• The Korean Journal of Pain
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• v.10 no.2
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• pp.166-169
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• 1997

Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISB) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred $39{\pm}18$ min after sitting position and $22{\pm}18$ min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-parish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.242-245
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• 1999

Gabapentin is an oral antiepileptic agent with an unknown mechanism of action. There have been many proposed uses for gabapentin, including neuropathic pain, reflex sympathetic dystrophy, postherpetic neuralgia, midscapular pain secondary to radiation myelopathy and migraine prophylaxis. This report presents patients who were treated with gabapentin when other pharmacologic interventions failed to relieve neuropathic pain 3 patients with neuropathic pain were included among these cases. All patients were started on 200 mg gabapentin. The maximum dose required for pain relief was between 800 mg and 2400 mg. Gabapentin may be a useful adjunct for treating neuropathic pain with minimum of side effects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.428-434
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• 2020

Orbital floor blowout fractures can result in a variety of signs and symptoms depending on the severity of the bone defect. Large defects often result in enophthalmos and restriction of ocular movement; yet the timing of surgery can be delayed up to two weeks with good functional outcomes. In contrast, an orbital trapdoor defect with entrapment of the inferior rectus muscle usually elicits pain with marked restriction of the upward gaze and activation of the oculocardiac reflex without significant dystopia or enophthalmos. When autonomic cardiac derangement is diagnosed along with an orbital floor fracture, it has been suggested that the fracture should be treated immediately. Otherwise, it will result in continued hemodynamic instability and muscular injury and may require a second surgery. This article reports the management of an unusual presentation of a trapdoor blowout orbital floor fracture surgery with oculocardiac response in an adult, with emphasis on its pathophysiology, management, and differential diagnosis.

• Journal of Korean Physical Therapy Science
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• v.9 no.1
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• pp.123-128
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• 2002

Objectives: The objective of this study was to investigate factor analysis of low back pain patients. Methods: The data were collected from hospital located in Daegu. Observation was made on 40 low back pain patients and factor analysis study was also performed in terms of their abnormal physical findings. Results: The low back pain patients occupied 20% of all clinical patients in male group and 20% in female group. The occurrence of acute low back pain in the first factor tended to be higher among in male group than among in female group. While it was significantly higher muscle weakness of the back in female group. The most prevailing abnormal finding among low back pain patients in the first factor were tender point on the back, While it was significantly lower Decreased tendon reflex in both sexes Conclusions: The factor pattern of abnormal physical findings in low back pain patients was much different between male and female patients, suggesting the different pattern of etiology. Although low back pain is one of the most common symptoms causing limitation activity, as yet there is no known specific effective treatment.

• Journal of Pharmacopuncture
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• v.9 no.3 s.21
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• pp.139-145
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• 2006

Objectives : The purpose of this case in so report the patient with Reflex sympathetic dystrophy, who is improved by Bee venom. Method : We treated the patient with Bee venom who was suffering from Reflex sympathetic dystrophy, using Digital Infrared Thermographic Imaging and Verbal Numerical Rating Scale(VNRS) to evaluate the therapeutic effects. We compared the temperature of the patient body before and after treatment. Result and Conclusion : We found that Bee venom had excellent outcome to relieve pain, atrophy and ankle joint ROM, and that Bee venom also had clinical effect on hypothermia on the Digital Infrared Thermographic Imaging.

• Journal of Korean Physical Therapy Science
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• v.4 no.3
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• pp.475-489
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• 1997

Connective tissue massage(CTM, Bindegewebs massage) are developed and named by Mrs. Elizabeth Dicke, a German physical therapist. The CTM is used primarily for internal disorder such as myocarditis, coronary insufficiency, high blood pressure, functional stomach and intestinal disorders, inflamma-tion of the gallbladder, and hepatitis, arterial circulatory problems, venous disorders, headache, particularly trauma to the head, and some gynecologic disorder, etc. Which is performed with special stroking technique of the subcutaneous tissue of the trunk, extremities, and face. The mechanism of effectiveness of CTM is based on a viscerocutaneous reflex. The stroking stimulates the nerve end-ings of the autonomic nervous system. The impulses activated by stroking travel to the sympathetic trunk and the spinal cord and brain, which causes a change in reaction susceptibility. The most important for apply CTM is necessary to know the reflex zone (Head's zone, Mackenzie's zone and Dicke's connective tissue zone). Dicke's connective tissue zones are only found by the special dia-gnostic stroking. Because the connective tissue zones no discomfort when unmanipulated, and thus the patient is unaware of them. It is characterized by diagnostic stroking that causes a sharp pain in the tissue. As a general rule, all treatment are preceded by the basic stroke from the level of the coccyx to the first lumbar vertebra and each stroke is done three times. The right side is done first, then the left side.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.231-246
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• 2000

Acupuncture has been used for treatment of numerous diseases, especially for pain control in the oriental culture. However, the mechanism of pain control by acupuncture was not clear so far. The present study was examined that the effects of electro-acupuncture (EA) applied to the acu-point of extra-segmental area on modulation of formalin induced pain in Sprague - Dawley rats. In order to apply EA to acu-points in the plantar area of right fore paws, a pair of teflon - coated stainless steel wires were implanted in HT 7 (shin-mun) and PC 7 (dae-neong) 5 days before behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\mu}l$) into the lateral plantar region of left hind paw. EA was delivered by a constant current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. The electromyographic activities were recorded in the biceps femoris muscle under chloral hydrate anesthesia. Test stimuli with 1~9mA were applied to the sural nerve territory including the medial portion of the 4th toe and the lateral portion of the 5th toe. Behavioral responses including favoring, flinching and bitting were occured in the biphasic pattern, such as the lst phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited Che behavioral responses. EMG activities of flexor reflex had a latency of 100~300 ms and thresholds of test stimuli for EMG were 4~5 mA in normal rats. Injection of formalin decreased threshold of test stimuli and increased EMG activities for 2hrs after injection. However, EA significantly inhibited EMG activities of flexor reflex increased by formalin and recovered EMG evoked thresholds. These results suggest that contralateral extra-segmental EA inhibits the first and second phases of formalin induced pain but their mechanism be needed to examine additionally.

• Clinical Pain
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• v.18 no.2
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• pp.133-137
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• 2019

The long-term prognosis of complex regional pain syndrome is difficult to predict because of its unclear pathophysiology. The syndrome can spontaneously spread to other regions in the body. We report a case in which a complex regional pain syndrome that occurred in a 75-year-old male patient after a stroke spread to the opposite side.

• The Korean Journal of Pain
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• v.3 no.2
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• pp.101-107
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• 1990

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.93-96
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• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.