• The Korean Journal of Pain
• /
• v.33 no.2
• /
• pp.183-191
• /
• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.4
• /
• pp.479-485
• /
• 2001

Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

• Journal of Oral Medicine and Pain
• /
• v.20 no.1
• /
• pp.133-139
• /
• 1995

The aim of this study was to investigate the state of anterior tooth contacts in patient with internal derangement of TMJ. We have investigated the change of the number of tooth contacts after conservative treatment including stabilization spint in 83 patients with TMJ internal derangemnet who visited the Orofacial Pain Clinic, Dept of Oral Diagnosis, Seoul National University Dental Hospital. The obtained results were as follows : 1. The gender ratio of patients was 1:3.7(M:F) 2. The number of patients with bony changes in TMJ was 17(20.5%) 3. The number of patients with absence of incisor tooth contacts was 73(88%) 4. The number of Tooth contacts after treatment was decreased compared with that before treatment in both groups. However there was no significant difference between groups 5. There was the decrease in the number of tooth contacts in 12(76%) of 17 patients with bony changes in TMJ and in 23(34.8%) of 66 patients without bony changes in TMJ. 6. The ratio of patients who showed the decrease of the number of tooth contacts was higher in patients with bony changes in TMJ than patients without bony changes in TMJ. 7. After conservative treatments with stabilization splints in patients with TMJ internal derangement, the possibility of the decrease in the number of tooth contacts had no relationship with the presence of incisor tooth contacts. However, the incidence was higher in patients with bony changes in TMJ.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.18 no.3
• /
• pp.193-196
• /
• 2015

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.18 no.4
• /
• pp.255-259
• /
• 2018

Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.

• Journal of Acupuncture Research
• /
• v.38 no.4
• /
• pp.320-324
• /
• 2021

Lumbar spinal stenosis (LSS) is a common degenerative spinal condition that can have unpredictable improvement and worsening of symptoms which include low back pain, radiating pain, claudication, and degenerative lumbar scoliosis affecting quality of life. In this study, thread embedding acupuncture (TEA) was used as a conservative treatment for LSS in combination with complex Korean medicine treatments (acupuncture, herbal medicines, and physical therapy). The treatment was evaluated using the numerical rating scale, walking distance and duration, and inclination of radiological lumbar scoliosis according to antalgic posture. TEA was performed 27 times between June 8, 2020, and March 16, 2021. The patient showed improvement in numerical rating scale score from 7 to 2, pain-free walking distance from 10 m to 900 m, and scoliosis inclination following treatment. The findings of this study suggest that TEA may be helpful in the treatment of LSS.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.3
• /
• pp.136-142
• /
• 2022

Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

• Proceedings of the KACD Conference
• /
• 2002.11a
• /
• pp.721-721
• /
• 2002

For about half a century. dental implants made of titanium have developed as a method of restoration for the tooth loss. In these days. the titanium implants seem to be considered as the alternative for the conventional prosthodontics. But its hard to say that the titanium implants are superior to the treatments that preserve the natural tooth. As this is a general opinion among dentists. the implant will not be able to be the alternative for all the prosthetic treatments. Clinically, there are many causes for extracting tooth. The severe destruction of the tooth structure or periodontal diseases leads to inevitable tooth extraction. When the complete cure is doubtful because of narrow intraoral visibility and improper accessibility in approaching to the tooth and periodontal lesion, we. clinicians often inevitably extract tooth. Passive treatments like conventional restoration, curettage or surgical flap cant be the perfect treatments for the tooth that has subgingival root caries or severe periodontal diseases involved furcation. Many clinicians might have been forced to pull out the relatively healthy tooth by the difficulties of approaching to the lesions and poor prognosis. Though the intentional tooth replantation is performed sometimes. as it doesnt have enough scientific foundation. it has not been considered as a popular treatment method yet. I have been felt keenly the necessity of positive tooth preservation, so I have been attempting the treatment that has new concept. calling Natural Tooth Implantation (NTI) clinically. NTI differs from the tooth replantation in the goal for the treatment and biological healing process. Now. I confirm that NT! is a very positive and valid method of tooth preservation. Like you can get from the name. NTI is the dental implant procedure using natural teeth and similar to the healing process of the titanium implants in many aspects. I have been using biocompatible composite resin. DRM. with NTI and got affirmative clinical results from that. So I would like to introduce.roduce.

• Restorative Dentistry and Endodontics
• /
• v.42 no.2
• /
• pp.125-133
• /
• 2017

Objectives: This study compared the effect of hexamethyldisiloxane (HMDSO) and ammonia ($NH_3$) plasmas on the bond strength of resin cement to fiber posts with conventional treatments. Materials and Methods: Sixty-five fiber posts were divided into 5 groups: Control (no surface treatment); $H_2O_2$ (24% hydrogen peroxide for 1 min); Blasting (blasting with aluminum oxide for 30 sec); $NH_3$ ($NH_3$ plasma treatment for 3 min); HMDSO (HMDSO plasma treatment for 15 min). After the treatments, the Ambar adhesive (FGM Dental Products) was applied to the post surface (n = 10). The fiber post was inserted into a silicon matrix that was filled with the conventional resin cement Allcem Core (FGM). Afterwards, the post/cement specimens were cut into discs and subjected to a push-out bond strength (POBS) test. Additionally, 3 posts in each group were evaluated using scanning electron microscopy. The POBS data were analyzed by one-way analysis of variance and the Tukey's honest significant difference post hoc test (${\alpha}=0.05$). Results: The Blasting and $NH_3$ groups showed the highest POBS values. The HMDSO group showed intermediate POBS values, whereas the Control and $H_2O_2$ groups showed the lowest POBS values. Conclusion: Blasting and $NH_3$ plasma treatments were associated with stronger bonding of the conventional resin cement Allcem to fiber posts, in a procedure in which the Ambar adhesive was used.

• Restorative Dentistry and Endodontics
• /
• v.44 no.1
• /
• pp.6.1-6.11
• /
• 2019

Objectives: The aim of the present study was to evaluate the effect of whitening mouth rinses alone and in combination with conventional whitening treatments on color, microhardness, and surface roughness changes in enamel specimens. Materials and Methods: A total of 108 enamel specimens were collected from human third molars and divided into 9 groups (n = 12): 38% hydrogen peroxide (HP), 10% carbamide peroxide (CP), 38% HP + Listerine Whitening (LW), 10% CP + LW, 38% HP + Colgate Plax Whitening (CPW), 10% CP + CPW, LW, CPW, and the control group (CG). The initial color of the specimens was measured, followed by microhardness and roughness tests. Next, the samples were bleached, and their color, microhardness, and roughness were assessed. Data were analyzed through 2-way analysis of variance (ANOVA; microhardness and roughness) and 1-way ANOVA (color change), followed by the Tukey post hoc test. The Dunnett test was used to compare the roughness and microhardness data of the CG to those of the treated groups. Results: Statistically significant color change was observed in all groups compared to the CG. All groups, except the LW group, showed statistically significant decreases in microhardness. Roughness showed a statistically significant increase after the treatments, except for the 38% HP group. Conclusions: Whitening mouth rinses led to a whitening effect when they were used after conventional treatments; however, this process caused major changes on the surface of the enamel specimens.