• Title/Summary/Keyword: pain and suffering

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Thoracotomy versus Video-Assisted Thoracoscopy in Pediatric Empyema

  • Mohajerzadeh, Leily;Lotfollahzadeh, Saran;Vosoughi, Armin;Harirforoosh, Iman;Parsay, Sina;Amirifar, Hesam;Farahbakhsh, Nazanin;Atqiaee, Khashayar
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.125-130
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    • 2019
  • Background: To compare the outcomes of video-assisted thoracoscopic surgery (VATS) in comparison to open thoracic surgery in pediatric patients suffering from empyema. Methods: A prospective study was carried out in 80 patients referred to the Department of Pediatric Surgery between 2015 and 2018. The patients were randomly divided into thoracotomy and VATS groups (groups I and II, respectively). Forty patients were in the thoracotomy group (16 males [40%], 24 females [60%]; average age, $5.77{\pm}4.08years$) and 40 patients were in the VATS group (18 males [45%], 22 females [55%]; average age, $6.27{\pm}3.67years$). There were no significant differences in age (p=0.61) or sex (p=0.26). Routine preliminary workups for all patients were ordered, and the patients were followed up for 90 days at regular intervals. Results: The average length of hospital stay ($16.28{\pm}7.83days$ vs. $15.83{\pm}9.44days$, p=0.04) and the duration of treatment needed for pain relief (10 days vs. 5 days, p=0.004) were longer in the thoracotomy group than in the VATS group. Thoracotomy patients had surgical wound infections in 27.3% of cases, whereas no cases of infection were reported in the VATS group (p=0.04). Conclusion: Our results indicate that VATS was not only less invasive than thoracotomy, but also showed promising results, such as an earlier discharge from the hospital and fewer postoperative complications.

Effects of Koryo Hand Therapy on Menstrual Cramps and Dysmenorrhea in College Women Students (고려수지요법이 여대생의 생리통 및 월경곤란증에 미치는 효과)

  • Kim, Chung-Nam;Chang, Young-Sim
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.432-444
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    • 2003
  • Purpose: This study attempted to verify the effect of Koryo hand therapy on menstrual cramps and dysmenorrhea among college students. Method: This study performed the quasi-experimental design with nonequivalent control group and the pre and post-test design from August 28 to November 4, 2002. The subjects of this experimental study consisted of 64 college students in the nursing college of K University in D city and K college students in K city, who had more than 5.0 GRS score of menstrual cramps. Among them, 16 people belonged to the experimental group A by using Ceramic Seo Am moxa therapy, 16 to the experimental group B by using Seo Am pellet therapy, 16 to the experimental group C by using combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy and 16 to the control group. Three different kinds of methods were used three times per week for $5{\sim}6$ weeks(a total of $15{\sim}18$ times) interventions were completed. For the experimental group, A Ceramic Seo Am moxa therapy was given for 40 minutes per each treatment; for the experimental group, B Seo Am pellet therapy was given for 4 hours: for the experimental group, C combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy was given. To measure menstrual cramps, the graphic rating scale (GRS) was used and to measure dysmenorrheal, a dysmenorrhea scale (15 contents) was used, which was modified from Han &Hur's scale (13 contents). Cronbach's was 0.78 in the pre-test, 0.83 in the first post-test, 0.89 in the following post-test. Data were analyzed by one-way ANOVA, 2 test, repeated measures ANOVA, time contrast test and Sheffe test with the SPSS/Win 11.0 program. Results: ? The first hypothesis, 'Among the experimental group A by using Ceramic Seo Am moxa therapy, the experimental group B by using Seo Am pellet therapy and the experimental group C by using combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy will have different graphic rating scores of menstrual cramps', was supported (F=6.77, p=0.000, Interaction: p=0.000). ? The second hypothesis, 'Among the experimental group A by using Ceramic Seo Am moxa therapy, the experimental group B by using Seo Am pellet therapy, the experimental group C by using combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy and the control group will have a significantly different level of dysmenorrhea', was supported (F=6.88, p=0.000, Interaction: p=0.000). From the above results, it can be an effective nursing intervention to give Koryo hand therapy to college students who have menstrual cramps and dysmenorrhea. Conclusion: These findings indicate that Koryo hand therapy could be applied to improve the quality of life and to prevent drug misuse among college students who are physically, mentally and psychologically suffering from menstrual cramps and dysmenorrhea. Furthermore, Koryo hand therapy could be developed as an effective Korean alternative and complementary care in the future. and it could also provide a guideline to apply Koryo hand therapy to other pain and difficulties.

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A Study on the Clinical Characteristics of Patients with Dry Mouth (구강건조증 환자의 임상적 특징에 관한 연구)

  • Oh, Jeong-Kyu;Kim, Youn-Joong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.331-343
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    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

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The Study on Safety of Scolopendrid Aqua-acupuncture (오공약침(蜈蚣藥鍼)의 안전성(安全性)에 관한 연구(硏究))

  • Lim, Seung-Il;Kim, Sung-Nam;So, Ki-Suk;Choi, Hoi-Kang;Lim, Jeong-A;Lee, Sang-Kwan;Moon, Hyung-Cheol;Soh, Kyung-Sun;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.7 no.1 s.12
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    • pp.37-51
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    • 2004
  • Objective : Recently scolopendrid aqua-acupuncture has been a good effect on pain control but it has not been known about clinical safety. The purpose of this study was to investigate acute toxicity of scolopendrid aqua-acupuncture. Method : In order to prove the clinical safety of scolopendrid aqua-acupuncture, We have observed a bacteriological examination and clinical pathology test after scolopendrid aqua-acupuncture treatment. Balb/c mice were injected intravenous with Scolopendrid aquaacupuncture treatment for $LD_{50}$ and acute toxicity test. We analyzed physical reaction(side effect)and clinical pathology test before and after Scolopendrid aqua-acupuncture treatment of mice and 20 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results : In the Blood agar plate and Nutrient agar plate, a bacteriological examination did not show a bacillus. In acute $LD_{50}$ toxicity test, there was no mortality thus unable to attain the value. Examining the toxic response in the acute toxicity test, there was no sign of toxication. In acute toxic test, running biochemical serum test couldn't yield any differences between the control and experiment groups. In the 20 patients treated with Scolopendrid aqua-acupuncture, hematologic test did not show remarkable change. In the 20 patients treated with Scolopendrid aqua-acupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 5.0% compared with previous study. Reanl function test(BUN, Cr) and abnormal rate showed a decrease of 5.0% compared with previous study. In the 20 patients treated with Scolopendrid aqua-acupuncture, Electrolyte were normal range before and after treatment. In the Urine analysis of 20 patients, Leukocyte, Protein, Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aqua-acupuncture treatment, and the rest almost made no difference.

Correction of Recurrent Ingrowing Toenail Using Partial Matricectomy and Paronychial Advancement Flap (부분기질절제술과 발톱주위전진피판을 이용한 재발성 내증식발톱의 교정)

  • Kim, Eui Sik;Kim, Sung Nam;Noh, Bok Kyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.347-352
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    • 2006
  • Ingrowing toenail has been treated conventionally by various surgical treatment modlities. However, none of these procedures are perfect to achieve esthetic results with low cost, recurrence, and complication rates. Although mild cases can be treated conservatively, in severe recurrent cases, surgical treatment is preferred. The purpose of this study is to evaluate the effectiveness and safety of using partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail. Eight patients suffering from recurrent ingrowing toenail were operated using partial matricectomy and paronychial advancement flap in our department from August 2004 to August 2005. The number of recurrent episodes ranged from 2 to 5. With digital nerve block, the excision area was marked on nailplate and inflammed lateral nail fold. The horizontally designed paronychial flap considering defect size was effective for wide exposure of the neighboring germinal matrix, which is later to be completely excised or cauterized because remnant germinal matrix made postoperative spicule formation. The nailplate on the affected side was removed about 3-5 mm width longitudinally, being cautious not to damage the proximal dorsal nail fold. The same width of the sterile matrix including germinal matrix was excised longitudinally with inflammed granulation tissue and partial lateral nail fold on the affected side. The subcutaneously elevated paronychial flap was advanced to cover the defect and was anatomically sutured with 5-0 nylon sutures. We evaluated our procedure's effectiveness by examining some factors such as cosmetic results, recurrence, spicule formation, postoperative pain and duration of return to normal activities. In eight patients, no complication was observed such as recurrence, severe pain and spicule formation except for 1 case of infection. Postoperative discomfort was minimal. Average duration of return to normal activities was 12 days. Cosmetically the results were acceptable in all patients. The partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail were found to be technically simple, efficient procedure with a relative low recurrence rate and better cosmetic results.

Modern Medicine and Phantom Pain (현대의학과 환상통 - 이응준의 『약혼』을 중심으로)

  • Ban, Jaeyu
    • Korean Medical Education Review
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    • v.13 no.1
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    • pp.25-34
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    • 2011
  • Modern medicine has early experienced the absence of mimesis and has been trying to replace the absence with objective grounds and experimental data. However, as medicine became science, the crisis of medicine spread more widely. Microscopic powers and violences are invisible, but individuals are powerless and vainly unable to resist. The anguish or introspection about the situation is sometimes described in stories such as An Engagement by Lee Eung Jun. An Engagement is mentioned in this article due to the writer's attitude, which shows his introspection and desire for harmony through the wounds of each trivial character. The writer is unceasingly talking about suffering people in his story and his seriousness enables readers to find his stronger sympathy over life and death than in any other medical stories. In fact, it is impossible for readers to comprehend the confusing propositions which the writer pours out, and even uncomfortable to read the story. Nevertheless, the propositions are always in contact with reality. Perhaps it is not the writer's confusing propositions that make us uncomfortable. It might be ourselves who are always alienated and starved. We can say that the characters' pains and wounds are phantom pains caused by the absence of mimesis. Since there is no affected area, their pains cannot be measured by only scientific medicine. However, the current medical profession regards objective research evidences as absolute truth and allows them to be the sole criterion. Although scientific skills such as DNA analysis and MRI scan can be the substitutes for doctors' judgment, so much of medicine is still interpersonal relationships. An Engagement. As a person promises to marry another, as all beings together in the world promise to subordinate to one another, every subject is consistently a valuable part of each other for the writer's eyes. He is aware that it is originally impossible to get engaged to the world, but he does not give up the possibility of genuine communication. In today's post-modernism society, where a large number of pathological views define the members and the world itself, endless questioning of existence and digging into pathology will be the only way to reduce the gap between individuals and their world. This article does not say that a literary work will lead the change of medical paradigm. It sprang from a desire for medical humanities to gain more interest of the medical field, where the encounter between literature and medicine is still unfamiliar, and to make medical education recognize the importance of humanities. Starting with this work, I believe that the humanities will help us to find the solution to the age of absence of mimesis and to the crisis of medicine.

A Study on the Menopause Experience : A Q Methodological Approach (폐경기 경험에 관한 연구 : Q 방법론적 접근)

  • 신혜숙
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.807-824
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    • 1995
  • This study was intended to provide women who are experiencing menopause with effective nursing care by exploring the menopause experience. The purpose of the research was to understand the subjective feelings of women about the question of what the menopause experience is. Q-Methodological method was used for that purpose. As the research method, Q-statements were collected preliminary to the study of through in -depth interviews and a literature review. For the study 34 Q-statements were selected. There were 21 women as subjects for the research. The 21 women sorted the 34 statements using the principle of Forced Normal Distribution. The principle of Forced Normal Distribution, which has nine scales to measure the individual opinions, was called Q-Factor Analysis by using PC Quanl Program to supply the material. As a result, there were four categories(self-com-passion type, self-regulation type, self-perception type, self-abandonment type) of special opinion about the menopause experience in these women. The first type was called Self-compassion This type' was associated with varying degrees of emotonal instability(psychological withdrawal). And type in menopause signifies loss of a socially valued status and may result in depressive symptoms. This type expresses the menopause experience as associated with negative reaction. The second type is called Self-regulation. This type overcomes the menopause experience more actively than the other types and do not express the menopause experience as one of suffering. This type make efforts by themselves to regulate the mono-pause experience. The third type is called Self-perception. This type perceives the experience of menopause which as typical menopausal syndrome (hot flashes and decreased vaginal lubrication, decreased estrogen producing atrophic changes of the labia and vaginal mucosa, making intercourse uncomfortable). The fourth type is called Self- abandonment. This type denies the experience of menopause. The meaning of menopausal experience is significantly related with a life accident or life load. Also, This type experiences pain in the musculoskeletal system. As a result, The meaning of the menopausal experience is affected by perceived subjective experience of the nurses, the need to understand each persons meaning of the menopause experience and to develop appropriate nursing interventions based on the typology of menopause experience. Finally. The result of the study will provide basic data for nursing intervention the menopausal women.

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Synovial Chondroma Causing Radial Nerve Palsy (요골 신경 마비를 유발한 활액막 연골종)

  • Chun, Young-Soo;Kim, Joon-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.55-59
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    • 2007
  • Synovial chondroma is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. We would like to present the case of a 65-year-old man suffering from synovial chondroma of the right elbow responsible for radial nerve entrapment neuropathy. This is a case of synovial chondroma of the right elbow in an 65-year-old man presenting with pain and restricted joint movement of the right elbow, loss of extension and sensation of the right thumb and wrist. Plain radiographs showed narrowing of elbow joint space, bony spur on the edge of the joint, and radio-opaque sclerotic change of subchondral area. MRI revealed $16{\times}12$ mm sized round mass on the radial head, homogenous low signal on T1WI, heterogenous high and low signal on T2WI. The patient underwent marginal excision of the mass, compressing the radial nerve. Diagnosis was confirmed by histologic examination.

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A Case Report of a Somatization Disorder Patient with Histrionic Personality Disorder (연극성 성격장애를 지닌 신체화장애 환자 치험 1례 -최면치료, EFT 중심으로-)

  • Kim, Soo-Jung;Ryu, Chun-Gil;Cho, A-Ram;Seo, Joo-Hee;Kim, Ji-Na;Sung, Woo-Yong;Park, Jang-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.2
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    • pp.85-98
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    • 2012
  • Objectives : The histrionic personality disorder(HPD) is characterized by a pattern of excessive emotion and attention-seeking behavior, including a seductive behavior. It is known that HPD is closely related to a somatization disorder. The somatization disorder is characterized with various physical symptoms that have no pathologic manifestation. This report is on a case of 55 years old woman with HPD, who has been suffering from various physical symptoms that are coincided with diagnostic criteria for somatization disorder by DSM-IV. Methods : The patient was treated with oriental medical treatments (acupuncture, moxibustion, cupping therapy, and herb-medication), hypnotic therapy, and emotional freedom techniques. The effects of treatment were measured by VAS. Results : Chest pain was improved by hypnotic therapy and oriental medical treatments. But the patient's pantalgia and abdominal discomfort were controlled effectively by emotional freedom techniques. Conclusions : This result suggests that EFT might be effective for the defensive and dependent somatization disorder patient with HPD.

"It's our grief": Re-membering Blanche beyond Pity and Fear (테네시 윌리엄스의 블랑쉬 다시 기억하기 - 공포와 연민을 넘어서 책임과 공감으로)

  • Kim, Mijeong
    • Cross-Cultural Studies
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    • v.38
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    • pp.29-63
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    • 2015
  • This paper attempts to re-read Tennessee William's A Streetcar Named Desire from a non-Aristotelian perspective, particularly focusing on the audience performativity. In Chapter 6 of the Poetics, Aristotle says that tragedy has a final purpose or end (telos) and that is to inspire a catharsis (literally "purification") of pity and fear by means of representation and to give pleasure from experiencing their relief. However, a dramatic theoretician Augusto Boal argues that Aristotelian catharsis is not to get rid of pity and fear through their vehement discharge; rather, the basic function of catharsis is the purging of antisocial elements from the social body and the restoration of order because catharsis occurs when the spectator, terrified by the spectacle of the catastrophe, is purified of his "hamartia" which looks similar to the tragic flaw of the hero in the play. Thus, Boal asserts that Aristotle's coercive system of tragedy manipulates the emotions of the passive spectator. By contrast, in non-Aristotelian aesthetics, tragedy functions not as legitimation for a particular political configuration but as the performance of ethical acts-through which all the participants, including not only the actors but also the audience, communicate more actively about practical problems and actively work in order to make sense of themselves, others, and society. Here, the audience is required to restore and reinforce his/her capacity to think and to act; thus, an unquestioning, passive, indifferent attitude is not allowed. In these contexts, this paper explores how Tennessee William's A Streetcar Named Desire involves the audience in the responsibility for what occurs on the stage, in order to urge the audience's ethical judgements and responsible acts. This paper argues that what this play asks of us is not catharsis, the purging of pity and fear, but empathy toward the other's pain, beyond pity and fear, to carry out our responsibility of sharing in and caring for the other's suffering. That is to say that it will be an ethical way to "re-member" Blanche DuBoi-the iconic Williams victim "dis-membered" by traumatic memories and open wounds and is thus unable to complete her grieving and mourning-as one of us, not as the other. It will be the only way to remember right regarding her tragedy.