• Title/Summary/Keyword: severe pain

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Early Diagnosis of Burkitt Lymphoma on the Mandible: A Case Report (하악골에서 발생한 Burkitt 림프종의 조기발견과 진단)

  • Kim, Miae;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.4
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    • pp.452-460
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    • 2016
  • Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin's B-cell lymphoma found primarily in the pediatric population. In the oral cavity, this tumor can grow rapidly and often brings about facial swelling or development of an exophytic mass involving the jaws. A 5-year-old boy was referred for swelling and pain in the left mandibular area. The patient showed diffuse swelling on the left side of the mandible and firm-moderate tenderness upon palpation. An intraoral examination showed moderate mobility and sensitivity to percussion on the left primary first and second molars, without severe caries. A radiographic examination revealed complete loss of the lamina dura on the left primary second molar and permanent first molar. There was a radiolucent osteolytic lesion and destruction of the cortical bone of the left mandibular body. Based on the clinical, radiographic, and immunohistochemical findings, the patient was diagnosed with BL, and was referred to a pediatrician for systemic evaluation and intensive chemotherapy. Even before the completion of chemotherapy, the swelling resolved and the displaced teeth were relocated to a normal position. This patient showed a good prognosis due to prompt diagnosis and intensive chemotherapy. Early diagnosis and referral for treatment can prevent the development of BL.

Ergonomic Design of Office Chair (사무실 의자의 인간공학적 디자인)

  • 곽원모;홍성수;정석길;이상도;이동춘;윤훈용
    • Archives of design research
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    • v.12 no.3
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    • pp.73-80
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    • 1999
  • Many domestic users complain about severe pain to the waist, neck, and shoulder as well as work performance because the domestic chair design was developed with western anthropometry dimension and design criteria. Ergonomic design standards are needed for office chair design to reduce stress and poor physical posture for various user body types. In this study, we have suggested design dimensions recommended from previous studies and Korean anthropometry data. We also have reviewed users' preference dimension through measured subjects and analyzed differences between users' preference dimension and the previous design criteria to verify physical appropriateness. We evaluated general office chairs and adjustable chairs which can adjust to fit each person. we also analyzed how each design dimension was reached and affected the human body by evaluation of physical discomfort and comfort. We have found seat height is very important in a workstation. If the seat height is high, it effects the thigh. If width, height, and angle of the backrest are wrong, fatigue to the shoulder, neck, and waist, etc.. As a result of this experiment, we suggested that the height of a seat for Koreans be 425mm for the fixed type and 365-484mm for the adjustable type. Also other design recommendations were suggested in the thesis. In conclusion, our research will be very important in the database because it provides adjustable ranges to fit user's body types in the various design fields.

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MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.114-118
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    • 2002
  • Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

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The Palliative Care and Hospice for the People Living with HIV (HIV 감염인을 위한 완화의료와 호스피스)

  • Choi, Jae-Phil
    • Journal of Hospice and Palliative Care
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    • v.20 no.3
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    • pp.159-166
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    • 2017
  • According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

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

  • Mun, Mi-Sook;Lim, Nan-Young
    • Journal of muscle and joint health
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    • v.6 no.1
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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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Ergonomic Evaluation of a Forearm Supporter for a Mouse (마우스 사용시 전완지지대의 인간공학적 평가)

  • Bae Dong Cheol;Chang Seong Rok;Jung Jae Hoon;Jin Sang Eun
    • Journal of the Korean Society of Safety
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    • v.20 no.2 s.70
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    • pp.169-174
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    • 2005
  • Traditionally, keyboards have been one of the most frequently used input devices for information processing using computers. As most computers adopt the Microsoft Windows for their operating system however, the usage of mouse has recently increased to a great extent. Moreover, the mouse has been used as the leading input device in such areas as industrial design and computer aided design. Excessive uses of mouse may cause a severe pain and fatigue on neck and upper limb due to the intensive and repetitive use of corresponding muscles, which renders a decline in efficiency and leads to musculoskeletal disorders. The main purpose of this study is to find the best working conditions to prevent musculoskeletal disorders when using mouse in a neutral posture. Utilizing electromyogram amplitude and Borg's scale, the role change and strength imposed on the muscles were measured and analyzed with and without the forearm support concerned. Also investigated were the effects of changes in elbow forearm supporter.

Sacroiliac Joint/Sacrum Uptake Ratio Measured by Quantitative Sacroiliac Joint Scintigraphy (골(骨)스캔을 이용(利用)한 천장관절(薦腸關節)/천골섭취비(薦骨攝取比)의 정량적(定量的) 측정(測定))

  • Lee, Young-Yiul;Park, Seon-Yang;Lee, Myung-Chul;Choi, Sung-Jae;Cho, Bo-Youn;Choe, Kang-Won;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.63-70
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    • 1982
  • To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

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Discrepancy of Ultrasound-MR arthrography-Arthroscopy for the Diagnosis of Rotator Cuff Tear - Case report - (회전근 개 파열의 진단에서 초음파-자기공명 조영술-관절경의 불일치 - 증례 보고 -)

  • Oh, Chung Hee;Oh, Joo Han;Jo, Ki Hyun;Kim, Sae Hoon;Bin, Seung Woo;Gong, Hyun Sik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.23-26
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    • 2008
  • Ultrasonography (USG) is widely accepted diagnostic method for the rotator cuff tear. The availability, low cost, easy to access is main factors that favor USG as a primary diagnostic modality for various cuff disorders. We experienced a case of discrepancy between USG, MR arthrography (MRA) and arthroscopic examination. Seventy four year old female patient complained of right shoulder pain. USG depicted rotator cuff tear with the size of 1cm, and MRA demonstrated about 3cm sized tear. Complex massive tear with delamination of degenerated rotator cuff was identified in the arthroscopic examination. When we encounter a patient who has loss of rotator cuff power or severe symptom than findings of USG, MRA or repeat USG is warranted. We report a case of discrepancy between examination modalities with brief review of the literature.

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Endoscopic Findings of Children with Henoch-Schonlein Purpura (소아 알레르기성 자반증의 위장관 내시경 소견)

  • Lee, Dong Hoon;Park, Chul Han;Park, Ji Min;Park, Geun Soo;Kim, Heung Sik;Kang, Chin Moo
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.572-575
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    • 2003
  • Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

Repair of Ruptured Papillary Muscle of the Tricuspid Valve as a Cause of Tricuspid Insufficiency Following Blunt Chest Trauma (흉부 둔상후 삼첨판막 폐쇄부전을 유발한 삼첨판막 유두근 파열의 치료)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Lee, Jung-Hoon
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.413-416
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    • 2010
  • A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.