• Title/Summary/Keyword: Pain evaluation

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Clinical Evaluation of Spontaneous Pneumothorax - A Review of 830 Cases - (자연기흉의 임상적 고찰)

  • Gwon, U-Seok;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.299-306
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    • 1988
  • We have reviewed 330 cases of spontaneous pneumothorax from Jan. 1980 to Jul. 1987 at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University. The ratio of male to female was 8.4:1, predominant in male. The incidence according to the age group was highest as 32% in the adolescence between 21 and 30 years old. The site of pneumothorax was right in 48%, left in 45% and bilateral in 7%. The initial symptoms were frequently dyspnea in 85%, chest pain in 63%. The etiologic factors were as follows; bleb origin in 31%, tuberculous origin in 30%, COPD in 3.3%, lung cancer in 1.5%, unknown in 29%. There was no significant difference in seasonal incidence irrespective of tuberculous or sex. The employed managements were as follows; bed rest with oxygen inhalation in 4 cases, closed thoracostomy in 326 cases, open thoracotomy in 122 cases, median sternotomy in 23 cases. The operative procedures at thoracotomy were as follows; simple pleurodesis in 5 cases, bleb excision or wedge resection in 113 cases, segmentectomy or lobectomy in 17 cases, decortication in 42 cases. Recurrence rate of each treatment was as follow; 50% in conservative treatment, 19% in closed thoracostomy, 2% in open thoracotomy, 4% in median sternotomy. Therefore overall recurrence rate was 12%. Open thoracotomy was the most effective procedure in recurrent pneumothorax, previous contralateral pneumothorax, bilateral simultaneous pneumothorax, visible bleb or bullae on the chest x-ray and persistent air leakage. 23 cases of unilateral spontaneous pneumothorax was examined whether or not underlying pathology of pneumothorax at opposite lung. 18 cases[78%] were positive findings. Therefore, bilateral thoracotomy by median sternotomy was a good operative method preventing contralateral pneumothorax.

The Evaluation of Video-Assisted Thoracic Surgery (비디오 흉부수술의 평가)

  • Seong, Suk-Hwan;Kim, Hyeon-Jo;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1015-1022
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    • 1994
  • Over the past few years, video-assisted thoracic surgery [VATS] has been used increasingly for intrathoracic pathologic problems as a less invasive operative techniques. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indications. Using video-assisted operative thoracoscopy, we performed consecutive 150 operations on 148 patients during the initial 2 years of our experience from July 1992 with the following indications: pneumothorax [n=53], hyperhidrosis [n=29], mediastinal mass [n=23], pleural disease [n=13], diffuse parenchymal or interstitial lung disease [n=12], benign pulmonary nodule [n=7], metastatic lung mass [n=3], primary lung cancer [n=3], bronchiectasis [n=2], malignant pericardial effusion [n=2], endobronchial tuberculosis [n=1], esophageal achalasia [n=1], and pulmonary parenchymal foreign body [n=1]. There were no death, and overall complicaton rate was 24.0%[n=36]. The most prevalent complication was persistent air leakage [longer than 5 days] in 14 cases [9.3%]. Persistent pleural effusion [longer than 5 days] occurred in 6 cases [4.0%]. Six patients were converted to an open thoracotomy because of inability to control the operative bleeding [n=3], failed adhesiolysis in bronchiectasis [n=2], and radical excision of an lung cancer [n=1]. Pneumothorax recurred in 3 cases[2.0%]. Other complications were Horner`s syndrome, diaphragm tears, temporary phrenic nerve palsy, hoarseness, subsegmental atelectasis, transient respiratory difficulty, and esophageal mucosal tear. The advantages of this minimally traumatizing operative technique lie in improved visualization, decreased pain, shortened hospital stay, and less postoperative morbidity. The indications of VATS has been extended increasingly to intrathoracic pathologies, but its role in the managements of primary lung cancer and esophageal disease remains to be defined.

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Primary Pulmonary Artery Osteosarcoma Mimicking Acute Pulmonary Artery Embolism - A case report- (급성 폐동맥 색전증으로 의심된 원발성 폐동맥 골육종 -1예 보고-)

  • 박상현;손정환;지현근;신윤철;유병수;박우정;박혜림;김응중
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.929-932
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    • 2004
  • The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.

Radionuclide Penogram in Diagnosis of Vasculogenic Impotence (혈관성 발기부전의 진단을 위한 방사성핵종 음경촬영술)

  • Lee, Jae-Tae;Kim, Kwang-Won;Ha, Sung-Woo;Lee, Kyu-Bo;Whang, Kee-Suk;Yoon, Yeo-Deuk;Park, Yoo-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.209-214
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    • 1989
  • Yasculogenic impotence is produced by abnormalities of vascular blood supply or drainage, and is the most common cause of various organic impotences. An increasing awareness of vascular causes of impotence has resulted from development of various diagnostic tests, but precise measurement of penile blood flow is difficult. Radionuclide penogram has been introduced recently to diagnose vasculogenic impotence. Forty-one impotent patients and 12 normal men were studied with radionuclide erection penogram using Tc-99m pertechnetate and an intracavernous injection of papaverine. We defined arteriogenic impotence as arterial index less than 0.66, and venogenic impotence as venous index greater than 0.09. By this criteria, the false positive ratio in normal men was 17%, and the false negative ratio in radically cystectomized patients was 0%. Side effects were small purpura of the penile shaft and dull pain during injection of papaverine. The radionuclide erection penogram was noninvasive and gave a dynamic evaluation of the arterial supply, venous drainage, and blood flow in the corporeal bodies. This method should be considered as a valuable adjunct to evaluate patients with vasculogenic impotence.

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$^{99m}Tc$-HDP Bone Scintigraphy Finding of Metastatic Renal Cell Carcinoma Bone Lesion Changed from Hot to Cold Lesion: Comparing with $^{18}F$-FDG PET/CT ($^{99m}Tc$-HDP 뼈스캔의 열소에서 냉소로 변한 신세포암 뼈전이 소견: $^{18}F$-FDG PET/CT와의 비교)

  • Seo, Young-Duk;Kim, Seong-Min;Kim, Kun-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.588-591
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    • 2009
  • A 26-year-old man with renal cell carcinoma underwent $^{99m}Tc$-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. $^{99m}Tc$-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. $^{99m}Tc$-HDP bone scintigraphy and $^{18}F$-FDG PET/CT were underwent for further evaluation. $^{99m}Tc$-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in $^{18}F$-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in $^{99m}Tc$-HDP bone scintigraphy and compare with $^{18}F$-FDG PET/CT.

Isolated Glycerol Kinase Deficiency (글리세롤 키나제 단독결핍증)

  • Lee, Jong Yoon;Kim, Hui Kwon;Bae, Eun Ju;Oh, Phil Soo;Park, Won Il;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.54-57
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    • 2012
  • A 3-year-old boy was transferred to emergency room (ER) with lethargy and abdominal pain. Physical examination revealed drowsy mental status but neurologically intact. Basic evaluation in ER shows hypoglycemia (43 mg/dL), hyperglycerolemia, ketonemia and ketonuria. Initial urine organic acid was performed and the result showed severe hyperglyceroluria. Under suspicion of isolated GKD, GKD gene was obtained from his DNA from white blood cell in peripheral blood and sequencing was performed. Isolated glycerol kinase deficiency (GKD) is an X-linked inborn error of metabolism that is either symptomatic or asymptomatic. GKD is due to deletions of, or mutations within, the GK gene, and there is no genotype-phenotype correlation. Gene study that we performed showed normal at a well-known mutation site, but found 4-base insertion at 79 base pair away from the beginning of exon 11.

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Physicochemical and Sensory Characteristics of Cucumber Salad Using Spicy Hot Flavor Graded Gochujang (매운맛 등급화 고추장으로 제조한 오이생채의 이화학적 관능적 특성)

  • Lee, In-Seon
    • Korean journal of food and cookery science
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    • v.31 no.3
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    • pp.255-263
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    • 2015
  • This study investigated the spicy hot flavor related quality characteristics of cucumber salad prepared using spicy hot flavor graded gochujang that had been stored for 60 and 120 days. The results showed that the pH of both the 60-day and 120-day fermented gochujang was significantly higher in the cap-200 sample (p<0.001). In contrast to the results on pH, the acidity of both the 60-day and 120-day fermented gochujang was found significantly lower in the cap-200 sample (p<0.001). Measurements of salinity were found to be significantly lower in the sample with higher capsaicin content than in the sample with lower capsaicin content. The sugar content was found to be generally higher in the sample with the 120-day fermented gochujang than that with the 60-day fermented gochujang. Lightness (L) was higher in the sample with a lower capsaicin content than in the sample with a higher capsaicin content. The redness (a) was found to be significantly higher in the cap-200 sample than in other samples (p<0.001). The values of the L, a, and b tended to be lower in the sample with the 60-day fermented gochujang than in the sample with the 120-day fermented gochujang. The hardness of the cucumber salad was found to be lowest in the 120-day fermented sample with the cap-200 gochujang, which had the highest capsaicin content (p<0.05). The results of the sensory evaluation of the cucumber salads showed that the spiciness was stronger with the higher capsaicin content (p<0.001), and approximately one-level higher than the spiciness rating of hot pepper. The results of a key ingredient analysis showed that the sample with high capsaicin content was classified as having a relatively hot spicy aroma and flavor, and strong stinging pain, and the sample with the low capsaicin content was classified as having a salty aroma and a dark appearance.

Quantitative Analysis of Sennoside A and Anthraquinones for the Guideline for the Quality Control of Rhubarbs (유통 대황의 Sennoside A 및 Anthraquinone 함량분석을 통한 품질관리 기준에 관한 연구)

  • Choi, Hee-Kyoung;Kim, Kyung-Hee;Seo, Yong-Taek;Yook, Chang-Soo;Jang, Young-Pyo
    • Korean Journal of Pharmacognosy
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    • v.42 no.2
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    • pp.144-148
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    • 2011
  • Rhubarb (Rhei Rhizoma) has been used for the various clinical purposes such as purgative, stomach protective and pain relief for a long time. However, rhubarb in current market has a problem of quality control under which many of rhubarb fail to meet the standard specified in Korean Pharmacopoeia. This study was carried out to validate the method for the evaluation of the quality of five rhubarbs and Rumex species; Rheum palmatum, R. officinale, R. tanguticum, R. franzenbachii, R. undulatum, and Rumex species. The content of sennoside A with five anthraquinones (aloe-emodin, rhein, emodin, chrysophanol and physcion) in five rhubarbs and one Rumex has been performed by using HPLC quantitation analysis. In results, only four samples in Palmata sect. were qualified with sennoside A and those samples were R. officinale and R. tanguticum. Samples of R. palmatum did not meet the standard contents of sennoside A. The contents of anthraquinones in Palmata sect. were two times larger than those in Rhapontica sect. Moreover the content variations of anthraquinones were smaller than those of sennoside A. Thus, anthraquinones can be the key characterizing molecules to control quality of rhubarb.

Influence of Microcurrent Therapy in Interleukin-1 Expression in Rhueumatoid Arthritis Rats (미세전류치료가 류마티스 관절염 유발 흰쥐의 Interleukin-1 발현에 미치는 영향)

  • Lee, Hyun-Min;Chae, Yun-Won
    • The Journal of Korean Physical Therapy
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    • v.21 no.2
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    • pp.103-108
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    • 2009
  • Purpose: Electrical stimulation is one of several treatments recommended for RA patients. Electrical stimulation of RA patients, reduces pain, or facilitates joint motion prior to exercises. However, there is still limited evidence on the efficacy of electrical stimulation and thus any conclusions drawn about this method remain controversial. Recently, Microcurrent Electrical Neuromuscular Stimulation (MENS) has received significant attention as a potential method of electrical stimulation. In this study, we investigated the effect of microcurrent treatment in rheumatoid arthritis rat. Methods: Subjects were allocated either to the control group or experimental group, which was subject to microcurrent stimulation. Interleukin-1 expression in the metatarsophlangeal joint and the oedema index in the ankle were used for classification and subsequent evaluation of pathology. Subjects were assessed at 1, 7 and 14 days after inducing rheumatoid arthritis through adjuvant injection. Thirty-six subjects, 18 in each group, were used in this study. Statistical analysis was performed by calculating the differences between the two groups and between each interval assessment. Categorical variables were compared between the two groups with the paired-T test. The one-way ANOVA test was performed to assess changes in ordinal variables. Results: Baseline characteristics were similar in both groups. Statistically significant differences were found between the two groups. The biological marker of pro-inflammatory cytokine and oedema index were decreased in response to this treatment. Conclusion: These data show that treatment of rheumatoid arthritis with a microcurrent stimulation device reduced the oedema index and pro-inflammatory cytokine IL-1.

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Feasibility study of insertable miniature x-ray source for dental imaging (치과 영상용 삽입형 초소형 X선 튜브의 가능성 연구)

  • Cho, Sung-Ho;Kim, So-Yeong;An, So-Hyun;Lim, Soo-Mee;Lee, Re-Na
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.39-45
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    • 2012
  • Conventional periphery radiography system has a various problem such as patient dose and the pain of X-ray examination. In this paper, to solve these problems, we suggested insertional miniature x-ray system and we verified the feasibility of this system. First, we performed the Geant4 x-ray simulation to design x-ray collimator and filter to use miniature x-ray tube and we decided optimized thickness of filter and collimator. Also, we measured x-ray spectrum using CdTe detector and PX4 module to verify simulation results. Also, we acquired teeth image of fabricated phantom using conventional dental x-ray and prosed miniature x-ray system. As a results, our system has good image quality as compared to those of conventional systems. Our evaluation of the proposed system indicates that it can be potentially very useful for dental imaging.