• 제목/요약/키워드: CRPS

검색결과 93건 처리시간 0.029초

외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도에 관한 연구 (Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome)

  • 박정미;김선정;정승현;이용택
    • Nuclear Medicine and Molecular Imaging
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    • 제42권1호
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    • pp.44-51
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    • 2008
  • 목적: 외상 후 복합부위통증증후군으로 진단된 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도를 평가하기 위하여 판독 일치도를 조사하였다. 대상 및 방법: 1994년 국제통증연구학회(IASP) 기준에 따라 외상 후 복합부위통증증후군으로 진단된 34명을 대상으로 하였다. 두 명의 핵의학 전문의가 삼상 뼈 스캔의 세부영상에서 섭취의 양상, 정도와 범위를 평가하여 관찰자내 와 관찰자간 일치도(kappa value)를 구하였다. 환측 사지 전체의 관류와 섭취가 증가되었을 때(기준 1), 지연영상에서 전체적으로 증가되었을 때(기준2), 국소이상의 섭취가 증가되었을 때(기준3)를 양성으로 판정하는 기준에 따라 재분류하여 판독자 임의로 분류하였을 때와 최종판독 일치도를 비교하였다. 결과: 세 영상에서 섭취 양상, 정도, 범위에 대한 관찰자내 일치도는 우수하였다. 세부 영상에 대한 관찰자간 일치도(0.64-0.90)에 비하여 혈액풀의 섭취 범위에 대한 일치도는 낮았다(0.55). 관찰자간 일치도는 임의의 기준으로 최종 판정하였을 때(0.63)에 비하여 공통의 양성 판정 기준에 따라 다시 분류하였을 때 약간 향상되었다(0.77-0.88). 임상시기별 임의 기준으로 분류한 관찰자간 일치도는(급성: 0.29, 만성: 0.37) 양성 판정 기준을 적용시에 크게 향상되었다(급성: 0.47-0.82, 만성: 1.0). 임상시기별 예민도는 급성에 비해 만성에서 대체적으로 낮았다. 결론: 본 연구에서 외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 시 관찰자간 변동성이 있는 것이 검증되었다. 그 변동성은 양성 평가의 기준이 관찰자마다 다른데서 기인하였다. 외상 후 복합통증증후군 환자에서 삼상 뼈 스캔의 판독 신뢰도를 높이기 위해서는 세부 영상 및 임상시기에 따른 구체적인 양성 판정 기준을 정할 필요가 있다.

요부경막외차단술 후 발생한 복합부위 통증증후군에서의 경막외 Ketamine의 효과 -증례 보고- (The Effect of Epidural Ketamine in Complex Regional Pain Syndrome Occuring after Lumbar Epidural Block -A case report-)

  • 옥경종;한경림;김진수;김찬;김은영
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.251-254
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    • 2000
  • A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

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Stability and Structural Change of cAMP Receptor Protein at Low and High cAMP Concentrations

  • GANG JONGBACK;CHUNG HYE-JIN;PARK GWI-GUN;PARK YOUNG-SEO;CHOI SEONG-JUN
    • Journal of Microbiology and Biotechnology
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    • 제15권6호
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    • pp.1392-1396
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    • 2005
  • Proteolytic digestion and CD measurement of wild-type and mutant cyclic AMP receptor proteins (CRPs) were performed either in the presence or absence of cyclic nucleotide. Results indicated that transition of a structural change to the hinge region by the binding of cAMP to the anti site was required for the binding of cAMP to the syn site near the hinge region and, although the occupancy of cAMP in the anti site increased the protein stability, CRP adopted more a stable conformation by the binding of cAMP to the syn site.

Reduction in mechanical allodynia in complex regional pain syndrome patients with ultrasound-guided pulsed radiofrequency treatment of the superficial peroneal nerve

  • Chae, Won Soek;Kim, Sang Hyun;Cho, Sung Hwan;Lee, Joon Ho;Lee, Mi Sun
    • The Korean Journal of Pain
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    • 제29권4호
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    • pp.266-269
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    • 2016
  • The superficial peroneal nerve is vulnerable to damage from ankle sprain injuries and fractures as well as surgery to this region. And it is also one of the most commonly involved nerves in complex regional pain syndrome type II in the foot and ankle region. We report two cases of ultrasound-guided pulsed radiofrequency treatment of superficial peroneal nerve for reduction of allodynia in CRPS patients.

소염약침으로 치료한 복합부위통증증후군(CRPS) type I 환자 1례 증례보고 (The clinical observation of 1 case of the Complex Regional Pain Syndrome)

  • 이은정;윤일지
    • 혜화의학회지
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    • 제18권1호
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    • pp.109-116
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    • 2009
  • Objective: The objective of this study is to observe the effect of anti-inflammatory herbal acupuncture on the Complex Regional Pain Syndrome Methods : Anti-inflammatory herbal acupuncture, A-Shi Point, Sa-am acupunture were used to treat shoulder pain & ROM(range of movement)disorder, chest pain, finger's causalgic pain. We evaluated the patient through VAS(Visual Analog Scale) daily and Physical Examinations Results & Conclusions : After 42days of treatment, shoulder pain was decreased from VAS10 to VAS3, chest pain was decreased from VAS10 to VAS1.5, finger's causalgic pain was decreased from VAS10 to VAS2.5. and the patient showed that the ROM(range of movement) of shoulder was better, oriental treatment is good method for pain relief and better movement.

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A Promoter SNP (rs1800682, -670C/T) of FAS Is Associated with Stroke in a Korean Population

  • Kang, Sung-Wook;Chung, Joo-Ho;Kim, Dong-Hwan;Yun, Dong-Hwan;Yoo, Seung-Don;Kim, Hee-Sang;Seo, Wan;Yoon, Jee-Sang;Baik, Hyung-Hwan
    • Genomics & Informatics
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    • 제8권4호
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    • pp.206-211
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    • 2010
  • The Fas (TNF receptor superfamily, member 6) (FAS)/FAS ligand (FASLG) interaction plays a central role in the regulation of programmed cell death. FAS and FASLG polymorphisms in promoter regions affect transcriptional activities. To investigate whether FAS and FASLG polymorphisms are associated with the development and clinical phenotypes of stroke, 2 promoter single nucleotide polymorphisms (SNPs) in FAS (rs1800682, -670C/T) and FASLG (rs763110, -844C/T) were selected and genotyped by direct sequencing in 220 stroke patients [107 ischemic stroke (IS), 77 intracerebral hemorrhage (ICH), and 36 subarachnoid hemorrhage (SAH)] and 369 control subjects. For the analysis of clinical symptoms, all stroke patients were divided into 3 clinical phenotypes according to the respective results of the National Institutes of Health Stroke Survey (NIHSS) and the Modified Barthel Index (MBI) and the presence or absence of complex regional pain syndrome (CRPS). The SNPStats, SNPAnalyzer, and Helixtree programs were used to analyze the genetic data. Multiple logistic regression models (codominant, dominant, and recessive) were used to estimate odds ratios (ORs), 95% confidence intervals (CIs), and p-values. The promoter SNP rs1800682 was associated with stroke in the codominant (OR=0.48, 95% CI=0.25-0.94, p=0.04) and dominant models (OR=0.51, 95% CI=0.30-0.87, p=0.011). However, a FASLG SNP (rs763110) was not in Hardy-Weinberg equilibrium (p<0.05). In the analysis of stroke types, rs1800682 was associated with IS in the codominant (OR=0.30, 95% CI=0.12-0.74, p=0.025), dominant (OR=0.44, 95% CI=0.23-0.88, p=0.018), and recessive models (OR=0.45, 95% CI=0.21-0.99, p=0.042). The genotype frequencies of rs1800682 were different between ICH and controls in the dominant model (OR=0.49, 95% CI=0.26-0.94, p=0.031) but not between SAH and controls. In the analysis of clinical symptoms, however, rs1800682 was not related to the 3 clinical phenotypes (NIHSS, MBI, and CRPS). These results suggest that a promoter SNP (rs1800682, -670C/T) in FAS may be associated with the development of stroke in the Korean population.

Effects of photobiomodulation on different application points and different phases of complex regional pain syndrome type I in the experimental model

  • Canever, Jaquelini Betta;Barbosa, Rafael Inacio;Hendler, Ketlyn Germann;Neves, Lais Mara Siqueira das;Kuriki, Heloyse Uliam;Aguiar, Aderbal Silva Junior;Fonseca, Marisa de Cassia Registro;Marcolino, Alexandre Marcio
    • The Korean Journal of Pain
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    • 제34권3호
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    • pp.250-261
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    • 2021
  • Background: Complex regional pain syndrome type I (CRPS-I) consists of disorders caused by spontaneous pain or induced by some stimulus. The objective was to verify the effects of photobiomodulation (PBM) using 830 nm wavelength light at the affected paw and involved spinal cord segments during the warm or acute phase. Methods: Fifty-six mice were randomized into seven groups. Group (G) 1 was the placebo group; G2 and G3 were treated with PBM on the paw in the warm and acute phase, respectively; G4 and G5 treated with PBM on involved spinal cord segments in the warm and acute phase, respectively; G6 and G7 treated with PBM on paw and involved spinal cord segments in the warm and acute phase, respectively. Edema degree, thermal and mechanical hyperalgesia, skin temperature, and functional quality of gait (Sciatic Static Index [SSI] and Sciatic Functional Index [SFI]) were evaluated. Results: Edema was lower in G3 and G7, and these were the only groups to return to baseline values at the end of treatment. For thermal hyperalgesia only G3 and G5 returned to baseline values. Regarding mechanical hyperalgesia, the groups did not show significant differences. Thermography showed increased temperature in all groups on the seventh day. In SSI and SFI assessment, G3 and G7 showed lower values when compared to G1, respectively. Conclusions: PBM irradiation in the acute phase and in the affected paw showed better results in reducing edema, thermal and mechanical hyperalgesia, and in improving gait quality, demonstrating efficacy in treatment of CRPS-I symptoms.

THE QUEST FOR COSMIC RAY PROTONS IN GALAXY CLUSTERS

  • PFROMMER C.;ENSSLIN T. A.
    • 천문학회지
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    • 제37권5호
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    • pp.455-460
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    • 2004
  • There have been many speculations about the presence of cosmic ray protons (CRps) in galaxy clusters over the past two decades. However, no direct evidence such as the characteristic $\gamma$-ray signature of decaying pions has been found so far. These pions would be a direct tracer of hadronic CRp interactions with the ambient thermal gas also yielding observable synchrotron and inverse Compton emission by additionally produced secondary electrons. The obvious question concerns the type of galaxy clusters most likely to yield a signal: Particularly suited sites should be cluster cooling cores due to their high gas and magnetic energy densities. We studied a nearby sample of clusters evincing cooling cores in order to place stringent limits on the cluster CRp population by using non-detections of EGRET. In this context, we examined the possibility of a hadronic origin of Coma-sized radio halos as well as radio mini-halos. Especially for mini-halos, strong clues are provided by the very plausible small amount of required CRp energy density and a matching radio profile. Introducing the hadronic minimum energy criterion, we show that the energetically favored CRp energy density is constrained to $2\%{\pm}1\%$ of the thermal energy density in Perseus. We also studied the CRp population within the cooling core region of Virgo using the TeV $\gamma$-ray detection of M 87 by HEGRA. Both the expected radial $\gamma$-ray profile and the required amount of CRp support this hadronic scenario.

다한증 환자에서 흉강경 하 흉부교감신경 절제술 후 발생한 복합부위 통증 증후군 -1례보고- (Complex Regional Pain Syndrome after Thoracoscopic Sympathectomy in a Patient with Hyperhidrosis -A case report-)

  • 권종범;심성보;원용순;박건;이재광;곽문섭;김종렬;윤건중
    • Journal of Chest Surgery
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    • 제33권6호
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    • pp.528-530
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    • 2000
  • Thoracoscopic sympathectomy is a common technique used to treat plamar hyperhiodrosis. The complications of thoracoscopic sympathectomy are rare. Recently, we experienced a complex regional pain syndrome(CRPS) after thoracoscopic sympathecotomy in a patient with hyperhidrosis. The treatment of this complication was chemical epidural sympathetic block and conservative pain control. The result of this treatment was good. The patient was recovered after one month.

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Pregnancy in Woman with Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report and Review of the Literature

  • Yoo, Hyung-Seok;Nahm, Francis Sahngun;Yim, Kyoung-Hoon;Moon, Jee-Youn;Kim, Yung-Suk;Lee, Pyung-Bok
    • The Korean Journal of Pain
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    • 제23권4호
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    • pp.266-269
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    • 2010
  • Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity, During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.