• 말소리와 음성과학
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• 제5권3호
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• pp.55-60
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• 2013

The purpose of this study was to investigate the acoustic characteristics of crying infants according to the communication intents such as hunger and pain in terms of acoustic differences in the fundamental frequency ($F_0$), jitter, shimmer, noise-to-harmonic ratio(NHR), habitual pitch, and intensity. The subjects were 20 healthy, normal infants, less than seven days old, from the city of Seoul and were born after 38 to 42 weeks(full term) of pregnancy. The sound of crying was recorded for three minutes. The crying due to pain was induced by means of the inborn metabolism error test, whereas the crying due to hunger was verified by means of the rooting reflex by waiting for the designated eating time. The results were as follows: (1) the fundamental frequency, noise-to-harmonic ratio(NHR), and intensity of the infants' crying due to pain was higher than that by hunger, showing a significant difference between the mean values. (2) the infants' crying due to hunger and that by pain did not have a significant difference in the mean jitter and shimmer values but both of them were largely outside of the normal threshold values(jitter by 1.04% and shimmer by 3.81%). This study was significant in the sense that it showed the acoustic characteristics of infants' crying from hunger and pain were very different from each other according to the communication intents in terms of the six acoustic parameters.

• The Korean Journal of Pain
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• 제1권1호
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• pp.59-63
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• 1988

Recently, epidural tunnelling was introduced for the convenience of keeping a catheter inserted for a long period of time. We had 15 cases in which used epidural tunnelling for the treatment of intractable pain mainly in terminal cancer patients. Epidural puncture with cannulation was carried out in the same technique as used for epidural anesthesia. After the subcutaneous epidural tunnelling was done from the site of the epidural entry to the anterior chest, just under the slim using a tunnelling device, the catheter was threaded through the tunnelling needle at the site of the outlet, was fixed and the tip of the catheter was connected to a filter. Five ml (2 mg) of saline diluted morphine can be given at home as needed when intractable pawn occurs. This long-term treatment of intractable pain by morphine injections through the epidural cannula place by subcutaneous tunnelling, is very convenient for the patient's daily routine and a better alternative in such a situation. Our technique, its advantages and problems were described in this paper.

• Journal of Acupuncture Research
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• 제20권6호
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• pp.36-44
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• 2003

Objective: We have various ways in evaluating the level of low back pain as sequelae, general approaches such as neurologic examination, MRI, Radiologic examination and evaluating the effect of psychological stress on the low back pain. Besides We can find another approach to evaluating the sequale of low back pain in TA patients. So, I intend to analyze how much relationship the patients that got low back pain by TA have with Roland Morris Disability Scale(RMS) in 2 months after discharge. Methods: In this article, I will compare two results of TA inpatients and non-TA inpatients, which obtained with the RMS. This study was carried out about 22 TA patients and 18 non-TA patients, who had low back pain and were hospitalized between March 2002 and July 2002. Results & conclusions : 1. RMS point is related with the post-discharge term to a point of time of answering the questionnaire in both TA patients and non-TA patients. 2. In distribution of RMS point, Gr II take most possesion as 41% in TA patients while Gr I take most possesion as 56% in non-TA patients. 3. In distribution of RMS point, patients that correspond to more than Gr III take 27% in TA patients, 16% in non-TA patients. 4. TA patients show higher level of distribution than non-TA patients in RMS point in verifying them by mean value and T-test. 5. Degree of pain score change(${\Delta}$P.S), using mean value and T-test, showed lower level of distribution in TA patients than non-TA patients. 6. We can see that TA patients have more restriction in their life for low back pain.

• The Korean Journal of Pain
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• 제23권1호
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• pp.82-87
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• 2010

Occipital neuralgia is a form of headache that involves the posterior occiput in the greater or lesser occipital nerve distribution. Pain can be severe and persistent with conservative treatment. We present a case of intractable occipital neuralgia that conventional therapeutic modalities failed to ameliorate. We speculate that, in this case, the cause of headache could be the greater occipital nerve entrapment by the obliquus capitis inferior muscle. After steroid and local anesthetic injection into obliquus capitis inferior muscles under fluoroscopic and sonographic guidance, the visual analogue scale was decreased from 9-10/10 to 1-2/10 for 2-3 weeks. The patient eventually got both greater occipital neurectomy and partial resection of obliquus capitis inferior muscles due to the short term effect of the injection. The successful steroid and local anesthetic injection for this occipital neuralgia shows that the refractory headache was caused by entrapment of greater occipital nerves by obliquus capitis inferior muscles.

• 한국간호교육학회지
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• 제5권1호
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• pp.20-38
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• 1999

This study is conducted to test an effect of the guided Imagery program on artificially induced pain and to develop an effective nursing intervention for patients with pain. The subjects of this study were 37 normal female university students. The data were collected from September 1998 to December 1998. And two group non-equal quasi -experimental research with pre and post design was used in this study, The data were analyzed with the SPSS $PC^+$ program with percentage, t-test, paired t-test and ANCOVA. The results of this study were as follows : 1. There are no significant differences of systolic blood pressure between groups. 2. The experimental group showed significantly lower diastolic blood pressure than control group after treatment. 3. There are no significant differences of pulse rate between groups. 4. The experimental group showed significantly higher body temperature than control group after treatment. 5. There are no significant differences of pain intensity between groups. 6. There are no significant differences of pain sensation between groups. 7. There are no significant differences of perceived pain tolerance time between groups. 8. The experimental group showed significantly longer real pain tolerance time than control group after treatment. 9. There are no significant differences of anxiety scores between groups. 10. There are no significant differences of Self-esteem scores between groups. 11. There are no significant differences of Self-esteem scores between groups. 12. There are no significant differences of imagability scores between groups. 13. The post-experimental group showed significantly higher relaxation rate than pre -experimental group. 14. There are no significant differences of imaging depth degree between pre-experimental group and post-experimental group. From the above results, it can be concluded that 1. This guided imagery program could be recommenced as an effective nursing intervention to relieve pain. 2. A follow up study is needed to identify long-term effects.

• 척추신경추나의학회지
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• 제4권2호
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• pp.109-120
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• 2009

Objectives : We already know the importance of stability and flexibility on the vertebra. It is important to keep the lumbar lordosis for stability and flexibility. We hope to reduce lower back pain and low extremity pain by changing the angle of the Lumbar Kyphosis through conservative treatment. We have evaluated the effect of conservative treatment with Saamchimbeop Pejeonggyeok by experimenting one patient suffering from Lumbar Kyphosis with lower back pain and low extremity pain. Methods : One patients were diagnosed as Lumbar Kyphosis through X-ray examination. We used conservative treatment, especially Pejeonggyeok Treatment to the patients and measured NRS((Numerical Rating Scale), rating scale for low back pain, low extremity pain and SLR(Straight Leg Raising) test and walking time in whole term of admission, and we also measured flexion, extension angle and lumbar kyphosis using lumbar x-ray lateral view after diganosing by Lumbar Kyphosis. Results and Conclusions : After treating conservative therapy, We figured out that the patient were on the mend, and we found out the angle change in flexion, extension and lumbar Kyphosis. These results suggest that Pejeonggyeok Treatment were effective to improved Lumbar Kyphosis and reduced the low back pain.

• The Korean Journal of Pain
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• 제29권2호
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• pp.103-109
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• 2016

Background: The location and the number of lumbar sympathetic ganglia (LSG) vary between individuals. The aim of this study was to determine the appropriate level for a lumbar sympathetic ganglion block (LSGB), corresponding to the level at which the LSG principally aggregate. Methods: Seventy-four consecutive subjects, including 31 women and 31 men, underwent LSGB either on the left (n = 31) or the right side (n = 43). The primary site of needle entry was randomly selected at the L3 or L4 vertebra. A total of less than 1 ml of radio opaque dye with 4% lidocaine was injected, taking caution not to traverse beyond the level of one vertebral body. The procedure was considered responsive when the skin temperature increased by more than $1^{\circ}C$ within 5 minutes. Results: The median responsive level was significantly different between the left (lower third of the L4 body) and right (lower margin of the L3 body) sides (P = 0.021). However, there was no significant difference in the values between men and women. The overall median responsive level was the upper third of the L4 body. The mean responsive level did not correlate with height or BMI. There were no complications on short-term follow-up. Conclusions: Selection of the primary target in the left lower third of the L4 vertebral body and the right lower margin of the L3 vertebral body may reduce the number of needle insertions and the volume of agents used in conventional or neurolytic LSGB and radiofrequency thermocoagulation.

• Journal of Hospice and Palliative Care
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• 제12권2호
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• pp.56-60
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• 2009

암성 통증의 80%는 진통제를 투여하는 약물치료로서 조절될수 있지만 $10{\sim}20%$는 다른 대책이 필요하다. 신경파괴제를 사용하는 블록은 이런 경우 중요한 역할을 한다. 신경블록은 암환자의 통증을 예방하고 삶의 질을 증가시킬수 있다. 특히 암성 통증이 신체 말단부위나 어떤 한 부위에 국한되 있는 경우 말초신경블록이나 교감신경블록은 좋은 효과를 나타낸다. 신경파괴제를 사용하는 교감신경블록 특히 복강신경총블록은 조기에 시행하면 훨씬 효과적이며 장기간 효과를 나타낸다. 환자 선택이 성공적인 결과를 얻는데 중요하다. 신경파괴제를 사용하는 신경블록은 복부 및 골반강내 암성통증을 감소시키고 진통제의 사용량을 감소시킬뿐 아니라 진통제에 관련된 부작용을 감소시키므로서 삶의 질을 향상시킨다. 따라서 조기단계에서 보다 적극적인 신경블록요법이 권고된다.

• 대한관절경학회지
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• 제4권2호
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• pp.117-122
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• 2000

목적 : 전방 십자 인대 손상을 치유하기 위해 사용되는 골-슬개건-골 자가 이식건은 많은 장점이 있지만 이식후 슬개건의 공여부와 슬개대퇴 관절 주위에 합병증이 발생하는 등의 단점이 있어 현재 다른 이식건을 이용한 재건술이 많이 시행되고 있다. 그러나 합병증에 대한 대부분의 문헌이 단기간의 추시 결과에 의한 것이다 저자들은 추시 기간이 길어짐에 따라 이러한 합병증의 빈도가 현저하게 감소하는 양상을 관찰할 수 있어서 이에 대한 연구를 시행하고자 하였다. 대상 및 방법 : 술후 2년 이상 추시가 가능하였던 골-슬개건-골 자가 이식건을 이용한 전방 십자 인대 재건술을 시행받은 76례를 대상으로 2년에서 4년까지의 추시군(평균 2년 10개월)을 중기 추시군, 4년에서 7년 10개월까지의 추시군(평균 4년 6개월)을 장기 추시군으로 분류하여 임상적 및 방사선학적 결과와 슬개골 주위 합병증을 비교분석 하였다. 결과 : Lysholm Knee Score와 슬관절의 안정성은 술전에 비하여 중기 추시군과 장기 추시군 모두 호전을 보였으며 두 군간의 차이는 없었다. 이식건 공여부에 있어서 경도의 동통과 감각의 저하, 슬관절에서의 탄발음, 대퇴 사두근의 위축 등은 중기 추시군 보다 장기 추시군에서 통계학적으로 유의하게 발생빈도가 적었으며 전방 십자 인대 손상전의 운동능력으로 회복된 경우도 각각 19례$(46.3\%)$, 27례$(77.1\%)$로 두 군사이에 통계학적인 차이를 보였다. 결론 : 이상의 결과로 골-슬개건-골 자가 이식건을 이용한 전방 십자 인대 재건술에서 중기 추시군과 장기 추시군을 비교했을 때 슬관절의 안정성은 두 군 사이에 유사한 결과를 보이고 있었다. 그러나 문제시 되고 있는 슬개건 공여부와 슬개대퇴 관절 주위의 합병증은 추시 기간이 증가함에 따라 현저한 감소를 보이고 있음을 알 수 있었다.

• 대한족부족관절학회지
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• 제13권1호
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• pp.40-45
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• 2009

Purpose: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. Materials and Methods: The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with $HINTEGRA^{(R)}$ Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. Results: Average follow-up period was 29 months (13${\sim}$55 months), and the age was average 62 years (39${\sim}$75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7${\sim}$10) to 2.0 (0${\sim}$5) and the AOFAS functional score improved from 41.8 points (13${\sim}$71 points) to 90.6 (77${\sim}$100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. Conclusion: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.