• Title/Summary/Keyword: 통증 양상

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Diagnostic Criteria to Differentiate Medial Meniscal Injury from Degenerative Changes on $^{99m}Tc-MDP$ Knee SPECT in Patients with Chronic Knee Pain (만성 무릎관절 통증환자에서 내측 반월상연골 손상과 관절 퇴행성 변화의 감별을 위한 $^{99m}Tc-MDP$ 무릎관절 SPECT의 진단기준)

  • Paeng, Jin-Chul;Chung, June-Key;Jeong, Hwan-Jeong;Yoo, Jae-Ho;Kang, Won-Jun;So, Young;Lee, Dong-Soo;Lee, Myung-Chul;Seong, Sang-Cheol;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.103-109
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    • 2003
  • Purpose: In patients with chronic knee pain, the diagnostic performance of $^{99m}Tc-MDP$ knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake is increased in medial compartment. Materials and Methods: A total of 49 knee SPECT of the patients with chronic (more than 3 months) knee pain, which showed increased $^{99m}Tc-MDP$ uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. Results: The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improved diagnostic performance, especially, specificity. Conclusion: In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.

Sleep Patterns of Pregnant Women (임부의 수면양상)

  • Choi, Byeung-Sun;Yoon, Jin-Sang
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.45-53
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    • 1998
  • Objectives : The change of sleep patterns commonly occurs in association with the pregnancy. This study was to investigate sleep habits during the course of normal pregnancy. Methods : Sleep habits questionnaire was administered to healthy women in their first trimester(TR1) of pregnancy and then the same questionnaire was repeatedly administered during their second(TR2) and third(TR3) trimesters. The following aspects were assessed : patterns of night sleep, daytime status, sleep posture, reasons for sleep alteration, and the experience of any particular parasomnias, as well as sleep problem-related treatment or medication. Data analysis was based on 26 women who maintaind good health throughout their pregnancy and completed the questionnaire three times. Results : In comparisons between each trimester and non-pregnant state, total night sleep time, daytime tiredness, and sleepiness were significantly increased in all trimesters. Sleep latency was significantly decreased in TR1 and TR2, but not in TR3. In addition, refreshed feeling on waking the following day was significantly decreased and the number of awakenings during night sleep was significantly increased in TR3, but not in TR1 and TR2. In comparisons between trimesters, there was a significant increase in sleep latency, daytime sleepiness and the number of awakenings during night sleep and a significant decrease in refreshed feeling on waking the following day in TR3 compared to TR1 and TR2. Over the course of pregnancy, the rate of lateral position during sleep was gradually increased and all the pregnant women took the lateral sleeping posture in TR3. The major reasons for sleep pattern alteration were nausea, vomiting and heartburn in TR1, urinary frequency, fetal movement and ache in hips in TR2, and urinary frequency, fetal movement, cramp in legs and backache in TR3. Conclusion : These findings are expected to be useful for educating pregnant women about sleep hygiene. In future studies, the underlying factors and mechanisms regarding sleep patterns during pregnancy will need to be clarified.

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Quality of Life in Korean Patients with Burning Mouth Syndrome (한국인을 대상으로 한 구강작열감증후군 환자의 삶의 질 평가)

  • Park, Ju-Hyun;Kwon, Jeong-Seung;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.81-89
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    • 2011
  • The purpose of this study was to evaluate the individually perceived quality of life in Korean patients with BMS using two questionnaires : the Medical Outcome Short Form Health Survey Questionnaire (SF-36) and the Oral Health Impact Profile (OHIP-49). This cross-sectional study included sixty subjects diagnosed with BMS and sixty healthy subjects as controls. All subjects in this study completed two questionnaires: the Medical Outcome Short Form Health Survey Questionnaire (SF-36) and the Oral Health Impact Profile (OHIP-49), which had been translated into Korean and subsequently validated for use in Korea. All of the subscales in the SF-36 exhibited significantly lower scores in BMS patients than control groups. Comparison of the mean SF-36 scores between the two groups revealed the greatest differences to be for the subscales of physical pain and role emotional (role limitations due to emotional problems). The mean score on each subscale of the OHIP-49 was significantly higher in BMS patients than control groups. Comparison of the mean OHIP-49 scores between the two groups revealed the greatest difference to be for the subscale of physical pain. These findings demonstrated that BMS had an impact on various components of a patient's quality of life. BMS patients exhibited more impaired results and a poorer quality of life than control groups.

Massive Rotator Cuff Tear Repair (광범위 회전근 개 파열의 봉합술)

  • Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.167-174
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    • 2010
  • Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.

Arthroscopic Management for the Treatment of Ankle Gutter Syndrome (족 관절 구 증후군에 시행한 관절경적 치료)

  • Choi Chong Hyuk;Park Jin-Oh;Ogilvie-Harris D. J.
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.54-60
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    • 2000
  • Purpose : The purpose of this study was to evaluate the gutter pathologies and the clinical results of arthroscopic treatment for ankle gutter syndrome. Materials and Methods : Seventy six patients(77 ankles) who had lesions in the ankle gutter were treated by arthroscopy. The gutter pathology could be divided into 3 categories; hypertrophic scar tissue, loose bodies and bone spurs. Fifty two patients were evaluated subjectively and functionally with authors' criteria. The follow-up period averaged 44 months(range, 2.9 year-8.5 year). Results : The incidence of the gutter lesion was $21\%$(77 ankles) among 366 ankles undergoing arthroscopy. The most common pathology was hypertrophic scar tissue. In 31 ankles$(40\%)$, the lesions were found only in gutter, and 46 ankles$(60\%)$ were associated with pathologies in other areas. All of parameters for subjective and functional evaluation were improved with statistical significance(p<0.001). Seventeen patients$(33\%)$ could returned to competitive or contact sports activity with same level of premorbid period. Conclusion : Ankle gutter is an important site of pathologies which cause chronic ankle pain, and should be explored in ankle arthroscopy. The ankle arthroscopy is a very effective treatment method fur the removal of pathologies in ankle gutter syndrome.

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Comparison of Clinical Menifestations between Adolescents and Unmarried Young Women with Endometriosis in Daegu (대구 지역 청소년 및 미혼 여성 자궁내막증 환자의 임상 특성에 관한 비교연구)

  • Kim, Yoon-Jeong;Choi, Min-Hye;Chung, Min-Ji;Lee, Jung-Ho;Lee, Taek-Hoo
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.167-172
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    • 2007
  • Objective: The purpose of this study is to find out the differences of clinical characteristics of endometriosis and to emphasize the significance of early diagnosis of endometriosis to protect disease progression in adolescents. Methods: A retrospective analysis was carried out. All cases (n=130) were diagnosed surgically as endometriosis between January 2000 and August 2007 in two university hospitals in Daegu. Adolescents were 23 cases and unmarried young women were 107 cases. Data were collected through review of medical records. Results: The predominant symptom in adolescents was cyclic pain. 52.2% of adolescent patients were stage I or II. And stage III was 47.8% but stage IV was none. The other side 82.2% of unmarried young women patients were stage II or III and stage IV was 15.8%. Serum CA-125 level was elevated in adolescents, also. But there was no significant difference between the two groups. Conclusions: Endometriosis is progressive disease. Early diagnosis is necessary for prevention of the disease progression and free from pain. Appropriate gynecologic examination and careful concerns about adolescents are mandatory.

Treatment of Gingival Irritation Fibroma Using $CO_2$ Laser (이산화탄소 레이저($CO_2$ laser)를 이용한 치은에 발생한 자극성 섬유종의 치료)

  • Choi, Young-Chan;Park, Ju-Hyun;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.119-122
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    • 2010
  • Carbondioxide($CO_2$) laser is one of the most widely employed lasers in oral soft tissue surgery because of its excellent affinity for water based soft tissues. It has some inherent advantages such as hemostasis, less postoperative swelling, reduction of bacterial population at surgical site, less need for suturing, less scarring, and less postoperative pain compared to conventional surgical therapies including the use of scalpel, diathermy, cryotherapy and electrosurgery. A 30-years-old male was presented with gingival swelling. Clinical examination revealed a well?defined pedunculated fibrotic mass on the buccal gingiva near right maxillary 1st molar. In radiographic examination, no remarkable abnormality was seen. Excisional biopsy was performed with $CO_2$ laser (continuous wave mode, 4.0W). Histological diagnosis was "Irritation fibroma". $CO_2$ laser has advantages those are suitable for surgical treatment of intraoral lesion. If appropriate training and experience are provided, the dentist would be able to manage intraoral lesions more efficiently and successfully with the use of the $CO_2$ laser.

A Study for Prevalence of Pain and Bony Changes of the Elbow in Baseball Players (야구 선수 주관절의 통증과 골 변화에 대한 유병률 조사)

  • Lim, Che-Joon;Kim, Seong-Tek;Kim, Chang-Yoon;An, Ki-Yong;Park, Jin-Bum;Youn, Te-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.50-56
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    • 2007
  • Purpose: To evaluate the aspect of occurrence and transition of the elbow injuries in baseball players from childhood to adult. Materials and Methods: We had a survey and took the simple X-ray from the anteroposterior view and the lateral view of both elbows for subjects of total 320 baseball players. - each of 80 players in elementary school, middle school, high school, and professional baseball players between January and December in 2004. Results: The region of pain and the bony changes in elbow were the most frequent in medial side from all the groups of players. Especially, hypertrophy of medial epicondyle were the most numerous. As baseball players got older, the radiological changes of elbow were increased. The bony changes were found out 52 cases (65%) of the elementary school players, 66 cases (82%) of the middle school players, 68 cases (85%) of the high school players and 70 cases (88%) of the professional players out of the total 320 baseball players. Conclusion: The bony changes of the elbow in baseball players got frequent as they were getting older and increased in comparison with past.

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Dedifferentiated Parosteal Osteosarcoma - A Case Report - (역분화성 방골성 골육종 - 증례 보고 -)

  • Sung, Ki-Sun;Chang, Moon-Jong;Lim, Kyung-Sub
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.195-200
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    • 2007
  • Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

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The Converge Effects of the BeHaS Exercise Program on Health Status, Depression and Suicidal Ideation in Female Elderly Who Live Alone in Community (베하스 운동프로그램이 지역사회 여성노인의 신체건강, 우울, 자살생각에 미치는 융합적 효과)

  • Kim, Hyunjoo;Kim, Sun Kyung;Kim, Jong-Im;Kim, Sunae;Jun, Young Suk;Park, Keumok
    • Journal of the Korea Convergence Society
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    • v.9 no.3
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    • pp.111-119
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    • 2018
  • This study was conducted to evaluate the converge effects of the Be Happy and Strong (BeHaS) exercise program on female elders living alone, using a nonequivalent control-group pretest-posttest design. The BeHaS exercise program was conducted twice each week for 4 weeks (total 8 sessions). The outcome measures included pain, shoulder flexibility, grip strength, depression, and suicidal ideation. Independent t-test, Chi-squre test, paired t-tests and ANCOVA were used for the statistical data analysis. A statistically significant improvement emerged in pain (t=4.044, p=.000) and right and left shoulder flexibility (t=2.192, p=.038 and t=2.568, p=.016) 4 weeks later. In a group comparison, a statistically significant difference arose in changed scores of suicidal ideation (F=7.32, p=.010) between groups. The BeHaS exercise program may effectively improve the physical and psychological health of female elders living alone.