• The Korean Journal of Pain
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• v.13 no.2
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• pp.149-155
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• 2000

Background: Pulsed radiofrequency (RF) lesioning is a painless procedure and causes no neurodestruction and neuritis-like reaction are common following conventional RF lesioning. There is little data about the effect of pulsed RF especially with regard to its suitability for the treatment of acute pain. The possibility of a placebo effect cannot be ruled out because a double-blind study was not performed in previous studies. There is also no neuropathologic study about pulsed RF. Methods: The rats were anesthetized with sodium pentobarbital (40 mg/kg, i.p.; supplemented as necessary). The common sciatic nerve was exposed by blunt dissection through biceps femoris. Pulsed RF was administered to the common sciatic nerve using a 30 ms/s pulse with for 120 seconds. The temperature reached was no more than $42^{\circ}C$. Analgesia was determined using hot-plate assay shortly and, 3 days and 1 week before, and 2 weeks after operation. Lesions were examined with LM (light microscope) and EM (electron microscope) 2 weeks later. Results: There were no differences in response latencies between the control and experimental group. There were many vacuoles with hyaline bodies in the Schwann cell cytoplasm rather than axon in LM and larger electron dense bodies. No changes were found in the axon or unmyelinated fibers. Only small changes were found in the sheaths of myelinated fibers and Schwann cells. Conclusions: We therefore do think that any analgesic effect of pulsed RF is not a result of block of neural conduction. But rather than it can be attributed to others factors. It was also ineffective as a treatment for acute pain such as that caused by the hot-plate test.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.533-538
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• 2008

Purpose: Sensory changes in the upper limb are complications of a mastectomy with immediate breast reconstruction with the treatment of breast cancer. The purpose of this study is to clarify whether immediate breast reconstruction worsens the sensory changes. Methods: From March 2004 to December 2005, 20 patients who had a mastectomy with immediate breast reconstruction(reconstruction group) were compared with 23 patients who had a mastectomy alone(control group). All patients had stage I or II breast cancer. The sensory changes were assessed in a blind manner by one examiner that used light touch sensation, static two-point discrimination, pain, vibration, hot and cold temperature perception. The sensory changes were identified along the sensory dermatome for diagnosing the damaged nerves. The following factors and their relationship with the sensory changes were analyzed : age, complications, and the mastectomy method. Results: There was no statistical difference in the static two-point discrimination, pain, vibration, hot and cold temperature perception between the two groups. However, the ability to recognize light touch was significantly better(p=0.045) in the reconstruction group than in the control group. The main site of sensory change was the proximal and medial portion of the upper limb in both groups. At these sites, the mean value of Semmes-Weinstein monofilament was $1.01g/mm^2$(reconstruction group 0.82, control group 1.17) and 2-point discrimination was 51.74(converted to perfect score of 100; reconstruction group 42.50, control group 59.78). The total rate of early complications was found to be significantly lower(p=0.006) in the reconstruction group than in the control group. Conclusion: These findings suggest that an immediate breast reconstructive procedure following a mastectomy is as safe as or safer than a mastectomy alone with respect to postoperative sensory changes of the ipsilateral upper limb.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.83-91
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• 2011

Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

• Journal of Acupuncture Research
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• v.27 no.1
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• pp.21-29
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• 2010

Objectives : This study aims to evaluate current clinical evidence of acupuncture treatment for rehabilitation in patients with traffic accident in South Korea. Methods : Seven Korean databases were searched for prospective clinical trials for acupuncture on rehabilitation in patients with traffic accident from their inception to June, 2009. Only studies conducted in Korean language were searched. Risk of bias in included randomized controlled trials were assessed by Cochrane Handbook procedure. Results : Fifteen clinical trials were included among 31 studies searched. Eight were observational studies, five were non-randomizedcontrolled trials, and two were randomized controlled trials. In all of included studies, acupuncture were conducted with other concomitant treatment. Included studies dealt with such conditions as neck pain, low back pain tinnitus after traffic accident, post-traumatic stress, oculomotor nerve palsy, diplopia and insomnia. All of included studies reported favorable effects of acupuncture group compared to baseline or control group. All of included studies lacked the occurrence of adverse events. High risk of bias were observed in two randomized controlled trials. Conclusions : There is no evidence that acupuncture is effective for rehabilitation of traffic accident. All of included studies lacked appropriate methodological qualities and internal validity. Future welldesigned clinical trials that evaluate the effects and safety of acupuncture treatment for rehabilitation in patients with traffic accident is needed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.213-220
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• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.89-101
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• 1996

This study was performed to investigate influence of the changes of head posture on resting electromyographic (EMG) activity in anterior temporalis, masseter, sternocleidomastoid muscle and trapezius, and on status of occlusal contacts. For this study twenty-nine patients with temporomandibular disorders(TMD) and thirty dental students without any masticatory symptoms were selected as patients group and control group, respectively. EMG activity($\mu$V) at rest was observed in four kind of head postures such as natural or normal head posture(NHP), forward head posture(FHP), upward head posture(UHP), downward head posture(DHP), and in NHP and FHP, EMG activity with flat occlusal splint was also checked. BioEMG$^\textregistered$(Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles with eight locations on both sides. The author used T-Scan$^\textregistered$(Tekscan Co., USA) system to investigate the changes of oclusal contats on clenching in the four head postures about number, force, time(duration) and total left-right statistis(TLR, occlusal stability crossing left-right dental arch on clenching). For taking in upward or downward head posture, head was inclined $10^{\circ}$ upward or downward and CROM$^\textregistered$ (cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure. The results obtained were as follows : 1. For resting EMG activity, anterior temporalis did not show any difference by change of head posture, but masseter and sternocleidomastoid muscle showed higher value of EMG activity in FHP and UHP, and trapezius showed higher value of EMG activity in FHP and DHP. 2. EMG activity of trapezius was higher than that of any other muscles in NHP, FHP, and DHP, but in UHP, the activity was the lowest reversely. 3. Patients group showed higher EMG activity than control group did in all the muscles in NHP. And significant difference between the two groups were also observed in anterior temporalis in FHP, in sternocleidomastoid muscle in UHP, and in sterno-cleidomastoid muscle and trapezius in DHP with higher activity in patients group. 4. There was no change of EMG activity in NHp with splint, but EMG activity in anterior temporalis and masseter was decreased in FHP with splint. 5. In general, status of occlusal contacts was not changed with head posture in all subjects, and difference between patients group and control group was only noted for number and force of tooth contact in UHP and DHP with more value in control group. 6. Correlationship between EMG activity and number ad force of tooth contacts was shown negatively with regard to masseter in NHP, and trapezius in UHP and DHP.

• 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.

• Journal of Animal Science and Technology
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• v.59 no.3
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• pp.5.1-5.10
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• 2017

Background: Bovine respiratory disease (BRD) is one of the leading causes of economic losses in the beef and dairy industry. Reliable antemortem tools for diagnosing BRD would improve the efficacy of treatment and reduce costs. Here we examined whether the relatively simple technique of thoracoscopy can support BRD diagnosis under field conditions. We also compared various equipment set-ups in order to optimize the safety and efficacy of the procedure. A total of 24 thoracoscopic procedures were performed in 17 calves diagnosed with BRD and in 2 healthy control calves. Rigid and flexible endoscopes and industrial videoscopes were tested using various insertion approaches. The suitability of the technique was assessed in terms of duration, volume of air extracted, visualization score, and image quality. Safety was assessed in terms of rectal temperature, body weight, breaths/min, presence of fibrinogen, pain score, recovery time, intraoperative complications and risk of laceration or threatening collapse. Results: Insertion of a flexible endoscope via a right, dorso-caudal approach at the $5^{th}$ intercostal space allowed complete examination of the right lung in 15 min, as well as identification of main lung lesions and adherences in calves with BRD, without compromising calf welfare. While the dorso-caudal approach was optimal, it was associated with substantial discomfort when rigid endoscopes were used, minimal complications or mortality due to thoracoscopy were observed up to 28 days after the procedure. Videoscopes were as safe and easy to use as endoscopes, but endoscopes provided better image quality. Conclusion: This study provides the first field evidence that thoracoscopy can be safe to explore BRD-diseased calves. These results justify a larger study to rigorously assess the diagnostic performance of the technique.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.9-14
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• 2006

Purpose: The proximal tibial sarcoma patients, especially in their growing ages have problems of reconstruction. This study is to devise a methodology which can circumvent this limitations. Materials and Methods: Four cases of proximal tibial osteosarcoma underwent hemiarthroplasty. The mean age was 13 years (11~15) with a mean follow-up of 64 months (47~89). The procedure consists of ultrahigh molecular weight polyethylene (UHMWPE) liner as an substitute for the joint surface and this piece was fixed to the remaining tibial bone stock with Ender nail and bone cement. Results: Final functional score was 23.5 (78.3% of control) by MSTS criteria. All the cases showed stable joint without pain. Hemiarthroplasty related complications were absent. By saving the femoral physis, expected leg length discrepancy could be minimized by this procedure. Conclusions: Hemiarthroplasty of proximal tibia can be an option in pediatric sarcoma patients.

• Journal of Korean Medical classics
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• v.24 no.4
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• pp.23-32
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• 2011

The texts of "Hwangjenaegyeong(黃帝內經)" explains Hakjil(瘧疾) in detail, especially in the "Jahak(刺瘧)" chapter, where bloodletting treatment is applied in many cases. The following paper categorized and organized Hakjil(瘧疾) cases treated by bloodletting methods, then analyzed applicable subjects and appropriate time for the procedure based on the texts. Afterwards, the mechanism for the cessation of Hakjil(瘧疾) seizures was examined. The findings of this research are as follows. 1. In the contents of "Hwangjenaegyeong(黃帝內經)", the appropriate time for acupuncture and bloodletting procedure is when Hakjil(瘧疾) seizures start to present themselves. 2. When a seizure takes place as a symptom of the body getting rid of the Hak(瘧) pathogen, Yanggi(陽氣) rushes to the locus of the pathogen, causing congestion of Gi(氣) and Blood(血) resulting in static blood[瘀血]. Therefore, bloodletting at the time of seizure initiation helps the flow of Gi(氣) and Blood(血), preventing the rush of Yanggi(陽氣). This is a restoration of the balancing function of Eum(陰) and Yang(陽), which indicates that bloodletting not only promotes smooth flow of Gi(氣) and Blood(血), but extends its effects to mental functions that balances Eum(陰) and Yang(陽). 3. Although Hakjil(瘧疾) seizures are presented in terms of Gi(氣) and Blood(血) in symptoms such as chill and fever[寒熱], static blood[瘀血], pain, etc., a fundamental disturbance in mental functions that control cold and heat seems to be present.