• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.99-107
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• 2003

Disorders of the shoulder in which conservative management is indicated as a primary treatment include idiopathic frozen shoulder, atraumatic instability. acute calcific tendinitis , subacromial impingement syndrome, partial thickness or small full thickness tear of the rotator cuff, and chronic rotator cuff tear in elderly population. Aside from medication and various physical modalities used for relief of pain, the mainstay of orthopaedic rehabilitation consists of stretching of the tendons and capsulologamentous complex, and strengtnening of rotator cuff muscles as well as surrounding muscles. However, orthopaedic rehabilitation in chronically painful conditions of the shoulder differs in detail according to the specific diseases or injuries, And it is important to make the rehabilitation program that can be undertaken by the patients rather than adhering to a fixed schedule. Also the program should be changed as the condition of the patient improves or deteriorates. Nevertheless there are basic rules of stretching and strengthening , which should always be observed in applying orthopaedic rehabilitation treatment.

• Journal of Acupuncture Research
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• 제38권2호
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• pp.85-95
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• 2021

Low-level laser therapy including laser acupuncture has been widely used for non-specific chronic low back pain in primary Korean medical clinics. However, there is no critically appraised data regarding which treatment conditions are most effective. A systematic review and meta-analysis was conducted to determine effective treatment conditions using 12 databases (PubMed, Ovid, CENTRAL, KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS, CNKI, CiNII, and J-STAGE). There were 1,019 studies retrieved and 13 studies included in this review. It was determined that when the power output was ≥ 50 mW, the beam size was increased to ≥ cm², the energy dose was increased to ≥ 4 J per point, the treatment interval was increased to ≥ 3 times a week, and the number of treatment sessions was increased to ≥ 10 treatments, these conditions appeared to increased treatment effectiveness.

• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.32-35
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• 2021

Angioleiomyoma is a benign soft tissue tumor originating from vascular smooth muscle. We report a case of a 20-year-old student who presented with pain in the right shoulder of 4 years duration. Shoulder movements were pain-free throughout the range of motion except resisted external rotation. Magnetic resonance imaging visualized a well-circumscribed lesion over the infraspinatus tendon. The lesion was surgically removed and sent for histopathological analysis. Morphology and immunohistochemistry results were suggestive of angioleiomyoma. The most common location for such a lesion is the lower limb, with less than 1% being reported in the upper arm, of which an angioleiomyoma of the shoulder is extremely rare.

• Clinics in Shoulder and Elbow
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• 제23권4호
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• pp.203-209
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• 2020

Calcific tendinitis is the leading cause of shoulder pain. Among patients with calcific tendinitis, 2.7%-20% are asymptomatic, and 35%-45% of patients whose calcific deposits are inadvertently discovered develop shoulder pain. If symptoms are present, complications such as decreased range of motion of the shoulder joint should be minimized while managing pain. Patients with acute calcific tendinitis respond well to conservative treatment and rarely require surgery. In contrast, patients with chronic calcific tendinitis often do not respond to conservative treatment and do require surgery. Clinical improvement takes time, even after surgical treatment. This review article summarizes the processes related to the diagnosis and treatment of calcific tendinitis with the aim of helping clinicians choose appropriate treatment options for their patients.

• 한국임상수의학회지
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• 제28권1호
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• pp.33-39
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• 2011

The present study was aimed to investigate the effect of intraperitoneal bupivacaine instillation on postoperative pain after laparoscopic ovariohysterectomy (LOHE) in dogs. Twelve female German shepherd dogs (17-30 kg) were divided into two groups. The treatment group received 4.4 mg/kg of instilled intraperitoneal bupivacaine diluted to 0.25% with an equivalent volume of saline after pneumoperitoneum, but the control group received 1.76 ml/kg of 0.9% saline. Two blind observers measured the extent of dog's pain and sedation by using dynamic interactive visual analogue scale (DIVAS) preoperatively and 0.5, 1, 2, 4, 6, and 12 h postoperatively. At each designated time, blood cortisol, glucose, and creatine kinase (CK) concentrations were also measured. Based on the repeated-measures ANOVA, there were significant differences in time-dependent postoperative changes in patterns of DIVAS-pain score between two groups. In addition, the treatment group had significantly lower DIVAS-pain scores at 1, 2, 4, and 6 h postoperatively compared to the control group. DIVAS-sedation score and biochemical measures including cortisol, glucose, and CK did not show any significant differences between two groups. No complications associated with bupivacaine administration were observed. Thus, instilled bupivacaine intraperitoneally may be an effective method on relieving behavioral expressions associated with postoperative pain after laparoscopic ovariohysterectomy in dogs.

• 구강회복응용과학지
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• 제36권1호
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• pp.55-60
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• 2020

물리적 항균효과를 나타내는 4차 암모늄 화합물을 치과 진료실 미생물 주요 오염 구역에 도포 후 시기별 오염도의 변화를 측정하고자 하였다. 4개의 국내외 치과병의원에서 미생물 감염이 쉬운 유닛체어 핸들, 타구대 표면, 핸드피스 거치대 등에 ATP (adenosine triphosphate) 모니터링 시스템과 ATP 표면검사 테스트 키트를 사용하여 항균제 도포 전과 후 시기별 오염도를 비교 측정하였다. 4차 암모늄 화합물 도포 전 구역별 미생물 오염도는 치과의사가 주로 사용하는 핸드피스 거치대가 가장 높았다. 도포 후 시기별 오염도의 변화를 분석한 결과 대부분의 진료실에서 현저한 오염도의 감소를 보였으며, 대략 4-6개월 정도 효과가 지속되는 양상을 보였다. 항균효과의 지속성과 최소량의 화학성분 노출이라는 장점으로 향후 대단위 후속연구를 통해 4차 암모늄 화합물이 치과 진료실에서 효과적으로 사용될 수 있을 것으로 기대된다.

• 대한예방한의학회지
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• 제23권2호
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• pp.1-10
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• 2019

Backgrounds : In 2017, National Health Insurance implemented the pilot coverage program for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the program to monitor the effectiveness and patients' satisfaction of insured CMT. Objectives : This study aimed to evaluate patients' satisfaction of CMT in the pilot coverage program of National Health Insurance. Methods : Survey participants were recruited among the patients who used CMT at the designated organizations. On-line questionnaire link was sent to the smart phones of patients who agreed to participate in the survey and provide personal contact information. The questionnaire consisted of the basic charactersitics of respondents, imformation on using CMT satisfaction with CMT and willingness to recommend CMT to others. The answers that were automatically coded and saved were statistically analyzed. Results : Of 386 participants who completed the questionnaire, 92.8% satisfied or strongly satisfied with the CMT. Most frequent reason of satisfaction was 'Good effectiveness', and there was no difference in satisfaction between patients of hospital and those of clinics. Patients with the highest and the lowest level of pain satisfied more than those with other pain levels(p=0.003), but the level of copayment and reasons of CMT use did not affect the satisfaction results(p=0.405). The proportions of respondents who had willingness to recommend CMT to others and to revisit for CMT use were 97.8% and 98.8%, respectively. Conclusions : Most patients were satisfied with CMT in the pilot coverage program, and it can provide the rationale for expanding the insurance coverage of CMT to all KM hospitals and clinics.

• The Korean Journal of Pain
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• 제10권1호
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• pp.124-126
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• 1997

Stellate ganglion block is the most widely practiced procedure in the pain clinics due to its wide range of indications. We experienced a rare case who exhibited severe hematoma in neck following stellate ganglion block. A 58-year-old female patient injured by a traffic accident was admitted to the department of negro surgery for the treatment of cerebral contusion, cervical and lumbar sprain and left arm paresis. Because left sensory neural hearing loss occurred, the patient was referred to the pain clinic for treatment with stellate ganglion block due to her left sensory neural hearing loss. The next day stellate ganglion block was done with a negative aspiration for blood. Three hours later, hematoma in neck was found and the patient complained of pain in the neck and dyspnea. The symptoms and signs of respiratory difficulty were progressively aggravated. The hematoma was removed and ruptured muscular branch of vertebral artery was ligated under surgical exploration. In this case, the needle was apparently in the branch of vertebral artery during or after injection in spite of the negative aspiration for blood. Authors recommend that compression of the injected site over 5 minutes should be necessary to prevent a hematoma formation despite of a negative aspiration for blood.

• The Korean Journal of Pain
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• 제2권2호
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• pp.203-207
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• 1989

통증치료의 분야에서 뿐 만 아니라 환자를 진단하고 치료하는 의학의 전반에 걸쳐 예기치 못한 합병증의 발생은 어쩌면 피할 수 없는 것인지도 모른다. 따라서 환자를 진료하는 의사는 합병증의 발생에 대한 잠재적 가능성을 언제고 염두에 두어야하고, 일단 합병증이 발생하였더라도 임기응변으로 적절히 대처할 수 있는 지식과 기술을 폭넓게 갖추고 있어야 한다고 생각된다. 저자들은 통증치료목적으로 지주막하 alcohol차단, 경천추차단, 경막외 catheter 거치중 폐기종, 약물의 이상확산, catheter 절단을 각각 경험하였으므로 이에 관하여 고찰하였다.

• 한국임상수의학회지
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• 제34권6호
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• pp.441-444
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• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.