• The Korean Journal of Pain
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• v.14 no.1
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• pp.7-11
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• 2001

Background: Although several mechanisms of causalgia, which results from a partial injury to the peripheral nerve trunk, have been proposed, whether or not antidromic impulses from the injured neurons contribute to the development of the mechanical hyperalgesia has not been studied. The purpose of this experiment is was to investigate the role of antidromic impulses to the peripheral sensory receptor site on the development of mechanical hyperalgesia in a rat model of peripheral neuropathy. Methods: Rats were prepared with tight ligation of by tightly ligating the left fifth and sixth lumbar spinal nerves. The effect of bupivacaine pretreatment on the development of mechanical hyperalgesia was evaluated by injecting 0.5% bupivacaine (0.3 ml) into the plantar surface of the left hind paw before the skin incision was made. For the control group, normal saline (0.3 ml) was injected instead of bupivacaine. To measure the mechanical hyperalgesia, paw withdrawal thresholds were measured using a series of von Frey hairs. Mechanical hyperalgesia was measured a the day before, and 1, 2, 3, 4, 7, and 14 days after the surgery. Results: The control group showed decreased withdrawal thresholds from the day after the surgery (the values were $14.0{\pm}0.5$, $8.9{\pm}1.3$, $8.4{\pm}1.6$, $6.9{\pm}1.2$, $8.8{\pm}1.5$, $10.5{\pm}1.3$, and $8.6{\pm}1.3$ g; at -1, 1, 2, 3, 4, 7, and 14 days after the surgery, respectively). However, withdrawal thresholds of the bupivacaine-pretreated group showed increased withdrawal thresholds for three days after the surgery ($14.5{\pm}0.3$, $12.6{\pm}1.4$, $12.7{\pm}1.1$, $10.5{\pm}1.3$ g; at 1, 1, 2, 3 days after the surgery). Conclusions: Our result suggests that antidromic impulses to the peripheral sensory receptors are at least partly responsible for the initial development of mechanical hyperalgesia in a rat model of peripheral neuropathy.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.11 no.1
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• pp.9-16
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• 2015

Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.18-24
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• 1995

We produced the causalgiform pain by the tight ligation of L5 and L6 spinal nerves in the adult rats. To evalute the effect of Ketamine -noncompetitive NMDA (N-methyl-D aspartate) antagoinst- on the causalgiform pain, we tested the changes of; withdrawal sensitivity to the innocuous mechanical stimulation of Von Frey hair 2.35 g(mechanical allodynia); withdrawal frequency to the cold stimulation of acetone (cold allodynia); and total withdrawal time (second) to the cold ($4^{\circ}C$) plate stimulation (cold hyperalgesia) after the administration of 1 mg, 3 mg, 10 mg/kg ketamine. The results were as follows: 1) Cold hyperalgesia was significantly reduced (p<0.05) by 1 mg, 3mg, 01 mg/kg ketamine. 2) Cold allodynia and mechanical allodynia was significantly reduced (p<0.05) by 10 mg/kg ketamine. Above results suggest a therapeutic utility of ketamine in treatment of causalgia - especially, cold hyperalgesia.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.125-128
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• 1988

A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.518-520
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• 2006

Purpose: Glomus tumors are uncommon benign neoplasms arising from the neuromyoarterial apparatus, usually seen in the nail bed of fingers. Most of this mass presents typical symptoms such as severe pain, point tenderness and hypersensitivity to cold like neuroma, gout or causalgia. Concerning about the origin, there were few written reports about extra-digit glomus tumor, especially that occurred in the skeletal muscule. Methods: A 48-year-old female complained of painful tender mass in her right calf aggravated several months ago. Her MRI and femoral angiogram showed a well defined hypervascular tumor such as hemagioma or hemagioendothelioma in the right calf. Surgical treatment was performed, and it proved glomus tumor in soleus muscle histologically. Results: After the operation, patient didn't complain of her symptoms any more and there was no evidence of recurrence during 1 year follow-up period. Conclusion: Authors have found only eight cases of intramuscular glomus tumor reported in the literature and present here the ninth case of an intramuscular glomus tumor and first case of soleus muscle.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.157-185
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• 2009

Objectives : The aim of this study is to suggest approach of oriental medical management and necessity by research of eastern and western medical literatures for Complex Regional Pain Syndrome(CRPS). Methods : We reviewed the clinical and experimental literatures of eastern and western concerned with CRPS which is related causation, signs and symptoms, diagnosis, etiology and management. Results : 1. CRPS is divided into type I and II by nerve injury. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. These conditions can be charaterized clinically by the sensory abnormalities, vascular abnormalities, oedema, sweating abnormalities, motor or trophic changes. 2. CRPS are well known to patients and physicians relatively, but the pathophysiology, causation and treatments are still unclear. 3. CRPS is needed to take the early diagnosis and multidisciplinary approach for significant effect. 4. CRPS can be regarded for obstruction syndrome of Ki and blood(痺證), blood stasis(瘀血), Wei symptom(痿證), numbness(痲木) in the oriental medical management of CRPS. Conclusions : Above the results, it is suggested that further studies and active approach of management of CRPS will be conducted precisely in oriental medicine.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.226-232
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• 1998

With recent advancements in the instrumentation and technique of VATS, it has become the method of choice to cure facial hyperhidrosis. From July 1996 to April 1997, we performed 43 thoracic lower stellate ganglionectomy with VATS for facial hyperhidrosis. There were 33 men and 10 women whose ages ranged from 17 to 63 years(mean age, 37 years). Of those patients, 23 complained only of facial hyperhidrosis, and 20 complained of facial hyperhidrosis along with excessive sweating of the palm or foot. Thoracoscopic sympathetic ganglionectomy procedures included lower stellate ganglionectomy in 12 patients; lower stellate ganglionectomy and T2-sympathetic ganglionectomy in 28 patients; and lower stellate, T2 and T3 sympathetic ganglionectomy in 3 patients. Common complications were compensatory hyperhidrosis(36 patients) and causalgia(8 patients). At the end of the follow-up period(minimum, 3 months) ninety-five percent of the patients reported satisfactory results. Thoracic lower stellate ganglionectomy with VATS is an efficient, safe and minimally invasive surgical procedure for facial hyperhidrosis.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.2
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• pp.108-115
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• 2009

Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.519-524
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• 1998

From January 1996 to December 1996, we performed 137 thoracic sympathetic ganglionectomies with VATs for primary hyperhidrosis in the department of thoracic and cardiovascular surgery at Anam hospital, Korea university medical center. There were 83 men and 54 women whose ages ranged from 13 to 63 years old(mean age: 25years). Of these patients, 128 patients had complained of palmar hyperhidrosis and 26 of facial hyperhidrosis. Thoracoscopic sympathetic ganglionectomies procedures included lower 1/3 Stellate ganglionectomies in 4 patients; lower 1/3 Stellate ganglionectomies and T2-sympathetic ganglionectomies in 18 patients; T2-sympathetic ganglionectomies in 86 patients; T2 and T3 sympathetic ganglionectomies in 10 patients; and T2, T3 and T4 sympathetic ganglionectomies in 19 patients. The mean operating time was 59 minutes(range: 25 to 162 minutes), and the mean hospital stay was 3.8 days(range: 2 to 8 days). Common complications were compensatory hyperhidrosis(109 patients) and causalgia(18 patients). At the end of the follow-up period(mean: 8 months) ninety-seven percent of the patients reported satisfactory results. Thoracic sympathetic ganglionectomy with VATs is an efficient, safe, and minimally invasive surgical procedure for primary hyperhidrosis.