• The Korean Journal of Pain
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• 제9권1호
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• pp.210-214
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• 1996

Thoracic sympathetic ganglion block(TSGB) with alcohol is a traditional method for treating a variety of disease at pain clinics. But it is a difficult block to perform requiring both skill and experience. Therefore, we performed a thoracic endoscopic cauterization to evaluate the efficacy of this method. A patient suffering sever forearm and hand pain due to radius fracture of the right arm, one and half years earlier, was referred to several different orthopaedic department of various hospitals with continued aggravated symptoms. He was then admitted to our hospital's orthopaedic department. Our diagnosis, confirmed by thermography, revealed reflex sympathetic dystrophy. Patients was therefore referred to the pain clinic where treatment consisted of endoscopic thoracic sympathetic cauterization under general anesthesia. Patient was intubated with Robertashow 37 Fr. double lumen tube left sided. Left lateral and slight head up position was applied to make lesion side up. Incisions were made to penetrate trocas 5 mm diamether on 4 th intercostal space along mid axillary line and midclavicular line. Negative pressure suction on ipsilateral lung and CO2 insufflation under 10 mmHg was applied to reduce lung size. Cauterization on thoracic sympathetic chain at T3 level was done under endoscoic guide. 24 Fr. chest tube was inserted. Patient's symptoms cleared and he was satisfied with the results of this treatment.

• The Korean Journal of Pain
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• 제10권2호
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• pp.301-303
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• 1997

A 35-year-old female patient was referred to our hospital with neurologic symptoms after continuous epidural block performed 2 days earlier. She die not have any prior no previous lumbar surgery or experience trauma, intraspinal hemorrhage, infections or other known causative factors to associate with neurologic symptoms. Continuous epidural block is widely used for postoperative pain control. Complications can occur with this block including postduralpuncture headache, epidural abscess and rare cases of arachnoiditis etc. We experienced such a case of spinal arachnoiditis after continuous epidural block. Neurologic examination revealed painful bilateral hypoesthesia below $S_2$ level dermatomes, urinary and fecal incontinence and various degrees of leg weakness. The following day, the patient was noted to have bilateral sacral radiculopathies and lesion on proximal portion of both tibial nerve. CSF study reported: protein 264 mg/dl, sugar 64 mg/dl, WBC $7/mm^3$. L-spine MyeloCTscan results were unremarkable. She was discharged after a month of hospitalization and has regular checkups but her neurologic symptoms show no signs of improvement.

• 대한물리치료과학회지
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• 제2권4호
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• pp.763-770
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• 1995

The primary purpose of this study was to determine the reliability of lumbar flexion and extension range-of -motion measurements obtained with the modified -modified $Sch{\ddot{o}}ber$ methods on normal and subjects with low back pain. Sixty two, aged 20 to 30 years(x = 22.0, SD = 2.07), with normal and twenty two, aged 14 to 66 years(x = 35.6, SD = 15.88) with chronic low back pain were measured by two physical therapist with 3 to 10 years (x = 6.5) of clinical experience. The therapist used the modified-modified $Sch{\ddot{o}}ber$(MMS) techniques to measure, in random order and on two occasions, the subjects' lumbar flexion and extension. For therapist 1, Intraclass correlation coefficients(ICC) for test-retest reliability for normal varied .9923, .8802(flexion, extension). and low back pain pateint varied .9950, .9313(flexion, extension). For therapist 2. ICC. for test-retest reliability for normal varied .9903, .8921(flexion, extension). and low back pain pateint varied .9843, .9551(flexion, extension). Interrater reliability for normal varied .9477, .6960(flexion, extension) and low back pain pateint varied. 9776, .7576(flexion, extension). Thus the MMS. method appears to be a reliable method for normal and patient with low back pain.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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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.

• 여성건강간호학회지
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• 제23권4호
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• pp.221-232
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• 2017

Purpose: This study aimed to conduct a systematic review and to describe characteristics of the birth experience assessment instrument. Methods: Literature related to the development of the birth experience assessment instrument was examined using a systematic review method. A literature search was conducted using the keywords as '[normal birth]; [$satisfac^*$ OR care quality]; [instrument OR scale] AND (development)' through PubMed, CINAHL, SCOPUS, PsycINFO, and RISS. The search used quality appraisal through QUADAS (Quality Assessment of studies of Diagnostic Accuracy included Systemic reviews) yielding 17 records. Results: The birth experience assessment instrument was categorized for instrumental characteristics: birth satisfaction (n=8), perception of labor experience (n=5), and birth care quality assessment in normal and operative birth experiences (n=4). Important key elements for content characteristics were as follows: nursing practice (n=10), pain control (n=5), environment (n=5), participation (n=4), and support (n=4). Conclusion: This study demonstrated that the birth experience instrument is appropriate for measuring quality of birth care in various clinical conditions. This review of the birth experience instrument reports that an appropriate psychometric tool for enhancing quality of birth care is important.

• 감성과학
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• 제13권3호
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• pp.551-558
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• 2010

통증은 매우 복합적이고 다양한 수준의 경험으로 주관적이거나 객관적일 수 있다. 침술은 통증을 치료하기 위한 아주 오래된 방법이며, 경락 이론을 바탕으로 한다. 침의 효과에 대한 임상적 결과들은 수없이 많이 있지만, 그 기능에 대한 과학적인 이해는 부족한 상태이다. 또한, 실생활에서의 통증 유발 원인과 침술을 통한 통증 억제 또는 치료는 그 차이가 매우 크게 느껴진다. 그러나 최근 연구들을 통해 통증과 침술의 관련성이 밝혀지고 있다. 본 논문에서는 최근 급격히 발달하고 있는 뇌영상 기술들(functional magnetic resonance images, 및 positron emission tomography, electroencephalograph, magnetoencephalography)을 간략히 살펴보고, 이들을 이용한 통증 및 침술 연구들을 살펴보고자 한다. 통증과 침술에 관여하는 뇌 영역들을 확인하여, 이 둘의 유사성 및 차이를 비교하고, 뇌영상 기술을 통해 밝혀지는 뇌의 정보처리 과정을 통해 통증과 침술에 대한 이해를 넓히고자 한다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.271-274
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• 2005

Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.

• 대한정형도수물리치료학회지
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• 제12권2호
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• pp.11-20
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• 2006

Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.

• 근관절건강학회지
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• 제3권2호
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• pp.194-208
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• 1996

Many arthritis patients experience physical and psychological impairments. Two hundred and three patients were examined to identify the relationships between the variables such as pain, ADL depression, self-efficacy and the effect of self-efficacy on pain, ADL and depression. It was found that ADL is significantly negatively related to depression and pain, and positively related to self-efficacy. Pain was significantly negatively related to self-efficacy, and positively related to depression and ADL. Then stepwise multiple regression was performed to Identify the variables to predict ADL, pain and depression. Self-efficacy predicted negatively depression and positively ADL. Depression predicted positively pain. So it was revealed that self-efficacy decreased pain indirectly by influencing depression. Also Pain predicted negatively ADL. ADL was predicted directly by pain and self-efficacy. So it is suggented that nursing intervention improving self-efficacy would be useful for patients with depression, pain, and ADL limitation. Moreover, these subjects gained 44 score in depression which means severe depressed state. So it is very important to implement nursing intervention to increase self-efficacy. Recommendations for future research was suggested.

• The Korean Journal of Pain
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• 제20권2호
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• pp.158-162
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• 2007

Background: After burn patients are discharged from the hospital, they may continue to feel pain and paresthetic sensations at the site of a healed burn and these problems may persist for years. This study was designed to describe the characteristics of these symptoms in terms of intensity, frequency, and influencing factors. Methods: Patients that developed paresthetic sensations at sites of a healed burn were recruited from the pain management center from January 2003 to April 2006. Data was collected using a structured interview protocol. Results: Fifty one adults, with a total body surface area burned (TBSA) of $21.1{\pm}16.3%$ aged $42.0{\pm}12.9$ years were studied. A paresthetic sensation was reported to be present every day in 52.9% (27/51) of the subjects. A variation in the intensity was most commonly related to changes in the weather. A tight sensation and itching types of sensations were significantly more frequent in patients with more extensive injuries. Conclusions: Recognition and understanding of the chronic paresthetic sensation that many burn patients continue to experience at sites of a healed burn deserve further attention. Not only do clinicians need to be aware of these problems but also strategies for prevention and alleviation shou\d be explored.