• 제목/요약/키워드: Pain improvement

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족근관 증후군의 수술적 치료 (Surgical Treatment of Tarsal Tunnel Syndrome)

  • 안재훈;김갑중;김하용;최원식;양대석
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.187-191
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    • 2007
  • Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.

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원인이 밝혀진 족근관 증후군의 수술적 치료의 결과 (Clinical Results of Tarsal Tunnel Decompression in Case of Known Etiology)

  • 성기선;박세준
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.192-197
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    • 2007
  • Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

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교합안정장치 사용후 하악과두의 위치변화에 관한 연구 (A STUDY ON THE CHANCES OF CONDYLAR POSITION AFTER USE OF THE OCCLUSAL BITEPLANE SPLINT)

  • 송영복;김인권;이호용
    • 대한치과보철학회지
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    • 제26권1호
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    • pp.171-184
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    • 1988
  • The establishment of an optimal and functional condylar position (centric relation) as the therapeutic and diagnostic reference position during occlusal treatment for patients with temporomandibular joint and muscle pain. dysfunction has long been an important subject in dentistry. The objective of this study was to compare the reproducibility md the changes of condylar position in normal group to those in patient group after use of the occlusal biteplane splint. For this study, 11 normal adults who had no symptoms of masticatory dysfunction and 18 patients who had visited at the department of occlusion in dental infirmary of Yonsei University were selected. For each subject three centric relation records were recorded before treatment, after 2 weeks and after symptoms were improved. And the condylar positions in centric relation were measured using articulators and a Vericheck. On the basis of this study, the following results were obtained. 1. In normal group, there was no significant difference of reproducibility in condylar position before and after the use of the occlusal biteplane splint for 2 weeks. 2. In patient group there was significant improvement in the reproducibility of condylar position after treatment (P<0.01). The reproducibility in patient group, however, was less than normal group. (P<0.01) 3. The mean distance of condylar movements was $0.38{\pm}0.22mm$ after 2 weeks in normal group. 4. In patient group, condylar movements were $1.36{\pm}0.70mm$ (P<0.01), significantly different from normal group. (P<0.01) 5. In patient group, the main direction of condylar movements after treatment was toward anterior and superior, preponderance being at superior direction.

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월경곤란증의 자하거 약침효과에 관한 연구 (Effect of Hominis placenta Pharmacopuncture on the Dysmenorrhea (A Pilot study, Single blind, Randomized, Controlled Clinical Trial))

  • 김수민;장선희;김철홍;윤현민;송춘호;안창범;장경전
    • 대한약침학회지
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    • 제11권3호
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    • pp.123-131
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    • 2008
  • Objective: This study was designed to evaluate the effect of Hominis placenta Pharmacopuncture treatment on Dysmenorrhea of Women. Methods: 49 subjects who were suffering from dysmenorrhea volunteered to answer the MMP(Measure of Menstrual Pain) and MSSL(Menstrual Symptom Severity List) questionnaire. They were divided into two groups, a Hominis placenta Pharmacopuncture treatment group(Experiment al group, n=25) and a Normal Saline(N/S) treatment group(Control group, n=24). The two groups were injected on the $CV_4,\;S_{36},\;Sp_9$ and $Sp_6$ acupuncture point. They were treated totally five times depending on the individual menstruation cycles. The scores of MMP and MSSL were measured overall three times before and after the menstruation cycle. The collected data were analyzed as paired t-test, independent t-test using SPSS 12.0 WIN Program. Results: As a result of the evaluation by MMP and MSSL, a significant improvement on dysmenorrhea was made in the two groups(p<0.05), and both scores of Experiment group were decreased more than Control group. But there was no significant difference between the two groups. Conclusions: The Hominis placenta Pharmacopuncture treatment and the Normal Saline treatment were effective in decreasing the symptom of Dysmenorrhea.

비소세포성 폐암 4기 환자의 악성흉수로 인한 증상이 이음전가미방으로 호전된 1례 (A Case Report of a Stage IV Non-small Cell Lung Cancer Patient Treated with Modified Yieum-jeon Showing Improvement in Malignant Pleural Effusion and other Respiratory Symptoms)

  • 박소정;강휘중;이연월;조종관;유화승
    • 대한한방내과학회지
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    • 제35권3호
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    • pp.366-372
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    • 2014
  • Objectives: This is a report of a case of a stage IV non-small-cell lung cancer (NSCLC) patient whose malignant pleural effusion & respiratory symptoms have been relieved with Korean medicinal prescription, modified Yieum-jeon. Methods: A 56-year-old male diagnosed with stage IV NSCLC suffering malignant pleural effusion with complaints of cough, sputum, bilateral leg edema, dysphagia, post neck and left scapular pain was treated with modified Yieum-jeon and acupuncture during 16days. After treatment, blood lab and chest X-ray were used to follow the condition of malignant pleural effusion & pulmonary symptoms. Results: Malignant pleural effusion and pulmonary symptoms were improved with modified Yieum-jeon intake without any related adverse side effects. Conclusions: This study suggests Yieum-jeon may play a positive role in improving the malignant pleural effusion symptoms in advanced lung cancer cases.

갑상선 전절제술 후 부갑상선기능저하증이 발생한 갑상선암 환자의 인삼양영탕을 활용한 한양방 복합 치료 증례 보고 1례 (A Case Report of a Thyroid Cancer Patient with Hypoparathyroidism after Total Thyroidectomy by a Combination of Korean-Western Medicine Treatment Including Insamyangyoung-tang)

  • 김두리;이수영;이현승;문병순;윤종민
    • 대한한방내과학회지
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    • 제39권4호
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    • pp.814-821
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    • 2018
  • Thyroid cancer is one of the most common cancers in Korea, and thyroidectomy is the first-line treatment. Hypoparathyroidism is a common complication of thyroidectomy and can cause symptoms such as numbness, spasm, and anxiety, but these issues have seldom been reported in the Korean medical literature. The present case was a 53-year-old thyroid cancer patient who complained of numbness caused by hypoparathyroidism, general weakness, fatigue, and postoperative pain after total thyroidectomy. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion, and her changes in clinical symptoms were measured with a numeric rating scale (NRS), the Karnofsky performance status scale (KPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). After treatment, her clinical symptoms were improved, leading to an improvement in her quality of life. Therefore, Korean medicine may be effective in the treatment of thyroid cancer patients who experience numbness caused by hypoparathyroidism, general weakness and fatigue after total thyroidectomy.

종격동에 발생한 성장 기형종 증후군(Growing Teratoma Syndrome)의 치험 -1예 보고- (Treatment of Mediastinal Growing Teratoma Syndrome - A case report -)

  • 조종호;손호성;조원민;민병주;이인성;신재승
    • Journal of Chest Surgery
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    • 제38권10호
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    • pp.729-732
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    • 2005
  • 특이 병력 없던 15세 남자가 내원 한 달 전부터 시작된 우측 흉통과 함께 기침을 호소하여 본원 응급실로 내원하였다. 흉부 전산화 단층촬영에서 $10\times15\times16cm$크기의 전 종격동 종양으로 상대 정맥과 심장을 압박하면서 침범하고 있는 소견을 보였다. 수술 절제가 불가능한 것으로 판단하여 항암 및 방사선 치료를 시행하였다. 이후 종양 표지자는 거의 정상화되었으나 오히려 종양의 크기가 증가하는 소견을 보여, 종격동의 성장 기형종 증후군(Mediastinal Growing Teratoma Syndrome)으로 판단되어 수술을 시도하였다. 종양의 수술적 제거 후 환자는 24개월째 잔존 종양 및 재발 없이 외래 관찰 중이다.

편도주위농양에 합병된 하행 괴사성 종격동염 -치험 1례- (Descending Necrotizing Mediastinitis Secondary to Peritonsillar Abscess -A Case Report-)

  • 최필조;이용훈;우종수;이기남;손춘희;박헌수;이인규
    • Journal of Chest Surgery
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    • 제32권7호
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    • pp.686-689
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    • 1999
  • 하행 괴사성 종격동염은 구강인두와 경부 염증의 드문 합병증 중의 하나로서, 높은 사망률과 합병증 등을 낮추기 위해 조기에 적극적이고 효과적인 수술적 배농술이 필요하다. 39세 남자 환자가 연하통, 경부 종창, 연하곤란 및 호흡곤란으로 내원하여 촬영한 경부 CT상 편도주위농 양과 인두 후부 및 주위의 농양이 발견되어 이비인후과에서 경부절개를 통한 배농술을 시행하였다. 1차 수 술 이후에 발열, 양측 견갑통이 재발하였으며 재촬영한 경부 및 흉부 CT에서 종격동 농양이 발견되어 경부 배농술과 더불어 개흉술을 통한 종격동 배농술을 시행하였다. 수술시에 시행한 종격동 농양과 농흉, 그리고 객담으로부터의 균배양 결과 Klebsiella pneumona로 밝혀졌다. 2차 수술후 환자는 호전되어 술후 85일째 퇴원 할 수 있었다. 결론적으로 CT촬영으로 하행 괴사성 종격동염을 조기에 진단하고 경부 배농술 뿐만 아니라 개흉술을 통한 광범위하고 효과적인 배농술이 환자의 생존율을 높이는데 도움이 되리라 본다.

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진행된 키엔벡 병에서의 방형회내근 유경 요골 피판을 이용한 관절성형술의 중장기 결과 (Mid to Long-term Outcome of Vascularized Pronator Quadratus-wrapped Radial Bone Flap Arthroplasty for Advanced $Kienb{\ddot{o}}ck's$ Disease)

  • 공현식;백구현;이영호;김세훈;조영재;정문상
    • Archives of Reconstructive Microsurgery
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    • 제15권2호
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    • pp.101-106
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    • 2006
  • The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.

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만성 두통에 대한 뇌청혈해독탕의 임상적 효과 (The clinical effect of Noechongyolhaedok-tang on the chronic headache)

  • 김제영;이시섭;유정석;송범용;김락형;육태한
    • 동의신경정신과학회지
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    • 제18권1호
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    • pp.133-142
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    • 2007
  • Objective : Chronic headache is the most common headache. The objective of this study is to find the clinical manifestation of chronic headache and has been carried out to investigate the effects of Noechongyolhaedok-tang on the chronic headache. Method : This observation was carried out on 73 patients with chronic headache. They were applied to Noechongyolhaedok-tang and the degree of improvement of chronic headache was evaluated by VAS. Results : 1. Distribution of study population by sex, age : male : female = 1 : 3, 30s-50s group = 81% Duration of onset : over 10years = 48% Reported site of chronic headache : the whole = 28% Clinical pain characteristics : be torn = 25% Frequency of headache : everyday = 72% Time of attack : irregular = 52% 2. In VAS scores, there were significant differences between before and after Noechongyolhaedok-tang treatment. There were no differences between before and after treatment in each sex and the duration of onset Conclusion : The effectiveness of Noechongyolhaedok-tang on the chronic headache was shown through VAS. Further study is needed about Noechongyolhaedok-tang.

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