• Title/Summary/Keyword: 진통형

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Effeects of Low Level Laser Irradiation with 904nm Pulsed Diode Laser on the Extraction Wound (904nm의 펄스형 다이오드 저수준레이저광조사가 발치창에 미치는 효과)

  • 김기석
    • Journal of Oral Medicine and Pain
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    • v.23 no.4
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    • pp.301-307
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    • 1998
  • 본 연구에서는 904nm의 다이오드 레이저를 발치창에 조사하여 효과를 분석하교, 동물실험에서 제시된 가설 즉 레이저 광조사가 주위정상조직을 자극하여 창상치유를 촉진하고 진통, 항염증효과가 있는지를 확인하고저 하였다. 먼저 19명의 발치환자에게 발치후 즉시 1분간 평균 14mW의 저수준레이저를 조사하였다. 이들중 8명은 대조군으로서 위조사(sham-irradiation)하였다. 일주일동안 시간경과에 따른 동통의 정도, 진통제의 사용횟수, 진통제 사용기간등을 각각조사하였다. Visual analogue scale로 두근에서 동통의 정도를 비교한 결과 대조군 보다 레이저 조사군에서 동통이 유의하게 감소하였으며, 진통제의 사용횟수가 기간도 레이저조사군에서 유의하게 감소하였다. 이러한 결과로 보아 비록 1분간의 적은 량의 레이저 조사라도 발치후 합병증을 억제하여 동통을 억제하고 치유를 촉진한다고 사료된다.

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Breakthrough Cancer Pain (돌발성 암성 통증)

  • Seo, Min Seok;Shim, Jae Yong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.1-8
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    • 2015
  • Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.

C-Reactive Protein in Pregnancy and Labor (임신주령과 진통에 따른 임부 혈청 C-Reactive Protein의 동태)

  • Kim, Jong-Ho;Kim, Byung-Suk;Lee, Jae-Yul;Lee, Young-Gi;Lee, Tae-Hyung;Lee, Seung-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.298-305
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    • 1993
  • In order to evaluate the clinical usefulness of maternal serum C-reactive protein measurement in early detection of infectious morbidity at term laboring women, serum C-reactive protein levels were measured in 521 healthy pregnant women ; 64 who were not in labor before term, 55 who were in labor before term, 71 who were not in labor at term and 331 who were in labor at term. The frequencies of elevated serum C-reactive protein level were compared in relation to the gestational weeks, the presence or absence of labor, the status of amniotic membranes and the degree of cervical dilation. The obtained results were as follows. 1. The frequencies of women with elevated serum C-reactive protein, 0.8mg/dl or higher and 2.0mg/dl or higher, in 521 health pregnant women were 12% and 4%, respectively. 2. C-reactive pretein levels of 0.8mg/dl or higher were more frequent in the group of women in labor than those not in labor(5.93%, vs. 13.73%, p<0.05), but the frequencies of C-reactive protein level of 2.0mg/dl or higher were not statistically different between both groups. The frequencies of C-reactive protein level of 0.8mg/dl or higher and 2.0mg/dl or higher were not statistically different between the groups before term and at term, intact and ruptured membranes, latent phase and active phase of labor, respectively. 3. Before term, C-reactive protein levels of 0.8mg/dl or higher and 2.0mg/dl or higher were more frequent in the group of women in labor than those not in labor(23.64 vs. 4.69, p<0.001 and 12.73% vs. 3.13%, p<0.05, respectively), but those statistical differences were not seen between both group at term. Above results and review of literature suggest that serum C-reactive protein level of 2.0mg/dl or higher may be reliable in early detection of infectious morbidity at term laboring women as well as laboring women before term, and the presence of subclinical infection should be suspected in the laboring women before term with serum C-reactive protein level of 0.8mg/dl or higher.

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Physician's Attitude toward Treating Breakthrough Cancer Pain in Korea

  • Seo, Min Seok;Shim, Jae Yong;Choi, Youn Seon;Kim, Do Yeun;Hwang, In Gyu;Baek, Sun Kyung;Shin, Jin Young;Lee, Juneyoung;Lee, Chang Geol
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.18-25
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    • 2017
  • Purpose: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. Methods: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. Results: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. Conclusion: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.

Free Vibration Characteristics of Columns Immersed in Fluid with a Concentrated Mass at the Top (상단에 집중질량을 갖는 유체에 잠긴 기둥의 자유진동 특성)

  • 오상진
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.42 no.1
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    • pp.105-112
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    • 2000
  • This paper deals with the free vibrations of columns immersed in fluid. The column model is based on the classical Bernoulli-euler theory which neblects the effects of rotatory inerital and shear deformation. The eccentricity and rotatory inertial of the concentrated mass at the top are taken into accuont. In the governing equation for the free vibration of column, thedensity of immersed part was midified to account for theadded fluid mass. The govering differential equations are solved numerically using the corresponding boundary conditions. The lowest four natural frequencies and corresponding mode shapes are calculated over a range of non-dimensional system parameters ; the mas density ration of fluid to column, the ratio of fluid depth to span length, the ratio of tip mass to total column mass, the dimensionless mass moment of inertia, and the eccentricity.

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The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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Sedative and Analgesic Effects of Intravenous Detomidine and Tramadol on Horses (말에서 detomidine과 tramadol의 정맥 투여에 의한 진정 및 진통효과)

  • Kim, Tae-Hoon;Jang, Min;Lee, Hang;Lee, In-Hyung
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.226-232
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    • 2012
  • This study was performed to evaluate the sedative and analgesic effects of intravenous (IV) administration of detomidine (D) and tramadol (T) to horses. Six warmblood horses each received D (10 ${\mu}g/kg$), T (2 mg/kg), and a combination of DT (10 ${\mu}g/kg$ and 2 mg/kg). No significant differences in the heart rate, respiratory rate, rectal temperature, indirect arterial pressure, and gastrointestinal motility between D and DT were observed. The sedative effect was evident within 5 min after D and DT administration, but no significant difference between D and DT was observed. D and DT induced a similar analgesic effect up to 50 min after injection and DT maintained a longer analgesic effect than D. A significant increase in blood glucose was shown for D after the injection, but not for DT. A horse with T and DT showed an excited behavior within 5 min of the injection. This study suggests that the DT combination could be used for diagnostic procedures and simple surgeries in standing horses, with caution for excitement in the early phase after the administration.

Safety Considerations for Workers with an Implanted Electronic Medical Equipment in Various Working Environment (전자의료기 인체 삽입자의 작업환경에 따른 안전성에 관한 고찰)

  • 김정국;이종우;이상준;최태종;변미경;박재현;허웅
    • Proceedings of the Safety Management and Science Conference
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    • 2004.05a
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    • pp.233-239
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    • 2004
  • 현재 국내 인체 이식용 전자 의료기의 이식건수는 매년 약 1800 여건으로 해마다 증가하고 있으며 그 연령대도 다양한 작업환경에 노출되는 청장년층으로 급속히 확대되어 가고 있다. 이러한 이식용 의료기는 인공 심장 박동기, 이식형 제세동기, 진통억제를 위한 이식형 전기 펄스 발생기, 이식형 약물주입기 등을 포함한다. 그러한 기기들은 미세한 생체 신호에 따라 반응하기 때문에 생체 신호이외의 잡음에 의한 오동작은 절대적으로 피해져야 하며 경우에 따라 생명위협과도 직결된다. 본 논문에서는 현재사용 중인 이식형 전자의료기들의 구조와 동작원리, 다양한 작업 환경 하에서 잡음의 영향을 고찰하고, 잡음에 의한 오동작의 방지 방안을 고찰함으로써 전자의료기 인체 삽입자의 작업환경에 따른 안전문제를 제고하고자 한다.

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Treatment of the Headache (두통의 치료)

  • Chung, Kyung-Cheon
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.263-273
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    • 1999
  • Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

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The Effectiveness of Ultrasound-Guided Thoracic Paravertebral Block for Percutaneous Radiofrequency Ablation of Hepatic Tumors: A Pilot Study (간종양의 경피적 고주파 열치료에서 초음파 유도하 흉부 방척추블록의 효용성: 예비 연구)

  • Kim, Hyungtae;Kim, Youngjun;Kim, Beum Jin;Shin, Sung In;Yim, So Mang;Lee, Ju-Hyung
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.323-331
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    • 2018
  • Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.