• Title/Summary/Keyword: CRPS

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Development of Complex Regional Pain Syndrome after a Snake Bite: A Case Report

  • Seo, Yong Han;Park, Mi Ran;Yoo, Sie Hyeon
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.68-71
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    • 2014
  • The occurrence of CRPS after a snake bite was very rare, only two cases were reported worldwide. Here we report a case that the 44-year-old female patient bitten by snakes CRPS type 1 was treated consecutive intravenous regional block, lumbar sympathectomy and antiepileptic drug therapy, also discuss the possible pathophysiology.

Bee Venom Pharmacopuncture: An Effective Treatment for Complex Regional Pain Syndrome

  • Kim, Jong-Min;Jeon, Hyung-Joon;Kim, Hyun-Ji;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.17 no.4
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    • pp.66-69
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    • 2014
  • Objectives: Treating complex regional pain syndrome (CRPS) is difficult because it still does not have a recommended therapy. A 29-year-old man was diagnosed with CRPS after surgery on his $4^{th}$ and $5^{th}$ left toes 7 years ago. Though he had undergone diverse pain treatment, the symptoms persisted, so he visited Dunsan Korean Medicine Hospital of Daejeon University. This case report presents results on the effect of bee venom pharmacopuncture in treating patient with CRPS. Methods: Bee venom pharmacopuncture (BVP), 0.15 to 0.4 mL dosage, was administered at GB43. The treatment was applied each week for a total 14 times. The symptoms were evaluated using a numeric rating scale (NRS) and the dosage of pain medicine. Results: On the first visit, he was taking an anticonvulsant, a trycyclic antidepressant, and an analgesic. On the NRS the worst pain in the toes received a score of 8. He also complained of severe pain and hypersensitivity when the $4^{th}$ and the $5^{th}$ toes were touched just slightly. Other complaint included dyspepsia, rash, and depression. After treatment, on the NRS, the score for toe pain was 0, and he no longer needed to take pain medication. During the 4-months follow-up period, he has remained without pain; neither have additional symptoms appeared nor adverse events occurred. Conclusion: BVP may have potential benefits for treating patients with CRPS.

Cognitive Assessment in Complex Regional Pain Syndrome Patients (복합부위통증증후군 환자의 인지기능 평가)

  • Moon, Jee Youn;Kim, Yong Chul;Park, Mi Jung;Lee, Pyung Bok;Lee, Sang Chul;Kang, Do Hyung;Shin, Min Sup;Kwon, Tae Myung
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.28-32
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    • 2009
  • Background: Complex regional pain syndrome (CRPS) is characterized by severe neuropathic pain and disability, which can result in psychological and behavioral dysfunction. The goal of the present study was to evaluate neurocognitive disability, and to assess the relationship between clinical variables and neuropsychological features in CRPS patients. Methods: We investigated the neuropsychological features of 15 CRPS I patients. The neuropsychological tests that we made comprised of a full intelligence quotient, memory quotient, trail-making test A, trail-making test B (TMT-B), and MMPI (Minnesota multiphasic personality inventory). Results: The results showed severe disability in performance on TMT-B. There was no significant correlation between specific cognitive variables and MMPI scales. Conclusions: Decreased performance on TMT-B which shows mental flexibility in the prefrontal lobe exists independently from depressive disorders in CRPS patients.

Evaluation of YouTube videos as sources of information about complex regional pain syndrome

  • Altun, Aylin;Askin, Ayhan;Sengul, Ilker;Aghazada, Nazrin;Aydin, Yagmur
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.319-326
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    • 2022
  • Background: As the internet usage becomes easily accessible, the patients are more frequently searching about diseases and medical/non-medical treatments. Considering that complex regional pain syndrome (CRPS) is a debilitating disease, it is important to check the information that patients are accessing. Therefore, this study aimed to investigate the reliability, sufficiency, and accuracy of the YouTube videos about CRPS. Methods: This study is a descriptive research which is derived by searching videos using the keyword 'complex regional pain syndrome' on YouTube. Relevance-based sequencing was used to sort the videos. Sources and video parameters were documented. To evaluate the accuracy, reliability and content quality of the videos, Global Quality Score, Journal of American Medical Association Benchmark Criteria and Modified DISCERN Questionnaire scales were used. Results: A total of 167 videos were included in this study. The majority of the videos originated from USA (80.2%, n = 134). The median number of views was 639 and the viewing rate was 73.3. Most of the videos had partially sufficient data and the interaction index viewing rate parameters for videos with high content quality were greater than videos with low content quality (P = 0.010, P = 0.014). Conclusions: Our results showed that videos about CRPS on YouTube mostly had partially sufficient data and include intermediate-high quality contents. Moreover, high-content quality videos had higher viewing rates, interaction indexes, number of likes, longer durations, as well as better reliability and accuracy scores. Videos with high quality and reliable content are needed to reduce misinformation about CRPS.

A comparison of analgesic efficacy and safety of clonidine and methylprednisolone as additives to 0.25% ropivacaine in stellate ganglion block for the treatment of complex regional pain syndrome: a prospective randomised single blind study

  • Sreyashi Naskar;Debesh Bhoi;Heena Garg;Maya Dehran;Anjan Trikha;Mohammed Tahir Ansari
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.216-229
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    • 2023
  • Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

Enhancing Medium-Range Forecast Accuracy of Temperature and Relative Humidity over South Korea using Minimum Continuous Ranked Probability Score (CRPS) Statistical Correction Technique (연속 순위 확률 점수를 활용한 통합 앙상블 모델에 대한 기온 및 습도 후처리 모델 개발)

  • Hyejeong Bok;Junsu Kim;Yeon-Hee Kim;Eunju Cho;Seungbum Kim
    • Atmosphere
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    • v.34 no.1
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    • pp.23-34
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    • 2024
  • The Korea Meteorological Administration has improved medium-range weather forecasts by implementing post-processing methods to minimize numerical model errors. In this study, we employ a statistical correction technique known as the minimum continuous ranked probability score (CRPS) to refine medium-range forecast guidance. This technique quantifies the similarity between the predicted values and the observed cumulative distribution function of the Unified Model Ensemble Prediction System for Global (UM EPSG). We evaluated the performance of the medium-range forecast guidance for surface air temperature and relative humidity, noting significant enhancements in seasonal bias and root mean squared error compared to observations. Notably, compared to the existing the medium-range forecast guidance, temperature forecasts exhibit 17.5% improvement in summer and 21.5% improvement in winter. Humidity forecasts also show 12% improvement in summer and 23% improvement in winter. The results indicate that utilizing the minimum CRPS for medium-range forecast guidance provide more reliable and improved performance than UM EPSG.

Study on the structure of cAMP receptor protein(CRP) by temperature change (온도변화에 의한 cAMP 수용성 단백질(CRP)의 구조)

  • 주종호;구미자;강종백
    • Journal of Life Science
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    • v.10 no.3
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    • pp.279-285
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    • 2000
  • CRP (cyclic AMP receptor protein) regulate transcription of catabolite-sensitive genes in Escherichia coli. Wild-type and mutant CRP (S83G and S128A) proteins were used to measure the thermal stability and the temperature-dependent structural change by proteolytic digestion, UV spectrophotometer and CD spectrapolarimeter. The result indicated that wild-type CRP was more thermally stable than the mutant CRPs in the presence of cAMP. At a low temperature, wild-type CRP with cAMP was more sensitive to subtilisin than the mutant CRPs. At a high temperature, there was no difference of sensitivity to subtilisin among wild-type, S83G and S128A CRPs. CD spectra suggested that the secondary structure of CRP was destroyed partially at a high temperature.

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Management of Complex Regional Pain Syndrome Type 1 With Total Spinal Block

  • Ok, Se-Jin;Yang, Jong-Yeun;Son, Ju-Hyung;Jeong, Won-Ju;Lee, Yoon-Sook;Kim, Woon-Young;Park, Young-Cheol
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.70-73
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    • 2010
  • Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient’s continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.

Ultrasound-guided Aspiration of the Iatrogenic Pneumothorax Caused by Paravertebral Block -A Case Report-

  • Park, Jin-Suk;Kim, Young-Hoon;Jeong, Su-Ah;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.33-37
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    • 2012
  • Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.

Concurrence of Malignant Peripheral Nerve Sheath Tumor at the Site of Complex Regional Pain Syndrome Type 1 - A Case Report -

  • Jeong, Yeong Ho;Choi, Eun Joo;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.160-163
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    • 2013
  • Malignant peripheral nerve sheath tumors (MPNSTs) are very rare sarcomas derived from various cells in the peripheral nerve sheath. Malignant peripheral nerve sheath tumors have a known association with neurofibromatosis type 1. Diagnosis of MPNSTs is difficult in patients with chronic pain, when MPNST occurs at an overlapping area of chronic pain. Therefore, the diagnosis can be missed unless clinicians pay attention to the possibility of this disease. Here in, we report a case of concurrent malignant peripheral nerve sheath tumor with complex regional pain syndrome type 1. A 44-year female patient, who was diagnosed with complex regional pain syndrome (CRPS) type 1 in her left ankle, visited our clinic because of aggravated pain. The cause of the aggravated pain was revealed as concurrent MPNST in the left common peroneal nerve territory, which overlapped the site of pain from CRPS.