• Title/Summary/Keyword: physical pain

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Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis (무릎 내측 구획 골관절염에서 초음파 유도하 경 반월상 연골 주사의 임상적 효과)

  • Jung, Eui Yub;Wang, Joon Ho;Lee, Eui-Sub;Lee, Sung-Sahn;So, Sang-Yeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.418-425
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    • 2020
  • Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.

Experience of Patients with Cancer Participating in a Clinical Trial for the Development of a New Drug (암환자의 신약개발 임상시험 참여 경험)

  • Kim, Hyun-Young
    • Asian Oncology Nursing
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    • v.6 no.2
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    • pp.121-132
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    • 2006
  • Purpose: The purpose of this study was to describe the lived experience of the patients with cancer participating in a clinical trial for the development of a new drug. Method: This study was based on a phenomenological approach. The eight patients participating in a clinical trial were selected as the participations of this study. The data were obtained through in-depth interviews from the participants and were analyzed using the Giorgi method. Results: Essential experiences of the patients with cancer under a clinical trial consisted of anticipating recovery of physical health and a social role, passing the strict criteria of a clinical trial, diminishing economic burden, satisfaction with special treatment receiving, social contribution, concerns about side effects and withdrawal from the clinical trial, conflicts as a participant, pain, limited administration of other treatments, regret for giving up other treatments, strict compliance with instructions, prevention of side effects and maintaining desirable life-style. Integrated units of meaning of these components were hope, good luck, a sense of satisfaction, fear, distress, and the will of self-control. Conclusion: The most essential meaning of the cancer patients participating in a clinical trial was hope. Hope was found to be a primary factor reinforcing the will of self-management. The results of this study can be of great help to the research nurses to understand the lived experience of the patients with cancer and to plan an effective nursing intervention for the patients.

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Death with Dignity and the Right to Decide (생명권과 자기결정권, 그리고 의사의 진료의무)

  • Yoo, Seung-Ryong
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.11-52
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    • 2008
  • Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

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Resection and Prosthetic Replacement of Aneurysm of Aortic Arch (대동맥궁 동맥류 -치험 1례 보고-)

  • Ahn, Hyuk;Kim, Young-Jin;Rho, Joon-Rhang
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.274-279
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    • 1980
  • A 21 years old male student was admitted because of mediastinal mass that was noticed in routine physical examination. He complained progressive hoarseness, mild dysphagia, and anterior chest pain on deep respiration. This mediastinal mass was diagnosed as aortic aneurysm involving ascending, transverse, and descending thoracic aorta with aid of aortogram. Total prosthetic replacement of aneurysm was performed successfully using extracorporeal circulation and hypothermia. For myocardial protection during aortic cross clamping, cardioplegic solution was used and topical myocardial cooling was also adapted For simplicity of cardiopulmonary bypass, Y-shaped connectors took cerebral perfusion catheters to the main perfusion line beyond the arterial pump. Total bypass time was 219 minutes, and aortic cross clamp time was 104 minutes. Recovery was uneventful except respiratory insufficiency for first 4 days. Isotope aortogram checked on post operative 30th day showed normal aortic configuration. He was discharged on post operative 35th day. A follow-up chest X-ray study 5 months later showed nearly normal anatomy.

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TRAUMATIC TMJ INJURY (외상성 악관절 손상)

  • Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.191-199
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    • 1997
  • Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

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Correlation analysis of stress and meridian electromyography in Korean adult males. (한국 남자 성인의 스트레스와 승모근.흉쇄유돌근 경근전도의 상관성 분석)

  • Kim, Min-Beum;Ryu, Ji-Mi;Kim, Sung-Soo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.141-150
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    • 2007
  • Objectives : The purpose of this study was to investigate the correlation of stress and meridian muscle electrography in Korean adult males. Methods : Sixty-nine volunteers suffering from stress participated in this study. Physical examination, stress survey and meridian muscle electrography were performed. Each variable was compared with each other by correlation analysis. Results : Correlation between stress response inventory and fatigue of trapezius muscle right upper portion was statistically significant. In relationship between sub scales of stress response inventory and meridian muscle electrography, fatigue of trapezius muscle right upper portion was statistically significant with tension, depression, and frustration. Contraction power of left sternocleidomastoid muscle was significant with somatization and others were not significant. Conclusions : In Korean adult males, trapezius muscle shows more fatigue under more stress. This suggests that stress influences muscle fatigue. Although meridian muscle electrography is not a typical method for the evaluation of pain nor stress, this is referential method to clinical evaluation of painful shoulder caused stress.

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Investigation of Musculoskeletal Disorders Among Mid-old Aged Woman Caregiver at a Long-term Hospital

  • You, Young-Youl;Lee, Byoung-Hee
    • Journal of the Ergonomics Society of Korea
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    • v.30 no.2
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    • pp.349-356
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    • 2011
  • Objective: The purpose of this study was to analyze the risk factors of the musculoskeletal workload of mid-old-age female caregivers by identifying work postures and subjective symptoms. Method: This study was carried out on a total of 206 subjects 206 mid-old-age caregivers(45~65 years old) from November 2009 to April 2010: 206 mid-old-age caregivers (45~65 years old) at the long-term hospital. A questionnaires survey on general factors and subjective symptoms of subjects was conducted. The risk factors of the musculoskeletal workload evaluation method is based on OWAS, RULA, REBA according to occupation properties. Results: The analysis of the rates of the subjective symptoms showed that 78.6% subjects experience low back pain. The analysis of the work type showed that transfer is the highest rate(36.3%) and position change is the second(18.2%). The analysis of the work postures showed that the thrusted back with twisting position over $20^{\circ}$ is highest rate(37.4%), the bended back forward with twisting position is the second(27.5%). Conclusion: This study suggested that the need of preventive education for caregivers and workload improve. It is hoped that subsequent study on the difference of subjective symptoms between educated caregivers and non educated caregivers will be conducted.

Factors related to Fear of Recurrence in Stroke Patients (뇌졸중 환자의 재발염려에 영향을 미치는 요인)

  • Chung, Ji Won;Kim, Jung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.2
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    • pp.190-197
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    • 2015
  • Purpose: Recently, the number of post-stroke survivors has increased. The physical deficits following stroke have been well studied, but there is little information on fear of recurrence in stroke patients. Objective: The purpose of this study was to investigate the health risk behaviors, health motivation and sense of control on fear of recurrence after a stroke. Method: Data were collected through a questionnaire that included items on general characteristics. Participants were recruited from the convalescent centers and outpatients clinics. Participants completed the mastery scale, health motivation scale, and a fear of stroke recurrence scale. The data were analyzed using hierarchial multiple regressions analysis with SPSS version 18.0. Results: Levels of fear of recurrence, health motivation and sense of control were moderate with means of 19.76(SD=5.15), 26.85(SD=5.10), and 16.69(SD=4.65), respectively. Health motivation and sense of control contributed to fear of recurrence. The variables explained 30.5% of variance in fear of recurrence. Conclusions: Results indicate that interventions for fear of recurrence management after stroke should take into account health motivation and sense of control.

The Effect of Thread-embedding therapy on 9 Patients with Partial Obesity (매선요법을 이용한 부분비만치료 9례 보고)

  • Shin, Hwa-Young;Kwon, Hyo-Jung;Lee, Yun-Kyu;Lim, Seong-Chul;Jung, Tae-Young;Lee, Bong-Hyo;Kim, Jae-Su
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.27-34
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    • 2011
  • Objectives : The purpose of this study was to examine the effect of thread-embedding therapy against partial obesity. Methods : 9 women from 20 to 30 with partial obesity were treated with thread-embedding therapy and then surveyed satisfaction, reaction after treatment and whether they were re-treated or not. The results of before and after treatment were compared with physical measurement, body composition tests and fat thickness measured by ultrasound. Results : The satisfaction of patients was high and side effects were pain, bruises and unnaturalness of action, but 8 of 9 patients wanted to re-treatment. The effect of thread-embedding therapy against partial obesity was continuous and was most pronounced during the first week. Conclusions : Thread-embedding therapy may be useful to reduce partial obesity without different treatments of obesity, diet, exercise etc.

Impact of a Cryotherapy and Tai Chi Self-help Program on Women with Fibromyalgia Syndrome (섬유근통 자조관리 프로그램이 여성 섬유근통 증후군에 미치는 영향)

  • Lee, Hea-Young;Bak, Won-Sook;Choi, Jung-Hyun;Lee, Soon-Hee;Eom, Ae-Yong
    • Korean Journal of Adult Nursing
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    • v.23 no.1
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    • pp.10-19
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    • 2011
  • Purpose: The purpose of this study was to evaluate the impact of a protocol of cryotherapy and Tai Chi on women with Fibrolmyalgia Syndrome. Methods: The study design was a pretest and posttest quasi-experimental, nonrandom assignment. The subjects were 48 outpatients with a diagnosis of fibromyalgia based on the American College of Rheumatology Standards. The setting was a University Medical Center in S city. The protocol was self administered ten times a week, for a two week period resulting in twenty treatments. Results: A protocol of cryotherapy and Tai Chi self-help program showed significant improvement in the fibromyalgia impact as measured by reports of physical impairment, feeing good, number of missed work days, ability to perform work, reports of pain, fatigue, rest, stiffness, anxiety and depression as reported by the comparison group (p<.001). No significant differences between the two regarding in reports of the tender points (p=.062). Conclusion: The results suggested that a protocol of cryotherapy and Tai Chi self-help program may be a promising multidisciplinary strategy for fibromyalgia patients.