• 제목/요약/키워드: pain and suffering

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과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로- (Hypersensitive Large Intestine Syndrome in Hyungsang Medicine)

  • 최병래;최영현;한진수;이용태
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

관상동맥 질환을 가진 환자에서 폐동맥카테터로 측정한 전부하 지표들은 수액부하 반응을 예상할 수 있는가? (Assessment of Parameters Measured with Volumetric Pulmonary Artery Catheter as Predictors of Fluid Responsiveness in Patients with Coronary Artery Occlusive Disease)

  • 이지연;이종화;심재광;유경종;홍승범;곽영란
    • Journal of Chest Surgery
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    • 제41권1호
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    • pp.41-48
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    • 2008
  • 배경: 전부하의 정확한 평가와 수액요법을 통한 적절한 유지는 관상동맥질환자의 심박출량을 최적화하는데 있어서 매우 중요하다. 본 연구는 수액부하에 따른 일회 박출량지수의 변화와 전부하 지표들간의 상관관계를 살펴봄으로써, 이러한 전부하 지표들이 수액부하 반응을 예측할 수 있으며 수액요법의 지침으로 유용한가를 평가하였다. 대상 및 방법: 관상동맥우회술을 시행 받은 환자 96명을 대상으로 연구를 진행하였다. 마취유도 10분 후(T1)에 혈역학 변수들을 기록하고, 6% hydroethylstarch 130/0.4를 체중 kg당 10 mL를 20분에 걸쳐 정주하였으며, 이후 10분 후(T2)에 혈역학 변수를 다시 기록하였다. 결과: 수액부하에 따른 일회박출량지수 변화량(%)과 수액부하 전(T1)의 우심실박출계수가 통계적으로 유의한 상관관계를 보였으며(r=0.272, p=0.017), 중심정맥압, 폐모세혈관쐐기압, 이완기말우심실용적지수는 유의한 상관관계를 보이지 않았다. 이들 중 어떠한 지표도 ROC (receiver operating characteristics) 곡선아래 영역이 0.7을 넘지 않았다. 수액부하에 따라 일회박출량지수가 10% 이상 증가한 반응군으로, 증가하지 않은 군을 비반응군으로 정의하였을 때, 반응군은 31명, 비반응군은 65명이었으며, 우심실박출계수를 제외한 수액부하 전 지표들은 두 군간 차이를 보이지 않았다. 결론: 관상동맥 질환 환자에서 폐동맥카테터로 얻을 수 있는 전부하 지표들을 이용하여 수액부하에 따르는 일회박출량지수의 반응을 예측할 수는 없었다.

A Patient with Guillain-Barre Syndrome Treated with Combined Korean Medicine Treatments

  • Cha, Hyun Ji;Kim, Beom Seok;Lee, Ye Ji;Kim, Hyo Bin;Sung, Ki Jung;Lee, Young Rok;Kim, Jin Youp;Kim, Eun Seok;Jeon, Ju Hyun;Kim, Young Il
    • Journal of Acupuncture Research
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    • 제38권2호
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    • pp.170-174
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    • 2021
  • A patient diagnosed with Guillain-Barre syndrome (GBS) suffering from numbness in the toes and fingers, paralysis in the face, and back pain received intravenous immunoglobulin on December 28, 2019. Without an improvement in symptoms the patient was admitted to a Korean medicine hospital on January 1, 2020 to receive combined Korean medicine treatment including herbal medicine (Sipjeondaebo-tanggami and Hyangbujasunkipalmul-tang), acupuncture treatment, moxibustion, cupping treatment, and physical therapy. Treatment was administered over 51 days, of which 17 days were during hospitalization. Paralysis of facial muscle, and numbness in fingers and toes were evaluated using the Yanagihara score and numeric rating scale (NRS) score, respectively. Facial paralysis improved (21 to 40 based on Yanagihara score) and paresthesia of the hands and feet disappeared (NRS score 6-7 to NRS score 0). There were no side effects or sequela. This study suggested combined Korean medicine treatment may be effective for the treatment of GBS.

영국 NHS의 모성서비스 관련 의료과오보상제도의 경험과 그 함의 (The NHS litigation scheme related to Maternity Services in UK: its experiences and implications)

  • 한동운;황정혜
    • 의료법학
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    • 제11권2호
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    • pp.181-208
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    • 2010
  • Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

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여성의 몸·여성의 주체성 -중세여성 명상가와 여성으로서의 예수 (Medieval Female Mystics and the Divine Motherhood)

  • 윤민우
    • 영어영문학
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    • 제56권4호
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    • pp.639-666
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    • 2010
  • Meditation on Christ's body is peculiar to late medieval female mysticism. The somatic meditation on Christ basically derives from the Incarnation, but the female mystics focused more on the Passion and the Eucharist, i.e., Christ's bleeding and feeding. Then, female body structure and the gender role of nurturing were combined to make facile her imitatio Christi, because the female body was aptly identified with Christ's body. The blood flowing in the side of Christ was often in medieval graphics and texts identified with a mother's milk for a baby to suck. Wound and food, suffering and nourishing, were inseparable in Christ's and the female mystics' body. Thus, in late medieval female mystical practice, it is important to note, first, female mystics' bodily pain was not to be cured but endured; second, that not only did a female mystic eat Christ's body, but her own body was to be "eaten" by poor neighbors, just as Christ gave his own body to be eaten by believers. As Christ's body is punctured, so does the female body have open holes, and as Christ is food, so is the female body. This female meditation on Christ's body developed the notion of "divine motherhood" to be accepted and enjoyed quite literally by the female mystics in late medieval times. Yet, in a sense, the female mystics' meditating on Christ's feminine function of nourishing can be considered as their accepting and interiorizing the socially constructed female gender role and thus lacking in subversive power. Nevertheless, this meditative practice at least functioned to redeem the female body which had typically been labelled inferior and even dirty. Through Christ's feminized body, the female mystics rehabilitated their bodily dimension, presenting it to be shared by male believers. Capitalizing on the gender stereotype of womanhood itself, they converted female weakness to power.

24년생 장생도라지 약침액(藥鍼液)의 폐렴 증상 개선효과에 대한 임상례 (Clinical report on the improvement of the symptoms of pneumonia by the aqueous extract of Platycodon grandiflorum)

  • 김숙경;최성권;임희정;문익렬;박형선;오수진
    • 대한약침학회지
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    • 제4권3호
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    • pp.59-67
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    • 2001
  • Objective: The purpose of this report is to prove the clinical effect of Platycodon grandiflorum aqueous extract on pneumoniae patients. Methods: We used the aqueous extract of Platycodon grandiflorum to treat two pneumoniae patients. It was injected into five acupuncture points, which was Chondol(天突:CV22) 1 point, Pyesu(肺兪 : BL13) 2 point, and Kworumsu(厥陰兪: BL14) 2 point. Results & conclusions: We have used the aqueous extract of 24-year-old JK for treating the patients suffering from lung diseases, and have experienced the actual effects. Of the treated, two pneumonia-involved patients showed apparent improvement in simple chest X-ray and clinical symptoms. The patients were treated with JK (Jang-saeng platycodon) aqueous extract 25 and 22 times individually. The results were as follows. 1. The symptoms including coughing, phlegm, and fever were improved in two cases. 2. The lung infiltration in simple chest X-ray decreased and the WBC count was kept within normal range in two cases. 3. Side effect such as itching was not found in the process of JK aqueous extract treatment. 4. The criteria for pneumonia are fever, coughing with purulent phlegm, pleural chest pain, the evidence of new infiltration in simple chest X-ray, sign of lung sclerosis in auscultation, increase of WBC count, etc. But they may not be the proper objective diagnostic standards. So we had trouble in statistic process and numerical interpretation. Putting these results together, the JK aqueous extract is considered to be effective in treating patients for pneumonia, and the continuous research and accumulation of data is needed.

증상이 동반된 소아 유연성 편평족 치료에서의 Calcaneo-stop 술식 (Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot)

  • 이강;남영준
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.176-180
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    • 2015
  • Purpose: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. Materials and Methods: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. Results: Clinically, AOFAS ankle-hindfoot scale improved from $70.3{\pm}5.6$ to $97.3{\pm}2.5$ and VAS improved from $6.4{\pm}1.6$ to $0.2{\pm}0.4$. Radiographically, talonavicular coverage angle improved from $28.3^{\circ}{\pm}12.3^{\circ}$ to $10.9^{\circ}{\pm}8.1^{\circ}$, lateral talo-first metatarsal angle improved from $-19.3^{\circ}{\pm}9.0^{\circ}$ to $-2.4^{\circ}{\pm}8.1^{\circ}$, and hindfoot alignment angle improved from valgus $11.9^{\circ}{\pm}10.0^{\circ}$ to $3.5^{\circ}{\pm}4.3^{\circ}$ at minimum 2-year follow-up. No complications occurred postoperatively. Conclusion: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra;Jung, Seung Wook;Jung, Hwi-Dong;Lee, In Yong;Yong, Tai-Soon;Jeong, Su Jin;Kim, Hyun Sil
    • Parasites, Hosts and Diseases
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    • 제55권4호
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    • pp.433-437
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    • 2017
  • Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

식중독의 사회경제적 비용추정: 삶의 질 개념을 적용한 질병비용추정법을 이용하여 (Socioeconomic Costs of Food-Borne Disease Using the Cost-of-Illness Model: Applying the QALY Method)

  • 신호성;이수형;김종수;김진숙;한규홍
    • Journal of Preventive Medicine and Public Health
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    • 제43권4호
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    • pp.352-361
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    • 2010
  • Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

선천성 문정맥의 기형으로 인한 문맥압항진증에 시행한 Shunt 의 1례 보고 (A Case Report of the Mesocaval Shunt in the Failed Splenorenal Shunt)

  • 정성규
    • Journal of Chest Surgery
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    • 제5권2호
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    • pp.107-112
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    • 1972
  • Recently we experienced a case of the portal hypertension, extrahepatlc origin in the National Medical Center, Seoul. The case was a male aged 19 who was undergone the elective splenorenal shunt with splenectomy 9 years ago and emergency ligation of the coronary vein because of recurred variceal rupture 6 years later and had recurring esophageal varices with bleeding this time.At the age of 10 he had been occasionally suffering from nasal bleeding and visited to our Pediatric department, when there was encountered for the first time the splenomegaly, esophageal varices in the lower third esophagus on the esophagogram, and stenosis and kinking of the portal vein with rich collateral circulation on the splenoportography without hepatic functional impairment.The elective splenorenal shunt with splenectomy was undergone under the diagnosis of portal hypertension due to congenital anomaly of the portal vein and postoperatlvely no troubles had been obtained until postoperative 1st attack of massive hematemesis due to esophagenl variceal rupture recurred about 6 years later which was confirmed by control esophagogram and it was resulted by stenosis of previous anastomotic site of the splenorenal shunt.Then emergency ligation of the coronary vein was only made for bleeding control and no episodes of hematemesis had been encountered thereafter until April 1972 about 3 years after the 2nd operation, when hematemesis recurred again. In this time, recurring esophageal varices were noted in the lower third esophagus on the control esophagogram and he was employed side to end mesocaval shunt as the final step of portal decompression,and following results were obtained. 1] No postoperatlve troubles as leg edema or pain: Postoperatively leg elevation and elastic bandage on the both legs were employed until discharge. 2] During operation the portal pressure was 300 mm $H_2O$ and immediately lowered to 170 mm $H_2O$ after shunt.

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