• Title/Summary/Keyword: physical pain

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Delayed awakening time from general anesthesia for dental treatment of patients with disabilities

  • Choi, Junglim;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.3
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    • pp.219-226
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    • 2021
  • Background: Patients with disabilities often require general anesthesia for dental treatment because of their cooperative or physical problems. Since most patients with disabilities take central nervous system drugs, the management of recovery status is important because of drug interactions with anesthetics. Methods: The anesthesia records of patients under general anesthesia for dental treatment were reviewed, and data were collected. Healthy patients under general anesthesia for dental phobia or severe gagging reflex were designated as the control group. Patients with disabilities were divided into two groups: those not taking any medication and those taking antiepileptic medications. The awakening time was evaluated in 354 patients who underwent dental treatment under general anesthesia (92 healthy patients, 183 patients with disabilities, and 79 patients with disabilities taking an antiepileptic drug). Based on the data recorded in anesthesia records, the awakening time was calculated, and statistical processes were used to determine the factors affecting awakening time. Results: Significant differences in awakening time were found among the three groups. The awakening time from anesthesia in patients with disabilities (13.09 ± 5.83 min) (P < 0.0001) and patients taking antiepileptic drugs (18.18 ± 7.81 min) (P < 0.0001) were significantly longer than in healthy patients (10.29 ± 4.87 min). Conclusion: The awakening time from general anesthesia is affected by the disability status and use of antiepileptic drugs.

Successful Postoperative Management of Gastrointestinal Stromal Tumor in a Dog

  • Lee, Ki-Sung;Kim, Keon;Yang, Chul-Ho;Suh, Guk-Hyun;Lee, Chang-Min
    • Journal of Veterinary Clinics
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    • v.38 no.4
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    • pp.184-188
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    • 2021
  • A 10-year-old spayed female Maltese with a history of vomiting and lethargy was referred to the hospital. Physical examination revealed dehydration and severe pain following abdominal palpation. A large mass was observed in the cranial abdomen through radiography and ultrasonography. Laparotomy was performed to find the origin of the mass. The mass was about 8 cm originating from the cecum and subsequently removed. Histopathologic evaluation revealed that the cecal mass was suspected to be a mesenchymal-derived tumor. Through immunohistochemistry, the mass was diagnosed as a gastrointestinal stromal tumor (GIST) based on the c-kit expression. Given its recurrence, postoperative preventive therapy was initiated with masitinib mesylate, which is a tyrosine kinase inhibitor. The animal did not show any side effects during the medication period. After 6 months of therapy, it was well controlled without any recurrence. In this case, we introduced a novel postoperative management of GIST using masitinib mesylate.

Carbon-ion radiotherapy in osteosarcoma of the mandible: a case report

  • Ha, Tae-Wook;Park, Slmaro;Youn, Min Yeong;Kim, Dong Wook;Kim, Hyung Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.315-320
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    • 2021
  • Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.

Factors associated with dental service utilization among older adults (한국 노인의 치과의료이용 영향 요인)

  • Choi, Hye-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.2
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    • pp.117-124
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    • 2022
  • Objectives: It is crucial to detect and prevent oral problems early. Older adults, in particular, should go for regular dental checkups to maintain a healthy oral environment. This study identified the factors affecting regular dental examinations and unmet dental needs in older adults. Methods: This study analyzed 3,362 older adults aged 65 or over using the data from the 7th Korean National Health and Nutrition Examination Survey (KNHANES). Frequency analysis was performed on general characteristics. In addition, chi-square tests were done to determine differences in regular dental checkups and unmet dental needs according to general characteristics. Logistic regression analysis was performed on factors influencing regular dental checkups and unmet dental needs. Results: Factors influencing regular dental checkups were statistically significant according to residential areas, level of education, household income, and levels of physical activity (p<0.05). Factors influencing unmet dental needs were statistically significant according to residential areas, level of education, private medical insurance, and levels of dental pain (p<0.05). Conclusions: National level policy strategies should be implemented to improve the oral health of older adults. These strategies should encourage regular dental checkups to effectively lower the rate of unmet dental needs.

Improved Symptoms of Peripheral Facial Nerve Palsy in ChAdOx1 nCoV-19 Vaccine Recipients Following Complex Korean Medicine Treatment

  • Jang, Woo Seok;Jang, Jung Eun;Jung, Chan Yung;Kim, Kyung Ho
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.139-144
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    • 2022
  • Peripheral facial nerve palsy is a neurological condition/disease characterized by unilateral paralysis of the facial muscles. We report the effects of complex Korean medicine treatment in 2 patients diagnosed with Bell's palsy who developed symptoms 3-4 days following vaccination with ChAdOx1 nCoV-19 and who received oral steroids and antiviral medications. Complex Korean medicine treatments including acupuncture, electroacupuncture, bee venom acupuncture, cupping therapy, herbal medicine, and physical therapy were performed. Symptom improvement was evaluated daily using the Numerical Rating Scale, House-Brackmann Grade, and Yanagihara's Score. Patient 1 was hospitalized for 22 days and Patient 2 visited the outpatient clinic 20 times. In both cases, postauricular pain caused by Bell's palsy disappeared, and symptoms of facial paralysis improved following completion of treatment. These findings could suggest that combined Korean medicine treatment may improve symptoms of peripheral facial nerve palsy.

Analysis of Health Problems among Airline Pilots in Korea (2016~2018) (민간 항공기 운항승무원의 건강문제 분석(2016~2018))

  • Kim, Ji Seon;Choi, Yun Young
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.1
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    • pp.34-39
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    • 2020
  • The medical fitness of pilots is part of the civil aviation safety scenery. This study aimed to analyze the health problems occurring among Korean commercial pilots. Three data sources were used to identify the health problems: 7,574 aviation medical examination data, 5,400 sick leaves and 39 cases of a decrease in medical fitness during flight duty period and layover of Korean commercial pilots who have been working for K airline from Jan. 1, 2016 to Dec. 31, 2018. This study was retrospectively analyzed using SPSS 22 statistical program. Waiver of medical certificates was an average 11.9% of total issuance for 3 years, with a denial of 0.1%. The leading cause of denial of medical certificates was predominantly of cardiovascular cause (55.6%). Mild respiratory and digestive disease accounted for 82% of total sick prevalence and 68% of total sick days. The psychiatric and cardiovascular disease were ranked high according to the number of days lost per case. The most common cause of decrease in medical fitness during flight duty period was acute abdominal pain (36.4%) and musculoskeletal disorder (40%) when staying abroad. Aeromedical emphasis on minimizing cardiovascular risk remains appropriate. Major pilot health problems identified in this study should be considered in establishing pilot health promotion programs for aviation safety.

Isolated Spinal Accessory Nerve Palsy from Volleyball Injury

  • Holan, Cole A.;Egeland, Brent M.;Henry, Steven L.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.440-443
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    • 2022
  • Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

Subungual Osteochondromas of the Toe: Two Case Reports for Diagnosis and Treatment

  • Myung Chul Lee;Chan Eol Seo;Wook Youn Kim;Wan Seop Kim;Jeenam Kim;Donghyeok Shin;Hyungon Choi
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.101-105
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    • 2023
  • Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

Reconstruction of Triceps Tendon Avulsion Using Mesh Graft and Krackow Suture in a Border Collie

  • Hyeon-Jong Choi;Jong-Hoon Kim;Eunchae Yoon;Tae-Sung Hwang;Hee-Chun Lee;Dongbin Lee;Jae-Hoon Lee
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.378-383
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    • 2022
  • A 3-year-old, 24-kg intact female Border Collie was referred for a toe-touch weight-bearing stance, intermittent weight-bearing lameness, and moderate pain reaction of the right forelimb on physical examination and right humerus olecranon avulsion fracture on diagnostic imaging examination. Surgical repair was performed using tension band wiring to re-attach the triceps tendon and distal olecranon. Migration of the distal olecranon fragment was observed due to comminuted fracture of the fragment 5-days after surgery, and revision surgery was performed. The tension-relieving sutures were passed through the pre-drilled hole in the olecranon, and the polyester mesh was augmented to the suture region, covering the triceps tendon and olecranon drilling hole using the Krackow suture pattern. The elbow joint was immobilized using a type IA transarticular external fixator, which was removed 8 weeks after surgery. Fourteen weeks after surgery, no lameness was observed on gait evaluation. At follow-up after 7 months, the distal olecranon fragment had stabilized, and no lameness was observed.

The Effects of Thoracic-Lumbar Dissociate and Slump Motions on Thoracic-Lumbar Erector Spinae and Rectus Abdominis Activity (등-허리뼈 분리동작과 슬럼프 동작이 등-허리뼈 척추세움근과 배곧은근 활성도에 미치는 효과)

  • Jung, Ju-Hyeon
    • PNF and Movement
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    • v.20 no.1
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    • pp.51-58
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    • 2022
  • Purpose: The purpose of this study was to investigate the effect of thoracic-lumbar dissociation motion and slump motion on thoracic-lumbar erector spinae and rectus abdominis muscle activity. Methods: Seventeen healthy adult volunteers participated in this study. All participants performed two motions (thoracic-lumbar dissociation motion, slump motion). Muscle activation during the two motions was measured using a surface electromyography device. The data from this were collected from the iliocostalis thoracis, iliocostalis lumborum, and rectus abdominis. The activities of these muscles before and after each motion were then compared. Results: The iliocostalis thoracis activation was significantly greater during the thoracic-lumbar dissociation motion than during the slump motion (p <0.05). The iliocostalis lumborum activation was greater during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). The rectus abdominis activation was lesser during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). Conclusion: This study confirmed that individual contraction of the erector spinae muscles is possible during thoracic-lumbar dissociation motion, which increases the stability of the thoracic spine. In addition, this motion could improve control of the rectus abdominis. Therefore, thoracic-lumbar dissociation motion should be considered for rehabilitation programs for patients with kyphosis and back pain.