• Title/Summary/Keyword: severe pain

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A Case of RUL Bronchopleural Fistula Occluded by Flexible Bronchoscope with Endobronchial Watanabe Spigot (EWS) (기관지내시경을 통한 Endobronchial Watanabe Spigot (EWS) 삽입으로 치료한 기관지흉막루 1례)

  • Choi, Young In;Cho, Jin Hui;Shim, Jin Young;Sheen, Seung Soo;Oh, Yoon Jung;Park, Joo Hun;Hwang, Sung Chul;Lee, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.404-409
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    • 2005
  • An 86 year old woman was admitted complaining of dyspnea and right pleuritic pain with a 5 week durations. A physical examination, chest X-ray, and diagnostic thoracentesis upon admission revealed findings consistent with severe pneumonia and empyema on the right lung. Despite the insertion of a chest tube and negative suction via Emersion pump, the continuous air leakage was sustained, and a bronchopleural fistula (BPF) was found on the chest-CT. A flexible bronchoscopic occlusion with an Endobronchial Watanabe Spigot (EWS) was performed after 56 days of admission. An 5 mm diameter EWS was successfully inserted into the anterior segmental bronchus of the right upper lobe by flexible bronchoscope. There was no aAir leakage detected after this procedure. The patient was discharged 30 days after the EWS occlusion.

Effects of hallux valgus angle on one-legged stance and gait parameters in young adults: a preliminary study

  • Ji, Minkyung;Park, Hyodong;Lee, Heeyeon;Yoo, Minjoo;Ko, Eunsan;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.10-17
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    • 2020
  • Objective: Hallux valgus (HV) is a common musculoskeletal deformity that is accompanied with pain and continues to decrease one's quality of life and ability to perform daily life activities by affecting gait and static stability. Therefore, this study aimed to investigate the effect of the angle of HV (HVA) and to compare the one-legged stance and gait parameters in young adults with less HV and severe HV. Design: Cross-sectional study. Methods: Forty young adults were divided into two groups, where HVA ≥15° (n=20) was defined as HV, and HVA <15° (n=20) was defined as normal. For balance ability, the center of pressure (COP) path, velocity, length of axis of the COP path, deviation of the x-axis and y-axis, and percentage of foot pressure were measured, and gait, the foot rotation angle, step length, percentage of each phase of the gait cycle, time change from the heel to forefoot, and maximum pressure of the forefoot and midfoot were measured. Results: Significant differences were found in sway length and time change from heel to forefoot during walking between the normal and HV groups (p<0.05). Most parameters were not associated with the HVA, but parameters such as length of axis and time to change from heel to forefoot were significantly associated with the HVA (p<0.05). Conclusions: These results suggest that most one-legged stance and gait parameters were not significantly affected by the HVA in young adults; therefore, future studies are needed in order to address other dynamic parameters and other methods of gait analysis for detecting clinically meaningful conditions.

Phenomenological Study of the Lived Experience of Elderly People (현상학적 접근을 통한 노인의 삶의 경험)

  • Huang, Bo-Sun;Shin, Yu-Sun;Yun, Suk-Ok;Lee, Ji-Hyun;Jung, Kyung-Yim;Kim, Jung-Soon;Kim, Lee-Soon;Kim, Bok-Yong;Kang, Young-Mee
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.133-160
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    • 1995
  • The purpose of this study was to understand the structure of the lived experience by poor elderly people. The research question was 'What is the structure of the lived experience of life of a poor elderly people.' The sample consisted of 21 single poor elderly persons in Pusan. The unstructured interviews were audio-recorded and analyzed using the Van Kaam method. This study was 368 responses which yielded of descriptive expressions and priority classifications. The result generated 74 common elements, 18 syntheses of hypothetical definitions and 5 identifications of the structural definition. The structural definitions and hypothetical definitions were as follows; 1. physical discomfort ; complaints of severe pain ; dysfunction of physical organs 2. emotional cognition ; despair ; resignation ; attitude toward death 3. support system ; interaction with family ; thinking about God ; economical difficulties ; expectancy of social services ; opinions about health service ; leisure ; interaction with neighborhood ; dissatisfaction due to inadequate environment 4. past reminiscence ; negative reminiscence of one's past ; past regret ; positive reminiscence of one's past 5. desire ; desire of unrealization life ; self satisfaction The significance of this study for nursing are; Comprehension of the lived experience of client and identification' of nursing approach method concerning the lifestyle of client.

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The Primary Reverse Total Shoulder Arthroplasty for Post-septic Destroyed Shoulder - A Case Report - (감염 후 손상된 견관절에 선택된 일차적 역구형 견관절 대치술 - 1 례 보고 -)

  • Moon, Young-Lae;Nam, Ki-Young;Jo, Sueng-Hwan;Venkat, Gorthi
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.232-235
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    • 2009
  • Purpose: We report here on a solution for the case of a 71 year old lady with cartilage destruction in the left shoulder and the loss of the rotator cuff secondary to post-septic arthritic sequelae. Materials and methods: After thorough laboratory, clinical and radiological investigation of the patient to rule out any foci of active infection, we contemplated performing reverse total shoulder arthroplasty as a primary procedure. Results: At 22 months follow up, the patient had an excellent result according to the UCLA and ASES scales. Conclusion: Reverse total shoulder arthroplasty seems to be an efficient procedure to improve pain and function in the post-septic shoulder accompanying severe rotator cuff injury.

Clinical Outcomes of Arthroscopic Rotator Cuff Repair Using Poly Lactic-co-glycolic Acid Plus β-tricalcium Phosphate Biocomposite Suture Anchors

  • Chung, Seok Won;Oh, Kyung-Soo;Kang, Sung Jin;Yoon, Jong Pil;Kim, Joon Yub
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.22-29
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    • 2018
  • Background: This study is performed to evaluate anchor-related outcomes and complications after arthroscopic rotator cuff repair using 30% ${\beta}$-tricalcium phosphate (${\beta}$-TCP) with 70% poly lactic-co-glycolic acid (PLGA) biocomposite suture anchors. Methods: A total of 78 patients (mean age, $61.3{\pm}6.9years$) who underwent arthroscopic medium-to-large full-thickness rotator cuff tear repair were enrolled. The technique employed 30% ${\beta}$-TCP with 70% PLGA biocomposite suture anchors at the medial row (38 patients, Healix $BR^{TM}$ anchor [Healix group]; 40 patients, Fixone anchor B [Fixone group]). The radiologic outcomes (including perianchor cyst formation or bone substitution) and anatomical outcomes of the healing failure rate were evaluated using magnetic resonance imaging at least 6 months after surgery, the pain visual analogue scale at 3, 6 months, and final follow-up visit, and American Shoulder and Elbow Surgeons scores at least 1 year postoperatively. Anchor-related complications were also evaluated. Results: The perianchor cyst formation incidence was similar for both groups (60.5%, Healix group; 60.0%, Fixone group; p=0.967), although severe perianchor cyst incidence was slightly lower in the Fixone group (15.0%) than in the Healix group (21.1%). There was no occurrence of anchor absorption and bone substitution. No differences were observed in the healing failure rate (13.2%, Healix group; 15.0%, Fixone group; p=0.815) and functional outcome between groups (all p>0.05). Anchor breakage occurred in 5 patients (2 Healix anchors and 3 Fixone anchors); however, there were no major anchor-related complications in either group. Conclusions: No differences were observed in the clinical outcomes of the Healix and Fixone groups, neither were there any accompanying major anchor-related complications.

Endobronchial Chondroid Hamartoma - A case report- (기관지 내 연골성 과오종 -1예 보고-)

  • Lee Song Am;Kim Jun Seok;Lee Tae Hoon;Lim So Dug;Hwang Eun Gu;Kim Yo Han;Hwang Jae Joon
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.240-243
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    • 2006
  • Pulmonary hamartoma is a common benign tumor of the lung, but endobronchial hamartoma is a rare tumor. Although bronchoscopic rcemoval or removal by bronchotomy or sleeve resection with preservation of the lung may be possible, when irreversible lung damage has occurred because of chronic obstruction and pneumonitis, pulmonary resection may be indicated. We herein report a case of endobronchial hamartoma which was treated by left upper lobectomy. A 42-year-old female with 3-week history of cough and left chest pain visited our hospital. Bronchoscopy showed total occlusion of the orifice of the left upper lobe bronchus by a lobulated endobronchial tumor and bronchoscopic biopsy was failed due to bleeding. A left upper lobectomy was performed because of severe consolidation of the left upper lobe by chronic obstruction. The patient was discharged on postoperative 14th day.

Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Idiopathic Polymyositis in a Young Mature Alaskan malamute (젊은 성숙 알라스칸 말라뮤트에서 특발성 다발성근염 증례)

  • Lee, Jae-Il;Hong, Sung-Hyeok;Son, Hwa-Young;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.244-246
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    • 2007
  • Clinical and histopathologic features of idopathic polymyositis in twenty-month-old Alaskan malamute dog are described. The clinical signs were progressive exercise intolerance with acute exacerbation of weakness, muscle atrophy, synchronous pelvic limb gait, short stiff steps and tip-toeing as like walking on eggshells. Physical and clinical examination revealed no evidence of neurologic, skeletal and secondary muscular disorders associated with other diseases. Therefore muscle biopsy was performed at the most severe muscle atrophy lesions to confirm by histopathology. Histopathologic findings documented mononuclear cell infiltration and necrosis of muscle fiber and it was diagnosed as idiopathic polymyositis. Initial treatment was focused on pain relief. Prednisone at immunosuppressive dose (2 mg/kg) was administered orally twice daily. After 3 weeks of starting treatment, the patient showed improvement of gait, appetite, exercise as well as gradually return to normal state of hematologic and serum chemistry profiles.

Hemilaminectomy for Herniated Discs at the Cervicothoracic Junction in a Beagle Dog (편측추궁절제술을 이용한 비글견의 경흉연접부 추간판 탈출증의 치료)

  • Kang, Byung-Jae;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.511-514
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    • 2014
  • A 7-year-old, female Beagle dog presented with a primary complaint of severe neck pain and paretic gait. A lesion was suspected between C6 and T2 on the basis of neurological examinations. Magnetic resonance imaging of the cervicothoracic spine revealed herniation of disc material from the C7-T1 intervertebral space resulting in marked spinal cord compression. Hemilaminectomy was performed to treat the intervertebral disc disease at C7-T1. Treatment was effective and the clinical condition of the dog was remarkably improved. This result suggests that hemilaminectomy is an effective option for surgical treatment of intervertebral disc disease at the cervicothoracic junction in dogs.

Retrospective Evaluation of Alfaxalone as an Induction Agent of Inhalation Anesthesia: 150 Cases (호흡마취 유도제로서 alfaxalone의 후향적 평가: 150례)

  • Jang, Min;Son, Won-gyun;Jo, Sang-min;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.135-139
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    • 2017
  • This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.