• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.446-452
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• 2011

Objective : We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. Methods : A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. Results : The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. Three (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. Conclusion : These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.661-668
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• 2016

Objectives: To describe the effect of traditional Korean medicine and treatment on Miller Fisher syndrome (MFS).Methods: A 54-year-old woman diagnosed with MFS presented with eyeball dysfunction, diplopia, vertigo, right facial palsy, and back dysesthesia. The patient had been treated with immunoglobulin for 21 d, but her symptoms failed to improve. Thus, herbal medicine, acupuncture, electropuncture, pharmacopuncture, and moxibustion were added. Length of eyeball movement, distance that the patient recognize double images in the eyes and Visual Analogue Scale (VAS) are measures for the syndrome.Results: The symptoms of the patient considerably improved, with the return of eyeball movement to normal and disappearance of diplopia.Conclusions: The results suggest that Korean medicine may be an effective therapy for MFS.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.177-195
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• 2009

Objectives : This study is performed to investigate the acupuncture on Sciatica through the literature of oriental medicine. Methods : We collected the oriental medical literature from ancient to modern times, and extracted the causes, symptoms, treatments and acupoints of sciatica. Results : The findings of this study are as follows: 1. The etiology of Sciatica is differentiated into the exogenous pathogenic factors(wind, cold, dampness, trauma, bad posture) and the internal pathogenic factors(deficiency of the kidney energy, congenital debility). 2. The symptoms of Sciatica are pain, weakness and dysesthesia in the low back, hip and lower limb. 3. In the treatment of Sciatica, The Leg Greater Yang Bladder (BL) Meridian and The Leg Lesser Yang Gall Bladder (GB) Meridian out of 12 meridians were mainly used and the acupoint GB30(Hwando) was most frequently used in the acupuncture literature. 4. The number of acupoints used for sciatica was 95, and those acupoints in the order of frequency were GB30(Hwando), GB34(Yangnungch'on), BL40(Wijung), BL60(Kollyun), GB31(P'ungshi), GB39(Hyonjong), BL57(Sungsan), ST36(Chok-samni). Conclusion : The most frequently used acupoints for the treatment of sciatica are as follows; GB30(Hwando), GB34(Yangnungch'on), GB31(P'ungshi), GB39(Hyonjong) of The Leg Lesser Yang Gall Bladder Meridian, BL40(Wijung), BL60(Kollyun), BL57(Sungsan) of The Leg Greater Yang Bladder Meridian.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.747-752
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• 2018

Objective : To prospectively compare facial pain outcomes for patients having either a repeat microvascular decompression (MVD) or percutaneous balloon compression (PBC) as their surgery for trigeminal neuralgia (TN) recurrence. Methods : Prospective cohort study of 110 patients with TN recurrence who had either redo MVD (n=68) or PBC (n=42) from July 2010 until September 2016. The mean follow-up was 45.6 months. Results : After redo MVD, 65 patients (95.6%) experienced immediate relief of pain. After PBC, 34 patients (81%) were immediately relieved of their neuralgia. After 1 month, the clinical effect of redo MVD was better than PBC (p<0.01). Patients who had redo MVD more commonly were pain free off medications (93.4% at 1 year, 78.2% at 4 years) compared with the PBC patients (85.1% at 1 year, 59.3% at 4 years). However, mean length of stay was longer (p>0.05). Patients after PBC who occurred developed herpes simplex (35.7%), facial numbness (76.2%), and annoying dysesthesia (21.4%) more frequently compared with patients after redo MVD who occurred developed herpes simplex (14.7%), facial numbness (8.8%), and hypoesthesia (5.9%) (p<0.05). The symptoms recurred respectively in 15 patients (22.1%) and 19 patients (45.2%) after redo MVD and PBC within the entire 6-year follow-up period. Conclusion : For the patients with TN recurrence, redo MVD was a more effective procedure than PBC. The cure rate and immediate relief of pain were better, and the incidence of complications was lower.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.768-775
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• 2019

Objective: The aim of this study was to report a case in which Korean medicine treatment with Gami-daebo-tang and acupuncture improved the clinical symptoms in a patient with Wallenberg syndrome. Methods: The patient was treated for 53 days with a Korean medicine treatment consisting of Gami-daebo-tang and acupuncture. We measured dysesthesia based on the number of affected dermatomes. Gait ataxia was estimated with the Korean version of the Berg Balance Scale (K-BBS) and the number of times that the patient had stumbled per day. Dizziness was measured with a numerical rating score (NRS). Results: After treatment, the number of affected dermatomes was decreased. The K-BBS score was improved from 52 to 56, and the frequency of stumbling decreased from 20 to 0 times per day. The NRS score of dizziness decreased from 8 to 0. Conclusion: This case showed that Korean medicine treatment might be helpful for improving the symptoms of patients with Wallenberg syndrome.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.276-286
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• 2022

Objective : Spinal cord stimulation (SCS) is an effective treatment for chronic neuropathic pain. However, its clinical efficacy in regard to specific types of pain has not been well studied. The primary objective of this study was to retrospectively analyze the clinical outcomes of paddle-type SCS according to the type of neuropathic pain. Methods : Seventeen patients who underwent paddle-lead SCS at our hospital were examined. Clinical outcomes were evaluated pre- and postoperatively (3 months, 1 year, and last follow-up) using the Neuropathic Pain Symptom Inventory (NPSI). The NPSI categorizes pain as superficial, deep, paroxysmal, evoked, or dysesthesia and assess the duration of the pain (pain time score). Changes in NPSI scores were compared with change in Visual analogue scale (VAS) scores. Results : After SCS, the pain time score improved by 45% (independent t-test, p=0.0002) and the deep pain score improved by 58% (independent t-test, p=0.001). Improvements in the pain time score significantly correlated with improvements in the VAS score (r=0.667, p=0.003, Spearman correlation). Additionally, the morphine milligram equivalent value was markedly lower after vs. before surgery (~49 mg, pared t-test, p=0.002). No preoperative value was associated with clinical outcome. Conclusion : The NPSI is a useful tool for evaluating the therapeutic effects of SCS. Chronic use of a paddle-type spinal cord stimulation improved the deep pain and the pain time scores.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.544-554
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• 2023

Background: Postural hypotension refers to a drop in systolic blood pressure of 20 mmHg or diastolic blood pressure of 10 mmHg or more within three minutes after standing up from lying down. Symptoms of postural hypotension not only include dizziness and blurred vision but also fatigue, cognitive decline, leg weakness, headache, and, in severe cases, fainting. Postural hypotension is a phenomenon that occurs in about 6% of the total population, and in Korea, the number of patients with postural hypotension is continuously increasing. Both pharmacological and non-drug therapies, which are treatment methods for this disease, do not show a satisfactory symptom improvement effect. Case summary: A 65-year-old male patient who visited the hospital complaining of dizziness and paresthesia due to postural hypotension was treated with acupuncture, moxibustion, and herbal medicine. For symptom evaluation, the numeric rating scale (NRS) of each symptom was used, and blood pressure change according to posture was measured. After treatment, the NRSs of dizziness and dysesthesia were decreased, and blood pressure changes according to posture was improved. Conclusion: This case report suggests that Korean medicine treatment, including acupuncture, electro-acupuncture, moxibustion, and herbal medicine, can be an effective treatment for dizziness with postural hypotension.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.105-107
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• 2015

Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.113-115
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• 2015

Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.275-281
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• 1997

The radial artery as a graft for myocardial revascularization was introduced by Carpentier in the early 1970s. Mid-term results were unfortunately discoura ing, and the clinical experience with this graft was interrupted. At the end of the 1980s, these authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a radial artery graft in Seiong General Hospital. Left internal mammary artery was concomitantly used as a pedicled Vift in 34 patients. Fifteen patients (42%) had a complete arterial waft revascularization. A total of 12) distal anastomoses were performed (average 3.4 per patient), including 36 left internal mammary artery wafts (two sequential in 2 patients), and 23 saphenous vein grafts. The remaining 64 distal anastomoses were perFormed with radial artery grafts (mean 1.8 per patient). The radial arteries were anastomosed to the circumflex (n=38), diagonal (n= 18), right coronary(n=G), and left anterior descending coronary artery(n=2). The percent ge of radial artery graft anastomoses (64) to the total anastomoses(123) was 52%. The radial artery was used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures coronary endarterectomy (14), coronary artery patch angioplasty (4), mitral valve repair (1), and repair of ventricular septal rupture (1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand aftcr removal of the radial artery. Only 1 patient required reexploration of the am, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiovaphic controls were obtained in 11 patients(31%) postoperative 79 to 210 days (mean 126 days). The patency rate were as follows : left internal mammary artery (100%), saphcnous vein (100%), and radial artery(95%). We concluded that the radial artery is useful alternative graft, but long term clinical and angiographic studies are required to derterminc whether wider application is warranted.