• Title/Summary/Keyword: 통증 양상

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Opioids Use and Adrenal Insufficiency (마약성 진통제 사용과 부신기능부전)

  • Jung, Ji Hoon;Choi, Youn Seon;Kim, Jung Eun;Kim, E Yeon
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.113-121
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    • 2014
  • The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.

The Effects of perceived health status, sleep, depression and pain on quality of life by Gender in Community-dwelling Older Adults (저소득층 재가노인의 지각된 건강상태, 수면, 우울, 통증이 삶의 질에 미치는 영향)

  • Chang, Koung-Oh;Park, Su-Jin;Bae, Du-Yi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1566-1575
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    • 2014
  • In this study, we have investigated the effect of perceived health status, sleep, depression and pain on quality of life by Gender in Community-dwelling Older Adults. A cross-sectional descriptive study was conducted with a survey of elderly aged 65 years or older that registered in the health care center located in J city from december 20, 2012 to february 15. Data were analyzed with descriptive statistics, t-test, ANOVA. Pearson correlation coefficients and multiple regression analysis using the SPSS Win 18.0 program. The result of perceived health status on average $9.89{\pm}2.21$ points, sleep $39.72{\pm}8.79$ points, depression, $7.13{\pm}7.54$ points, pain $5.37{\pm}1.90$ points and quality of life, the average was $7.61{\pm}2.25$ points. Perceived health status of low-income that perceived health status, sleep, and pain. explained 44.6% of variance in their quality of life. Based on the findings of the study, low-income elderly in home in order to improve the quality of life of the systematic development of intervention programs for health care and nursing needs to be applied.

Correspondence between Temporomandibular Disorder Symptoms and Clinical Examination Findings (측두하악장애 환자에서 주관적 증상과 임상검사 소견 간의 일치성)

  • Im, Yeong-Gwan;Baek, Hey-Sung;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.83-91
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    • 2010
  • Objectives: This study aimed to assess the characteristics of temporomandibular disorder (TMD) symptoms and to determine the correspondence between TMD symptoms and clinical examination findings. Material and methods: A total of 218 patients (143 females and 75 males; age=$31.3{\pm}14.0$) were enrolled in this study who completed a questionnaire and underwent a clinical examination and radiographic assessment. Patients were asked about all the symptoms and complaints, including onset or duration, and locations of the symptoms. Clinical examination included amounts of mouth opening, palpable temporomandibular joint (TMJ) sounds, and tenderness to palpation of the TMJ and all masticatory muscles. Tenderness scores obtained from palpation of the masticatory system were summated to define the variables for further analysis. Results: Pain was the most frequently reported symptom (78.9%), followed by joint sounds (45.4%), and limitation in mouth opening (17.0%). Jaw pain comprised 91.9% of pain complaints. The subjective intensity of jaw pain was low to medium in most patients (93.7%), but it was poorly correlated with the sum of tenderness scores of the TMJ and masticatory muscles (Kendall tau = 0.084). In contrast, the side in which pain was reported by patients was well associated with the clinical examination results (pain of the right side, p < 0.001, and left side, p < 0.001). There was moderate agreement in TMJ sounds between the side identified by patients as symptomatic and clinical examination findings (kappa = 0.482). Finally, patients who complained of restricted mouth opening showed about a 10 mm less opening in all three measurements, compared to other patients (p < 0.001). Conclusion: The most frequent symptoms reported by TMD patients were jaw pain, TMJ sounds, and mouth opening limitation. The side of jaw pain, the side of TMJ sounds, and the presence of opening limitation were highly concordant between symptom reports and examination findings.

Expression Pattern of T Lymphocyte Regulatory Factors in Unstimulated Whole Saliva of Erosive Oral Lichen Planus and Recurrent Aphthous Stomatitis Patients (미란형 구강편평태선과 재발성 아프타성 구내염 환자들의 비자극성 전타액내 T림프구 조절인자들의 발현 양상)

  • Yoon, Seon-Hack;Ko, Hyun-Mi;Park, Ji-Il;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.363-369
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    • 2009
  • Erosive oral lichen planus (EOLP) and recurrent aphthous stomatitis (RAS) are T-cell mediated inflammatory immune disorders. It was investigated mRNA expression pattern of several regulatory factors, such as, CD28, CD45, CD152, CD154, CD279, which influence T lymphocyte in unstimulated whole saliva (UWS) of EOLP and RAS patients. It was collected unstimulated whole saliva during 10 minute in EOLP 18 people, RAS patients 12 people, healthy control 8 people. We investigated mRNA expression of T lymphocyte regulatory factors, such as, CD28, CD45, CD152, CD154, CD279, with real time reverse transcription polymerase chain reaction. In EOLP group, CD45, CD279 expressed higher and CD154 expressed lower than control. In RAS, CD45, CD270 expressed higher and CD28, CD154 expressed lower than control. In addition CD152 salivary mRNA expression of EOLP is higher than that of RAS. The above results were suggested that the mRNA expression of T lymphocyte regulatory factors in unstimulated whole saliva of EOLP and RAS contributes to diagnosis of diseases.

Long Term Follow-Up of Cyclic Vomiting Syndrome (주기성 구토증(cyclic vomiting syndrome)의 장기 추적 관찰 -이형 편두통(migraine variant)으로의 이행 과정인가?-)

  • Hwang, Jin-Bok;Oh, Hee-Jong;Choi, Kwang-Hae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.75-83
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    • 2000
  • Cyclic vomiting syndrome(CVS) is a disorder of unknown etiology that is characterized by its clinical pattern of intermittent episodes of severe vomiting, similar in time of onset and duration, with no symptoms during the intervening period. By definition, CVS is an idiopathic disorder that requires exclusionary laboratory testing. Not only can it be mimicked by many specific disorders, eg, surgical, neurologic, endocrine, metabolic, renal, but within idiopathic CVS there may be specific subgroups that have different mechanisms. It has been reported that CVS usually begins in toddlers and resolves during adolescence. Migraine is also self-limiting episodic condition of children and the clinical features of migraine and CVS show considerable similarity. It is proposed that CVS is a condition related to migraine. This paper reports clinical courses of long term follow-up and reversible EEG changes in three patients whose history included CVS. Clinical situations of attack interval, duration and associated symptoms had changed variablely in each patients through long term follow-up period. Cyclic vomiting subsided in two cases. Abnormal delta activity was seen during episodes and resolved at follow-up, when the patient asymptomatic. The brain wave changes support the interpretation of CVS as a migraine variant.

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Transection of the posterior horn of the medial meniscus at the posterior tibial attachment - Clinical features and A new repair technique (Pullout suture) - (내측 반월상 연골 후각의 후방 경골 부착부위의 절단 파열 - 임상 양상 및 새로운 봉합 수기(pullout suture) -)

  • Ahn, Jin-Hwan;Ha, Chul-Won;Kim, Ho;Kim, Sung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.109-114
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    • 1999
  • Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

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Analysis Characteristic the Using Surface Electromyography of Head Neck and Around of Shoulder Muscles Express Scaling Working of the Dental Hygienist (치과위생사의 스켈링 작업 시 발현되는 두경부 및 견부 주위 근육들의 표면 근전도를 이용한 특성 분석)

  • Jeon, Eun-Suk;Nam, Kun-Woo;Ha, Mi-Sook
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.437-442
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    • 2012
  • The current research examines the aching part and the muscle activity that happens during scaling practice subject to 20 dental hygienic students and therefore propose a basic data according to the working attitude of the Dental Hygienist. During the scaling we used the free EMG (BTS Inc., Milan, Italy) to measure the muscle activity, and in order to check the musculoskeletal pain area we used the Nordic-style questionnaire, and the measured research results are as following: At the moment of scaling according to posture the occurrence of the pain showed no difference among the groups elbow, back, leg, knee, ankle/foot but in the neck, shoulder, wrist/hand, waist showed a high difference in the degree of pain according to posture. Results from measuring the muscular activity according to posture, in the group that had a good posture, the trapezius and brachial muscles showed a change according to time, and in the group that had a bad posture a high muscle activity was shown in larynx, trapezius and brachial muscles. In the muscle activity, the changing aspect between the two parts, the group that fulfilled a scaling in a good posture showed a low muscle activity, but in the group that fulfilled the scaling in a bad posture the muscle activity increased excessively. Therefore we examined that when fulfilling a scaling maintaining a bad posture can help in using more effectively the activity of the muscle, in the future I think there is a need to raise the office efficiency by subjecting to dental hyginiest that are in the clinics and performing experiments.

Thoracoscopic Thoracic Sympathectomy for Reflex Sympathetic Dystrophy -One Case Report - (반사성 교감신경 위축증의 흉강경하 흉추교감신경절제술 - 치험 1례 -)

  • Kim, Tae-Sik;Kim, Kwang-Taik;Kim, Hyoung-Mook;Kim, Hak-Jei;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.208-211
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    • 1998
  • Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.

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A Feature of Maintaining the Maximum Bite Force on Central Incisors in Adult Females with Signs and Symptoms of Temporomandibular Disorders (측두하악장애를 가진 성인여성에 있어 중절치부 최대교합력 유지양상)

  • Kim, Chung Min;Shin, Geum Baek
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.47-52
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    • 1987
  • In order to evaluate the effect of signs and symptoms of temporomandibular disorders on the bite force of anterior teeth, the author estimated a feature of maintaining the maximum bite force on central incisors in Korean 34 adult females with signs and symptoms of temporomandibular disorders (TMD group) and in Korean 31 adult females within normal masticatory function far from any sign or symptom of TMD (control group), and analyzed the data statistically. The obtained results were as follows: 1. There was not a significant difference of the maximum bite force on central incisors between TMD group and control group (P>0.05). 2. The duration of maintaining the maximum bite force on central incisors in TMD group was shorter than it in control group (P<0.01).

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Clinical Characteristics of Headaches in Temporomandibular Disorder Patients : Primary Headache vs Headache Attributed to TMD (측두하악장애 환자의 두통 양상의 분류 : 일차성 두통 vs 측두하악장애로 인한 두통)

  • Ryu, Ji-Won;Bae, Kook-Jin;Hong, Seong-Ju;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.325-331
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    • 2009
  • The objective of this study was to describe the prevalence of the headache attributed to Temporomandibular disorder(TMD) symptoms and to investigate the relationships of headache and TMD. 66 patients seeking care for signs and symptoms of Temporomandibular disorders(TMD) and Orofacial pain in the department of oral medicine, Dental Hospital, Chosun University, from January, 2008 to June, 2008, were recruited. The obtained results were as follows : 1. A muscle and TMJ origin combined was the most common in study populations(54.55%), grouped as TMD classification. 2. Tension type headache was the most common in study population(89.39%), grouped as headache classification. 3. 36 patients out of 66(54.55%) had headaches which related to TMD. 4. Out of 36 patients who had suffered the headache which were attributed to TMD, 19 patients(52.78%) described that their headache related to TMD was different from their own primary headaches. In conclusion, headache attributed to TMD is relatively common in the patients who had headaches and TMD symptoms together. And the new headache patterns may related to headache and TMD chronification. Larger-scale studies and more specified and controlled comparison study is needed to confirm the relationship between the headache and TMD.