• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.31-36
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• 2011

Purpose: This pilot case series study aimed to evaluate the efficacy of continuous radiofrequency (CRF) application on dorsal root ganglia (DRG) to reduce spasticity of spinal cord lesion (SCL) patients. Methods: We performed CRF procedures on DRG in 8 subjects (7 males; mean age 39 years, range 31-53 years) with intractable spasticity that impeded activities of daily living and caregiving, although they had maximal tolerable doses of anti-spastic medications and active rehabilitative treatment. All subjects underwent CRF (90 seconds at $90^{\circ}C$) at multiple lumbosacral and/or cervical DRG. Muscle tone of the extremities was measured by the modified Ashworth scale (MAS) before and one month after procedures. Functional goals were established at baseline, and subjects' satisfaction levels were categorized one month after procedures. Results: A total of 54 CRF treatments were performed in 8 patients. In all patients, we found some improvement in muscle tone measured by the MAS. Six patients reported themselves satisfied with their current status at one month's post-treatment, and 2 patients were fairly satisfied with their gait pattern. In 3 patients, neuropathic pain was present after CRF on DRG. In 1 lumbar case, the pain subsided after several days, and the other 2 cervical cases suffered from tolerable neuropathic pain treated with anti-convulsant medication. Conclusion: CRF on DRG might be a promising alternative treatment to reduce spasticity in SCL patients. Further well-designed clinical trials on the efficacy and safety of CRF application on DRG are needed.

• The Korean Journal of Pain
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• 제22권1호
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• pp.33-38
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• 2009

Background: Complex regional pain syndrome (CRPS) is still difficult to diagnose in the field of chronic pain management. CRPS is diagnosed by purely clinical criteria based on the characteristic signs and symptoms, which have to be differentiated from similar pain conditions like posttraumatic neuropathic pain. Until now, there has been a lack of objective diagnostic tools to confirm the diagnosis of CRPS. The aim of this study was to evaluate the usefulness of a three phase bone scan (TBS) for making the diagnosis of CRPS. Methods: A total of 121 patients who had been diagnosed with CRPS were evaluated. All the patients were examined by performing a TBS as a part of the diagnostic work-up. A diffuse increased tracer uptake on the delayed image (phase III) was defined as a positive finding for CRPS. Results: Forty-one patients (33.9%) out of 121 showed the positive results on the TBS. The patients with a duration of pain of less than 24 months had a significantly higher positive result (43.4%) on the TBS than did the patients with duration of pain longer than 24 months (12.1%). Conclusions: A TBS could give a better objective result for diagnosing CRPS for patients with a shorter duration of pain and a TBS gives little information for the diagnosis of CRPS in patients with a duration of pain longer than 24 months.

• The Korean Journal of Pain
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• 제35권4호
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• pp.488-488
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• 2022

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.151-154
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• 2010

The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.

• Asian-Australasian Journal of Animal Sciences
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• 제21권3호
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• pp.443-448
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• 2008

Beak trimming in laying hens is a routine practice in which about 1/3-1/2 of the upper and lower beak is removed with the aim of reducing cannibalism. This experiment aimed to identify if this procedure causes pain by examining self-administration of an analgesic (carprofen) and pecking behaviour in 80 laying pullets beak-trimmed by two different methods at one day of age using hot-blade cauterisation or infra-red cauterisation. We also tested a control treatment, pullets with intact beaks, and a positive control treatment of pullets beak trimmed at 10 weeks of age which were expected to experience some pain due to recent severing of the underlying nerves in the beak. At 11 weeks of age birds trimmed at 10 weeks of age pecked more (p<0.001) gently ($0.6{\pm}0.06N$) at a disc attached to a force-displacement transducer than birds trimmed at 1 day of age with an infra-red machine ($0.9{\pm}0.1N$) or a hot blade ($1.1{\pm}0.07N$) and intact birds ($1.2{\pm}0.1N$). Maximum force of pecks recorded was also lower (p<0.001) in birds trimmed at 10 weeks of age than birds trimmed at 1 day of age with an infra-red method or a hot blade and intact birds. However, the pecking force in birds trimmed at 10 weeks of age was not increased by providing them with analgesic-treated feed, though birds that ate more carprofen had a higher maximum force of peck (p = 0.03). Pecking force in birds beak-trimmed at 1 day of age was the same as the pecking force of intact birds, and was unaffected by feeding pullets carprofen. A method of self-administration of an analgesic had previously revealed that chickens in neuromuscular pain arising from lameness consumed more of a feed containing carprofen than healthy chickens. However, we found no evidence that beak-trimmed pullets consumed more carprofen-treated feed than pullets with an intact beak. It should be noted that the three beak trimming methods resulted in an average 34% reduction in beak length, considered a light trim, and is perhaps not representative of commercial birds where greater portions of the beak are removed. We conclude that although carprofen has been reported to have an analgesic effect on neuromuscular pain in chickens, it appears to have no analgesic effect on potential neuropathic pain arising from the nerves severed by a light beak trim.

• Clinical Pain
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• 제19권1호
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• pp.16-22
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• 2020

Objective: Recent studies have shown that repetitive peripheral magnetic stimulation (rPMS) reduces pain in various conditions. This pilot study aimed to investigate the effects of rPMS depending on the pain characteristics. Method: Adult patients aged 19~85 years evaluated at our institution between September 1, 2017 and February 28, 2018 for subacute to chronic musculoskeletal pain equivalent to a numeric rating scale of 3 or higher for at least one month were enrolled. Pain scores as determined using a numeric rating scale at baseline and at the end of treatment were set as the primary outcome. Additionally, we classified the pain into nociceptive, intermediate, or neuropathic pain using the PainDETECT questionnaire and compared the responsiveness to rPMS according to the type of pain. Results: The average pain scores significantly decreased after the 2-week rPMS treatment in all enrolled subjects (p<0.001). There was no statistically significant difference in pain reduction between groups divided by PainDETECT questionnaire. Conclusion: This study suggests that rPMS could safely relieve various types of pain.

• The Korean Journal of Pain
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• 제20권1호
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• 기본간호학회지
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• 제15권2호
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• pp.161-170
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• 2008

Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

• The Korean Journal of Pain
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• 제19권2호
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• pp.159-163
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• 2006

Background: Despite the enormous amount of basic research on neuropathic pain, there is the lack of an objective diagnostic test for complex regional pain syndrome (CRPS). The aim of this study was to evaluate the usefulness of cold stress thermography in the diagnosis of CRPS. Methods: The study involved 12 patients with CRPS type 1, according to the IASP criteria, who were compared with 15 normal healthy volunteers. All subjects underwent thermographic examination under baseline conditions at $21^{\circ}C$. A cold stress test (CST; $10^{\circ}C$ water for 1 minute) was then applied to both hands below the wrists, immediate, and after 10 and 20 minutes. Results: The temperature asymmetry between the patients with CRPS and the volunteers showed significant discrimination at the baseline and after a 20 minute recovery period from the CST. Among the study subjects having temperature asymmetry of both hands of less than $1^{\circ}C$ (8 out of 12 CRPS patients and 14 out of 15 volunteer), 7 (87.5%) of the 8 CRPS patients and 3 (21%) of the 14 volunteers showed a temperature difference of more than $1^{\circ}C$ after the 20 minute recovery period. The actual temperature values during the four periods did not discriminate between the patients with CRPS and the volunteers. Conclusions: Thermography, under the CST, could be a more objective test for the diagnosis of CRPS. A temperature asymmetry greater than $1^{\circ}C$ during the 20 minute recovery period following CST provides strong diagnostic information about CRPS, with both high sensitivity and specificity.

• Journal of Oral Medicine and Pain
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• 제34권2호
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• pp.217-225
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• 2009

통증은 포괄적이고 생리적, 심리적, 사회적 복합현상이기 때문에 통증을 보다 잘 이해하고 더 나은 치료를 위해서는 환자의 삶의 질과 심리적 상태에 대한 평가가 필요하다. 본 연구는 비치성 구강안면통증 환자들이 느끼는 통증의 정도와 통증으로 인한 일상생활의 제한(pain interference)을 평가하고 심리적 요인과의 관련성을 평가하고자 하였다. 또한 성별 및 연령, 통증의 지속기간과 진단에 따른 차이를 함께 평가하고자 하였다. 연구대상은 3개월간 단국대학교 부속 치과병원 구강내과구강안면통증클리닉에 내원한 초진환자들 중에서 간이동통목록(Brief Pain Inventory, BPI)과 병원불안우울척도(Hospital Anxiety and Depression Scale, HADS)의 두 가지 설문지에 답하고, 비치성 구강안면통증으로 진단받은 환자들을 대상으로 하였다. 환자들은 의사와의 첫 면담 전 대기실에서 설문지를 작성하도록 하였고, 작성 후에는 진료실에서 임상검사와 면담을 통해 진단을 내렸다. 총 163명의 환자들이 연구에 포함되었는데, 남녀비 1:1.5, 평균 연령 34.6세, 평균 통증지속기간 13.3개월이었다. 진단에 따라 삼차신경통군(Trigeminal Neuralgia group; TN), 신경병성동통군(Neuropathic Pain group; NeP), 만성안면통증군(Persistent Idiopathic Facial Pain; PIFP), 턱관절장애군(TMD)으로 나누고 TMD는 저작근장애군(TMD-m), 관절장애군(TMD-j) 및 근육-관절 복합군(TMD-c)으로 세분하였다. 비치성 구강안면통증 환자들은 중등도의 통증과 중등도의 일상생활 제한을 보였다. 3개월 이상의 만성통증을 가진 환자들은 급성군에 비해 높은 수준의 불안과 우울척도를 보였다(p<0.05). TMD 환자들보다 삼차신경통, 만성안면통증 및 신경병성통증 환자들의 통증이 심하고 pain interference가 컸으며 불안과 우울척도도 높았다 (p<0.05). Pain interference는 통증의 강도과 강한 상관관계를 보였고 우울 및 불안척도와 중등도의 상관관계를 보였다 (p=0.000). 우울 및 불안척도는 통증의 강도와 약한 상관관계를 보였다 (p<0.05). 결론적으로 구강안면통증의 성공적인 치료를 위해서는 통증 자체의 조절뿐 아니라 통증으로 인한 심리적, 사회적 영향에 대한 평가와 심리사회적 측면에서의 지원(psychosocial support)가 필요함을 알 수 있다.