• The Korean Journal of Pain
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• v.34 no.3
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• pp.332-338
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• 2021

Background: Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. Methods: From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. Results: The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. Conclusions: The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.194-201
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• 2024

Objective : This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain. Methods : Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI). Results : Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months' follow-up. Conclusion : The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

• Journal of the Korean Society of Food Culture
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• v.36 no.1
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• pp.121-129
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• 2021

Sodium intake has been associated with the health-related quality of life (HRQoL). This study examined the demographic factors related to HRQoL and whether there is an association between sodium intake and HRQoL in adults residing in rural areas. A total of 1,980 adults (aged ≥20 years) were selected from a cross-sectional study conducted between December 2013 and February 2014 in Gyeongju, South Korea. The sodium intake and HRQoL were measured using a validated food frequency questionnaire and the EuroQol Five-Dimension (EQ-5D) (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), respectively. The education levels (<5 years) were inversely associated with all five dimensions of HRQoL. Men had better EQ-5D scores for each of the five components examined. Adults living with spouses had better scores related to usual activities and anxiety/depression, whereas widowers had decreased scores of mobility and self-care. Unlike older adults aged 70-79 years, adults aged <60 years were more likely to have greater scores related to mobility, usual activities, and pain/discomfort. The income levels were also inversely related to the scores for self-care, usual activities, pain/discomfort, and anxiety/depression. Sodium intake was positively associated with the HRQoL related to self-care, usual activities, and pain/discomfort, but it was negatively associated with anxiety/depression. In conclusion, these findings suggest that the demographic factors and sodium intake were independently associated with HRQoL. The results highlight the need to provide tailored, targeted policies and interventions that consider personal characteristics and dietary intake to improve the overall HRQoL in adults residing in rural areas.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.84-93
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• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.277-288
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• 2018

Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

• Journal of Korean Biological Nursing Science
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• v.9 no.2
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• pp.125-134
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• 2007

Purpose: To examine knowledge and attitudes of nurses on post-operative pain, and to find the factors that hinder pain management by the nurses. Method: Data was collected using a questionnaire from all the nurses working in the surgical units and intensive care units in a hospital in Seoul between March 12 and 22, 2007. Data was analyzed with descriptive statistics, t-test, $x^2$ test, and Pearson Coefficient Correlation. Result: The average knowledge score on pain was $9.33{\pm}1.55$, and that for analgesics was $6.89{\pm}2.00$. There was a significant difference in knowledge of analgesics in terms of career(p=0.012), present work place(p=0.024) and education(p=0.042). The knowledge on pain etiology was significantly different in career. Around 61.1% of respondents answered that they would administer analgesics immediately if patients complaint pain, and 94.1% re-administer analgesics if the VAS score is over 5.69.3% thought that their knowledge was adequate for pain management. The attitudes of pain management were significantly different in career. Conclusion: We found that a further improvement on nurses' knowledge on pain management and analgesics is necessary. This study also suggests a need for professional education for nurses on post-operative pain management.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1683-1686
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• 2018

Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.6
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• pp.367-373
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• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.447-457
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• 2022

Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.35-41
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• 2021

Purpose : It is necessary to demonstrate the effect of non-invasive and non-pharmacological interventions such as manual therapy and therapeutic exercise for the management of nonspecific neck pain. In the present study, we aimed to investigate the efficacy of myofascial release therapy plus therapeutic exercise for disability owing to neck pain and quality of life in individuals with nonspecific neck pain. Methods : Eighteen participants with nonspecific neck pain were randomly allocated to intervention (n=9) and control groups (n=9). The intervention group received a myofascial release therapy for 20 min and performed neck stabilization exercises for 30 min twice a week for 4 weeks. The control group performed neck stabilization exercises for 30 min twice a week for 4 weeks at the same time points as the intervention group. Disability owing to neck pain and quality of life were quantified using the neck disability index (NDI) and the Korean version of the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), respectively. NDI and WHOQOL-BREF were assessed before and after intervention. Results : The disability owing to neck pain significantly changed between the groups over time (total score of NDI, p=.049). There were significant time and group interactions in pain (pain intensity of NDI, p=.035) and concentration (concentration of NDI, p=.049). Personal care, lifting, reading, headaches, work, driving, sleeping, and recreation did not show significant improvement between the groups over time. Total score, overall quality of life and general health, physical health domain, psychological domain, social relationships domain, and environmental domain quantified by WHOQOL-BREF did not show significant improvements between the groups over time. Conclusion : These results suggest the clinical use of myofascial release therapy in addition to therapeutic exercise for the management of nonspecific neck pain. Further studies are needed to generalize the findings of this study.