Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
Journal of Trauma and Injury
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v.26
no.4
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pp.304-307
/
2013
Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.
We made a comparative study, A patient who had suffered dizziness and ataxia took Hyungbangsabaek-san(荊防瀉白散) at first and next took Hyungbangdojeock-san(荊防導赤散). He was diagnosed as a Soyangin suffering chest knotting syndrome(結胸證) by Sasang constitutional medicine(四象醫學) and took two kinds of herbs in a row. We observed his phase of dizziness and ataxia with the conditions of stool and urine excavation, pink eye, sweating, and tongue color and tongue coating. When he took Hyungbangdojeock-san these conditions improved more than when he took the other one and his dizziness and ataxia also improved. Hyungbangdojeock-san was more useful when the severity of the disease was shallower and he had more exterior syndromes than Hyungbangsabaek-san.
Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.
Background: Although it is rare for the fracture itself to become a life threatening injury in patients suffering from rib fracture, the lives of these patients are occasionally threatened by other associated injuries. Especially, early discovery of patients with rib fracture and intra-abdominal organ injury is extremely important to the prognosis. This study analyzed the link between rib fracture and intra-abdominal injury to achieve improved treatment. Materials and Methods: Among trauma patients that had visited the hospital emergency room from January 2007 to December 2009, a retrospective study was conducted on 453 patients suffering from rib fracture due to blunt trauma. Rib fracture was classified according to location (left, right, and bilateral), and according to level (upper rib fracture [1-2nd rib], middle rib fracture [3-8th rib], and lower rib fracture [9-12th rib]). The researched data was statistically compared and analyzed to investigate the correlation between the location, level, and number of rib fracture and intra-abdominal organ injury. Results: Motor vehicle injury was found to be the most common mechanism of injury with 208 cases (46%). Associated injuries accompanied with rib fracture were generated in 276 cases (61%). Intra-abdominal organ injury was discovered in 97 cases (21%). Liver injury was the most common intra-abdominal injury associated with rib fracture with 39 cases (40%), followed by spleen injury, with 23 cases (23%). Intra-abdominal injury according to level of rib fracture was presented as upper rib fracture in 11 cases (11%), middle rib fracture in 31 cases (32%), and lower rib fracture in 55 cases (57%), thus verifying that intra-abdominal injuries were commonly accompanied in lower rib fractures (p=0.03). In particular, significant increase of intra-abdominal injury was presented in fractures below the 8th rib (p=0.03). The number of intra-abdominal injuries requiring emergency operations was significantly higher in patients with more than 6 rib fractures (p=0.04). Conclusion: Intra-abdominal organ injury is more common in patients with lower rib fracture, especially fractures below the 8th rib. Intra-abdominal organ injuries generated in multiple rib fracture patients with more than 6 fractures significantly higher severity. These cases must be thoroughly inspected and carefully observed as there is possibility of emergency operation.
This analysis has been projected as a preliminary analysis to develop the therapy program for people who is suffering from stress disorder after car accident such as sense of fear or anxiety using virtual reality. The analysis verified the effect of driving scenario which is core technology of stress disorder program and of anxiety reduction training such as relaxation training through clients. The relaxation training has been tested to 8 people; 7 normal and 1 sufferer from car accident presenting them 3 different types of driving scenarios. As a result, relaxation training was effective but, it was not statistically good enough although it showed incensement of uneasiness by each different driving scenario. In spite of normal clients, it is interesting that anxiety lever after relaxation training using VR is lowered, but this result need to verify to client suffering real car accident.
Jo, Kae Hwa;Park, Ae Ran;Lee, Jin Ju;Choi, Su Jung
Journal of Hospice and Palliative Care
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v.18
no.4
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pp.276-284
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2015
Purpose: This study was performed to identify factors affecting terminal care performance of clinical nurses. Methods: The participants in this study were 175 nurses working in hospitals in Daegu and North Gyeongsang Province. Data were collected using a self-reported questionnaire and were analyzed with the IBM SPSS WIN 19.0 program. Results: Nurses' terminal care performance was significantly related with suffering experience, empathy ability and caring behaviors. Significant predictors for terminal care performance were their department, empathy ability and caring behaviors. These factors explained 43.52% of the variance in terminal care performance of clinical nurses. Conclusion: Our study results suggest that terminal care performance of clinical nurses can be strengthened by improving empathy ability and caring behaviors.
The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.
Jo, Dae Hyun;Kwon, Min Soo;Kim, Jung Hwan;Choi, Ji Eun;Han, Ji Sun;Nam, Dong Woo;Choi, Do Young;Lee, Jae Dong
Journal of Acupuncture Research
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v.32
no.2
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pp.229-240
/
2015
Objectives : The purpose of this report is to show the effect of complex traditional Korean medical care focused on warm needling(WN) and bee venom(BV) injection for a patient suffering from traumatic brachial plexus injury(BPI). Methods : A 51-year-old female patient with BPI was suffering from paresis and hypoesthesia with upper-extremity impairment. The patient had been treated once a day from 4 Feb to 11 Apr of 2015 mainly with WN and BV injection on the acupoints near the distribution of the brachial plexus. Improvement of the symptoms was measured by range of motion(ROM), manual muscle test(MMT) grip strength, and with the numeric rating scale(NRS) of tactile and pain sensitivity. Results : After 67 days of treatment, all obtained results showed remarkable improvement. The patient's satisfaction declaration was recorded through an interview at the end of the treatment. Conclusions : The results suggest that anatomically concerned WN and BV treatment can be a valuable option in reducing or normalizing pains from traumatic BPI.
Kim, Jong Han;Yoo, Je Hyuk;Park, Ji Min;Lee, Seung Min;Im, Se Hoon;Lee, Sang Hoon;Lee, Jae Dong;Nam, Dong Woo
Journal of Acupuncture Research
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v.30
no.3
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pp.165-171
/
2013
Objectives : The purpose of this study is to investigate the effect of acupuncture treatment on a patient suffering from CRPS Type 1. Methods : A 30-year-old female patient suffering from CRPS Type 1 with symptoms of intense burning pain, joint stiffness, restricted mobility, rapid hair and nail growth, allodynia, hyperalgesia and coldness of the right leg was treated with acupuncture on six acupuncture points on the leg from 13 July to 18 July of 2011. Improvement of the patient's symptoms was evaluated by Numerical Rating Scale(NRS), Digital Infrared Thermographic Image(DITI). Results : After 6 days of treatment, NRS score decreased significantly and the DITI results showed moderate improvement in temperature. Conclusions : The results suggest that acupuncture may be an effective in reducing the symptoms of CRPS. Further study is needed to evaluate the significancy of this report.
This study investigates how Korean traditional family consciousness interacts with Korean industrialization in the 1970s. In Our Children, Lee Sun depicts a family's struggle within the turmoil brought about by rapid industrialization to escape from the ranks of the working class. It is well known that one of the consequences of industrialization was the breakup of the larger family structure into nuclear families, but Lee Sun presents Korea's industrialization in the 1970s in the light of the traditional Korean family culture before the breakup. In other words, he gives us a portrayal of Gemeinschaft in Gesellschaft in his description of the extended family's struggle to overcome the day-to-day pressures of modernization and urbanization. The novel presents three generations of a traditional extended family. The eldest son is portrayed as a knife, strong and sharp. His wife has a temporary job that she hopes to give up once they own a house, which symbolizes the family's escape from the working class. The relationship among the family members reveals the core aspects of the ideology governing traditional extended families: the husband is the despotic monarch of the household, solely responsible for the family's economy; the husband is the sky and the wife the earth; and children (the more the better) are expected to lead to stability, welfare, and prosperity. One curious aspect of this family relationship as portrayed by Lee Sun is the expectation that being the eldest son, who already is or will become the patriarch of the family, is the fastest way of reaching middle-class status. And, despite a slight reversal, the novel has a happy ending wherein the family's expectations are fulfilled without much suffering. This aspect should be considered in light of the revolutionary romantic idealism of the novels of the 1930s. The lack of suffering and the easy happy ending may be attributed to the fact that Korea's industrialization came about rapidly and radically, and therefore it is likely that Lee Sun was not able fully to appreciate the full costs of industrialization. This limitation calls for a deeper investigation into the social structure and class consciousness of the 1970s, and also a study of the intertextual relationship of Our Children with other novels of the time.
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