• The Korean Journal of Pain
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• 제22권1호
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• pp.83-87
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• 2009

Case reports after accidental subdural injection during attempted epidural block have usually described extensive neuraxial blocks with a characteristic radiographic appearance on contrast injection. We experienced a case of cervical subdural injection with unusual clinical findings and radiographic appearance. A 51-year-old female patient with central herniated nucleus pulposus at cervical (C5/6) and lumbar level (L4/5, L5/S1) was referred to the pain clinic. During attempted cervical epidural block at the C6/7 interspace with fluoroscopy, injection of the 4 ml contrast showed posterior spread at cervical level. After cervical epidural steroid injection, the contrast was also confined to the posterior aspect of the spinal canal at lumbar level with fluoroscopy. In order to discriminate subdural space from epidural space, we performed transforaminal epidural injection of the 2 ml contrast at the L5/S1 interspace and we could confirm cervical epidural injection was made into the subdural space. We discuss the clinical characteristics of a subdural injection and the appearance of the cervical and lumbar subdurogram.

• The Korean Journal of Pain
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• 제8권1호
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• pp.93-98
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• 1995

Arthritis is one of the most common disease of mankind. Major of arthritis is osteoarthritis(OA), but the cause is not clear and the characters are chronic and often progressive. So the management and the pain control of OA are very difficult and adequate ways of controlling it have not been discovered. In the present study we investigated the effects of Knee Intra-articular Injection(KII) of lidocaine with aspirin on OA of the knee. Thirty OA patients with Visual Analogue Scale(VAS) above 8 were studied and they were divided into two groups as follows; Group I(n=15); KII with 1% lidocaine 5 ml Group II(n=15); KII with 2% lidocaine 2 ml and aspirin 2 ml(180 mg, diluted with normal saline) In two groups, KII was done 2 times a week for 4 weeks and we compared the changes of VAS between two groups. The results were as follows; 1) Before the KII, initial mean VAS of group I and II was 8.8 and 8.9. After KII 2 times, VAS of group I and II was 6.6 and 6.4. These deceases were statistically significant, but there was no significant difference of VAS between two groups. 2) After KII 4 times, VAS of group I and II was 6.3 and 5.5, significant decrease was observed in group II. 3) After KII 6 times and 8 times, VAS of group I and II was not decreased anymore, but the VAS of group II was maintained in significant decreased state that of group I. We experienced that KII of lidocaine with aspirin was more effective than that of lidocaine only. So we suggest that KII of mixed solution of lidocaine and apsirin may be one of treatments for OA of the knee.

• 대한정형외과 초음파학회지
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• 제1권2호
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• pp.117-121
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• 2008

증식치료는 정상세포나 조직을 성장시키기 위해 성장인자 또는 성장인자 생성 자극제를 주사하는 것이다. 비록 수십 년 동안 논쟁이 되어 오고 있지만 갈수록 더 많은 의사들이 증식치료를 시술하고 있다. 증식치료라는 단어는 1950년 대에 Hacket에 의해 기술되었는데 인대나 근건에 있는 정상조직의 증식을 의미 하였다. 인대 염좌 등의 불완전한 치료는 만성 통증뿐만 아니라 관절불안 등을 초래하고 골관절염의 진행을 촉진할 수 있다. 증식치료는 통상적인 치료에 불응하는 이러한 근골격계 질환에 사용된다. 사용되는 증식제나 수기는 의사마다 수련과정 또는 선호도에 따라 차이가 있을 수 있지만 최근 가장 많이 사용되는 증식제는 10~25%의 포도당이다. 고해상도 초음파기기의 발전에 따라 인대나 근건 등을 실시간으로 볼 수 있게 됨에 따라 이를 증식치료에 접목하여 수기의 정밀도를 높이고 주입되는 약의 확산을 확인 할 수 있게 되었고 그 치료 결과를 기록할 수 있게 되었다.

• 디지털융복합연구
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• 제14권12호
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• pp.283-292
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• 2016

본 연구는 당뇨병 환자를 대상으로 인슐린 치료에 대한 문화적 관점과 경험을 탐색하기 위해 19명의 제1형과 2형 당뇨병 환자를 대상으로 포커스 그룹 인터뷰를 실시하였다. 인터뷰 내용을 기록하고 녹취한 후 내용분석을 통해 당뇨병 환자들이 경험하는 인슐린 치료에 대한 사전인식요인과 장애요인 및 촉진요인을 목록화하였으며 이들 3가지 목록에 포함되는 주요어를 도출하였다. 그 결과 인슐린에 대한 막연한 두려움이 사전인식요인의 주요어로 확인되었고 장애요인으로는 인슐린과 관련된 걱정(통증, 낮은 지식과 문해력, 자가 주사에 대한 낮은 자신감, 경제적 부담, 저혈당에 대한 두려움)과 의료진에 대한 양가감정, 의지하게 된 삶, 친구, 친척과 가족에 대한 감정, 불편감, 과거에 대한 후회, 부끄러움이 주요어로 도출되었다. 촉진요인으로는 깨달음과 신체적 회복 및 혈당조절에 대한 자신감이 확인되었다. 본 연구결과를 토대로 국내 당뇨병 환자의 인슐린 치료에 대한 경험과 지각에 대한 의료인의 이해가 필요하며 당뇨병 환자의 이러한 경험은 존중되어야 할 것으로 사료된다.

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.70-79
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• 2021

본 연구는 장기간 스테로이드 주사 및 연고, 항히스타민제 복용 등에도 악화된 중증 각화성 결절 양진 환자 치험례이다. 환자에게 한약 투약, 침, 증기, 습부항, 약침, 한방 외용제 치료를 시행한 결과 결절 과각화 감소 및 소양감, 열감, 통증, 수면 장애 등 제반 증상에 치료 효과가 있음을 확인할 수 있었다.

• Clinical Pain
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• 제19권1호
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• pp.8-15
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• 2020

Objective: To compare the therapeutic efficacy of the bone marrow aspirate concentrate (BMAC)- platelet-rich plasma (PRP) complex with hyaluronic acid in patients with knee osteoarthritis. Method: Thirty-four patients with knee osteoarthritis participated in this study. Seventeen patients in the study group underwent BMAC and PRP extraction followed by intra-articular injection of BMAC-PRP complex within affected knee. Seventeen patients in the control group underwent intra-articular injection of hyaluronic acid. Knee injury, osteoarthritic outcome score (KOOS), and EuroQol-5D (EQ-5D) questionnaire were evaluated before, one month, three months, and six months after the injection. Results: There were statistically significant temporal differences in total KOOS scores in both BMAC-PRP and HA groups. However, there were no significant group difference in the study period. In the Sports and Recreational Function Scale, there was statistically significant improvement in the BMAC-PRP group compared to the HA group at three months (p=0.041). There were no side effects or complications in both groups. Conclusion: Intra-articular injection of BMAC-PRP showed better functional recovery in the OA at three months and this can be an alternative treatment in terms of functional recovery in the OA in addition to the decrease of pain.

• Clinical Pain
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• 제20권2호
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• pp.127-130
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• 2021

Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

• Clinical Pain
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• 제20권2호
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• pp.99-104
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• 2021

Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.

• Clinical Pain
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• 제19권2호
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• pp.116-119
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• 2020

Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

• Pediatric Infection and Vaccine
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• 제29권3호
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• pp.173-178
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• 2022

Streptococcus intermedius는 입안, 상부 호흡기, 위장관 등에 정상 상재균 중 하나로 존재하는 그람 양성 산소내성 혐기성 알균이다. 면역저하나 심장질환자에서 외상 또는 침습적 치료 후에 발생하는 기회 감염의 원인이 될 수 있다. 저자들은 최근 침습적 치료나 외상 등 특이 과거력이 없이 건강했던 7세 소아에서 S. intermedius에 의해 발생한 엉덩관절 화농 관절염을 경험하였기에 보고하고자 한다. 환자는 내원 3주전부터 왼쪽 엉덩관절 통증이 있었으며, 본원 내원 당일부터 발열이 발생하였다. 엉덩관절 자기공명영상에서 왼쪽 엉덩관절의 급성 화농 관절염으로 진단한 후 수술적 배농을 시행하였고, 혈액과 흡인 관절액에서 S. intermedius가 배양되었다. 수술 후 2주간의 ceftriaxone 정맥주사 후 3주간의 amoxicillin 경구 항생제로 치료한 후 재발없이 안정된 상태를 보이고 있다.