• Title/Summary/Keyword: Injection Pain

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Needling Procedures for Calcific Tendinitis Performed by Orthopedic Surgeons

  • Pang, Chae Hyun;Kum, Dong Ho;Jeong, Jeung Yeol;Park, Seung Min;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.84-89
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    • 2017
  • Background: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. Methods: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and postneedling size and shape of the calcific deposits were compared between the two groups. Results: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. Conclusions: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

Numerous Bilateral Radiographically Dense Branching Opacities after Vertebroplasty with Polymethylmethacrylate (Polymethylmethacrylate를 이용한 경피적 척추성형술 후 흉부 X선에서 관찰된 다수의 양측성, 분지상 선상 음영)

  • Cho, Jun Hyun;Jung, Jong Pil;Eum, Jun-Bum;Seo, Kwang Won;Jegal, Yang Jin;Choi, Seong Hoon;Ahn, Jong Joon
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.184-188
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    • 2006
  • Percutaneous vertebroplasty consists of the percutaneous injection of polymethylmethacrylate (PMMA) cement into a collapsed vertebral body in order to obtain pain relief and mechanically strengthen the vertebral body. This procedure is now extensively used in treating osteoporotic vertebral compression fracture. It is an efficient treatment, but it is not free of complications. Most complications after vertebroplasty are associated with PMMA leakage. Pulmonary embolism of PMMA is rare, but this can occur when there is a failure to recognize venous migration of cement early during the procedure. We encountered a case of a patient with asymptomatic pulmonary embolism because of PMMA after percutaneous vertebroplasty. Chest X-ray and CT scanning revealed numerous tubular branching opacities that corresponded to the pulmonary vessels at the segmental and subsegmental levels.

The Experience of One Day Surgery in Pediatric Patients (소아 환자의 당일 수술 경험)

  • Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Gwak, Mi-Jeung;Lee, Dong-Myung;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.147-154
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    • 2006
  • One day surgery in children has been practiced for last 10 years in this institution. This study is to examine its safety and effectiveness for patients younger than 15 years old treated at the Department of Pediatric Surgery, Asan Medical Center, from September. 1996 to December, 2005. A total of 3,709 patients, 37 % of the total pediatric operations, are included in this retrospective study. The most prevalent ages were between 1 and 3 years olds (1,199 patients). Twenty patients were younger than 6 months, and they all had one day surgery safely. Operations were herniorrhaphy in 3,126 patients,followed by excisional biopsy, chemoport removal, and OK 432 injection. There were 12 cases (0.32 %) of unplanned admissions, 7 occurred within 6 months of one day surgery. Perioperative fever was the most common cause of admission in 4 cases. The related conditions of unplanned admission were bleeding in 2 cases and radical surgery in 2. One day surgery in this institution was easily accessible and safe. This is to the result of appropriate selection of patients, cooperation with anesthesiologists, adequate control of postoperative pain, and home care programs.

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Three-Phase Bone Scintigraphic Diagnosis of Acute Transient Synovitis (3상 골신티그램을 이용한 급성 일과성 활막염의 진단)

  • Chung, Soo-Kyo;Lee, Myung-Hee;Kim, Choon-Yul;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.73-75
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    • 1985
  • Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.

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The effect of Bee Venom on type II Collagen-induced Arthritis (봉독약침이 제2형 콜라겐유도 관절염에 미치는 영향)

  • Kim, Tae-Woo;Choi, Do-Young;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.19 no.2
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    • pp.92-104
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    • 2002
  • Objective : Bee venom (BV) has traditionally been used in Oriental medicine to relieve pain and to treat inflammatory disease such as rheumatoid arthritis (RA). Autoimmunity to type II collagen (CII) may involve in the pathogenesis of RA. This study was performed to evaluate the effect of BV on type II collagen induced arthritis (CIA) with the naked eye, a immunohistochemical method and the examination of histology. Method : Male mice were immunized by subcutaneously injection of an $200{\mu}g$ emulsion mixed with bovine CII and complete Freund's adjuvant (CFA) twice for two weeks. In the control group, normal saline was injected, and in the experimental group, BV was applied. Result : The incidence of arthritis, the mean arthritis index and the number of the arthritic limbs of the BV group were all significantly lower than those of the control group. Among the pro-inflammatory cytokines, the production of $TNF-{\alpha}$ in the BV group was also suppressed compared with the control group, but $IL-1{\beta}$ was not. The examination on the histopathology of joints of CIA mice showed the effect of Bee Venom Herbal Acupuncture on the arthritis. Conculusion : Treatment with BV resulted in inhibition of development of arthritis and immune responses to CII.

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Effects of Bee Venom on Papain-induced Osteoarthritis in an Animal Model (봉독이 Papain으로 유도된 골관절염 동물 모델에 미치는 영향)

  • An, Hyun-Jin;Lee, Chong-Kee;Park, Ji-Hyun;Kim, Kyung-Hyun;Lee, Woo-Ram;Park, In-Young;Han, Sang-Mi;Lee, Kwang-Gill;Park, Kwan-Kyu
    • Korean Journal of Pharmacognosy
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    • v.43 no.2
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    • pp.167-172
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    • 2012
  • Osteoarthritis (OA) is an age-related joint disease characterized by degradation of articular cartilage and its association with chronic pain. Purified Bee venom (PBV) has been traditionally used to the treatment for inflammatory diseases. The purpose of the current study is to examine whether PBV regulates the pro-inflammation against a mouse model of knee OA induced by papain. We studied the effect of PBV on papain-induced OA in the knee joints of mice. Mice were split into following groups: normal control, papain induced OA, OA treated with PBV, OA treated with meloxicam as positive control. Proteoglycan deposition was analyzed by safranin O-fast green staining and H&E staining. Papain injection significantly degraded the proteoglycan in OA mice at 42 days. Cartilage proteoglycan density was significantly higher in PBV treated OA group than those of the positive control groups. These results demonstrate that PBV efficiently suppresses pathological processes in an OA model. Thus, PBV could be a potential therapeutic strategy for the treatment of OA.

Treatment of glabellar frown lines using selective nerve block with radiofrequency ablation (고주파절제술을 통한 선택적 신경차단법을 이용한 미간주름의 개선)

  • Hwang, Yong Seok;Kim, Young Seok;Roh, Tai Suk;Tark, Kwan Chul;Lee, Kun Chang
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.205-210
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    • 2009
  • Purpose: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages ranging from possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. Methods: A total of 80 patients were recruited in our study during the period between Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. Results: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. Conclusion: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.

Influence of Microcurrent Therapy in Interleukin-1 Expression in Rhueumatoid Arthritis Rats (미세전류치료가 류마티스 관절염 유발 흰쥐의 Interleukin-1 발현에 미치는 영향)

  • Lee, Hyun-Min;Chae, Yun-Won
    • The Journal of Korean Physical Therapy
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    • v.21 no.2
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    • pp.103-108
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    • 2009
  • Purpose: Electrical stimulation is one of several treatments recommended for RA patients. Electrical stimulation of RA patients, reduces pain, or facilitates joint motion prior to exercises. However, there is still limited evidence on the efficacy of electrical stimulation and thus any conclusions drawn about this method remain controversial. Recently, Microcurrent Electrical Neuromuscular Stimulation (MENS) has received significant attention as a potential method of electrical stimulation. In this study, we investigated the effect of microcurrent treatment in rheumatoid arthritis rat. Methods: Subjects were allocated either to the control group or experimental group, which was subject to microcurrent stimulation. Interleukin-1 expression in the metatarsophlangeal joint and the oedema index in the ankle were used for classification and subsequent evaluation of pathology. Subjects were assessed at 1, 7 and 14 days after inducing rheumatoid arthritis through adjuvant injection. Thirty-six subjects, 18 in each group, were used in this study. Statistical analysis was performed by calculating the differences between the two groups and between each interval assessment. Categorical variables were compared between the two groups with the paired-T test. The one-way ANOVA test was performed to assess changes in ordinal variables. Results: Baseline characteristics were similar in both groups. Statistically significant differences were found between the two groups. The biological marker of pro-inflammatory cytokine and oedema index were decreased in response to this treatment. Conclusion: These data show that treatment of rheumatoid arthritis with a microcurrent stimulation device reduced the oedema index and pro-inflammatory cytokine IL-1.

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Hepatoprotective Activity of Crataegii Fructus Water Extract against Cadmium-induced Toxicity in Rats (카드뮴유발 흰쥐의 간손상에 대한 산사(山査)추출물의 보호효과)

  • Shin, Jeong-Hun;Jo, Mi-Jeong;Park, Sang-Mi;Park, Sook-Jahr;Kim, Sang-Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.2
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    • pp.249-257
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    • 2010
  • Crataegii Fructus is commonly used as a improving digestion, removing retention of food, promoting blood circulation and resolving blood stasis agent in East Asia. Cadmium (Cd) is widely distributed in the environment due to its use in industry. An exposure to Cd causes dysuria, polyuria, chest pain, hepatic and renal tubular diseases. The liver is the most important target organ when considering Cd-induced toxicity because Cd primarily accumulates in the liver. This study investigated the protective effect of Crataegii Fructus water extract against cadmium ($CdCl_2$, Cd)-induced liver toxicity in H4IIE cells, a rat hepatocyte-derived cell line and in rats. Cell viability was significantly reduced in Cd-treated H4IIE cells in a time and concentration-dependent manner. However, Crataegii Fructus water extract (CFE) protected the cells from Cd-induced cytotoxicity via inhibition of PARP cleavage. To induce acute toxicity in rats, Cd (4 mg/kg body weight) was dissolved in normal saline and intravenously injected into rats. The rats then received either a vehicle or silymarin (as a positive control) or CFE (50, 100 mg/kg/day) for 3 days, and were subsequently exposed to a single injection of Cd. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were significantly increased by Cd treatment. In contrast, pretreatment with CFE reduced ALT, AST and LDH. In histopathological analysis, CFE reduced the hepatic degenerative regions and the number of degenerative hepatocytes. These are considered as direct evidences that Crataegii Fructus has favorable inhibitory effects on the Cd-intoxicated liver damages. The efficacy of Crataegii Fructus shows slight lower than that of silymarin in the present study.

The Study on The Method of Manufacturing Herbal Acupuncture (약침액(藥鍼液) 제조법(製造法)에 대한 문헌적(文獻的) 고찰(考察))

  • Lee, Jun-Hee;Lee, Sang-Ryong
    • Korean Journal of Acupuncture
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    • v.22 no.2
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    • pp.127-149
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    • 2005
  • This study is designed to investigate the method of manufacturing herbal acupuncture through literature of oriental medicine. The findings of this study are as follows; 1. The methods of manufacturing herbal acupuncture go through the process of abstraction, purification, mixing, filtration, putting and tight sealing in the container, sterilization, quality control, printing and packing 2. There are many ways to manufacturing herbal acupuncture, for example water-alcohol precipitation, alcohol-water precipitation, liquid-liquid abstract, acid-base abstract, metal base precipitation, distillation, molecular structure, polyamide absorption, dialysis, and ion exchange, etc. And popular method is water-alcohol precipitation. This is through alcohol precipitate extracting the principal ingredients from water abstraction. This is very simple and efficient way using melting characteristics of compounds in herb to water and ethanol. 3. Sterilization of herbal acupuncture is through heating-pressure, boiling, steam flowing, low temperature, filtering, radiation, cooling, and microwaves. Nowadays filtering is commonly used. And sterilization is estimated by an examination of asepsis . 4. Herbal acupuncture must be undergo study and experiment to clinical use. The problems of herbal acupuncture are turbidity, instability, causing hemolysis, pain, and fever. So many provisions (addition, sterilization, and filtration etc.) must be prepared. 5. The theory of manufacturing herbal acupuncture is from oriental medicine, not western. So it must be corresponded to oriental medical theory, for example Gimi(氣味), Guigyung(歸經), Ingyung(引經), Bosa(補瀉), and Match of Herb. It is recommended that further study of many other sided investigations in the future.

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