• 제목/요약/키워드: severe pain

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자율신경 기능 이상을 동반한 Guillain-Barre 증후군 1례 (Report on the Guillain-Barre Syndrome with Autonomic Dysfunction(1 Case))

  • 김동웅;신선호;조권일;신학수;한명아;최진영;최우정;양재훈;정용준;김관식
    • 대한한방내과학회지
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    • 제22권3호
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    • pp.453-458
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    • 2001
  • Guillain-Barre syndrome, or acute inflammatory demyelinating Polyradiculoneuropathy, is frequently accompanied by cardiac and autonomic dysfunction. We report a patient who had tachycardia, orthostatic hypotension, hypertension, pronounced blood pressure fluctuations, abnormal sweating, constipation and urinary frequency as well as qudriparesis. We thought that the GBS was incurred by Damp-Heat, used Heat-Clearing and Dampness-Transforming decoction(Chongjoo-tang) in the early stage. In the later stage, fortifying the Spleen and Boosting Qi plus Supplementing the Kidney decoction(Palmultang+chongawon) was used to remove low back pain and boost recovery. The patient reached the nadir 14 days after onset. He became bed-bound and autonomic dysfunction was very severe. From 3rd week, abnormalities of autonomic function and paresis impoved gradually and he could walk above 5m without walker or equivalent support at the 5th week after onset.

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Tc-99m MAG3 Scan의 배뇨 후 배설상으로 진단된 역류성 신병증 1례 (Reflux Nephropathy Detected by Post-voiding Image on Scintigraphic Tc-99m MAG3 Scan)

  • 김홍국;유재은;함주연;윤석남;배기수
    • Childhood Kidney Diseases
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    • 제7권2호
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    • pp.239-244
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    • 2003
  • 저자들은 우측 옆구리 통증과 발열을 주소로 내원한 12년 8개월 된 여아에서 복부초음파 검사와 $^{99m}Tc-MAG3$ Scan의 후면 관류상 및 배뇨후 지연 배설상으로 진단된 중등급 이상의 방광요관역류와 동반된 역류성 신병증 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 또한 요로 감염증 및 신병증이 있는 환아들의 경우 심한 역류와 역류성 신병증의 조기발견과 신속한 대처를 위해 고식적 검사와 배뇨 후 지연 배설영상검사를 시행하기에 앞서 비침습적인 $^{99m}Tc-MAG3$ Scan을 시행할 것을 제안하는 바이다.

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삼차신경통에 대한 미세혈관감압술의 효과 (The Efficacy of Microvascular Decompression for Trigeminal Neuralgia)

  • 김성훈;최창화
    • Journal of Korean Neurosurgical Society
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    • 제37권5호
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    • pp.357-363
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    • 2005
  • Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.

임신중 경증불편감 호소율과 영향 요인에 관한 연구 (The Complaints Rates of Minor Discomforts and Its Influencing Factors.)

  • 이미라;조정호;김은경;송미승
    • 모자간호학회지
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    • 제1권
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    • pp.16-22
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    • 1991
  • Various minor discomforts are reported to be complained by the pregnant women. but what were and how much were they complained has not been revealed until recently. So, These lack of knowledge have given nurses difficulties in planning of care to promote the health during the pregnancy. Objectives of this study were to identify the rate of complaints in each minor discomforts and to explore the influencing factor on reduction of complaints of minor discomforts. The subjects were 120 mothers, who delivered their babies in hospital, from September to December 1990 and the reason why the postpartum mothers were selected as the subjects were minor discomforts could develope during the entire period of pregnancy. Data were gathered by the questionnares and analized statistically using SAS and SPSS program. Results were as follows. 1. More than one third of the subjects complained frequent urination, fatigue, increase of the vaginal discharge, morning sickness, the increased urination at night, pain in leg, backache, edema in leg, constipation, dyspnea, varicose vein, flatulence, headache. 2. Minor discomforts complained to be severe in more than one third of the subjects were frequent urination and increased urination at night. 3. The influencing factor to reduce the complaints of minor discomfort was revealed to be the perceived family support (r=0.030431, t=0.0007). We suggest that nurses should emphasize the importance of the family support to the pregnant women and their family, and to explore the relationships among the locus of control, the perceived family support and the complaints of minor discomforts.

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소방 공무원에서 간접 외상이 정신 건강에 미치는 영향 (Effects of Vicarious Trauma on Mental Health in Firefighters)

  • 백준혁;정영은;채정미;명준표;임현우;채정호
    • 대한불안의학회지
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    • 제6권1호
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    • pp.65-70
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    • 2010
  • Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

만성 수부 습진을 호소하는 소음인 환자 치험 1례 (A Clinical Case Report of Soeumin Patient with Chronic Hand Eczema)

  • 이지연;이민정;황민우
    • 사상체질의학회지
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    • 제33권3호
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    • pp.161-170
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    • 2021
  • Introduction Hand eczema is dermatitis that occurs on the hand and fingers. In this case, the patient had chronic hand eczema that had relapsed for 3 years, worsened for 6 months, and did not improve even with standard dermatological treatment. We report significant improvement of the patient with chronic hand eczema, diagnosed with Soeunmin Greater Yin Symptomatology based on Sasang Constitutional Medicine. Methods We prescribed herbal medicine, Sibimigwanjung-tang(十二味寬中湯), and the western medications were continued throughout the treatment period. To evaluate the treatment progression, we observed objective and subjective symptoms and took pictures of the patient's hands. Results At the first time of the outpatient visit, the patient complained of pain, oozing, scaling and severe itching even though she had taken dermatological medication for over 6 months. After 8 weeks of Korean medicine treatment, most symptoms showed improvement, and after about 47 weeks of treatment, the symptoms maintained 90% improvement even after stopping western medications and herbal medications. Conclusion The patient in this case showed a significant improvement of chronic hand eczema and the improvements have been maintained even stopping western medications and herbal medications during follow-up for 15 weeks. In addition, the patient showed improvement and maintenance of general conditions as well as skin-related symptoms. In this case, we can concern the effect of the Sasang Constitutional Medicine focused on treating the patient's general pathology as well as the patient's chief complaint at chronic hand eczema not responding to standard dermatological treatment.

경부에 발생한 괴사성 근막염에 대한 임상적 양상 분석 (A Clinical Aspect Analysis of the Cervical Necrotizing Fasciitis)

  • 양정환;최효근;이주한;박범정
    • 임상이비인후과
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    • 제29권2호
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    • pp.223-228
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    • 2018
  • Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

A Study on the Effectiveness of Herbal Medicine Treatment for 755 Traffic Accident Patients-A Retrospective Review According to the Type of Herbal Medicine Prescription

  • Bae, Jae Ryong;Ahn, Hun Mo;Roh, Ju Hee;Jo, Min Gun;Kim, Hye Ryeon;Kim, Seon Hye;Sung, Won Suk;Kim, Eun Jung
    • 대한한의학회지
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    • 제39권4호
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    • pp.62-73
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    • 2018
  • Objectives: This study conducted a retrospective review to compare the effectiveness of herbal medicine, while confirming the effectiveness of Korean medicine (KM) in traffic accidents (TA). Methods: We investigated the medical records of TA patients who were hospitalized at Muuido Korean medicine hospital from January 2016 to June 2018 retrospectively. Medical records included general characteristics (Gender, age), TA & treatment-related information (Collision type, chief complaint, hospitalization period, and herbal medicine prescription), and clinical scales (Five-scale improvement, numerical rating scale (NRS)). Statistical analysis was performed for data distribution and effectiveness comparison. Results: 755 TA patients showed 0.78:1 gender ratio. 20-50s years old, rear collision, pain in the cervical and lumbar spine, and hospitalization period within 14 days were the majority. KM improved 83.18% of 755 TA patients' symptoms and ROM over 'improvement' level, which indicated 30-70% improvement. With common KM treatments including acupuncture, cupping, heat therapy, and manipulation therapy, TA patients received various herbal medicines and herbal medicine for breaking severe blood stasis (Tongdo-san) showed improvement in both five-scale improvement and NRS change at the same time. Conclusions: We could confirm the effectiveness of KM, particularly herbal medicine in TA. It would be necessary to develop new herbal medicines such as Tongdo-san to treat TA-related symptoms.

여성 류마티스관절염 대상자의 고혈압, 당뇨, 이상지질혈증의 유병률, 인지율, 치료율 및 조절률 (Prevalence, Awareness, Treatment, and Control of Hypertension, Diabetes, and Dyslipidemia Among Patients with Rheumatoid Arthritis)

  • 윤혜원;부선주
    • 한국보건간호학회지
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    • 제33권2호
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    • pp.228-241
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    • 2019
  • Purpose: The purpose of this study was to evaluate the prevalence, awareness, treatment and control of hypertension, diabetes, and dyslipidemia among women with rheumatoid arthritis. Methods: This cross-sectional study of 288 women with rheumatoid arthritis was conducted in a university-affiliated hospital. Data were collected by reviewing the women's medical charts and self-report questionnaires. Results: The prevalence of hypertension, diabetes and dyslipidemia was 27.8%, 5.9% and 48.3%, respectively. Despite the high prevalence of dyslipidemia, the subjects'awareness of it and its treatment rates were the lowest, which resulted in a low control rate. Of the 288 subjects, 158 (55%) had at least one of the three conditions. The prevalence of the combination of cardiovascular risk factors increased with age, and 32.7% of those aged 60 or older had two or three of the cardiovascular risk factors. Combinations of cardiovascular risk factors were significantly related with severe pain and fatigue. Conclusion: Cardiovascular risk factors were highly prevalent among the women with rheumatoid arthritis, but the rates of awareness, treatment, and control were suboptimal. There is a pressing need to facilitate the prevention, early detection and appropriate management of hypertension, diabetes and dyslipidemia among patients with rheumatoid arthritis in order to prevent cardiovascular disease.

시멘트 경화제 중독으로 인한 급성 신손상 1례 (A Case of Cement Hardening Agent Intoxication with Acute Kidney Injury)

  • 서영우;장태창;김균무;고승현
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.157-160
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    • 2018
  • Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.