• 제목/요약/키워드: Pain Term

검색결과 759건 처리시간 0.027초

Arthroscopic Synovectomy of the Knee in Rheumatoid Arthritis (류마토이드 관절염에서 슬관절의 관절경적 활액막 절제술)

  • Chung, Jae-Hoon;Park, Il-Sung;Yang, Dong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • 제1권1호
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    • pp.91-97
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    • 1997
  • There has been a controversy about the effectiveness of the synovectomy of the knee in the rheumatoid arthritis. So we studied to determine if the arthroscopic synovectomy of the knee was of benefit in the rheumatoid arthritis. We ana lysed 25 knees of 15 patients who underwent the arthroscopic synovectomy of the knee joint for their rheumatoid arthritis from Jun. 1995 to Oct. 1996. The average follow-up period was 20.1 months($12\~28$ months). The results were as follows; 1. Satisfactory results were obtained in 20 knees $(80\%)$ for the pain and the effusion each, 23 $(92\%)$ for the range of motion and 19 $(76\%)$ for the functional capacity. 2. In the overall results for the pain. effusion. range of motion and the functional capacity. we obtained excellent results in 14 knees $(56\%)$ and satisfactory results in 9 knees $(32\%)$. 3. In the patient's self assessment, 11 patients $(44\%)$ were delighted and 10 patients $(40\%)$ were satisfactory. 4. In the overall results according to the articular cartilage damage, satisfactory results were obtained in 15 $(93\%)$ out of 16 knees in Grade I and II, and 6 $(75\%)$ out of 8 knees in Grade III and IV. In conclusion, arthroscopic synovectomy could be one of very useful treatments for the rheumatoid knee. But further study is needed to get the long-term results of the synovectomy because there's many reports saying gradual decrease of good results with increasing time. And continuous and proper medical treatment including DMARDs, is needed to effectively control the rheumatoid arthritis even after the synovectomy.

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Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome

  • Hosseinian, Mohammad Ali;Loron, Ali Gharibi;Soleimanifard, Yalda
    • Journal of Chest Surgery
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    • 제50권1호
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    • pp.36-40
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    • 2017
  • Background: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. Methods: In this study, 448 patients with symptoms of TOS were assessed. The male-to-female ratio was approximately 1:4, and the mean age was 34.5 years. Overall, 102 operations were performed, including unilateral, bilateral, and reoperations, and the patients were retrospectively evaluated. Of the 102 patients, 63 underwent the supraclavicular approach, 32 underwent the transaxillary approach, and 7 underwent the transaxillary approach followed by the supraclavicular approach. Complications were evaluated over 24 months. Results: The prevalence of pneumothorax, hemothorax, and vessel injuries in the transaxillary and the supraclavicular approaches was equal. We found more permanent and transient brachial plexus injuries in the case of the transaxillary approach than in the case of the supraclavicular approach, but the difference was not statistically significant. Persistent pain and symptoms were significantly more common in patients who underwent the transaxillary approach (p<0.05). Conclusion: The supraclavicular approach seems to be the more effective technique of the two because it offers the surgeon better access to the brachial plexus and a direct view. This approach for a TOS operation offers a better surgical outcome and lower reoperation rates than the transaxillary method. Our results showed the supraclavicular approach to be the preferred method for TOS operations.

Treatment of Intractable Hiccup with Midazolam and Baclofen -A case report- (Midazolan과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험 -증례 보고-)

  • Yang, Nae-Yun;Moon, Dong-Eon;Park, Cheol-Joo;Kwon, Ou-Kyoung;Park, Chong-Min;Shim, Jae-Yong;Choi, Jong-Ho
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.246-249
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    • 1997
  • Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

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Ryodoraku Application for Diagnosis : a Review of Korean Literature (양도락의 진단적 활용에 대한 문헌 고찰 - 국내문헌을 중심으로 -)

  • Noh, Seung-Hee;Kim, Kun-Hyung;Yoon, Young-Jin;Yang, Gi-Young;Kim, Jae-Kyu;Lee, Byung-Ryul;Yim, Yun-Kyoung
    • Korean Journal of Acupuncture
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    • 제28권4호
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    • pp.125-135
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    • 2011
  • Objectives : This study is aimed to evaluate the diagnostic value of Ryodoraku for traditional Korean medicine practice reported in the Korean literature. Methods : A search of seven Korean databases was performed up to May 2011 using the search term 'Ryodoraku(in Korean)'. All clinical studies on diagnostic Ryodoraku characteristics were included. Results : The search yielded 59 studies, of which 5 were considered suitable for this analysis. Four were observational studies. Only one was a controlled trial. Average Ryodoraku score(RS), mean values for each measure point, physiologic limit, number of Pyesaek and Gyeokcha, and pattern classification were used as references for the analysis. Correlations were observed between average RS and idiopathic Parkinson's disease, some sub-groups of respiratory disease, chronic low back pain, and menopause. Some mean values for measure points showed particularly high or low tendencies in patients with idiopathic Parkinson's disease, chronic low back pain, and menopause. Positive correlations were observed between the number of Pyesaek and H-Y stage in idiopathic Parkinson's disease and F2(肝) and the modified Kupperman's index with menopausal women. The four classes, organized based on Ryodoraku pattern, showed differences in various characteristics. Conclusions : Since only five studies met the experimental conditions, this evaluation of the diagnostic value of Ryodoraku in various situations is limited. Future studies should be conducted using various physiologic and pathologic situations.

An Observation of the Chief Complaints of Pediatric Outpatients (소아(小兒) 외래환자(外來患者)의 주소증(主所症)에 관한 임상적(臨床的) 고찰(考察))

  • Lee Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • 제15권1호
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    • pp.203-216
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    • 2001
  • Objective : The purpose of this study is to investigite the more effective oriental medical treatment in pediatric diseases and its clinical applicability and chief complaints at oriental pediatrics in an area of busan and kyeungnam. Method : 884 new patients of theirs ages between 0 term 20 years who were treated at the pediatrics in Dong-Eui Oriental Medicine Busan Hospital from 1. 2000 to 29. Feb. 2001 Result : 1. The number of male cases was 514 (58%) and female cases 370 (42%) an so male cases 1.38 more than female. In age distribution, 0-1year: 242 patients(27.4%), 2-6years: 455 patients(51.4%), 7-20years: 187 patients(21.2%). 2. The Chief Complaint according to systemical division was Resparatory diseases (37.4%) for common cold, chronic cought, take a easy cold etc and the Digestive diseases(23.6%) for anorexia, diarrhea, abdominal pain etc and Nervous also Mental(11.8%) diseases for sezure, tic, etc and Allergic diseases(6.2%) for atopic dermititis, allergic rhinitis, etc and Physique diseases(5.4%) for short stature, leg pain, etc and Genaral symptoms(4.5%) for sweat profusely, headache, etc and Urinary diseases(3.3%) for bed wetting, frequently voiding, etc Discussion : 1. The Chief Complaint cannot be found a regional specificity 2. The oriental medicine treatment was still congnated as a way to improve the weakness by patients, also was widely noised about preventive medicine. In particular, Respiratory and Disestive diseases are dependent on the oriental medicine. 3. The new diseases and the new treatment method should be investigated as field of oriental medical treatment.

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Comparison of polyethylene glycol 4000 and lactulose for treatment of chronic functional constipation in children (소아의 만성 기능성 변비 치료에 polyethylene clycol 4000과 락툴로스의 효과 비교)

  • Uhm, Ji Hyun
    • Clinical and Experimental Pediatrics
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    • 제50권8호
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    • pp.752-756
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    • 2007
  • Purpose : The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 4000 without electrolytes and lactulose, evaluating the efficacy and safety for the treatment of constipation in children. Methods : Fifty-six children with chronic functional constipation were randomly assigned to receive polyethylene glycol 4000 (24 patients) or lactulose (32 patients). Patients or their parents reported defecation frequency, stool consistency, abdominal pain, stool incontinence and side effects after 1, 3, 6 and 12 months of treatment. Percentage of recovered patients were compared with each group. Results : Defecation frequency, abdominal pain and stool incontinence were improved in each group. At 12 months of follow up, 60% of patients treated with polyethylene glycol and 57.7% of patients treated with lactulose were considered as recovered. Conclusion : In this study, both polyethylene glycol and lactulose were equally effective and safe in the long-term treatment of constipation in children. There were no significant differences in recovery rates between 2 groups.

Prolotherapy for the Upper Extremity (상지에서의 증식치료)

  • Shin, Keun Man
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • 제1권2호
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    • pp.117-121
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    • 2008
  • Prolotherapy can be defined as the injection of growth factors or growth factor production stimulants to grow normal cells or tissue. Even though it has been a controversal procedure for decades, it is currently gaining in popularity among many physicians. The term prolotherapy was coined by Hacket in the 1950s to imply proliferation of normal tissue at ligamentous and tendinous entheses. The procedure has been described by other terms, such as sclerotherapy, regenerative injection therapy, and stimulated ligament repair. Incomplete healing from sprains or strains is common and can lead to chronic pain, joint instability and laxity, and is a risk factor for the development of osteoarthritis. Prolotherapy is commonly used for these musculoskeletal conditions which are refractory to usual care therapies. The proliferant solution and technique varies according to physicial training and preferance. Commonly reported proliferants include 10% to 25% dextrose, P2G and sodium morrhuate. High resolution ultrasound imaging of musculoskeletal tissue is increasing in popularity because of patient tolerability, low cost, ability to visualize tissue in real time motion and superior resolution of highly organized tissue such as a tendon. This procedure can be introduced by ultrasound imaging and tissue growth and repair after this procedure in a tendon or a ligament can be documented with ultrasound.

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Using Quality of Life Scales with Nutritional Relevance after Gastrectomy: a Challenge for Providing Personalized Treatment

  • Lee, Seung Soo;Yu, Wansik;Chung, Ho Young;Kwon, Oh Kyoung;Lee, Won Kee
    • Journal of Gastric Cancer
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    • 제17권4호
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    • pp.342-353
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    • 2017
  • Purpose: This study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact. Materials and Methods: This study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared. Results: Multiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22). Conclusions: Long-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

Review of Literatures for Development of Clinical Trial Guideline for Total Ankle Arthroplasty (인공발목관절의 임상시험 가이드라인 개발을 위한 문헌적 고찰)

  • Park, Jin Oh;Lee, Moses;Lee, Jin Woo;Lee, Soo Bin;Han, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • 제18권4호
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    • pp.195-201
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    • 2014
  • Purpose: The purpose of this study is to develop guidelines for clinical trial of the total ankle replacement system for premarket approval. Materials and Methods: We selected and analyzed nine peer-reviewed articles whose quality had been proven in a previous phase. Two investigators extracted parameters for guideline criteria, including number of cases, patient age, follow-up period, failure rate, radiographic osteolysis rate, residual pain rate, and percentage of satisfaction. In addition, the inclusion and exclusion criteria were analyzed and developed. Results: Eight level IV studies and one level II study were included. The average number of cases was 159 cases and the mean patient age was 63.5 years. The mean follow-up period was 4.2 years, ranging from two to nine. The average failure rate of total ankle replacement in mid- to long-term follow-up was approximately 13% (2%~32.3%). The rate of osteolysis was approximately 18%. Residual pain was common (21.4%~46%), but overall patient satisfaction was approximately 85.6% (67.5%~97%). Conclusion: The results could be used as criteria for designing the clinical studies, such as number of cases, patient age (over 60 years), and follow-up period (minimum two years). The clinical scoring system and 36-item short form health survey (SF-36) was the most commonly used method for clinical evaluation for total ankle arthroplasty. In addition, the overall results, including failure rate, osteolysis rate, and patient satisfaction, could be used as a parameter of guidelines for premarket approval.

Clinical Outcomes after Percutaneous Vertebroplasty for Pathologic Compression Fractures in Osteolytic Metastatic Spinal Disease

  • Lim, Bong-Suk;Chang, Ung-Kyu;Youn, Sang-Min
    • Journal of Korean Neurosurgical Society
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    • 제45권6호
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    • pp.369-374
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    • 2009
  • Objective : Percutaneous vertebroplasty (VP) can provide immediate stabilization in pathologic fractures of spinal tumors. However, long term follow-up data in cases of pathologic fractures are lacking. The authors report follow-up results of VP in 185 pathologic fractures of 102 spinal tumor patients. Methods : Percutaneous VP was performed at 185 vertebral bodies of 102 patients from 2001 to 2007. Retrospective analysis was done with medical records and radiological data. The change of visual analogue score (VAS), vertebral body (VB) height and kyphotic angle were measured preoperatively and on postoperative one day and at 3, 6, and 12 months. Results : The patients were composed of metastatic spine tumors (81%) and multiple myeloma (19%). Involved spinal segments were between T6 and L5. Mean follow-up period was 12.2 months. VAS for back pain was 8.24 preoperatively, 3.59 (postoperative one day), 4.08 (three months) and 5.22 (one year). VB compression ratio changed from 21.33% preoperatively to 13.82% (postoperative one day), 14.36% (three month), and 16.04% (one year). Kyphotic angle changed from $15.35^{\circ}$ preoperatively to $12.03^{\circ}$ (postoperative one day), $13.64^{\circ}$ (three month), and $15.61^{\circ}$ (one year). Conclusion : Immediate pain relief was definite after VP in pathologic compression fracture of osteolytic spinal disease. Although VAS was slightly increased on one year follow-up, VP effect was maintained without significant change. These results indicate that VP could be a safe and effective procedure as a palliative treatment of the spinal tumor patients.