• The Korean Journal of Pain
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• v.5 no.1
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• pp.99-102
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• 1992

Severe intractable pain with paresthesia and severe dyspnea produced by lung cancer involving both brachial plexuses, refractory to ordinary pharmacologic approaches, was managed by epidural morphine and bupivacaine administration with the continuous Baxter infusion system. Chest pain, which is somatic pain in character, was well managed with the epidural morphine and bupivacaine administrations. However paresthesia and tingling sensation of the hand and forearm were poorly controlled by epidural morphine, and were finally managed by bolus epidural injections of bupivacaine. Supportive therapy included epidural steroid injection and TENS, but the effect was not satisfactory. Severe dyspnea seemed to aggrevate cancer related pain.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.80-87
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• 2020

Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.

• The Journal of Internal Korean Medicine
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• v.22 no.2
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• pp.257-262
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• 2001

Cheiro-oral syndrome is characterized by a partial sensory disturbance in one hand and the ipsilateral oral comer. Its lesion is on the sensory track, and it is comparatively small. Most studies are case studies. These studies reported less than 10 cases. We studied two cases. In one, we observed intracranial hemorrhage involving left thalamus, posterior limb of internal capsule about 5cc in brain computed tomographic scan. The case was shown paresthesia of the right hand and ipsilateral comer of the mouth. The patient also complained about disturbing dysstereognosis and disorder of graphaesthesia. In the other case, we observed nodular calcification at the left basal ganglia external capsule in brain computed tomographic scan. The patient also complained about dysesthesia of the right thumb and index finger, fatigue and verbal disturbance. These cases appeared to be typical strokes in the acute phase, but after acute phase, they had dysethesia in the hand and periord for three months.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.269-273
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• 2007

Purpose: High-pressure injection(HPI) injury is an injury caused by accidental injection of substances by industrial equipment. HPI injury of the hand is a serious injury that can be potentially devastating. There have been a number of publications on the results of its treatment and its functional outcome of these hands. Unfortunately, the clinical outcomes were unsatisfactory following an initial treatment approach of digital expression of the injection material, elevation, soaks, dressing changes, and antibiotics. Methods: A 43-year-old right handed man sustained a high pressure injection injury to the tip of the left index finger. The injected material was industrial paint thinner. Tissue necrosis was noted at the pulp of the finger. Several debridements and irrigation were required. A pedicled chest flap transfer was performed on the eighteenth day after injury as the dorsal nail complex remained viable. This is a retrospective review of our experience with high-pressure finger injection injury caused by paint. A literature review, retrospective chart and radiologic review were presented. Results: Follow-up length was about 1 year. The injuried hand was left nondominant hand, the index. Patient complaints were cold intolerance, paresthesia, contact pain, and impairment of activities of daily living. Conclusion: The outcome of high-pressure injection injuries of the hand is affected by many factors. The time between injury and operative treatment has been regarded as a key determinant by a number of authors. The nature of the injected material is probably more important. It has been noted by many authors that injuries with paints have a worse outcome than those with oil or grease. This study confirms the fact that high-pressure injection injury caused by paint thinner to the hand is a significant problem. Virtually a patient suffers sequelae of this injury. The injury has significant repercussions for future function and reintegration into the work force.

• Annals of Clinical Neurophysiology
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• v.15 no.1
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• pp.7-12
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• 2013

Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.101-104
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• 2018

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by focal compression of the median nerve in the carpal tunnel. However, many patients with CTS, who are diagnosed clinically and confirmed with electrophysiological studies, complain of the sensory symptoms extends to the ulnar nerve territory. The aim of this study was to evaluate whether a dysfunction in sensory fibers of the ulnar nerve was present or not in hands with CTS patients who had extramedian spread of sensory symptoms over the hand. We retrospectively analyzed the recording of the subjects who were diagnosed with CTS within a one-year-period of time. After exclusions, 136 hands recordings of 87 patient were included. We compared the results of median and ulnar nerve sensory conduction studies between normal hands and hands with CTS. We did not detect statistically significant difference on all parameters of ulnar nerve sensory conduction studies between the normal hands and the hands with CTS. The parameters of the obtained in median nerve sensory conduction studies were statistically different between the healthy control and CTS patients. The hands with CTS showed similar rate of ulnar sensory conduction abnormalities compared with the normal hands. In conclusion, our study showed that none of the parameters in ulnar sensory nerve conduction studies differ between two groups. Accordingly, our study revealed that ulnar nerve involvement does not contribute in CTS patients underlying the spread of paresthesia extends to the ulnar nerve territory.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.79-86
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• 2002

Thirty six patients, female 21(58.4%), male 15(58.4%), with centipede bite visited emergency room of Gimcheon Medical Center, from September 1998 to August 1999. The number of patients accompanying the seasons were increased once in June and were high in August and September; peaked in September, which conforms to the habitude that centipede likes the warmer climate. Frequency accompanying the time was high after sunset(from 6 p.m. to 6 a.m. next morning) than before sunset, which conforms to the habitude that centipede is nocturnal. Distribution of the bite sites was finger(30%), neck(28%), foot(25%) and hand(14%) as same as the previous researches showed. In case of finger and hand, patients got bitten while they were wearing gloves or doing works; foot, wearing shoes. They got bitten the neck while sleeping. Among the localized symptoms were localized pain: 36 patients(100%), swelling: 36 patients(100%), erythema: 26 patients(72.2%), paresthesia: 5 patients (13.9%). Systemic symptoms were dizziness 2 patients(5.6%) and nausea 1 patient(2.8%). Mostly the localized pain was improved within 48 hours, swelling in 48 hours and within 72 hours in case of paresthesia. Systemic symptoms such as dizziness and nausea were improved within 24 hours. Treatment and prognosis of scolopendra have similarity in many countries. We suggest that Korean standard treatment manual is needed so that the localized symptom, systemic symptom and external wound can be cured soon.

• Journal of Korean Biological Nursing Science
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• v.12 no.3
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• pp.166-174
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• 2010

Purpose: The purpose of this study was to compare the cardiac knowledge and symptoms recognition between men and women with acute coronary syndrome (ACS). Methods: Cross-sectional survey research design and convenience sampling were used in this study. 64 men and 42 women from a university medical center were participated in this study. Data collection were used with self reported questionnaires and medical records. Results: There was no difference in cardiac knowledge by gender. Women marked the higher score in symptoms recognition than men. Significant gender differences were observed in the reports of several symptoms (headache, nausea, palpitation, hand paresthesia, and leg numbness) and with ACS. There was significant correlation between cardiac knowledge and symptom recognition on both men and women. Conclusion: These findings suggest that health care professionals should pay attention to the differences in clinical symptoms between women and men. Furthermore, tailored information about possible symptoms of coronary artery disease according to the patient's gender is needed.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.954-958
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• 2000

In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.485-490
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• 2005

Fingertip is the end of tactile organ and the part of hand most frequently injured. Fingertip injuries should be evaluated on an individual basis considering patient's overall physical condition, medical history, etiology, time of injury, and anticipated future hand use, and accordingly one of various methods of reconstruction should be selected. Complications after the reconstruction of fingertip injuries have been reported as pain, hypersensitivity, numbness, distal paresthesia, cold intolerance, and atrophy. From January to December 2002, dermofat grafts were performed on 15 patients to correct painful fingertips after injury. The thickness of the soft tissue of fingertip was measured both preoperatively and postoperatively with simple X-ray. To evaluate the improvement of pain, visual analogue scale(VAS) was used through the direct interview with patients. The average of postoperative follow-up period was 10.9 months. The average of increased soft tissue thickness ratio was 88.4%(2.3mm to 3.8mm). The average of preoperative VAS was 7.6, and postoperative VAS was 3. Dermofat graft on fingertip needs a further long-term follow-up study for the absorption ratio of dermofat, however, this procedure is simple and could be done under local anesthesia, and would be a useful alternative procedure to correct painful fingertips with the soft tissue atrophy after injury.