• 제목/요약/키워드: lower limb pain

검색결과 145건 처리시간 0.025초

운동, 알코올, 약물 등 복합적 요인으로 유발된 횡문근융해증 환자 치험 1례 (A Case Report of Rhabdomyolysis Induced by a Combination of Exercise, Alcohol, and Medication)

  • 진준수;이희정;민백기;공원호;서호석;김진원
    • 대한한방내과학회지
    • /
    • 제39권5호
    • /
    • pp.904-913
    • /
    • 2018
  • Rhabdomyolysis is a syndrome that evokes either myopathy or cola-colored urine with elevated creatine kinase and myoglobin levels. The most common complication of rhabdomyolysis is acute renal failure (ARF). A large quantity of fluid must be injected promptly the first time symptoms appear, whereas sequela of symptoms has remained in the long run. In this report, a 58-year-woman was diagnosed with ARF due to rhabdomyolysis induced by exercise, alcohol, and medication. A treatment of acupuncture and herbal medicines was carried out for over 2 months. To evaluate the condition of the patient's lower limb, a short form of the McGill Pain Questionnaire, Visual Analogue Scale (VAS), European Quality of Life-5 Dimensions (EQ-5D), and Manual Muscle Test (MMT) points were used. As a result, clinical symptoms and quality of life improved noticeably after treatment with Korean medicine. This suggests that Korean medicine has an effect on rhabdomyolysis.

좌골신경통(坐骨神經痛)의 침구치료(鍼灸治療)에 관(關)한 문헌적(文獻的) 고찰(考察) (A Philological Study on the Acupuncture treatment of Sciatica)

  • 문자영;이준희;박철진
    • Korean Journal of Acupuncture
    • /
    • 제26권2호
    • /
    • pp.177-195
    • /
    • 2009
  • Objectives : This study is performed to investigate the acupuncture on Sciatica through the literature of oriental medicine. Methods : We collected the oriental medical literature from ancient to modern times, and extracted the causes, symptoms, treatments and acupoints of sciatica. Results : The findings of this study are as follows: 1. The etiology of Sciatica is differentiated into the exogenous pathogenic factors(wind, cold, dampness, trauma, bad posture) and the internal pathogenic factors(deficiency of the kidney energy, congenital debility). 2. The symptoms of Sciatica are pain, weakness and dysesthesia in the low back, hip and lower limb. 3. In the treatment of Sciatica, The Leg Greater Yang Bladder (BL) Meridian and The Leg Lesser Yang Gall Bladder (GB) Meridian out of 12 meridians were mainly used and the acupoint GB30(Hwando) was most frequently used in the acupuncture literature. 4. The number of acupoints used for sciatica was 95, and those acupoints in the order of frequency were GB30(Hwando), GB34(Yangnungch'on), BL40(Wijung), BL60(Kollyun), GB31(P'ungshi), GB39(Hyonjong), BL57(Sungsan), ST36(Chok-samni). Conclusion : The most frequently used acupoints for the treatment of sciatica are as follows; GB30(Hwando), GB34(Yangnungch'on), GB31(P'ungshi), GB39(Hyonjong) of The Leg Lesser Yang Gall Bladder Meridian, BL40(Wijung), BL60(Kollyun), BL57(Sungsan) of The Leg Greater Yang Bladder Meridian.

  • PDF

GNAS 메틸화 이상으로 인한 거짓부갑상선기능저하증 Ib 1예 (A Case of Pseudohypoparathyroidism Type Ib Caused by Aberrant Methylation in the GNAS Complex Locus)

  • 조성진;한은희;장우리;채효진;김용구;이건동;조원경;서병규;김명신
    • Laboratory Medicine Online
    • /
    • 제7권2호
    • /
    • pp.83-87
    • /
    • 2017
  • Pseudohypoparathyroidism (PHP) is a rare disorder caused by genetic and epigenetic aberrations in the GNAS complex locus resulting in impaired expression of stimulatory G protein ($Gs{\alpha}$). PHP type Ib (PHP-Ib) is characterized by hypocalcemia and hyperphosphatemia due to renal resistance to the parathyroid hormone, and is distinguished from PHP-Ia by the absence of osteodystrophic features. An 11-yr-old boy presented with poor oral intake and cramping lower limb pain after physical activity. Laboratory studies revealed hypocalcemia, hyperphosphatemia, and increased parathyroid hormone levels. The GNAS complex locus was evaluated using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. Gain of methylation in the NESP55 domain and loss of methylation in the antisense (AS) transcript, XL, and A/B domains in the maternal allele were observed. Consequently, we present a case of PHP-Ib diagnosed using MS-MLPA.

성인 척추질환자의 발균형 및 보행형태에 대한 운동역학적 분석 (Kinetic Analysis of Foot Balance and Gait Patterns in Patients with Adult Spinal Disease)

  • Park, Jae Soung;Lee, Joong Sook
    • 한국운동역학회지
    • /
    • 제29권1호
    • /
    • pp.23-32
    • /
    • 2019
  • Objective: The aim of this study was to provide kinematic data on the characteristics of spinal disease patients by comparing and analyzing kinematic variables related to foot balance and gait pattern of spinal disease. Method: The subjects of the study included 40 adult men and 60 adult women who visited the hospital in Busan. Patients who were diagnosed with spinal disease by a physician through X-ray examination were selected as subjects for the diagnosis of vertebral disc herniation, spinal stenosis, spinal disease diagnosed with spinal disease and the general public. Left and right foot pressure and contact area were checked by Gaitview pro meter. X-ray photographs were taken with a Zen-2090 mobile fluoroscopy under physicians' direct participation. One-way ANOVA was performed to compare the differences between the kinematic variables and post-hoc was performed by the Duncan method. Results: The difference in contact area between the left foot and the right foot was $115.30{\pm}14.15cm^2$ in the left side and $124.25{\pm}13.65cm^2$ in the left side in the spinal disease patients. The difference in pressure between the left and right side of the spinal disease patients was wider than that of the general people. Especially, the right side of the spinal disease patients showed a larger area of left foot contact than the general population. Conclusion: Spinal disease patients have wider contact area of the left foot than those of the general population. In the case of right spinal disease, the left foot support area is widened due to pain. In the gait, women showed slightly more posterior body center than men, and the upper body muscle imbalance and immobilization due to the spinal disease caused imbalance of the muscles moving to the lower limb, It was analyzed to inhibit movement.

이행성 척추에 동반된 골수부종 환자의 복합한방치료: 증례보고 (Combined Korean Medicine Treatment of Lumbosacral Transitional Vertebra with Localized Bone Marrow Edema: A Case Report)

  • 채지원;이윤하;최동주;안상준;최현진;황보승윤;백혜경
    • 한방재활의학과학회지
    • /
    • 제32권1호
    • /
    • pp.125-131
    • /
    • 2022
  • This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

Comparison of dexmedetomidine alone with dexmedetomidine and fentanyl during awake fiberoptic intubation in patients with difficult airway: a randomized clinical trial

  • Acharya, Ranjita;Sriramka, Bhavna;Koushik, Priyangshu
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제22권5호
    • /
    • pp.349-356
    • /
    • 2022
  • Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

Influence of the Vibration Exposure on Shoulder and Back Extensor Muscles Activity During Forward-head and Over-head Task

  • Cheon-jun Park;Duk-hyun An;Jae-seop Oh;Won-gyu Yoo
    • 한국전문물리치료학회지
    • /
    • 제30권1호
    • /
    • pp.23-31
    • /
    • 2023
  • Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

오인된 심부 정맥 혈전증에 대하여 항응고제 투여 후 발생한 급성 구획 증후군 (Acute Compartment Syndrome after Anticoagulant Therapy to Misdiagnosed Deep Vein Thrombosis)

  • 황석하;전호승;우영균;임성태
    • 대한정형외과학회지
    • /
    • 제54권2호
    • /
    • pp.177-181
    • /
    • 2019
  • 급성 구획 증후군은 정형외과적 응급 질환이며, 구획 내의 압력이 증가하여 비가역적인 조직의 괴사를 유발한다. 이것은 기능적 장애, 하지의 손실 및 심할 경우 신 기능 저하를 유발하여 사망까지 이를 수 있다. 환자가 초기에 통증과 종창을 호소하는 경우 심부 정맥 혈전증과 유사하여 두 질환 간의 감별이 매우 중요하다고 알려져 있다. 저자들은 마사지 후 좌측 하퇴부의 통증과 종창을 보이는 환자를 심부 정맥 혈전증으로 오인하였고 항응고제를 투여하여 발생한 급성 구획 증후군에 근막 절개술을 시행하였고 만족스러운 치료 결과를 얻었으며, 문헌 고찰과 함께 본 증례를 보고하고자 한다.

척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고 (Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report)

  • 최현진;유승호;안상준;김세윤;신우철;조재흥;정원석;송미연;김형석
    • 한방재활의학과학회지
    • /
    • 제33권4호
    • /
    • pp.243-249
    • /
    • 2023
  • 해면상 혈관종(cavernous hemangioma)은 인체 내 다양한 장기나 기관에서 발생할 수 있는 혈관기형으로, 순수 경막외 해면상 혈관종(pure epidural cavernous hemangioma)은 해면상 혈관종의 드문 경우에 속한다. 해면상 혈관종이 원인이 되어 발생한 증상에 한의학 치료를 적용한 연구가 드물게 보고되었으나, 순수 해면상 혈관종의 출혈로 인한 증상에 대한 것은 없었기에 관련 임상증례를 보고하고자 한다. 척추의 순수 해면상 혈관종으로 진단받은 51세 남성이 2022년도에 해면상 혈관종 출혈로 인해 발생한 보행장애에 대해 치료를 받기 위해 한방병원을 방문하였다. 척추의 순수해면상 혈관종 출혈로 인해 발생한 보행장애 환자는 침 치료, 전기 침 치료, 온침 치료, 한약, 추나, 뜸, 부항 치료를 시행 받았다. 평가지표는 25 foot walk test (25FW), timed up and go test (TUG), comfortable gait speed tests (CGS), 요통과 하지 통증에 대한 numeral rating scale (NRS), Berg balance score (BBS), Tinneti-score, manual muscle test (MMT), EuroQol-five dimension (EQ-5D), EQ-5D visual analog scale (EQ-5D VAS)이었으며, 25FW, TUG, CGS, NRS, BBS, EQ-5D (VAS)에서는 치료 후 호전을 보인 반면, Tinetti Score, MMT, EQ-5D의 지표는 치료 후에도 동일하게 유지되었다. 한의학은 척추 해면상 혈관종의 출혈로 인해 발생한 보행장애나 하지 강직감에 대한 치료의 한 방안으로 고려될 수 있다.

위증에 대한 동서의학적(東西醫學的) 고찰(考察) (The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine)

  • 김용성;김철중
    • 혜화의학회지
    • /
    • 제8권2호
    • /
    • pp.211-243
    • /
    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

  • PDF