• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.895-903
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• 2018

Objectives: This study reports on the efficacy of using integrative Korean medical treatments for Type 1 complex regional pain syndrome (CRPS). Methods: A 48-year-old female patient with Type 1 R/O CRPS was treated with herbal medicines, acupuncture, and pharmacopuncture for 38 days. The chief complaints were severe burning pain, general weakness, sleep disorder, and aggressive and depressed mood. The treatment effect was evaluated by measuring the numerical rating scale (NRS) of pain, improvement of the quality of sleep, and change in mood status. Results: After the hospital treatment, the patient's pain was controlled and the NRS score was decreased. Sleep and mood disorder also improved. Conclusions: The integrative Korean medical treatments appeared to be effective in reducing Type 1 CRPS symptoms. Further clinical research of patients with CRPS is needed.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.55-69
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• 1993

The purpose of this study is investigation on prevalence and clinical characteristics of headache among 10-39 years men and women. Information could be obtained with the questionnaire, and 1952 respondents completed the questionnaire. All participants were asked if they had experienced headache. Those responding positively were further questioned regarding the frequency, severity, character, location and duration of headache and were questioned regarding the experience of medical cunsultation and taking analgesics. The obtained results were as follows : 1. The life time prevalence of headache was 49.6% among men, 70.8% among women and 61.5% in all. 2. The prevalence of episodic tension type headache, chronic tension type headache, migraine, mixed type headache in this population was 27.1%, 5.0%, 2.8%, 23.1% respectively. 3. Headache duration was classified as less than 1 hour, 1-6 hours, 6012 hours, more than 12 hours for 1 day. The percentage of each other case is 41.8%, 46.2%, 7.4% and 4.4% of headache suffers respectively. 4. As regards the severity of headache, 4.2% of headache suffers had a very mild pain intensity, 17.9% a mild pain, 57.7% a moderate pain, 18.1% a severe pain and 2.2% a quite severe pain. 5. Headache occured at morning in 8.2% of headache suffers, at afternoon in 9.4%, at evening in 18.1%, at night in 4.3% and at anytime in 59.9%. 6. 11.7% of headache suffers among men consulted doctor, 13.9% among women and 13.1% in all. 7. 66.2% of headache suffers didnt have any analgesics because of their pain, 33.8% of headache suffers had analgesics because of their pain.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.189-196
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• 2022

The aim of this study was to investigate the effect of complex Korean medicine treatment especially Buja-tang and Aconitum ciliare decaisne pharmacopuncture on patients with type 1 complex regional pain syndrome caused after a traffic accident. The patients was treated with Buja-tang, Aconitum ciliare decaisne pharmacupuncture, acupuncture and physical therapy during 20 days of hospitalization. Numerical rating scale (NRS), short form McGill pain questionnaire (SF-MPQ), body temperature measurement of the foot, manual muscle test (MMT) were used for assessment. After treatments, NRS of burning pain in the left ankle decreased from 8 to 4-5 and NRS of burning pain in the right ankle decreased from 7 to 4-5. Also, SF-MPQ results, foot temperature measurement and MMT showed improvement during hospitalization. This study shows that complex Korean medicine treatment especially Buja-tang and Aconitum ciliare decaisne pharmacopuncture are effective in alleviating symptoms in patients with type 1 complex regional pain syndrome.

• Journal of Korean Neurosurgical Society
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• v.57 no.1
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• pp.32-35
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• 2015

Objective : The purpose of this study was to analyze the relationship between fracture pattern and the development of acute radiculopathy after osteoporotic lumbar compression fracture. Methods : This study included 59 patients who underwent bone cement augmentation for osteoporotic compression fracture below the L2 level, which can lead to radiculopathic radiating pain. The patients were divided into two groups according to the presence of radiculopathy (group A : back pain only; group B : back pain with newly developed radiating pain). We categorized compression fractures into three types by the position of the fracture line. The incidence of newly developed radiculopathy was examined retrospectively for each compression fracture type. Results : The overall incidence of newly developed leg pain (group B) was 25%, and the frequency increased with descending spinal levels (L2 : 0%, L3 : 22%, L4 : 43%, and L5 : 63%). The back pain-only group (group A) had mostly superior-type fractures. On the other hand, the back pain with radiculopathy group (group B) had mostly inferior-type fractures. Most patients in group B showed significant relief of leg pain as well as back pain after bone cement augmentation. Conclusion : The incidence of a newly developed, radiating pain after osteoporotic compression fractures increased gradually from the L3 to L5 levels. Most of these fractures were of the inferior type, and the bone cement augmentation procedures seemed to be sufficient for relief of both back and radiating pain.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.276-286
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• 2022

Objective : Spinal cord stimulation (SCS) is an effective treatment for chronic neuropathic pain. However, its clinical efficacy in regard to specific types of pain has not been well studied. The primary objective of this study was to retrospectively analyze the clinical outcomes of paddle-type SCS according to the type of neuropathic pain. Methods : Seventeen patients who underwent paddle-lead SCS at our hospital were examined. Clinical outcomes were evaluated pre- and postoperatively (3 months, 1 year, and last follow-up) using the Neuropathic Pain Symptom Inventory (NPSI). The NPSI categorizes pain as superficial, deep, paroxysmal, evoked, or dysesthesia and assess the duration of the pain (pain time score). Changes in NPSI scores were compared with change in Visual analogue scale (VAS) scores. Results : After SCS, the pain time score improved by 45% (independent t-test, p=0.0002) and the deep pain score improved by 58% (independent t-test, p=0.001). Improvements in the pain time score significantly correlated with improvements in the VAS score (r=0.667, p=0.003, Spearman correlation). Additionally, the morphine milligram equivalent value was markedly lower after vs. before surgery (~49 mg, pared t-test, p=0.002). No preoperative value was associated with clinical outcome. Conclusion : The NPSI is a useful tool for evaluating the therapeutic effects of SCS. Chronic use of a paddle-type spinal cord stimulation improved the deep pain and the pain time scores.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.103-114
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• 2009

This study was designed to evaluate the Temporomandibular Disorders(TMD) with Tension-Type Headache(TTH) by age. Patients with TMD and/or TTH visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study. Experimental group(n=170) is composed of TMD with TTH and control group(n=222) is composed of TMD without TTH. Evaluation list was pain quality, pain intensity, pain laterality, pain increase by routine physical activity and then it was analyzed statistically. The results were as follows ; 1. In the control group, pain quality was not significantly different by age. But, in the experimental group, pain quality was significantly different by age(p=0.042). 2. In the control group, pain intensity was significantly different by age(p=0.000). And, in the experimental group, pain intensity was significantly different by age(p=0.004). 3. In the control group, pain laterality was not significantly different by age. And, in the experimental group, pain laterality was not significantly different by age. 4. In the control group, pain increase by routine physical activity was not significantly different by age. And, in the experimental group, pain increase by routine physical activity was not significantly different by age. Therefore, it is considered that not temporomandibular disorder patients without tension-type headache but temporomandibular disorder patients with tension-type headache was influenced by age in the pain quality.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.254-264
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• 2015

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.303-316
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• 2009

This study was designed to evaluate the Temporomandibular Disorders(TMD) with Tension-Type Headache(TTH) by gender. Patients with TMD and/or TTH visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study. Experimental group(n=60) is composed of TMD with TTH and control group(n=111) is composed of TMD without TTH. Evaluation list was pain quality, pain intensity, pain laterality, pain increase by routine physical activity and then it was analyzed statistically. The results were as follows ; 1. In the control group, pain quality was significantly different by gender(p=0.04). But, in the experimental group, pain quality was not significantly different by gender. 2. In the control group, pain intensity was not significantly different by gender. And, in the experimental group, pain intensity was not significantly different by gender. 3. In the control group, pain laterality was not significantly different by gender. And, in the experimental group, pain laterality was not significantly different by gender. 4. In the control group, pain increase by routine physical activity was not significantly different by gender. And, in the experimental group, pain increase by routine physical activity was not significantly different by gender. Therefore, it is considered that not temporomandibular disorder patients with tension-type headache but temporomandibular disorder patients without tension-type headache was influenced by gender in the pain quality.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.240-245
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• 2005

Herein is described the successful treatment of complex regional pain syndrome type II with the combination treatment of spinal cord stimulation and radiofrequency thermocoagulation of the lumbar sympathetic ganglion. A 62 years old male patient, suffering from CRPS type II in his left lower extremity, visited our pain clinic. Medication and nerve blockade produced only slight improvement in his symptoms and signs. Therefore, a linear type spinal cord simulator was inserted into the thoracic epidural space, using a non-surgical percutaneous approach, with the cephalad lead located at the T11 level. Two months later, the repositioning of the electrode to the T12 level for more effective pain control, with radiofrequency thermocoagulation of lumbar sympathetic ganglion also performed at the left L2 and 3 levels for the control of trophic change. These resulted in significant pain relief and decreased trophic change, with no complications, after which the patient was able to resume a normal life.