• 제목/요약/키워드: Pain Clinics

검색결과 686건 처리시간 0.022초

관절경적 회전근 개 봉합술 : 1 - 4년 추시 결과 (Arthroscopic Rotator Cuff Repair : Outcome of 1 to 4 years follow up)

  • 박진영;정경태;멍예;박희곤
    • Clinics in Shoulder and Elbow
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    • 제5권1호
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    • pp.55-62
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    • 2002
  • Purpose : To compare and analyze the results of arthroscopic subacromial decompression and rotator cuff repair between partial rotator cuff tear and complete rotator cuff tear. Material and Methods : The authors studied 42 patients of rotator cuff tear with operation and followed over one year at Dankook university hospital from September, 1998 to March, 2001 The patient average age is 53 years and follow up period is 23 months (12-42mon1hs). We obtained 22 cases in the partial rotator cuff tear group and 20 cases in the complete rotator cuff tear group. In all cases, we used ASES methods to evaluated pain scale and function. Result : In the last follow up patients, the pain scale is decreased from 7.2 to 0.9 (ASES method : 34 to 91) in the partial rotator cuff tear group and from 7.6 to 1.2 (ASES method . 29 to 88) in the complete rotator cuff tear group, but there was no evidence of statistical difference between two groups (P>0.05). The range of motion after operation were increased in two groups. Excellent to good results were obtained 93% and 95% patients had pain relief and satisfied function. Conclusion : Arthroscopic subacromial decompression and arthroscopic rotator cuff repair showed good results for both of (ult-thickness and partial thickness rotator cuff tear patients in pain relief and improving the function.

상완골 간부 골절에 대한 선행성 교합 골수강내 금속정 고정술 후 견관절 기능 (Shoulder Function after antegrade intramedullary interlocking nailing for humeral shaft fracture)

  • 박진영;전지용;김명호
    • Clinics in Shoulder and Elbow
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    • 제6권1호
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    • pp.27-36
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    • 2003
  • Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

동결견에 대한 주사요법; 통증유발부위 주사 및 신경 차단술 (Injection Treatment for Frozen Shoulder ; Trigger Point Injection and Neruologic Blockade)

  • 오창욱;인주철;홍정길;박찬식
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.193-197
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    • 1998
  • Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

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전완부 총 신근 건 기시부의 석회화 건염 - 2예 보고 - (Calcific Tendinits at the Origin of Common Extensor Tendons of the Forearm - A Report of Two Cases -)

  • 김영규;조승현;문성훈;김남기
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.84-88
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    • 2011
  • 목적: 전완부 총 신근 건 기시부 생긴 석회화 건염 2예를 보고하고자 한다. 대상 및 방법: 좌측 주관절 굴곡 구축과 통증을 주소로 내원한 42세 여자 환자로 단순 방사선 및 자기공명영상 촬영 후 전완부 총 신근 건 기시부의 석회화 건염 진단 하에 수술적 제거술을 시행하였다. 우측 주관절의 급성 통증 및 운동 제한을 주소로 내원한 25세 여자 환자로 단순 방사선 사진상 전완부 총 신근 건 기시부에 석회화 건염 보여 체외충격파 치료를 시행하였다. 결과: 2예 모두 치료 후 통증의 소실과 운동 범위의 완전 회복을 보였다. 결론: 주관절 외측부에 통증 및 운동 범위 제한을 유발하는 질환의 감별진단에 총 신근 건 기시부의 석회화 건염이 고려되어야 한다.

Capsaicin 약침(藥鍼)이 흰쥐의 급성(急性) 염좌(捻挫)에 마치는 효과 (Capsaicin Pharmacopuncture Modulates Ankle Sprain Induced Pain in Rats)

  • 박상연;최윤영;전인숙;구성태;김경식;손인철;김재효
    • Korean Journal of Acupuncture
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    • 제23권2호
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    • pp.113-123
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    • 2006
  • Objectives: Pharmacopuncture which is a combination of acupuncture and herbal medicine helps to prevent and treat the diseases and symptoms including various pains. However, little was known about the therapeutic effects and its mechanisms on acute pain, although pharmacopuncture has been used frequently in acupuncture clinics. Acupuncture is known for producing analgesia for persistent ankle sprain pain in human. Furthermore, it also produces analgesia in a rat model of ankle sprain pain. Methods: To illuminate the underlying mechanisms of capsaicin pharmacopuncture-induced analgesia, weight bearing force (WBF) was observed on the acute ankle sprained rat model. Ankle sprain was induced in the rat by manually hyper-extending ligaments of the right ankle. Capsaicin pharmacopuncture was applied to SI6 (Yanglo) on the left forelimb (contralateral to the sprained ankle). Results: In behavioral test, capsaicin pharmacopuncture produced marked analgesic effects on acute ankle sprained animals as measured by WBF of the affected limb similar to manual acupuncture. Capsaicin pharmacopuncture was also suppressed by serotonin (5-HT) receptor antagonist methysergide (2 mg/kg, Lp.), but not by opioids receptor antagonist naltrexone (10 mg/kg, Lp.) and alpha adrenoceptor antagonist phentolamine (5 mg/kg, Lp.). Conclusion: The data suggest that capsaicin pharmacopuncture-induced analgesia is accomplished by activating the descending serotonergic inhibitory systems.

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The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar surgery

  • Sayphiboun, Phouthala;Boonsiriseth, Kiatanant;Mahardawi, Basel;Pairuchvej, Verasak;Bhattarai, Bishwa Prakash;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권3호
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    • pp.137-146
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    • 2020
  • Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

Mid- to long-term success rate and functional outcomes of acromioclavicular injections in patients with acromioclavicular osteoarthritis

  • Nienke Miedema;Inger Sierevelt;Tjarco Dirk Willem Alta;Roderick Jan Maximiliaan Vossen;Arthur van Noort
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.175-181
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    • 2023
  • Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

한방의료기관이용환자의 부작용 및 독성발생의 특성 - 2011년 한방의료이용실태조사(보건복지부)를 중심으로 - (Characteristics of Toxicity Occurring in Outpatients at Korean Medical Clinics in Korean)

  • 이기범;박영철;이선동
    • 대한한의학회지
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    • 제37권1호
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    • pp.135-150
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    • 2016
  • Research Methods: This research analyzed the data on those aged 20 and older from the Report on Korean Medicine Usage Research, which was conducted in 2011. The definitions of toxicity were defined by the presence of toxicity listed in the survey. The questions used in analysis were sex, age, household income, health insurance, medical fees, satisfaction rates on treatments, as well as the types of diseases and the presence of toxicity from treatments. The analysis was done through frequency analysis using SAS 9.2 and Fisher's Exact Test. Results: Toxicity occurred in 2.1% patients out of the 3518 studied. The types of toxicity were skin problems, such as hives and pruritus (34.7%), gastrointestinal problems (20.8%), neurological diseases (4.2%), liver(1.4%), kidney toxicity(1.4%), and others (22.2%). There were no differences in toxicity by sex, age, household income and the types of health insurances. However, toxicity were positively correlated with the increase in standard of education (p=0.0124). In addition, as treatment costs increased (p<0.0001) and satisfaction rates decreased, toxicity increased (p<0.0001). Toxicity increased in patients with low back pain (p=0.0429), hwabyung (p=0.0392), lumbar sprain (p=0.0004), correction body type (p=0.0118), growth (p=0.0045), and from motor accidents (p=0.0448). In logistic regression analysis, Toxicity were positively correlated with medical fees, and cancer treatment and negatively correlated with satisfaction rate on treatments. Conclusion: The toxicity that occurred in outpatients who used Korean medical clinics mostly happened in skin, digestive organs, nerves, livers, and kidneys toxicity. The occurrences differed by the Educational lengths, expensive costs of treatments, low satisfaction rates of the treatments, and cancer.

설치동물에서 통증에 대한 한국산 및 미국산 봉독의 진통효과의 비교 (Comparison of Antinociceptive Effect of Korean and American Bee Venoms on Pain in Rodent Models)

  • 김종민;한태성;강성수;김근형;최석화
    • 한국임상수의학회지
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    • 제27권6호
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    • pp.663-667
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    • 2010
  • 본 연구는 설치모델 동물에서 봉독의 항통각 효과를 평가하고, 한국산 봉독과 미국산 봉독의 항통각 효과를 비교하는 것이 주된 관심이다. 한국산 봉독은 특별히 고안된 봉독 추출기를 사용하여 일벌 (Apis mellifera L.)에 전기충격을 가하여 생봉독을 수집하였으며, 수집된 생봉독은 봉독 건조기를 이용하여 봉독을 건조하였다. 미국산 봉독은 미국 시그마회사에서 상업적으로 판매되는 건조 봉독을 이용하였다. 한국산 봉독과 미국산 건조봉독을 생리식염수에 희석하여 체중 kg당 6 mg과 0.6 mg, 0.06 mg을 마우스와 랫드에 피하로 투여하여 항진통 효과를 조사하였다. 항통각 효과는 한국산 봉독과 미국산 봉독은 서로 비슷하였으며, 봉독의 용량이 많을수록 항통각 효과가 크게 나타났다. 이상의 결과에서 한국산 건조 봉독은 통증 치료에 사용될 수 있을 것으로 생각된다.

추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용 (Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease)

  • 김영기;이승용;박세진;이스캇;김진현;이희천;장홍희;이효종;연성찬
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.122-127
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    • 2011
  • 후지마비와 심부통각의 소실을 보이는 5 년령의 수컷 Cocker Spaniel이 내원하였다. 신체검사, 신경검사, 방사선검사와 컴퓨터 단층촬영결과 심부통각의 소실을 동반한 요추 2번과 3번 사이의 디스크 탈출증으로 진단하였다. 편측 추궁 절제술을 시행하여 감압술과 탈출된 디스크 물질을 제거하였으며 $1{\times}10^6$ 개의 동종 지방유래 줄기세포를 $50{\mu}l$ 생리식염수에 희석하여 손상된 척수에 직접 주입하였다. 수술 10주 후, 양쪽 후지 모두에서 심부통각과 운동기능이 완전히 회복되었으며 세포이식과 관련된 부작용은 현재까지 발견되지 않았다. 본 증례를 통해 심각한 정도의 디스크질환을 가진 환축에서 감압술과 병행된 줄기세포의 이식방법은 좀더 나은 예후를 기대하기 위한 치료방법들 중 하나로 고려해볼 수 있을 것으로 생각된다.