• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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• pp.41-76
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• 2001

Rheumatoid arthritis is an incurable chronic inflammatory and destructive arthopathy that affects 1% of the population world-wide. It has substantial personal, social and economic costs. The long-term prognosis is poor: 80 percent of affected patients will become disabled within 20 years after onset of disease. Medical costs of rheumatoid arthritis average ∼$ 6000 (US) per patient (1), Current antirheumatic drugs have limited efficacy and many side effects and more importantly they do not improve the long-term prognosis of rheumatoid arthritis (2). After a decade of few notable advances in therapy, several biological response modifiers that target pathophysiological processes in the disease have now emerged in the clinic. These new drugs are termed biological agents, and although information about their use in the clinic is still limited to short term treatment, they appear to have the ability to modify disease progress. In addition, COX-2 selective agents have now been approved that have comparable efficacy with standard NSAIDs, but fewer gastrointestinal side effects (3). Thus today many more therapeutic options are suddenly open to patients that even five years ago had little hope of relief from chronic pain and inflammation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.233-240
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• 2019

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

• Child Health Nursing Research
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• 제7권1호
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• pp.35-50
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• 2001

The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotrans-mitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO₂. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25％ sucrose). Collected data were analyzed with the SAS program using X²-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25％ sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO₂: The SaO₂ score of placebo group(2ml 25％ sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO₂ score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.194-200
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• 2013

Objective : Lumbar spine stenosis (LSS) can result in symptomatic compression of the neural elements, requiring surgical treatment if conservative management fails. Minimally invasive surgery has come to be more commonly used for the treatment of LSS. The current study describes outcomes of bilateral microdecompression by unilateral or bilateral laminotomy (BML) for degenerative LSS after a minimum follow-up period of 3 years and investigates factors that result in a poor outcome. Methods : Twenty-one patients who were followed-up for at least 3 years were included in this study. For clinical evaluation, the Japanese Orthopedic Association (JOA) scoring system for low back pain was used. The modified grading system of Finneson and Cooper was used for outcome assessment. Radiographic evaluation was also performed for spondylolisthesis, sagittal rotation angle, and disc height. Results : Twenty-one patients (10 men, 11 women) aged 53-82 years ($64.1{\pm}8.9$ years) were followed-up for a minimum of 3 years (36-69 months). During follow-up, two patients underwent reoperation. Average preoperative JOA score and clinical symptoms, except persistent low back pain, improved significantly at the latest follow-up. There were no significant differences in radiological findings preoperatively and postoperatively. Thirteen patients (61.9%) had excellent to fair outcomes. Conclusion : BML resulted in a favorable and persistent outcome for patients with degenerative LSS without radiological instability over a mid-term follow-up period. Persistent low back pain unrelated to postoperative instability adversely affects mid-term outcomes.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.148-153
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• 2006

Objective : The authors conducted this study to present the long-term treatment outcomes [minimum 2 years] of Gamma knife radiosurgery[GKS] for trigeminal neuralgia[TN] and to demonstrate the correlation of treatment outcomes and the anatomical characteristics of TN. Methods : From 1997 to 2003, 44 consecutive patients suffering from medically intractable pain underwent GKS for TN. A single 4mm collimator was used with a median maximum dose of 80Gy [range $75{\sim}80Gy$] prescribed to the root entry zone of the trigeminal nerve. Median follow up duration was 30 months [range $24{\sim}78\;months$]. Anatomical measurements of trigeminal nerve in magnetic resonance images during GKS planning were correlated with clinical outcome. Results : Twenty-two patients [50%] achieved an excellent outcome [BNI grade I & II], 20 patients [45.5%] a good outcome [grade IIIa & IIIb], and only 2 patients [4.5%] a poor outcome [grade IV & V]. Eleven patients [25.0%] experienced pain recurrence after initial pain relief. Smaller volume of trigeminal nerve area irradiated more than 40Gy was significantly correlated with excellent outcome in both univariate and multivariate analyses respectively [P=0.033 and 0.040]. Conclusion : Anatomical considerations during the planning of GKS would be helpful for predicting clinical outcome in TN.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.215-220
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• 2016

Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

• 대한한방내과학회지
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• 제40권1호
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• pp.126-135
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• 2019

Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.129-143
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• 2022

Background: Patient-controlled analgesia (PCA) has been widely used as an effective medical treatment for pain and for postoperative analgesia. However, improper dose errors in intravenous (IV) administration of narcotic analgesics from a PCA infusion pump can cause patient harm. Furthermore, opioid overdose is considered one of the highest risk factors for patients receiving pain medications. Therefore, accurate delivery of opioid analgesics is a critical function of PCA infusion pumps. Methods: We designed a microbalance method that consisted of a closed acrylic chamber containing a layer and an oil layer with an electronic balance. A commercially available infusion analyzer (IDA-5, Fluke Co., Everett, WA, USA) was used to measure the accuracy of the infusion flow rate from a commercially available smart PCA infusion pump (PS-1000, UNIMEDICS, Co., Ltd., Seoul, Korea) and compared with the results of the microbalance method. We evaluated the uncertainty of the flow rate measurement using the ISO guide (GUM:1995 part3). The battery life, delay time of the occlusion alarm, and bolus function of the PCA pump were also tested. Results: The microbalance method was good in the short-term 2 h measurement, and IDA-5 was good in the long-term 24 h measurement. The two measurement systems can complement each other in the case of the measurement time. Regarding battery performance, PS-1000 lasted approximately 5 days in a 1 ml/hr flow rate condition without recharging the battery. The occlusion pressure alarm delays of PS-1000 satisfied the conventional alarm threshold of occlusion pressure (300-800 mmHg). Average accuracy bolus volume was measured as 63%, 95%, and 98.5% with 0.1 ml, 1 ml, and 2 ml bolus volume presets, respectively. A 1 ml/hr flow rate measurement was evaluated as 2.08% of expanded uncertainty, with a 95% confidence level. Conclusion: PS-1000 showed a flow accuracy to be within the infusion pump standard, which is ± 5% of flow accuracy. Occlusion alarm of PS-1000 was quickly transmitted, resulting in better safety for patients receiving IV infusion of opioids. PS-1000 is sufficient for a portable smart PCA infusion pump.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.174-183
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• 2023

Background: Office workers experience neck or back pain due to poor posture, such as flexed head and forward head posture, during long-term sedentary work. Posture correction is used to reduce pain caused by poor posture and ensures proper alignment of the body. Several assistive devices have been developed to assist in maintaining an ideal posture; however, there are limitations in practical use due to vast size, unproven long-term effects or inconsistency of maintaining posture alignment. We developed a headphone and necklace posture correction system (HANPCS) for posture correction using an inertial measurement unit (IMU) sensor that provides visual or auditory feedback. Objects: To demonstrate the test-retest reliability and concurrent validity of neck and upper trunk flexion measurements using a HANPCS, compared with a three-dimensional motion analysis system (3DMAS). Methods: Twenty-nine participants were included in this study. The HANPCS was applied to each participant. The angle for each action was measured simultaneously using the HANPCS and 3DMAS. The data were analyzed using the intraclass correlation coefficient (ICC) = [3,3] with 95% confidence intervals (CIs). Results: The angular measurements of the HANPCS for neck and upper trunk flexions showed high intra- (ICC = 0.954-0.971) and inter-day (ICC = 0.865-0.937) values, standard error of measurement (SEM) values (1.05°-2.04°), and minimal detectable change (MDC) values (2.92°-5.65°). Also, the angular measurements between the HANPCS and 3DMAS had excellent ICC values (> 0.90) for all sessions, which indicates high concurrent validity. Conclusion: Our study demonstrates that the HANPCS is as accurate in measuring angle as the gold standard, 3DMAS. Therefore, the HANPCS is reliable and valid because of its angular measurement reliability and validity.

• 대한약침학회지
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• 제11권1호
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• pp.21-29
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• 2008

Objectives : To investigate the therapeutic effects of SBVP in the treatment of patients with cancer-related pain. Design : A prospective randomized, double-blind, placebo-controlled study of SBVP. Setting : The study was conducted at the East West Cancer Center of Daejeon University Dunsan Oriental Hospital from March 1, 2007 to June 20, 2007. Patients : 11 patients diagnosed with cancer-related pain of over 3rd degree on the Numeric Rating Scale(NRS)(0, no pain at all, 10, worst pain imaginable) were entered into a double-blind, placebo-controlled trial of SBVP. They were randomized into Groups A and B(SBVP and control group, respectively) using the table of random sampling numbers and never informed of their affiliation by the coordinator. 5 of 6 patients in Group A and 4 of 5 patients in Group B completed the clinical trial. Intervention : SBVP(1ml/day) for group A and Normal Saline Placebo(1ml/day) for group B was injected into the abdomen acupoint, Zhong Wan(CV 12). The treatment was administered daily for five days. Outcome Measures : Degree of cancer-related pain was measured using the Numeric Rating Scale(NRS) before and after each treatment for "Pain right now" and "Average pain in last 24 hours". Statistical Analysis : Analysis regarding variations in NRS was carried out by applying t-tests(independent sample t-test and paired sample t-test) and Wilcoxon signed rank test with level of significance at 5%. Results : Differences in NRS of "Pain right now" for the two groups were statistically significant. The mean improvement point of SBVP was significantly higher than the control group($2.48^{\circ}{\pm}1.52$ vs $0.97^{\circ}{\pm}1.88$, p<0.05). Differences in average pain score before and after treatment in SBVP group were also significant($5.13^{\circ}{\pm}1.77$ vs $2.65^{\circ}{\pm}0.67$, p<0.05) compared with control group. The two groups showed no significant differences for long term effects in "Average pain in last 24 hours." Conclusion : Although further study will be needed on the large scale, SBVP shows potential as an effective treatment for immediate relief of cancer-related pain.