• Title/Summary/Keyword: Local muscles

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Analysis of biomechanical change of adjacent motion segment of the lumbar spine with an implanted artificial disc (인공추간판 적용 시 인접 운동 분절에서의 변화 분석)

  • Kim Y.E.;Yun S.S.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.244-247
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    • 2005
  • Although several artificial disc designs have been developed for the treatment of discogenic low back pain and used clinically, biomechanical change with its implantation seldom studied. To evaluate the effect of artificial disc implantation on the biomechanics of lumbar spinal unit, nonlinear three-dimensional finite element model of L1-L5, S1 was developed and strain and stress of vertebral body and surrounding spinal ligaments were predicted. Intact osteoligamentous L1-L5, S1 model was created with 1-mm CT scan of a volunteer and known material property of each element were applied. This model also includes the effect of local muscles which was modeled with pre-strained spring elements. The intact model was validated with reported biomechanical data. Two models implanted with artificial discs, SB Charite or Prodisc, at L4/5 via anterior approach were also developed. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, force on spinal ligaments, facet joint contact force with $2\sim12$ Nm flexion-extension moment.

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Use of a botulinum toxin A in dentistry and oral and maxillofacial surgery

  • Park, Kyung-Soo;Lee, Chi-Heun;Lee, Jung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.151-157
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    • 2016
  • Botulinum toxin (BT) was the first toxin to be used in the history of human medicine. Among the eight known serotypes of this toxin, those currently used in medicine are types A and B. This review article mainly discusses BT type A (BTA) because it is usually used in dentistry including dental anesthesiology and oral and maxillofacial surgery. BTA has been used mainly in the treatment of temporomandibular joint disorder (TMD) and hypertrophy and hyperactivity of the masticatory muscles, along with being a therapeutic option to relieve pain and help in functional recovery from dental and oral and maxillofacial surgery. However, it is currently used broadly for cosmetic purposes such as reducing facial wrinkles and asymmetry. Although the therapeutic effect of BTA is temporary and relatively safe, it is essential to have knowledge about related anatomy, as well as the systemic and local adverse effects of medications that are applied to the face.

A Case of Posterior Interosseus Neuroapathy due to Intrasupinator Ganglion Mimicking Iatrogenic Injection Nerve Injury (의인성 신경손상을 모방한 손뒤침근내 결정종으로 인한 뒤뼈사이신경병증 증례)

  • Park, Hong Bum;Kim, Ki Hoon;Park, Byung Kyu;Kim, Dong Hwee
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.153-158
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    • 2018
  • Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.

Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review

  • Wei-Ting Wu;Ke-Vin Chang;Vincenzo Ricci;Levent Ozcakar
    • Journal of Yeungnam Medical Science
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    • v.41 no.3
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    • pp.179-187
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    • 2024
  • Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

The clinical observation of patient with Headache Treated by Trigger point acupuncture therapy (발통점(發通點)을 이용(利用)한 두통(頭痛) 치험례(治驗例) 보고(報告))

  • Lee Seung-Yeon;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.133-143
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    • 1998
  • Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

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Chemical Neurolytic Block with Absolute Ethyl Alcohol on Cervical Sympathetic Ganglion in Rabbits (토끼에서 경부 교감신경절의 무수 에틸 알코올에 의한 화학적 차단)

  • Kang, Yoo-Jin;Suh, Jae-Hyun
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.162-169
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    • 1994
  • Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

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Consideration of Literatures on the Treatment of Pain in Shoulder and Arm Based on Oriental Medicine and Western Medicine (견비통(肩臂痛)의 치험(治療)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Park, Ki-Hong;Lee, Hyun
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.59-69
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    • 2006
  • Objectives & Methods : I investigated 45 literature of Oriental and Western medicine about the treatment of pain in shoulder and arm. Result and Conclusion : 1. The etiological causes of Pain in Shoulder and Arm based on literatures of Oriental medicine are attack of wind-heat on the lung, wind cold, damp-heat struggle between the vital energy and pathogenic factor and six pathogenic factors. And all these causes are the conception of blockage syndrome, Qi and blood stagnating in meridian system. 2. The treatment of Pain in Shoulder and Arm based on Oriental medicine is mainly composed of both medical therapy for Bi syndrome due to pathogenic wind, deficiency of both Qi and blood, consumption of the liver and the spleen, and also acupuncture and moxibustion treatment by selection for acupoint. And those treatments are for treating etiology. And also there are treatments using the meridian system and Twelve Muscle Region and Ashihyeol for the purpose of treating the symptoms. 3. The etiological causes of Pain in Shoulder and Arm based on literatures of Western medicine are degenerative cut of tendon and nerve symptoms caused by tendonitis, bursitis, calcification, ruptured cervical disc and thoracic outlet syndrome. 4. The treatment of Pain in Shoulder and Arm based on Western medicine is for alleviation of pain, such as giving an anodyne, steroid products, local anesthetic injection and stretching and strengthening the muscles.

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The Effects of Excluding Animal Products from the Diet on Sensory Properties of Pork from Pigs Grown in New Zealand as Assessed by Singaporean Panelists

  • Leong, Jasmine;Purchas, Roger W.;Morel, Patrick C.H.;Wilkinson, Brian H.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.1
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    • pp.122-130
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    • 2010
  • Sensory analyses of pork samples from leg muscles of female pigs raised in New Zealand (n = 17) were conducted using trained and untrained Singaporean panelists. The New Zealand pigs included three dietary groups, with one diet including animal products (NZA), and two containing plant products only (NZP & NZP+), with the NZP+ diet containing a supplement (0.614%) containing conjugated linoleic acid (CLA), selenium, and vitamin E. The New Zealand pork was also compared with Indonesian pork as local reference samples (n = 6). Pork samples from the NZA group had the highest score for mutton flavour and aftertaste, and the lowest score for brothy aroma, brothy flavour, meaty flavour, lightness and juiciness by trained sensory panels. Samples from NZP and NZP+ were similar except the NZP+ group had a stronger stale flavour than the NZP group (1.34 vs. 0.57 on a 100-point scale; p<0.05). The first and second functions of a discriminant analysis based on trained-panel scores for 14 attributes accounted for 95.4% of the variance, with function 1 (83.7%) being related mainly to mutton aroma, mutton flavour and aftertaste. Based on a 20-member untrained panel, the NZA pork had the highest mutton aroma and mutton flavour intensities (p<0.01) and aroma and flavour that was less acceptable than that from the NZP group (p<0.05). The acceptability scores of Indonesian pork were not significantly different from those of New Zealand pork, but its scores for mutton aroma and mutton flavour were significantly lower than NZP. Overall acceptability was positively associated with acceptability of aroma (r = 0.906), juiciness (r = 0.888), and tenderness (r = 0.904), but negatively associated with intensities of mutton aroma (r = -0.478) and flavour (r = -0.551).

Retrospective Study of Facial Nerve Block with O'Brien Method for Facial Spasm (안면경련 환자에서 O'Brien법을 이용한 안면신경 차단의 추적조사)

  • Kim, Chan;Kim, Sung-Mo;Lee, Hyo-Keun;Kim, Seung-Hie;Kim, Jeong-Ho;Kim, Boo-Seong
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.16-20
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    • 1997
  • Background : Hemifacial spasm commonly occurs on muscles about the eye, but may also involve or spread to the entire side of the face. There are many treatment for facial spasm, such as neuro-vascular decompression, local injection of Botulium toxin, facial nerve block at stylomastoid foramen, facial nerve block with O'Brien method. The present study was aimed to investigate the effects of facial nerve block with O'Brien method. Methods : Forty five patients with hemifacial spasm were treated by facial nerve block with O'Brien method from January 1996 to February 1997 We reviewed the charts, retrospectively. Results : Sex ratio was 1:1.7(17 male : 28 female patients). Most patients were 40~60 years old. Most patients well tolerated facial nerve block. Three patients failed to respond to the facial nerve block. We repeated the procedure within one week. Among the 45 patients who received nerve block, 35 received repeated block; 7 patients received second repeat block, 2 patients received third repeat block. After successful nerve block, all patients were free of spasm for 1 to 6 months. Average spasm-free period was 3.5 months. Conclusion : Although the spasm-free period was short, these results suggest facial nerve block with O'Brien method is a safe and comfortable method for treatment of facial spasm.

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The Effect of Trunk Muscle Activity on Bridging Exercise According to the Knee Joint Angle (슬관절 각도에 따른 교각운동이 체간근 활성도에 미치는 영향)

  • Kim, Kyung-Hwan;Park, Rae-Jun;Jang, Jun-Hyeok;Lee, Woo-Hyung;Ki, Kyong-Il
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.405-412
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    • 2010
  • Purpose : The purpose of this study was to assess the effects of the trunk muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system(LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA with post-hoc Bonferroni's correction was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratio. Results : The internal oblique of bridging exercises $120^{\circ}$, $90^{\circ}$ showed significantly(p<.05). The erctor spinae of all bridging exercises showed significant excepted between $60^{\circ}$ and $45^{\circ}$(p<.05). Median of internal oblique/rectus abdominis ratio of $120^{\circ}$ was 4.41, $90^{\circ}$ was 3.94, $60^{\circ}$ was 3.58, $45^{\circ}$ was 3.39. Median of internal oblique/external oblique ratio of $120^{\circ}$ was 2.66, $90^{\circ}$ was 2.43, $60^{\circ}$ was 2.87, $45^{\circ}$ was 2.64. Conclusion : Angular motion decreasing with knee joint flexion made erector spinae activation increase. on the other hand, as decreasing abdomen muscle activation, the more performing motor learning is required for abdomen muscle strength and co-contraction for the trunk stabilization.