BACKGROUND: Pain is one of the most common presenting complaints in the emergency department(ED) and adequate analgesia for painful conditions is an important goal of emergency medical practice. This study was designed to investigate on the actual condition regarding the use of analgesic injections for traumatized patients in the field of ED and to reconsider the concern and methods of pain management in the future. METHOD: We carried out a prospective, noninterventional observational clinical study of adult patients presenting with acute trauma in the ED. Using a numeric rating scale ranging from 0 to 10, patients quantified their pain intensity on arriving at the ED and on one hour after analgesic administrations in the cases of analgesic use or after initial Assessment in the cases of no analgesic use. They also were interviewed about the level of their satisfaction to pain relief before leaving the ED. RESULTS: Seventy eight percent of all patient received analgesic injections(nonsteroidal antiinflammatory drugs; 62%, opioids; 16%) and the remaining 22 patients(22%) were treated without analgesics. At the time of secondary assessment to pain, initial pain score in the cases of analgesic administration decreased. Patients who are beyond fair in the level of satisfaction were recorded for only 18% of all patient even though 78% of patients received analgesic injections. CONCLUSION: Our data illustrate that the patient of trauma commonly receive analgesic injections in the ED but their levels of satisfaction are under fair. This finding suggests that the concern and methods of pain management have to be reconsidered through the understanding of analgesic pharmacology and pattern of pain relief by analgesics.
Adult ; Analgesia ; Analgesics ; Analgesics, Opioid ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Pain Management* ; Pharmacology ; Prospective Studies

BACKGROUND: Victims of trauma in the emergency room(ER) suffer from kinds of discomforts derived from their physical injury and psychological instability. Although discomforts may be varied by the patient's characteristics and environmental factors such as medical personnel or facilities in ER, an active control for the discomfort should be required because it may affect an outcome of treatment and prognosis of illness. The purpose of this study is to analyze the distressing factors which traumatized patients have been experienced in the ER and to improve the management of trauma patients in the future. METHODS: From January 1, 1996 to June 30, 1996, we tried to interview patients about the painful experiences in ER before the decision of his or her discharge from ER. We analyzed the data on age, sex, religion, educational level, injury severity score(ISS), the most unpleasant experience, sleep deprivation, and friar for death. RESULTS: The 126 patients were enrolled in this study. The patients consisted of 93 male and 33 female, their mean age was 45 years old and mean ISS was 7.86. About seventy one percent of the patients complained unpleasant experiences during the stay in the ER. Of these, pain at the injury sites was the most frequent complaint (66.7%). The sleep deprivation was showed about sixty percent of the total patient and the most common cause of this was also due to pain(40%). Nineteen percent of the patients answered that they have felt the fear for death. There were statistically significant differences in degree of the ISS whether the fear for death and unpleasant experience were or not. When the patients demarked with whether the presence of pain, the occurrence of sleep deprivation, and fear for death were statistically related to the pain. However, the data was denoted no direct relationship with pain according to sex, educational level, or religion. CONCLUSION: The trauma patient admitted to ER suffered from various stressful conditions including not only their physical injury but care personnel or unstable environmental factors in ER. Therefore, emergency medical personnel has to understand some possible distresses of the patients and need to reduce them to provide more careful and proper managements.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Sleep Deprivation

No abstract available.

Authors examined 40,000 minifilms(boys and girls each 10,000 in junior and senior high schools) which were taken for survey of pulmonary tuberculosis for junior and senior high school students and checked the prevalence of scoliosis. It was considered lateral curvature of spine more than 10 degrees as nonpostural scoliosis, which were analyzed prevalence rate, degree of curvature, distribution of size of curvature, pattern of curve and direction of curvature. Following results were obtained. 1. The overall prevalence rate was 1.56; male 1.38. and female 1.70%(Junior high school 1.06%, Senior high school 2.05%). 2. Scoliosis secondary due to bony abnormality was found in 5 cases. 3. The most common pattern of curvature was the thoracic curve. 4. In sihgle curve, right to left ratio was 1.7, especially senior high school girls had more right curve and junior high school boys had more left curve. 5. The prevalence of senior high school students was greater than that of junior high school students and the degree of curvature was also severe in senior high school students than in junior high school students.
Busan ; Female ; Humans ; Korea ; Male ; Prevalence ; Scoliosis ; Spine ; Tuberculosis, Pulmonary

We did clinical analysis of 72 patients with branched retinal vein occlusion, who were diagnosed by indirect opthalmoscope and fluorescein angiography and treated with laser photocoagulatlon from Jan, 198l to May, l990. The results were as follows; 1. Final visual acuity has a Significant statistical correlation with macular edema in terma of 'quadrant area' 2. We were unable to demonstrate any statistical correlation between final visual acuity and the following factors: degree of nonperfusion, neovascularization type of laser photocoagulatlon, duration of symptoms before laser photocoagulation.
Fluorescein Angiography ; Humans ; Light Coagulation ; Macular Edema ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity

We assessed several emotional variables in patients experiencing conventional urodynamic and ambulatory urodynamic monitoring (AUM) to verify the hypothesis that AUM is tolerated as well as conventional urodynamics. A total of 33 women and 7 men from 23 to 72 years of age who were undergoing both procedures were prospectively included in this study. Prior to and immediately after the procedures, each patient completed a self-administered questionnaire. Answers were given on a visual analogue scale. The degree of anxiety was higher for conventional urodynamics than for AUM (p = 0.045), while the degree of boredom experienced during AUM was higher than that during conventional urodynamics (p= 0.013). There was no significant difference in the degree of shame or bother experienced by the patients during the two procedures. In general, patients tolerated both examinations extremely well. The examiner-rated degree of intolerance during conventional urodynamics was influenced by the subjective pain score (p=0.001), while all other emotional variables except bother were not significantly related with the degree of intolerance during AUM (p=0.007). A total of 74.4% and 84.6% responded that they were willing to repeat conventional urodynamics and AUM, respectively, which were not significantly different. Although AUM produced a significantly higher level of boredom than conventional urodynamics, our data demonstrates that patients are as tolerant of AUM as they are of conventional urodynamic procedures.
*Urodynamics ; Urination Disorders/*diagnosis/*urine ; Urinary Incontinence/diagnosis ; Questionnaires ; Pain Measurement ; Pain ; Monitoring, Ambulatory/*methods ; Middle Aged ; Male ; Humans ; Fluoroscopy/*methods ; Female ; Anxiety ; Aged ; Adult

Malignancy may cause variable musculoskeletal symptoms which resemble connective tissue disorder. This symptoms as a fine sign of hidden neoplasm can precede the diagnosis of underlying malignancy. But only one case of stomach cancer associated with cancer arthritis was reported in the world. This fact is very interesting in Asia which has high prevalence of stomach cancer. We experienced one case of gastric adenocarcinoma with oligoarthritis involving both knee and right elbow. A 48-year-old man was diagnosed stomach cancer by gastric endoscope and biopsy. After then, he complained pain, tenderness, heating sensation, swelling of both knee and right elbow with high fever. Both knee MRI showed abundant synovial effusion and soft tissue edema. Full dose of nonsteroidal anti-inflammatory drug was not effective to control fever and arthritis. But fever and arthritis were gone after resection of tumor.
Adenocarcinoma* ; Arthritis ; Asia ; Biopsy ; Connective Tissue ; Diagnosis ; Edema ; Elbow ; Endoscopes ; Fever ; Heating ; Hot Temperature ; Humans ; Knee ; Magnetic Resonance Imaging ; Middle Aged ; Prevalence ; Sensation ; Stomach Neoplasms

With the increasing use of PD as a replacement therapy in chronic renal failure, the number of complications related to PD also has increased. One of these is hydrothorax associated with pleuroperitoneal communications. Diagnosis is based upon confirming that the fluid in pleural space is dialysate. The chemical characteristics of the pleural fluid can help diagnose dialysate in pleural space. One can use dialysate mixed with dye (methylene blue, indigo). Peritoneographies with contrast and radionucleotides are safe, accurate, and reliable methods of diagnosing peritoneal defects. While these substances do not damage the peritoneum, their diffusion is low. We report 2 cases of hydrothorax associated with pleuroperitoneal communications in CAPD patients. We employed CT peritoneography and peritoneoscintigraphy to diagnose the hydrothorax associated with pleuroperitoneal leak.
Diagnosis ; Diffusion ; Humans ; Hydrothorax* ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory ; Peritoneum

We report a case with an isolated single coronary artery originating from the ascending aorta, which to our knowledge has never been described before. A 51-year-old man presented for evaluation of atypical chest pain, suffering from a short resting chest pain for 3 days. However, serial electrocardiogram showed no change during chest pain. Cardiac enzymes such as CK-MB, Troponin-I, and myoglobin were within normal limit. Aortography and coronary angiography revealed a single coronary artery originating from the postero-lateral wall of the ascending aorta above the left coronary siuns. However, this anomaly was not of clinical significance based on the atypical nature of the chest pain, negative exercise echocardiography and an absence of obstruction of the coronary artery.
Aorta* ; Aortography ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Echocardiography ; Electrocardiography ; Humans ; Middle Aged ; Myoglobin ; Troponin I

STATEMENT OF PROBLEM: Proper finishing and polishing enhance both the esthetics and the longevity of restored teeth. Blade finishing technique would be suited for smoothing and finishing. Evaluation of this technique are necessary. PURPOSE: The purpose of this study was to evaluate the blade finishing and polishing procedures on the surface profile and roughness of ormocer-based composite resin and nanohybrid composite resin. MATERIAL AND METHODS: The material included a ormocer-based composite resin (Admira(R) & Admira(R) Flow); a nanohybrid composite resin (Grandio(R) & Grandio(R) Flow). One hundred forty specimens of each group were prepared using a mylar strip and randomly divied into blade finishing and rubber polishing groups (n=10). The average surface roughness (Ra) in micrometers was measured and the surface profile was examined by scanning electron microscopy (SEM) (Magnification X 200). The data were analyzed by Mann-Whitney Test at 0.05 significance level. CONCLUSION: The results of this study indicated that the mylar strip produced the smoothest surface on all materials and among the finishing-polishing methods was not significanct difference (P>0.05). Ormocer-based flowable composite resin performedthe lowest variability in initial surface roughness among the tested materials.
Composite Resins ; Esthetics ; Longevity ; Microscopy, Electron, Scanning ; Polyethylene Terephthalates ; Rubber ; Tooth