• Title/Summary/Keyword: 통증정도

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The Influence of Video-Assisted Thoracic Surgery on Hospital Course of Spontaneous Pneumothorax (비디오 흉강경 수술법이 자연기흉의 치료과정에 미치는 영향)

  • 김재영;이석열;이길노
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.142-148
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    • 1998
  • Video-assisted thoracic surgery(VATS) is emerging as a viable alternative to thoracotomy when surgical treatment of spontaneous pneumothorax is required. 20 patients with spontaneous pneumothorax underwent bullectomy between July 1995 and May 1996. The patients were divided into two groups : Control group ; the patients who received with mid-axillary approach(n=10), Experimental group ; the patients who received with VATS (n=10). The results were as follows ; 1. The total sex distribution was male predominance (male:female=17:3). Mean age of control group was 29.6$\pm$9.8 years and experimental group was 27.2$\pm$11.9 years. 2. The mean period of postoperative chest tube indwelling duration and hospital stay were 3.3$\pm$0.8 days and 7.9$\pm$1.2 days in control group and 2.1$\pm$0.9 days and 5.2$\pm$3.1 days in experimental group(p=0.005 and p=0.02). 3. The mean time of operation, vital signs and arterial blood gas analysis did not showed any statistical differences between the groups. 4. Percent recovery of tidal volume and forced vital capacity were significantly improved in experimental group comparing with control group (p<0.05). 5. The patients undergoing VATS experienced significantly less postoperative pain and limitation of motion. In conclusion, VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.

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Factors Affecting Smartphone Addiction among University Students (대학생 스마트폰 중독의 영향요인)

  • Cho, Gyoo-Yeong;Kim, Yun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1632-1640
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    • 2014
  • This study was conducted to investigate the factors affecting smartphone addiction of university students and to provide the data for developing intervention program of smartphone addiction prevention. The data were collected from 354 university students and analyzed with t-test and multiple regression by using SPSS 18.0 program. The smartphone addiction rate was 27.4%, which the high risk group rate was 6.2% and potential risk group rate was 21.2%. The significant factors of smartphone addiction were gender(${\beta}=0.149$, p<.001), average daily using time in week(${\beta}=0.292$, p=.001), average daily using time in weekend(${\beta}=0.390$, p<.001), wrist pain in using smartphone(${\beta}=0.148$, p<.001), accident in using smartphone(${\beta}=0.133$, p=.002), sociality(${\beta}=-0.099$, p=.029), impulsiveness(${\beta}=0.211$, p<.001), SNS addiction(${\beta}=0.376$, p<.001). And these factors explained 43.3% of the variance in smartphone addiction. In conclusion, the results from this study indicated a need to develop the intervention program to prevent smartphone addiction considering these factors affecting smartphone addiction.

The Effects of Motor Control and Strengthening Exercise on Secondary Shoulder Impingement Syndrome at Postmastectomy (운동조절과 근력강화 운동이 유방절제술 후 견관절의 기능부전으로 유발된 견관절 충돌 증후군에 미치는 영향)

  • Bae, Young-Hyeon;Lee, Suk-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2240-2250
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    • 2012
  • This study was to identify treatment effects of the shoulder control and strengthening exercise, on the subjects with secondary shoulder impingement syndrome at postmastectomy. The subjects were patients who visited our hospital due to secondary shoulder impingement syndrome(1-2 stage) at postmastectomy and they randomly allocated to two groups: a shoulder control and strengthening group (n=10) and a conservative therapy group (n=10). Both groups received conservative therapy for 5 sessions (40 minutes per week) for 4week. The shoulder control and strengthening exercises group practiced additional motor control and strengthening exercises for 60 minutes. Values of handgrip strength, pain(visual analog scale), upper extremity circumference, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion were compared with those of the conservative therapy group. There were significant differences in the amount of change of the range of motion and Disabilities of the Arm, Shoulder and Hand scale between the two groups (p<.05), however as a measure of handgrip strength, pain(visual analog scale), upper extremity circumference did not show a significant differences. These results suggest that a motor control and strengthening exercise program is feasible, secure and suitable for secondary shoulder impingement syndrome at postmastectomy.

Quality of life and its related factors in patients with Korean chronic obstructive pulmonary disease (만성폐쇄성폐질환 환자의 삶의 질 관련요인)

  • Bang, So Youn
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1349-1360
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    • 2016
  • The purpose of this study was to identify the degree of quality of life (QoL) and its related factors in patients with Korean Chronic Obstructive Pulmonary Disease (COPD). With data collected by Korea National Health and Nutrition Survey in 2013, general and disease-related variables, pulmonary function test, and EuroQol-5Dimension (EQ-5D) were analyzed. The mean of EQ-5D index was 0.916 in patients with COPD and 0.941 in non-COPD. The EQ-5D index and its sub dimensions (mobility, self-care, usual activity, pain/discomfort, anxiety/depression) of COPD patients were significantly lower than that of non-COPD. However, difference in COPD patients' airway limitation was significant only for self-care of EQ-5D (${\chi}^2=9.50$, p=.013). The related factors of QoL in COPD patients were age, gender, level of education, quartile of household income, smoking status, and number of comorbid diseases. Based on the results, it is important to pay close attention to COPD patients' QoL as well as comprehensive interventions which possibly improve their QoL.

Biomechanical Properties of the Cervical Muscles Depending on Using of a Smartphone (스마트 폰 사용에 따른 경추부 근육의 생체역학성)

  • Kim, Yong-Woo;Kim, Maeng-Kyu
    • 한국체육학회지인문사회과학편
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    • v.55 no.3
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    • pp.543-551
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    • 2016
  • The study was aimed at investigating the relationship between biomechanical properties of cervical muscles and smartphone addiction score in fifty healthy males using smartphone more than 60 minutes each day. The usage of smartphone was evaluated by smartphone addiction survey developed from Korean International Society Agency. Biomechanical properties of three major cervical muscles; splenius capitis, sternocleidomastoid and upper trapezius, were measured by Myoton, and conducted five parameters; frequency, decrement, stiffness, creep, and relaxation time. As results, all parameters had less than 2% of coefficient of variation(CV) between measurement intervals. Also, intra-class correlation coefficient(ICC) indicated a high reliability(ICC>.9, p<.01). Moreover, the smartphone addiction score was significantly different in frequency(r=.353, p<.05) and stiffness(r=.346, p<.05) on upper trapezius; in addition, in decrement(r=-.284, p<.05) and creep(r=.288, p<.05) on sternocleidomastoid. Especially, splenius capitis was closely related with the overuse of smartphone(frequency, r=-.368, p<.01; decrement, r=-.405, p<.01; stiffness, r=-.424, p<.01). In conclusion, this study implied that the overuse of smartphone is significantly related with the damage of cervical muscles, cervical pain, and headache; furthermore, Myoton can be used as an effective device to assess mechanical properties of cervical muscles.

The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.724-732
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    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

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Analysis of the Perception of Hospice and Narcotic Analgesics by Family Caregivers of Terminal Cancer Patient (말기 암 환자 보호자의 호스피스와 마약성 진통제에 대한 인식도 분석)

  • Kwak, Kyung-Sook;Chun, Sung-Ho;Ha, Jung-Ok;Lee, Kyung-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.106-111
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    • 2006
  • Purpose: In terminal cancer patients, pain control with narcotic analgesics and supportive care by hospice are very useful treatment modality. However, many patients and their caregivers are poorly compliant in using narcotic analgesics for fear of addiction and tolerance. And also many patients and family caregivers are reluctant to accept hospice, presuming that hospice means patient's condition is no longer reversible and progressively deteriorating. The purpose of this study was to evaluate and analyze the perception of using narcotic analgesics and hospice by family caregivers of terminal cancer patients who play a critical role in health care in Korean culture. Methods: A total of 54 terminal ranter patient's family caregivers participated in this study. Questionnaire consisted of 15 questions about narcotic analgesics and hospice. Results: The study revealed following results. 1) family caregivers who are not aware of hospice are more than half (56.7%). 2) 81.8% of family caregivers agreed that hospice care is beneficial to terminal cancer patients. 3) 85.1% of family caregivers were under financial burden. 4) 83.2% of patient complained pain in 24 hours. 3) while 88.5% of family caregivers believed that narcotic analgesics can control pair, 79.1% and 79.6% of them also believed that use of narcotic analgesics would result in addiction and tolerance, respectively. Conclusion: There still exist barriers to family caregivers in using narcotic analgesics for pain control. And also, terminal cancer patient's family caregivers have poor information about hospice. Therefore, educational intervention about narcotic analgesics by pharmacist and doctors are needed for proper pain control for terminal ranter patients. In addition, more precise information about hospice care should be provided for terminal cancer patients and their family caregivers.

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Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Effect of Microcurrent Therapy on Interleukin-6 Expression in Adjuvant Induced Rheumatoid Arthritis Rat Model (미세전류치료가 아주반트 유도 류마티스관절염 유발 흰쥐의 인터루킨-6 발현에 미치는 영향)

  • Lee, Hyun-Min;Lee, Sang-Yeol;Chang, Jong-Sung;Lee, Myoung-Hee;Kang, Jong-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.551-558
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    • 2010
  • 연구목적 : 미세전류 자극이 아주반트로 류마티스 관절염을 유발한 실험동물의 염증반응과 통증에 미치는 효과를 알아보기 위하여 실험동물의 발허리발가락관절내 염증반응 정도를 나타내는 인터루킨-6(interleukin-6)의 발현과 핫플레이트(hot plate)를 이용한 발도피지연시를 측정하여 미세전류의 효과에 대하여 알아보고자 하는데 목적이 있다. 연구방법 : 실험동물은 무작위로 대조군(n=18)과 미세전류를 적용한 실험군(n=18)으로 구분하였고, 각 군당 6마리씩 1일군, 7일군, 14일군으로 배정하였다. 류마티스 관절염 유발후 1일, 7일, 14일에 모든 실험동물의 열통각 역치를 나타내는 발도피지연시와 발허리발가락관절내 인터루킨-6의 발현정도를 측정하였다. 각 집단 내의 기간에 따른 발도피지연시와 인터루킨-6의 면역반응성은 일원배치 분산분석을 실시하였고, 사후분석으로는 Duncan의 다중범위검정을 실시하였다. 실험군과 대조군을 비교하기 위하여 독립표본 t-test를 실시하였다. 연구결과 : 실험결과는 다음과 같다. 1) 아주반트 주사 1일후, 실험군과 대조군에서 인터루킨-6 면역반응성과 발도피지연시는 비슷한 양상을 보였다. 2) 인터루킨-6 면역반응성은 아주반트 주사 7일, 14일 후 대조군이 실험군보다 유의하게 증가되었다(p<.05). 3) 발도피지연시는 아주반트 주사 7일, 14일 후 실험군이 대조군보다 유의하게 증가되었다(p<.05). 결론 : 이상의 결과로부터, 미세전류 자극이 아주반트로 유발된 류마티스관절염 모델에서 활액 조직내 염증반응을 감소시키고 열통각역치는 증가되는 것을 알 수 있었다.

Revision of Failed Shoulder Instability Repair (실패한 견관절 불안정증의 봉합술에 대한 재수술)

  • Park, Jin-Young;Park, Hong-Geun;Oh, Jeong-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.135-140
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    • 2006
  • Diagnosis and treatment of the unstable shoulder is one of the more difficult problems in orthopaedic surgery. There is confusion between the normal laxity with translation and subluxation of the humeral head relative to the glenoid and an abnormal amount of laxity, leading to pain and dysfunction. Unfortunately, there is no single treatment that applied to all lesions that cause the instability. It is imperative, therefore, that an accurate diagnosis be made, including the directions and degree of shoulder instability as well as any coexisting problems. Anatomical defects must be defined. Common factors that could most readily compromised instability repair are examined. These include techniques for making an accurate diagnosis with identification of the precise anatomical pathology, and the rationale for appropriate surgical treatment with the avoidance of technical complication such as unnecessary hardware or exposures that might lead to residual instability, arthritis, and nerve or vascular injuries. Additional injuries may be prevented by careful rehabilitation postoperatively to restore shoulder stability, flexibility, and endurance prior to an individual's return to stressful sports or work.

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