• Title/Summary/Keyword: pain intervention

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Clinical Experience of Pyoderma Gangrenosum with Extensive Soft Tissue Necrosis (광범위 연조직 괴사를 동반한 괴저농피증의 치험례)

  • Lim, Sung Yoon;Park, Dong Ha;Pae, Nam Suk;Park, Myong Chul
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.615-618
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    • 2008
  • Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.

A Case of Metastatic Hepatocellular Carcinoma of the Orbit (간세포암종의 안와 전이 1예)

  • Yang, Young-Joo;Bae, Seung-Hyeon;Jang, Il-Young;Jun, Mi-Jung;Jung, Ji-Won;An, Ji-Hyun;Shim, Ju-Hyun
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.152-155
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    • 2013
  • Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Analysis of Published Papers and their Keywords in the Korean Journal of Women Health Nursing (2003-2006) (여성건강간호학회지의 최근 3년간의 논문분석(2004-2006년))

  • Kim, Jeung-Im;Park, So-Mi;Park, Hye-Sook;Chung, Chae-Weon;Ahn, Suk-Hee
    • Women's Health Nursing
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    • v.13 no.1
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    • pp.51-59
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    • 2007
  • Purpose: This research was aimed to explore the major subjects and research theme and to classify characteristics of the key words in recent Korean Journal of Women Health Nursing. Methods: With survey design, whole 103 published papers during 2003-2006 were analyzed with structured analysis form; research subjects, research methodology, data analysis, and key words of the published papers were classified and extracted. Various theme was founded and classified to 9 domains. Results: Most of the research subjects were women. Eighty-eight percent of papers conducted quantitative research; 83% chose convenience sampling and 69% used survey design, while experimental design was 29%. Key words were categorized 9 domains: demographic, health related concept, health behavior(intervention), sex-related, life event, disease, et al. Among 9 domains, health related concept, especially psycho-social topics such as depression, anxiety, stress were mostly studied and then physiologic topics such as labor pain, fatigue, and menstrual symptoms. Conclusion: Most of the subjects were women and the most common domain studied was health related concepts in Korean Journal of Women Health Nursing. And key words and topics were on women's health issues. We can conclude that Korean Journal of Women Health Nursing has published by her own philosophy.

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Improvements in Balance of Patients with Hemiplegia A Literature Review (편마비환자의 균형기능 향상에 관한 문헌적 고찰)

  • Kang, Kwon-Young;Song, Byung-Ho
    • Journal of Korean Physical Therapy Science
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    • v.15 no.2
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    • pp.87-95
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    • 2008
  • Background: Hemiplegic patients usually have difficulty maintaining balance. Balance training is a major component of there habilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of PLS(Posterior Leaf Spring), FES(Functional Electrical stimulation), treadmill training, and neurodevelopmental treatment on the improvement of balance in patients with hemiplegia. Methods: We looked into published studies from Dankook University’s electronic library databases of RISS4U, KMbase, NCBI, and MEDLIS concerning the effectiveness of any form of intervention leading to improvement of balance. All types of studies relevant to the topic that were published in English during the time period of 1986 to 2005 were included. Results: 1. There were significant differences in standing balance, dynamic activity balance, and gait speed between barefoot subjects and subjects who wore SPAFO and HPAFO(p<.05). 2. The changes in ROM and FRT related to sex, age, height, and weight part of the diagnosis, as well as experience relapse, was of meaningless value. Changes in ROM related to the duration of pain and experiences of falling down were also meaningless. However, FRT showed significant static differences(p<.05). 3. The body-weight-support treadmill training scoring of standing balance, step length, and a timed 10m walking test showed definite improvement. 4. The proprioceptive control approach improved dynamic balance in patients with hemiplegia. Conclusion: Consequently, further study is needed to verify methods when physical therapists are researching balance ability in hemiplegic patient.

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The Effect of Backrest Elevation Education on ICU Nurse's Knowledge, Perception and Performance (침상각도 상승 교육에 대한 중환자실 간호사의 지식, 인식 및 수행 정도)

  • Lee, Hyun Sim;Park, Young Woo;Kim, Jung Yeon;Lee, Eun Sook;Park, Ai Soon;Han, A Reum;Kim, Eun A;Lee, Ho Sun;Koh, Shin Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.117-128
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    • 2008
  • Purpose: This study was conducted to examine the differences of knowledge, perception, and performance between the points of time before and after ICU nurses had the backrest elevation education. Method: The study subjects were 58 nurses at a medical and surgical ICU of one general Y hospital located in Seoul. They received the education, including backrest elevation guideline and related education materials. Data were collected from May 11 throughout August 12, 2007 with a structured questionnaire. Results: 1) There were significant differences in the mean scores of knowledge(2.21 at pre-education, 5.24 at post-education), perception(36.96 at pre-education, 53.36 at post-education), and performance(32.08 at pre-education, 43.51 at post-education), 2) There was a significant correlation between nurse's perception and performance (p=.000). 3) The nurse's perception regarding the importance of the back rest elevation education was significantly effective on their performance (p=.000). Conclusion: The backrest elevation education would contribute to improve ICU nurse's knowledge, perception and performance. The more the nurses would consider the importance of this education, the better they would perform the nursing intervention of backrest elevation.

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The Research Trends on the Acupuncture Treatment of Lumbar Herniated Intervertebral Disc Using PubMed Database (PubMed 검색을 통한 요추 추간판 탈출증의 침치료 연구 동향)

  • Shin, Woo-Suk;Park, Won-Hyung;Cha, Yun-Yeop
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.49-60
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    • 2014
  • Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.

Sexual Dysfunction in Patients with Polycystic Ovary Syndrome in Malaysia

  • Dashti, Sareh;Latiff, Latiffah A;Hamid, Habibah Abdul;Sani, Suriani Mohamad;Akhtari-Zavare, Mehrnoosh;Bakar, Azrin Shah Abu;Inani Binti, Nur Amirah;Ismail, Maimunah;Esfehani, Ali Jafarzadeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3747-3751
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    • 2016
  • Background: Polycystic ovary syndrome (PCOS) is a combination of chronic anovulation, obesity, and hyperandrogenism and can affect sexual function in women of reproductive age. It is also associated with endometrial cancer. Our aim was to evaluate the frequency and predisposing factors of sexual dysfunction in PCOS patients. Materials and Methods: In this cross-sectional study, 16 married women with a definite diagnosis of PCOS were recruited. Sexual function was assessed in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain using the female sexual function index (FSFI) questionnaire. Patients were also assessed for mental health using the depression, anxiety and stress (DASS-21) questionnaire. Presence of hirsutism was assessed using the Ferriman-Gallwey (FG) scoring system. Demographic data were obtained from patients during in-person interview. Results: Sexual dysfunction was present in 62.5% of patients with the domains of arousal and lubrication particularly affected (93.8% and 87.5%, respectively). Patients with symptoms of depression and anxiety were significantly more likely to suffer sexual dysfunction than those without these symptoms (p=0.04 and p=0.03 respectively). Patients with stress symptoms reported higher orgasm dysfunction than those without (p=0.02). No significant difference in any of the FSFI score domains was observed between patients with and without hirsutism. Conclusions: PCOS patients markedly suffer from sexual dysfunction and therefore it seems appropriate to be screened for intervention. Poor mental health conditions that may be the result of infertility or other complications of PCOS should also be considered as curable causes of sexual dysfunction in these patients.

Primary Melanoma of the Stomach at Cardia (위 분문부에 발생한 원발성 흑색종)

  • Park, Jong-Ik;Kang, Sung-Gu;Park, Sang-Su;Yoon, Jin;Kim, Il-Myung;Shin, Dong-Gue
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.193-197
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    • 2006
  • Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

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The Analysis on Degree of Discomfort Caused by Delayed Extubation of Nasotracheal Tube - A Pilot Study (경비기관내튜브의 발관 지연에 따른 환자의 불편감 정도 분석 -A Pilot Study)

  • Shim, Jung-Hwan;Yi, Young-Eun;Kim, Hyun-Jeong;Yum, Kwang-Won;Park, Yun-Ki;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.1-5
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    • 2007
  • Background: It is well known that nasotracheal intubation is comfort for patient compared to oral intubation. We sometimes delay extubation when it is thought that the patient can not maintain airway, or there may be other emergency associated with airway. And we sometimes experience complaint of discomfort of nasotracheal tube. But, we could not find any report on degree of discomfort of delayed nasotracheal intubation. Methods: Eighteen patients in whom extubation of nasotraceal tube was delayed after operation because of difficulties of airway mamagement were selected. We surveyed the discomfort of nasotracheal tube with 0 to 10 visual analogue scale (VAS) and compared with the pain of operation site (VAS). Result: The VAS of nasotracheal intubation was $6.7{\pm}3.4$, and VAS of the primary operation site was $3.5{\pm}2.4$, and VAS of flap harvest site was $5.5{\pm}2.7$. 10 of the patients complained of nasotracheal suction extremely and 6 patients complained of respiratory difficulties. Conclusions: Nasotracheal intubation was discomfort and there must be intervention.

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Sleep patterns and it's influencing factors of hospitalized elderly in long-term care hospital (요양병원 입원 노인의 수면 양상 및 영향요인)

  • Jang, Hyo-Yoel;Kim, Tae-Im
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.3
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    • pp.773-789
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    • 2016
  • This study was conducted to identify the sleep patterns and influencing factors of hospitalized elderly in a long-term care hospital. The sleep patterns of 142 subjects were recorded using Sleep Charts. The average sleep time of subjects was 10.7 hours a day (3.9 hours in daytime and 6.8 hours in nighttime). Sleep regularity among participants were 71.7% in all day (58.1% in day time and 80.5% in night time). The presence of dementia patients in the room (PDPR) has been identified to be a statistically significant predictor of all day sleep, and pain, PDPR, and physical function have been found to be a significant predictors of sleep regularity in all day among subjects. It suggested that elderly patients in a long-term care hospital do not slept well during night, which leads to increase in daytime sleep and decrease the quality of their sleep. Therefore, an intervention program should be developed to promote the quality of sleep among hospitalized elderly.