Résumé
BACKGROUND: The aim of this study was to investigate the clinical characteristics of complex regional pain syndrome (CRPS) in young male patients in South Korea, especially focusing on the association with military service. METHODS: From January 2007 to May 2017, we investigated the electronic medical records of 430 consecutive patients, aged 18 to 30 years, who visited Seoul National University Hospital Pain Center, with a suspected diagnosis of CRPS at the initial visit. The following patient details were available for analysis: demographic and disease-related variables, relevance to military service, medications, and the treatment modalities received. RESULTS: Out of 430 patients, 245 (57.0%) were diagnosed with CRPS, of which, 200 were male patients and 45 were female patients. Of the male patients, 95 (47.5%) developed CRPS during military service. CRPS during military service was more likely to result from sprain/strain, and the incidence of CRPS was significantly higher in the lower extremities in patients from the military service group than in those from the non-military service group. During the follow-up period, 37.9% of male CRPS patients (n = 61/161) were treated successfully. Patients with moderate to severe initial pain intensity, and diagnosed during their military service, showed better outcomes. CONCLUSIONS: Our results demonstrated that manifestation of CRPS in the young Korean population was more common in male and among those male CRPS patients, about half the cases developed during the military service period.
Sujets)
Femelle , Humains , Mâle , Douleur chronique , Diagnostic , Dossiers médicaux électroniques , Épidémiologie , Études de suivi , Incidence , Corée , Membre inférieur , Médecine militaire , Personnel militaire , Névralgie , Centres antidouleur , Études rétrospectives , Séoul , Stress psychologiqueRésumé
The breakage of epidural catheter seldom makes severe complication, but it may be a stressful event to nervous chronic pain patients. We discovered a retained epidural catheter in plain x-ray image and CT scan following a percutaneous epidural neuroplasty for a 62-year-old woman. Even though surgical removal of the catheter was not tried for 1 year, we decided to remove the catheter fragment as the patient's request, if exploration would be easy. Sonographic evaluation showed that the tip of the epidural catheter beneath subcunateous tissue between sacral hiatus. Ultrasound will be an invaluable tool when trying to remove the broken catheter under local anesthesia if its tip is out of the sacral hiatus.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Anesthésie locale , Cathéters , Douleur chronique , Événements de vieRésumé
Phase transformation, superelastic characteristics and variation of surface residual stress were studied for Nitinol shape memory alloy through application of UNSM technology, and life extension methods of stent were also studied by using elastic resilience and corrosion resistance. Nitinol wire of Oslash1.778 mm showed similar surface roughness before and after UNSM treatment, but drawing traces and micro defects were all removed by UNSM treatment. It also changed the surface residual stress from tensile to compressive values, and XRD result showed less intensive austenite peak and clear martensite and additional R-phase peaks after UNSM treatment. Fatigue resistance could be greatly improved through removal of surface defects and rearrangement of surface residual stress from tensile to compressive state, and development of surface modification system to improve not only bio-compatability but also resistance to corrosion and wear will make it possible to develop vascular stent which can be used for circulating system diseases which run first cause of death of recent Koreans.
Sujets)
Alliages , Cause de décès , Corrosion , Alliage dentaire , Fatigue , Espérance de vie , Mémoire , Endoprothèses , Science des ultrasonsRésumé
Central venous catheterization is useful to evaluate intravascular volume status, while it has a chance of severe complications such as tension pneumothorax, cardiac tamponade, and so on. Now, we report a case of hemothorax after trying subclavian venous catheterization over again in a 2-year-old patient undergoing encephalo-duro-arterio-synangiosis, that required surgical intervention at the end. Though arterial puncture and massive hemothorax is a possible complication of subclavian venous catheterization, the injury of first intercostal artery might be due to inappropriate introducer needle accidentally. In conclusion, both routine chest image confirmation and close observation of expert might be important to prevent iatrogenic complication by anesthetic maneuvers.