• 제목/요약/키워드: Pain Control

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제세동이 가능한 심정지 환자를 119구급상황관리센터 상황요원이 예측한 지령 분석 (Analysis of Predicted Instructions about Shockable Cardiac Arrest Patients by Dispatcher at 119 Emergency Situation Management Center)

  • 정은경;정지연
    • 한국화재소방학회논문지
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    • 제27권6호
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    • pp.122-128
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    • 2013
  • 본 연구는 2010년 1월 1일부터 2011년 12월 31일까지 2년간 119구급대로 이송된 병원 전 제세동 가능한 심정지 환자를 대상으로 연구를 진행하였으며 연구대상자들의 구급활동일지와 구급지령서를 분석하였다. 119구급상황관리센터 상황요원(Dispatcher)이 가장 많이 예측한 지령은 실신으로 74건(33.3%)이었다. 다양하게 예측된 지령 중 실신, 흉통, 전신쇠약, 기타와 같은 지령은 심정지로 예측 불가능한 지령으로 112건(50.5%)을 차지하였으며, 심정지로 예측 가능한 의식장애, 호흡곤란, 무호흡, 심정지, 경련과 같은 지령은 110건(49.5%)을 차지하였다. 이 때 심정지로 예측 가능한 지령에서 목격자의 심폐소생술이 유의하게 높았다. 이와 같이 상황요원은 환자의 의식평가와 호흡평가를 구체적으로 질문하여 심정지를 정확하게 분류해야하며, 이렇게 분류된 심정지 환자는 목격자가 심폐소생술을 할 수 있도록 지도해야 한다. 또한 상황요원에 의해 심정지로 예측 가능한 지령(49.5%)을 받은 구급대원뿐만 아니라 심정지로 예측 불가능한 지령(50.5%)에서도 심정지가 아니라고 정확하게 판단되지 않았다면 현장 구급대원은 심정지 상황에 대비하여 현장출동 준비를 해야 한다.

대장암 환자의 한약 및 침치료에 대한 국내외 임상연구 결과에 대한 고찰 - Pubmed를 중심으로 (Review on Clinical Studies of Traditional Herbal Medicine and Acupuncture Treatments for Colorectal Cancer Patients)

  • 강윤환;홍미나;한창우;최준용;박성하;김소연
    • 동의생리병리학회지
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    • 제30권4호
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    • pp.219-228
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    • 2016
  • The aim of this study was to collect and analyze the clinical studies of traditional herbal medicine and acupuncture treatments for colorectal cancer patients searched in Pubmed and Cochrane library in English. We collected the clinical studies, including randomized controlled trial, case control study and cohort study, in the PubMed and Cochrane library using keywords 'Colorectal Cancer', 'Korean Medicine', 'Traditional Chinese Medicine', 'Kampo' and 'Acupuncture'. Then we analyzed them according to the objective of the therapy, i.e. improving therapy prognosis, reducing chemotherapy's adverse event and reducing operational adverse event. In case RCT, we evaluate the quality of the study with jadad scale. Total 18 studies were selected. There were 3 studies about improving therapy prognosis, 6 studies about reducing chemotherapy's adverse event and 9 studies about reducing operational adverse event. Traditional medicine might improve therapy prognosis in terms of the survival rate, relapse/metastasis rate, quality of life and immune function. The specific herbal formula, 'Goshajinkigan' might not be successful about reducing chemotherapy's adverse event, peripheral neurotoxicity. 'Hangeshanshinto' might reduce the duration of oral mucositis but it is not clear to reduce the incidence of that. 'PHY906' might reduce the incidence of diarrhea. Acupuncture might reduce operational adverse event such as gastrointestinal dysfunction and pain. And 'Daikenchuto' might not be successful in reducing operational adverse event, gastrointestinal dysfunction. Further studies are needed to clarify the efficacy of traditional herbal medicine and acupuncture for colorectal cancer patients.

무지 외반증의 새로운 변형 Chevron 절골술 (New Modified Chevron Osteotomy for Hallux Valgus)

  • 오인석;김명구;최성욱;반준호
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.126-130
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    • 2004
  • Purpose: In this study, we tried to develop the technique of osteotomy for hallux valgus. The new modified technique of osteotomy was accomplished with even more greater stability, accurate correction of the deformity and more effective than 'chevron' osteotomy in terms of correction of the deformity. Materials and Methods: Between March 1998 and December 2001, 55 cases of new modified osteotomy for hallux valgus were performed for 39 patients, 16 of whom underwent operation of both feet. Operations were made for 34 women and 5 men whose average age was 46 years old (range, $20{\sim}71$ years). Average follow up period was three years (range, $2{\sim}5$ years), and during the follow up, the patients underwent physical examination and assessment with use of the American Orthpaedic Foot and Ankle Society's hallux-metatarso-phalangealinterphalangeal scale and standard foot radiographic measurements. Results: 37 patients (53 cases) out of 39 patients (55 cases) had no pain, good cosmesis, and all of the patients were satisfied with the results of the operation. Two had occasional mild discomfort. The average score according to the hallux-metatarso-phallangeal-interphalangeal scale was 93.2 points (range, $78{\sim}100$ points). The average preoperative intermetatarsal angle was $14.4^{\circ}$, which was decreased to $7.9^{\circ}$ after the osteotomy with an average correction of $6.5^{\circ}$ and The average preoperative hallux valgus angle was $34.1^{\circ}$, which was decreased to $11.1^{\circ}$ after the osteotomy with an average correction of $23^{\circ}$. This new modified technique would prevent the angulation or shortening at the osteotomy site and it was also even more stable at osteotomy site, and could do even more effective and accurate correction of the deformity than conventional Chevron osteotomy. Conclusion: New modified chevron osteotomy for the treatment of symptomatic hallux valgus was done in 55 cases, and the results were satisfactory in all cases. This method was more stable at the osteotomy site than conventional Chevron osteotomy and was also possible to do more accurate and more effective correction of the deformity. It was also easy to control the distal fragment of first metatarsal bone.

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Effect of Dietary Calcium on Spinal Bone Fusion in an Ovariectomized Rat Model

  • Cho, Jae-Hoon;Cho, Dae-Chul;Yu, Song-Hee;Jeon, Young-Hoon;Sung, Joo-Kyung;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.281-287
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    • 2012
  • Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

  • Kim, Ho Jung;Bak, Koang Hum;Chun, Hyoung Joon;Oh, Suck Jun;Kang, Tae Hoon;Yang, Moon Sool
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.359-364
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    • 2012
  • Objective : Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods : From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results : The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively $7.16{\pm}2.1$ and $8.03{\pm}2.3$ in the IFD and pedicle screw groups, respectively, and improved postoperatively to $1.3{\pm}2.9$ and $1.2{\pm}3.2$ in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029) Conclusion : Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

Gamma Knife Radiosurgery Using Co-Registration with PET-CT and MRI for Recurrent Nasopharyngeal Carcinoma with Previous Radiotherapy : A Single Center 14-Year Experience

  • Lee, Chaejin;Park, Seong-Hyun;Yoon, Sang-Youl;Park, Ki-Su;Hwang, Jeong-Hyun;Hwang, Sung-Kyoo
    • Journal of Korean Neurosurgical Society
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    • 제63권3호
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    • pp.397-405
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    • 2020
  • Objective : We retrospectively evaluated the efficacy of Gamma Knife radiosurgery (GKS) for recurrent nasopharyngeal carcinoma (NPC) in patients who previously underwent radiotherapy, and analyzed the treatment outcomes over 14 years. Methods : Ten patients with recurrent NPC who had previously received radiotherapy underwent stereotactic radiosurgery using a Gamma Knife® (Elekta Inc, Atlanta, GA, USA) between 2005 and 2018. The median target volume was 8.2 ㎤ (range, 1.7-17.8), and the median radiation dose to the target was 18 Gy (range, 12-30). The median follow-up period was 18 months (range, 6-76 months). Overall and local failure-free survival rates were determined using the Kaplan-Meier method. Results : The NPCs recurred at the primary cancer site in seven patients (70%), as distant brain metastasis in two (20%), and as an extension into brain in one (10%). The recurrent tumors in seven of the 10 patients (70%) were found on the routine follow-up imaging studies. Two patients presented with headache and one with facial pain. Local failure after GKS occurred in five patients (50%) : two of whom died eight and 6 months after GKS, respectively. No adverse radiation effects were noted after GKS. The 1- and 3-year overall survival rates after GKS were 90% and 77%, respectively. The local failure-free survival rates at 6 months, 1 year, and 3 years after GKS were 80%, 48%, and 32%, respectively. The median interval from GKS to local failure was 8 months (range, 6-12). Univariate analysis revealed that using co-registration with positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) was associated with a lower local failure rate of recurrent NPC (p=0.027). Conclusion : GKS is an acceptable salvage treatment option for patients with recurrent NPC who previously received radiation therapy. PET-CT and MRI co-registration for dose planning can help achieve local control of recurrent NPC.

건강증진 보건교육 경험이 노인의 현재 건강상태에 미치는 영향 (Effects of health promotion education experience on present health status of elderly)

  • 이흥훈;황은정
    • 한국산학기술학회논문지
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    • 제20권11호
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    • pp.106-114
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    • 2019
  • 이 연구의 목적은 노인이 경험한 건강증진과 만성질환관리 보건교육, 정신문제 상담 경험이 현재 건강상태에 미치는 효과를 확인하는 것이다. 이 연구는 '2017년 지역사회 건강조사' 자료를 활용하여 65세 이상 노인 10,532명을 최종 대상자로 선정하였다. 건강증진 교육경험에는 손씻기 교육 및 홍보 경험, 금연 캠페인 경험, 금연교육 경험으로 구성되었다. 만성질환관리 교육 경험은 고혈압, 당뇨병, 또는 관절염 관리 보건교육 경험으로 구성되었다. 정신문제 상담 경험은 스트레스, 우울, 자살을 포함한 정신문제 관련 상담 경험으로 구성되었다. 현재 건강상태는 운동능력, 자기관리, 일상활동, 통증/불편, 불안/우울 정도로 구성되었다. 자료분석은 Chi-square test, Mann-Whitney test, 다변량 로지스틱 회귀분석을 활용하였다. 연구대상자의 일반적 특성은 남자가 4,075명(38.69%)이고, 여자가 6,457명(61.31%)이었으며, 평균연령은 73.71(±6.18)세이었다. 노인 대상자의 현재 건강상태에 영향을 미치는 유의한 요인으로는 연령(OR=0.909, 95% CI=0.886-0.933), 손씻기 교육 및 홍보 경험(OR=2.463, 95% CI=1.703-3.563), 금연캠페인 경험(OR=1.624, 95% CI=1.146-2.301), 정신문제 상담 경험(OR=0.533, 95% CI=0.359-0.791)으로 나타났다. 노인들이 오랫동안 유지해온 개인적 습성을 수정하여 교육의 효과를 보이기 위해서는 대상자의 특성을 고려한 장기간 꾸준한 교육이 효과적일 것이다.

Extremely Low Frequency Magnetic Field is an Environmental Stress Factor by Exerting Oxidative Stress

  • Park, Yong-Jin;Park, Won-Joo;Yim, Sung-Hyuk;Yang, Seong-Jun;Sun, Yuan Lu;Jeong, Ji-Hoon;Park, Eon-Sub
    • Biomolecules & Therapeutics
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    • 제15권1호
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    • pp.58-64
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    • 2007
  • The previous study reported the biological effect of magnetic field exerted by acting on endocrine and anti-oxidant system. The present study aims to study whether ELF-MF (extremely low frequency magnetic field) affects the physiological endocrine systems such as thyroid and whether ELF-MF affects the defense system against oxidative stress when it alters the function of thyroid. Finally, we correlate the effects of MF on oxidative stress, and adrenal and thyroid with an environmental stress factor. We exposed sham or MF to rats for 5 or 25 days. After the exposure, we determined pain sensitivity, level of TSH, $T_3$ and free $T_4$ in plasma. We also assayed in whole brain, lipid peroxidation, the activity of enzymatic anti-oxidant defense including superoxide dismutase(SOD) and glutathione peroxidase (GPx), and non enzymatic defense such as reduced or oxidized glutathione contents. MF induced the hypersensitivity to thermal stimuli with the reduction of latency. $T_3$ and $T_4$ levels were also increased by the exposure of MF. In addition, we observed the rise of MDA level in rat brain by MF although the MF did not change superoxide dismutase and glutathione peroxidase activity. The effect of MF on both reduced and oxidized glutathione results in decrease in reduced or oxidized glutathione in whole brain. In every experiment, there was no significant difference in MF influence between short term (5 days) and long term (25 days) exposure. Taken together, MF exposure affects the thyroid hormonal control in brain. The elevated thyroid hormone acts on brain, leading to hyper-utilization of oxygen. This phenomenon may be correlated with oxidative stress resulting from MF exposure. In conclusion, we suggest that MF exposure may be an environmental stress by exerting oxidative stress.

목단피((牧丹皮).도인(桃仁) 배합(配合)이 항염증(抗炎症) 작용(作用)에 미치는 영향 (Effect of Water Extract of Peonia Suffruticosa and Prunus Percica on Anti-inflammation)

  • 김영일;이성준;허진;이태형;신동근;이재철;신용서;윤용갑
    • 대한한의학방제학회지
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    • 제18권1호
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    • pp.105-120
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    • 2010
  • Paeonia Suffruticosa and Prunus Persica have been used as oriental medicine for removal of fever, alleviation of pain, an anti-phlogistic effect and removal of extravasated blood. However, it has been never shown the effects of these herbal medicines on anti-inflammatory processes. This experiment was performed to show how these herbs could act as anti-inflammatory medicines at cellular level. Anti-inflammation effects of water extracts from Paeonia Suffruticosa and Prunus Persica as well as their mixture have been investigated, and the results were follows; 1) each extract slightly suppressed the expression and production of inflammatory mediators and enzymes such as NO, iNOS, IL-$1{\beta}$, and TNF-$\alpha$ in lipopolysaccharid(LPS)-stimulated RAW264.7 cells and mouse primary peritoneal macrophages in a dose-dependent manner. These suppressive effects, however, were synergistically increased by their mixture. 2) Each extract of Paeonia Suffruticosa and Prunus Persica insignificantly suppressed the activation and activity of NF-${\kappa}B$ in LPS-stimulated RAW264.7 cells, which controls the expression of inflammatory mediators such as NO, iNOS, IL-$1{\beta}$, and TNF-$\alpha$. However, extract mixture of Paeonia Suffruticosa and Prunus Persica suppressed effectively the activation and activity of NF-${\kappa}B$. 3) Each of Paeonia Suffruticosa and Prunus Persica induced translocation of NF-${\kappa}B$ to the nucleus from the cytosol and DNA-binding activity of nuclear NF-${\kappa}B$ in LPS-activated RAW264.7 cells. The extract mixture of Paeonia Suffruticosa and Prunus Persica showed more significant suppression of the NF-${\kappa}B$ translocation and its DNA-binding activity, as compared to those of the each extract. These results suggest that the extract mixture of Paeonia Suffruticosa and Prunus Persica may affect different control mechanisms for NF-${\kappa}B$ activation and the expression and production of NF-${\kappa}B$-dependent inflammatory mediators, indicating that this extract mixture may be useful for treatment of inflammatory diseases.

藏府와 身形의 病機 및 病症에 대한 比較考察 (Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形))

  • 백상룡
    • 대한한의학원전학회지
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    • 제13권2호
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    • pp.21-21
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exegenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usuable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki)穀氣) 내 that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Maridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily froms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and connot fulfil their own functions. Because the meridian symtem unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.