• Title/Summary/Keyword: severe pain

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소형견에서 외측 무릎 종자뼈의 대칭적 다분화 (Symmetrical Multipartite of Lateral Fabella in a Small Breed Dog)

  • 조영권;이기창
    • 한국임상수의학회지
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    • 제26권6호
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    • pp.655-658
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    • 2009
  • 복부 팽만과 간헐적인 가벼운 좌측후지의 파행을 나타낸 11년령의 암컷 말티즈견이 내원하였다. 신체검사에서 복부 촉신 시 동통을 호소하였고 농성의 질 삼출물을 나타내었다. 혈액화학적 검사결과 독성변화를 동반한 심한 백혈구감소증, 질소혈증, 고인산혈증, 그리고 저나트륨혈증이 관찰되었다. 복부 방사선검사에서 소장을 앞쪽과 등쪽으로 변위시키는 연부조직음영의 관상구조를 가진 매스가 관찰되었고 복부 초음파검사에서 에코성의 물질이 함유된 종괴는 자궁음영으로 판단되어 자궁축농증으로 진단하였다. 후지의 방사선검사결과 양쪽 무릎에서 내측 슬개골탈구와 외측 종자뼈가 4-5 조각으로 분화된 다분화를 관찰하였다. 환자는 곧바로 난소자궁적출술을 받아 잘 회복되었으며 정상적인 혈액화학 수치를 보였다. 좌측 후지의 파행은 간헐적이고 매우 경미하였으므로 특별한 처치를 하지 않았다. 이후 지금까지 3개월동안 뚜렷한 후지파행은 관찰되지 않았다. 여러조각으로 갈라진 후지의 양측성 외측종자뼈는 선천적인 종자골 다분화로 여겨지며 파행과 직접적인 관련성은 없는 것으로 판단된다.

『동의수세보원(東醫壽世保元)』의 결흉(結胸) 해석 - 소양인 결흉을 중심으로 - (Interpretation of chest bind(結胸) in Donguisusebowon(東醫壽世保元) based on the chest bind disease of the Soyang pattern)

  • 장우창
    • 대한한의학원전학회지
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    • 제28권4호
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    • pp.99-119
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    • 2015
  • Objectives : This study aims to compare and analyze the contents and logic of Lee Jema's chest bind theory of the Soyang pattern with that of the traditional perspective since Shanghanlun, and to further investigate its underlying meaning and evaluate its value. Methods : Study chest bind related arguments of Lee through historical, demonstrative and positive investigation. First, contrast related texts starting from Shanghanlun, followed by reasoning based on general medical logic. Finally review clinical case studies from texts and papers for verification. Results : According to Lee, the key to diagnosis and treatment in preventing major chest bind which is a severe condition in the exterior cold pattern of the Soyang constitution, is to disperse fluid bind using GanSui(甘遂) in the water counterflow and vomiting(水逆嘔吐) stage prior to the major chest bind symptoms of stiffness and pain in the lower chest(心下硬痛), and reducing phlegm-rheum using DoJeokGangGiTang(導赤降氣湯) in the beginning stages of chest bind. HyeongBangDoJeokSan(荊防導赤散) is the main formula in treating phlegm-rheum, a causal factor to chest bind, modified according to the 'treat the three burners separately(三焦分治)' theory of the DaoChiSan(導赤散) section in WanBingHuiChun (萬病回春) to accomodate the Soyang constitution. Conclusions : If we follow Lee's diagnosis and treatment system on chest bind, it will allow us to diagnose chest bind in the earlier stages and secure safe treatment.

식이 식초 음독 후 발생한 부식성 손상 (Corrosive Injury Due to Edible Vinegar)

  • 김도현;이성우;남궁인;박종학;김수진;홍윤식
    • 대한임상독성학회지
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    • 제9권1호
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    • pp.34-38
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    • 2011
  • Vinegar is a very popular ingredient used in many cuisines. It is also known for its beneficial health, beauty and possible weight-loss properties. The authors report on a patient who presented to the emergency department with unstable vital signs complaining of generalized abdominal pain after ingestion of 450 ml of apple cider vinegar. We documented a case of corrosive gastrointestinal injury with persistent metabolic acidosis occurring after ingesting apple cider vinegar with an acetic acid concentration of 12~14%. Toxic damage to the liver and kidney were also observed, peaking on post-ingestion day 3. The patient received supportive care and hemoperfusion for three days without much clinical improvement and died in the seventh day of intensive care due to disseminated intravascular coagulation and multi organ failure. Edible vinegar, when taken in large amounts, is capable of inducing corrosive injuries of the GI tract as well as severe systemic toxicities, such as metabolic acidosis. Safety precautions regarding vinegar deserve more public attention and clinicians also should be astute enough to recognize the potential damage accompanying vinegar ingestion.

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개에서 단독으로 발생한 급성 비장 염전과 만성 비장 염전의 비교 (Acute and Chronic Isolated Splenic Torsion in Two Dogs)

  • 정주현;채웅주;장진화;윤정희;최민철
    • 한국임상수의학회지
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    • 제25권1호
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    • pp.52-57
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    • 2008
  • An intact male, 3-year old, Sapsari, weighing 29 kg with a history of respiratory distress, anorexia, abdominal distension, and depression for 1 day was referred. Radiographic findings included a C-shaped soft tissue mass in the mid-abdominal cavity and loss of serosal detail. Ultrasonographs showed splenomegaly with hypoechoic coarse parenchyma, loss of venous flow in the dilated splenic veins, and thrombi. Based on image findings, acute isolated splenic torsion was diagnosed. Splenectomy and prophylactic gastropexy was performed. Another case was a spayed female, 8-year old, Shih-tzu, weighing 3.7 kg with a history of intermittent abdominal pain and a palpable abdominal mass for 1 year. Radiographic findings showed splenomegaly characterized by a soft tissue round mass. Ultrasonographs revealed displaced splenic hilum and absence of venous flow in the dilated splenic vein. Chronic isolated splenic torsion was diagnosed and also splenectomy and gastropexy was performed. Two dogs were recovered normally after surgery without any complications. Acute form of isolated splenic torsion showed acute systemic clinical signs, severe C-shaped splenomegaly on radiographs, and loss of all of splenic venous flow, perivenous hyperechoic triangle sign, and thrombi on ultrasonographs. Chronic form of isolated splenic torsion showed chronic obscure clinical signs, moderate splenomegaly on radiographs, and partial loss of splenic venous flow on ultrasonographs.

개에서 발생한 혈뇨와 복강 내 출혈을 동반한 신장원성 혈관육종 (Primary Renal Hemangiosarcoma Complicated with Hematuria and Hemoperitoneum in a Dog)

  • 여정진;서정향;엄기동;박희명
    • 한국임상수의학회지
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    • 제29권2호
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    • pp.165-168
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    • 2012
  • 14년 령의 중성화 하지 않은 수컷 Siberian Husky는 1개월 전부터 혈뇨, 기면, 식욕부진을 보였다. 신체검사상 복부 팽만과 통증을 확인할 수 있었다. 혈액 및 혈청 화학 검사상 빈혈과 질소혈증을 확인할 수 있었다. 방사선 검사 상 신장의 비대를 확인할 수 있었으며 초음파 검사 상 피수질의 경계가 불분명하며 피질의 에코가 증가한 신장을 확인할 수 있었다. 뇨검사 상에서는 혈뇨와 단백뇨를 확인할 수 있었으며 초기의 감별 진단으로는 신부전, 방광염, 신우신염과 종양을 생각했다. 환자의 상태는 내원 후 계속적으로 악화되었으며 폐사했다. 부검 상에서 복강 내 출혈과 양측 신장의 종양을 확인할 수 있었다. 조직검사 상에서 혈관육종을 진단하였다. 본 증례에서는 개에서 비특이적으로 발생하는 양측성의 신장원성 혈관육종에 대해서 다룬다.

알레르기 비염의 비강 내 광 치료 : 체계적 문헌고찰 (Intranasal Phototherapy for Allergic Rhinitis : a systematic review)

  • 강정인;민경진;이동효
    • 한방안이비인후피부과학회지
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    • 제33권4호
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    • pp.55-73
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    • 2020
  • Objectives : We investigated the effectiveness and safety of intranasal phototherapy for allergic rhinitis (AR). Methods : We searched 8 electronic databases (PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) to identify randomized controlled trials (RCTs) that reported the use of intranasal phototherapy for AR from their inception until May 30, 2020. Two investigators independently searched, collected, and screened the RCTs. We performed data extraction and evaluation for risk of bias using the Cochrane risk-of-bias tool. Results : This study included 12 RCTs; six studies compared intranasal and sham phototherapy, of which four studies reported a significant inter group difference and two studies reported a significant difference partially. No significant changes in symptoms were observed between the phototherapy and conventional therapy groups. The phototherapy and concurrent acupuncture treatment group showed a significantly higher effectiveness rate compared with the group that received only acupuncture. Both the phototherapy and laser acupuncture group showed significant improvement in the symptom severity scale scores. Six studies reported mild adverse effects, such as dryness and nasal pain in the intranasal phototherapy group; however, no severe adverse effects were reported. Conclusions : This study confirmed the safety and effectiveness of intranasal phototherapy for symptom relief and improved quality of life in patients with AR. However, further studies are needed on this topic in order to demonstrate it clearly.

수종의 봉합사의 조직반응에 관한 비교연구 (Comparative Study of Tissue Response of Various Suture Materials in Rats)

  • 김재석;박준봉;이만섭;허익
    • Journal of Periodontal and Implant Science
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    • 제32권1호
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    • pp.113-127
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    • 2002
  • The purpose of this study is to evaluate histologically the tissue response and resorption of various nonresorbable and resorbable suture materials used for periodontal surgery, using a subcutaneous model on the dorsal surface of the rat. In this study, 10 Sprague-Dawley male rats (mean BW 150gm) were used and the commercially available materials included polyglactin 910, pain gut, nylon, e-PTFE. Animals were sacrificed at 3 days, 1, 2 and 4 weeks after implantation of various nonresorbable and resorbable suture materials. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : The resorption of plain gut was showed at 1 week after implantation, was lost their structure and almost resorbed at 4 weeks. The resorption of polyglactin 910 was started at 2 weeks and slowly absorbed untill 4 weeks. 2. Tissue response : Plain gut showed persistent and severe inflammatory reactions from 3 days to 4 weeks. Polyglactin 910, e-PTFE and nylon showed mild inflammatory reactions. Suture material should be biocompatible and be able to be functioned until tissue tensile strength reaches maximum level. In this study, polyglactin 910, nylon and e-PTFE are considered to be proper suture materials for periodontal surgery.

선천성 Antithrombin III 결핍증에서 발생한 폐색전증 1 예 (A Case of Pulmonary Thromboembolism Due to Congenital Antithrombin III Deficiency)

  • 박형관;박창민;고경행;임명수;김유일;황준화;임성철;김영철;박경옥
    • Tuberculosis and Respiratory Diseases
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    • 제47권3호
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    • pp.394-399
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    • 1999
  • 저자들은 갑작스런 흉통을 주소로 내원한 젊은 남자에서 AT III 결핍증에 의한 폐색전증을 진단하고 세 자녀 모두에서도 AT III 결핍이 확인됨으로써 폐색전증을 동반한 선천성, 가족성 AT III 결핍증을 경험하였기에 문헌고찰과 함께 보고한다.

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복어독의 주성분인 Tetrodotoxin의 항암 기전, 효과에 대한 문헌 고찰 (The Antitumor Mechanism and Effects of Tetrodotoxin: a Literature Review)

  • 조예은;이승민;윤강현;임지석;이승훈;최도영;이재동
    • Journal of Acupuncture Research
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    • 제32권1호
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    • pp.97-107
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    • 2015
  • Objectives : The purpose of this study is to explore the antitumor mechanism and effects of tetrodotoxin through a literature review of experimental and clinical studies. Methods : Medical databases, including The Cochrane Library, Pubmed, NDSL, RISS4u and National Assembly Library, were searched for relevant articles published from January 1, 2000 to October 31, 2014 using the keywords 'tetrodotoxin', 'cancer' and 'tumor'. The results were classified into experimental studies(in vitro and in vivo) and clinical studies. Analysis of the results was conducted on several research areas including the mechanism, antitumor effect and adverse effects of tetrodotoxin(TTX). Results : A total of 34 experimental studies(32 in vitro and 2 in vivo) and 3 clinical studies were found in the search. Most of the experimental studies suggested blocking of voltage-gated sodium channels in metastasis of tumor cells as the main antitumor mechanism of TTX. The most common type of cancers mentioned in the experimental studies were prostate and breast cancer. All of the clinical studies were on the application of TTX on moderate to severe cancer-related pain. No adverse effects of TTX were reported in in vivo studies but mild to moderate adverse events were reported in clinical studies. Conclusions : The results show that tetrodotoxin, which is the main component of Tetraodontidae(commonly known as pufferfish) poison, could be clinically used for antitumor therapy. However, further studies should be conducted on its safety.

기능제한(Functional Limitation) 관점에서 본 뇌성마비인의 일상생활수행능력과 취업여부의 관계에 대한 연구 (A Study on the Relationship between Activity of Daily Living and Job Status of the Disabled from the Functional Limitation Perspectives)

  • 김정우;김봉선
    • 한국사회복지학
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    • 제59권1호
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    • pp.223-249
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    • 2007
  • 본 연구는 개인에 대한 직업재활서비스의 적격성이 장애 등급만으로 결정될 수 있는지를 탐색하기 위해 수행되었다. 이론적 검토를 통해 '기능제한(functional limitation)'개념이 이에 대한 대안이 될 수 있음을 확인하였고 변형바델지수(Modified Barthel Index)를 이용하여 기능제한 정도를 측정하였다. 전체 381명의 뇌성마비인을 대상으로 신체적 손상(impairment)과 기능제한 그리고 취업여부의 관계를 파악한 결과, 뇌성마비유형과 부위 등 신체적 손상과 관련된 변인은 취업여부에 직 간접적 영향을 미치지 않았으나 통증문제와 이동능력은 간접적인 경로를 통해, 자기관리능력은 직접적인 경로를 통해 취업여부에 영향을 미침을 알 수 있었다. 이러한 연구결과를 통해 향후 각종 장애관련 연구나 서비스 전달체계의 적격성을 파악하는 과정에서 무엇을 '장애'로 규정할 것인지에 대해 고민해야 하며, 그 대안으로 신체적 '기능제한' 정도를 개념화 하는 것에 대한 추가적인 연구가 수행되어야 함을 알 수 있었다.

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