ; before treatment, 4th treatment, 7th treatment and after 10 days from the last treatment. We analyzed data using Paired t-test(p<0.05) and Wilcoxon signed rank test(p<0.05). Results : One case was dropped out due to pain and edema after 4th treatment. The surface distances of the 4 lines on face were significantly reduced and maintained after 10 days from last treatment. Water content was significantly increased and maintained after 10 days from last treatment. TEWL was significantly decreased. Erythema index was significantly decreased from the 3rd evaluations. Melanin index was slight decreased with no significance at the 2nd evaluations. Conclusions : These results show that Miso facial acupuncture can reduce sizes of the face and improve skin condition such as water content, TEWL and erythema index except melanin index.

병원을 이용하는 임산부들의 산과적 지식정도에 관한 일 조사 연구 (A STUDY TO DETERMINE THE LEVEL OF OBSTETRIC KNOWLEDGE OF PREGNANT WOMEN AND POSTPARTUM MOTHERS)

  • 이선자
    • 대한간호학회지
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    • 제4권3호
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    • pp.81-91
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    • 1974
  • The purpose of this study was to investigate the level of obstetric knowledge of pregnant women and postpartum mothers, and to contribute the data to community health teaching program as well as maternity nursing. 385 pregnant women and postpartum mothers visited at or admitted to Seoul Adventist Hospital were sampled. The results of the study were as follows. 1. 97.9% of the subjects were between the age of 21 to 35, most of them (82.9%) were housewives with high school education and with a middle class family background. 2. The first symptoms of pregnancy were amenorrhea (70.4%), nausea & vomiting (23.9%), change of skin color (1.6%). 3. 77.9% of the subjects did not know how to deal with morning sickness. 4. 52.9% did not know when the sex determination of the fetus-occurs. 5. Concerning the fetus position; 77.1% of them believed it lies head down. head up (12.0%). and not knowing (10.9%). 6. 73.2% recognized the need for a well balanced food during pregnancy. 7. As to the dangerous symptoms during pregnancy: vaginal bleeding was considered the 1st, edema, the and, continuous abdominal pain, the 3rd. 82% of them would confer with physician in case of vaginal bleeding. As to the type of activities restricted by pregnancy: hard exercise was considered first, travel the second, and coitus during 1st and last trimester of pregnancy the 3rd. 8. 82.4% of them visited antenatal clinic at the second or third month of amenorrhea and 88.5% realized the regular physical examination imperative. 9. The purpose of urine test was recognized correctly by 44.7%, blood test: 89.4%, B. P. and weight check ; 69.9%. 10. The need of breast care during pregnancy was recognized by 76.9% of the subject. 11. 75.8% realized that prenatal exercise was needed. The higher the education the better the understanding of the need for it before delivery. 12. The concept of postpartum period was understood correctly by 54.4%. 13. The state of uterus after delivery was understood correctly by 49.1% only. 14, Regarding the management of colostrums: 48.3% knew it was to feed infants, and it was to squeeze and discard 43.4%. 15. Dealing with postpartum exercise; 67.8% answered it was needed, 9.1% not needed, not heard about 23, 1%.

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비닐하우스 재배자의 피로자각증상에 관한 연구 (The Effects of Farming in Greenhouses with Respect to Subjective Fatigue Symptoms)

  • 황경애;이석구
    • 한국직업건강간호학회지
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    • 제7권2호
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    • pp.177-185
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    • 1998
  • The purposes of this study were to investigate the effects of farming in greenhouses with respect to subjective fatigue symptoms among farmers and the degree of symptoms. The study compared 176 green-house farmers with 216 open field farmers using a subjective fatigue symptoms rating scale developed by the Industrial Research Institute of Fatigue, Japanese Association for industrial Hygiene. 1. With respect to complaint rates of the subjective fatigue symptoms, the results indicated that greenhouse farmers have, in order of severity, high degrees of low back pain, difficulty in collecting thoughts, and apt to forget. 2. With respect to cumulative scores of fatigue symptoms, the results indicated that both groups of farmers exhibited a lack of attentiveness and a high degree of dullness and sleepiness(category I), body projection of fatigue(category II), and difficulty in concentration(category III). 3. With respect to general characteristics, it was found that the degrees of subjective fatigue symptoms were found to be higher among females, people with lower educational levels, and the elderly, regardless of the group. 4. With respect to work related factors, farmers with more years of experiences were found to have higher degrees of subjective fatigue symptoms, except for open field farmers with less than nine years experience. Both groups of farmers were found to have high degrees of subjective fatigue symptoms when working less than eight hours a day and less than six months a year. 5. With respect to health habits, for people who get less than eight hours of sleep per day exhibited higher fatigue scores than people who get more than eight hours. People who do not smoke and drink also exhibited higher fatigue scores than people who smoke and drink. 6. The results of multiple regression showed that the risk factors related to the subjective fatigue symptoms of farmers in the greenhouse group were ages, levels of education, sex and for the comparison group, were sex. years of farming, and hours of sleep. The R-square were 12.5% in the greenhouse group and 12.1% in the comparison son group. The differences between the greenhouse and open field farmers in the degrees of fatigue symptoms were found not to be statistically significant even if the working conditions of the greenhouse farmers were poor. This may be attributed to non-work related factors, i.e., social, economical, and psychological factors among greenhouse farmers.

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Clinical Practice Guideline for Care in the Last Days of Life

  • Shin, Jinyoung;Chang, Yoon Jung;Park, So-Jung;Choi, Jin Young;Kim, Sun-Hyun;Choi, Youn Seon;Kim, Nam Hee;Yum, Ho-Kee;Nam, Eun Mi;Park, Myung Hee;Moon, Nayeon;Moon, Jee Youn;Kang, Hee-Taik;Kang, Jung Hun;Park, Jae-Min;Lee, Chung-Woo;Kim, Seon-Young;Lee, Eun Jeong;Koh, Su-Jin;Kim, Yonghwan;Cho, Myongjin Agnes;Song, Youhyun;Shim, Jae Yong
    • Journal of Hospice and Palliative Care
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    • 제23권3호
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    • pp.103-113
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    • 2020
  • A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

내적모형과 대응자원을 이용한 만성관절염 환자의 적극적 대응전략모형 (Active Coping Strategy Model for Chronic Arthritis : Appling Internal Model of World and Coping Resource)

  • 문미숙;임난영
    • 근관절건강학회지
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    • 제6권1호
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    • pp.100-135
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    • 1999
  • Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

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섬유조직염 환자의 질병 특성과 치료행태 (Disease Characteristics and Behavior Pattern of Treatment for Patient with Fibromyalgia)

  • 한상숙;강현숙
    • 근관절건강학회지
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    • 제6권1호
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    • pp.22-36
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    • 1999
  • The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

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흉벽에 발생한 원발성 종양에 대한 고찰 (Clinical Review of Primary Chest Wall Tumors)

  • 백효채;강정한;최성실;정경영
    • Journal of Chest Surgery
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    • 제36권3호
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    • pp.175-181
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    • 2003
  • 원발성 흉벽종양은 흉부의 연조직이나 뼈 또는 연골에서 다양하게 발생할 수 있는 종양으로서 전체 원발성 종양의 약 l∼2%를 차지한다. 수술적 절제술은 만성 궤양이나 심한 통증이 있는 환자에서 효과적인 치료법이며 조직학적 진단 및 수술방법에 따라서 장기생존이 가능할 수 있다. 대상 및 방법: 1976년 9월부터 2001년 3월까지 원발성 흉벽종양을 가진 125명(양성종양 86명, 악성종양 39명) 의 환자에서 수술적 절제술을 시행하여 수술결과와 예후에 영향을 미치는 요소들을 해석하고자 하였다. 결과: 양성종양은 수술적 치료로 재발 없이 완전 치료가 되었으며 악성종양은 대부분 광범위 절제술을 시행하였으며 환자에 따라 수술 후 보조요법을 병행하였다. 양성종양 중 신경초종이 가장 많았으며 악성종양은 악성섬유성조직구종이 가장 많은 빈도를 보였다. 악성종양의 경우 3년 생존율이 76.0%, 10년 생존율이 60.5%이었다. 수술과 관련된 사망은 없었으며 외래 추적 중 사망한 환자의 원인은 원격 전이에 의한 장기부전 이었으며 11명에서 재발하였다. 안전거리 절제면을 4 cm 이상과 미만으로 구분하였을 때 두 군간의 생존율에 차이가 없었다. 결론: 양성종양의 경우 수술적 치료로 재발 없이 완치가 가능하였으며 악성종양도 비교적 좋은 장기생존율을 나타내었다. 안전거리 4 cm는 예후에 미치는 영향은 발견할 수 없었으나 재발 시에는 예후가 좋지 않았다.

미세전류발생 신발 착용이 만성 족저근막염 환자의 혈류량 변화에 미치는 영향 (Effects of Induced Microcurrent Shoes on Change of Blood Circulation to patients with Chronic Plantar)

  • 이윤미;최상준;;조미숙;조정선;조용호;박소현;박래준
    • The Journal of Korean Physical Therapy
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    • 제18권3호
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    • pp.71-78
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    • 2006
  • Purpose: The purpose of this study was to investigate how induced microcurrent shoes influenced changes of the blood circulation in patients with Plantar Fasciitis. Methods: Initially, the subjects were comprised of 5 males and 5 females, who agreed with this research and are more than fifty years old, but 4 of those were dropped during the experiment. They all have plantar fasciitis and pain on their feet. Subjects wore the induced microcurrent shoes for more than 4 hours everyday during 4 weeks. When they wore those shoes, they also wore the specially produced shocks made of silver-mixed thread and they were asked to avoid intense exercise. Assessments were carried out before and after walking on a treadmill and we measured changes between the test before and after 4 weeks. In the examination of the before test, general shoes were used, and in the examination of the after test, induced microcurrent shoes were used. Temperature difference was measured by thermograpy DOREX spectrum 9000MB(USA). Subjects walked total 20 minutes and during gait, the walking rate on a treadmill was increased from 2Km/h to 3Km/h after 10 minutes. We measured plantar temperature by thermograpy especially both heel, 1st, and 5th metatarsal areas. Results: Firstly, in comparison of the blood circulation on the left and right foot at 0 week and 4 weeks, it tended toward increasing blood circulation but there was. no statistically significant difference (p>0.05). Secondly, in comparison of the blood circulation before and after treadmill with the induced microcurrent shoes, the blood circulation of the heel and the 5th area on the right foot was increased to all subjects(p<0.05). Conclusion: The results of this study revealed that subjects showed tendency to increase blood circulation in both right and left feet after wearing microcurrent shoes and specially after walking treadmill at 4 weeks. Therefore induced microcurrent shoes are useful to improve blood circulation for patients with plantar fasciitis.

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목단피((牧丹皮).도인(桃仁) 배합(配合)이 항염증(抗炎症) 작용(作用)에 미치는 영향 (Effect of Water Extract of Peonia Suffruticosa and Prunus Percica on Anti-inflammation)

  • 김영일;이성준;허진;이태형;신동근;이재철;신용서;윤용갑
    • 대한한의학방제학회지
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    • 제18권1호
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    • pp.105-120
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    • 2010
  • Paeonia Suffruticosa and Prunus Persica have been used as oriental medicine for removal of fever, alleviation of pain, an anti-phlogistic effect and removal of extravasated blood. However, it has been never shown the effects of these herbal medicines on anti-inflammatory processes. This experiment was performed to show how these herbs could act as anti-inflammatory medicines at cellular level. Anti-inflammation effects of water extracts from Paeonia Suffruticosa and Prunus Persica as well as their mixture have been investigated, and the results were follows; 1) each extract slightly suppressed the expression and production of inflammatory mediators and enzymes such as NO, iNOS, IL-$1{\beta}$, and TNF-$\alpha$ in lipopolysaccharid(LPS)-stimulated RAW264.7 cells and mouse primary peritoneal macrophages in a dose-dependent manner. These suppressive effects, however, were synergistically increased by their mixture. 2) Each extract of Paeonia Suffruticosa and Prunus Persica insignificantly suppressed the activation and activity of NF-${\kappa}B$ in LPS-stimulated RAW264.7 cells, which controls the expression of inflammatory mediators such as NO, iNOS, IL-$1{\beta}$, and TNF-$\alpha$. However, extract mixture of Paeonia Suffruticosa and Prunus Persica suppressed effectively the activation and activity of NF-${\kappa}B$. 3) Each of Paeonia Suffruticosa and Prunus Persica induced translocation of NF-${\kappa}B$ to the nucleus from the cytosol and DNA-binding activity of nuclear NF-${\kappa}B$ in LPS-activated RAW264.7 cells. The extract mixture of Paeonia Suffruticosa and Prunus Persica showed more significant suppression of the NF-${\kappa}B$ translocation and its DNA-binding activity, as compared to those of the each extract. These results suggest that the extract mixture of Paeonia Suffruticosa and Prunus Persica may affect different control mechanisms for NF-${\kappa}B$ activation and the expression and production of NF-${\kappa}B$-dependent inflammatory mediators, indicating that this extract mixture may be useful for treatment of inflammatory diseases.