• 동의생리병리학회지
• /
• 제26권2호
• /
• pp.206-211
• /
• 2012

Here we described 8 patients treated with acupuncture and moxiburstion due to chronic postoperative pain as a comlication of gastrointestinal surgery. The patients were suffering from pain that continued for more than 6 months after laparotomy for gastric cancer (n=1), rectal cancer (n=2), cholangiocarcinoma (n=2), hepatocellular carcinoma (n=2) and ischemic colitis (n=1), respectively. Mean time elased from surgery were 31.25(${\pm}21.72$)months, pain grade on first visit by VAS(visual analogue scale, 0~10mm) was 3.75(${\pm}0.97$)point, and acupuncture and moxiburstion were performed 12.63(${\pm}5.74$)times during 5.5(${\pm}2.4$)weeks, on average. At the end of treatment, pain was decreased 2.75(${\pm}0.97$)point compared to first visit. Based on the that results, it is reasonable to assume that acupuncture and moxiburstion can be effective to persistent post-surgical pain after laparotomic gastrointestinal surgery, at least to some laparotomized patients.

• Korean Journal of Acupuncture
• /
• 제21권1호
• /
• pp.113-127
• /
• 2004

Objectives : The usage of acupuncture has gained popularity as an alternative method of treatment for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to foot samli$(ST_{36})$ on the carrageenan-induced knee arthritic pain was examined. Methods : A common source of persistent pain in humans is the knee arthritis. Knee arthritis was induced by injection of 2 % carrageenan $50\;{\mu}l$ into the knee joint cavity. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The weight bearing force of the hind limb was measured for an indicator of pain level after each manipulation. Results : The average weight borne by the hind limb during normal gait was 55% of total body weight, which was reduced to less than 10% after knee arthritis. EA improved the weight bearing of the arthritic hind limb significantly for the duration of 4 hr. EA applied to $ST_{36}$ point produced a significant improvement of stepping force of the arthritic foot lasting for at least 4 h. However, $GB_{31}$ point did not produce any significant increase of weight bearing force. The analgesic effect was specific to the acupuncture point since the analgesic effect on the knee arthritis model could not be mimicked by EA applied to a nearby point, $GB_{31}$. The relations between EA-induced analgesia and endogenous nitric oxide(NO) and inducible NO synthase(iNOS)/neuronal NOS was also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which is increased by arthritis were suppressed by EA stimulation applied to $ST_{36}$ point. Conclusions : The data suggest 1) that EA produces a potent analgesic effect on the rat model of chronic knee arthritis pain in a point specific manner and 2) that EA-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.

• 대한족부족관절학회지
• /
• 제8권2호
• /
• pp.149-152
• /
• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Neurosurgical Society
• /
• 제59권4호
• /
• pp.374-378
• /
• 2016

Objective : A modified surgical technique of posterior cervical foramintomy called posterior cervical inclinatory foraminotomy (PCIF) was introduced in previous preliminary article. PCIF allows better preservation of facet joint and capsule than conventional techniques. The authors conducted a study to investigate long-term outcomes of PCIF. Methods : We retrospectively reviewed demographic, radiologic, and clinical data from the patients who underwent PCIFs at our institution. Criteria included a minimum of 48 month follow-up and PCIFs for patients with radiculopathy from foraminal stenosis (C2-T1; single or multilevel) with persistent or recurrent root symptoms despite conservative treatment for more than 3 months. Patients who had undergone previous cervical operation were excluded. The visual analogue scale (VAS) score was used for clinical follow-up, and radiologic follow-up was performed to compare the changes of cervical sagittal alignment, focal angle and disc-space height of treated segment. Results : The PCIFs were performed between April 2007 and March 2011 on 46 patients (32 males and 14 females) with a total of 73 levels affected. The average duration of follow-up was 74.4 months. Improvements in radiculopathic pain were seen in 39 patients (84.7%), and VAS score decreased from $6.82{\pm}1.9$ to $2.19{\pm}1.9$. Posterior neck pain also improved in 25 patients (71.4%) among 35 patients, and VAS score decreased from $4.97{\pm}2.0$ to $2.71{\pm}1.9$. The mean disc-space heights of treated segment were $5.41{\pm}1.03mm$ preoperatively and decreased to $5.17{\pm}1.12mm$ postoperatively. No statistically significant changes in cervical sagittal alignment, focal angle were seen during the follow-up period (Cox proportional hazards analysis and Student t-test, p>0.05). Conclusion : The PCIF is highly effective in treating patients with cervical spondylotic radiculopathy, leading to long-lasting relief in pain. Long-term radiologic follow-up showed no significant spinal angular imbalance.

• 대한족부족관절학회지
• /
• 제22권1호
• /
• pp.16-20
• /
• 2018

Purpose: To evaluate the clinical and radiographic results of surgical treatment for patients with sinus tarsi pain due to accessory talar facet impingement. Materials and Methods: Between July 2013 and July 2015, nine patients who underwent surgery for the accessory talar facet impingement were reviewed. The mean follow-up period was 18.6 months (12~36 months), and the mean age was 33.1 years (19~60 years). Previous trauma history, duration of symptom, and types of surgery were analyzed. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS). Radiographic results were assessed using Meary's angle, calcaneal pitch angle, heel alignment angle, and heel alignment ratio. Results: All patients had evident trauma history prior to the initial symptom. The mean duration of symptoms was 25.6 months (6~120 months). Four patients received only accessory anterolateral talar facet (AALTF) excision, and four patients received medial sliding calcaneal osteotomy (MSCO). One patient underwent both AALTF excision and MSCO. The AOFAS ankle-hindfoot score was significantly improved from 73 (62~77) preoperatively to 93 (67~100) postoperatively. The VAS score was decreased from 6 (5~7) preoperatively to 1 (0~5) postoperatively. The Meary's angle and calcaneal pitch angle showed no significant difference after surgery. The heel alignment angle and ratio increased from $-3.6^{\circ}$ ($-10^{\circ}{\sim}5^{\circ}$) and 0.22 (-0.15~0.6) preoperatively to $2.8^{\circ}$ ($1^{\circ}{\sim}5^{\circ}$) and 0.42 (0.3~0.6) postoperatively, respectively. Conclusion: If there is persistent sinus tarsi pain in patients with hindfoot valgus, accessory talar facet impingement caused by AALTF could be considered as a cause of chronic sinus tarsi pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권3호
• /
• pp.297-303
• /
• 2020

The musculoskeletal system can be involved as an extra-intestinal manifestation of inflammatory bowel disease. Among these, myositis in ulcerative colitis (UC) is very rare. A 14-year-old girl was admitted due to severe shoulder tenderness. She had complained of left jaw pain and swelling for the past 10 days. Inflammatory markers were elevated with no evidence of infectious etiology. Myositis was suspected by shoulder magnetic resonance imaging. Three days after admission, she developed hematochezia. Muscle biopsy and colonoscopy was performed due to worsening left mandibular area pain and persistent hematochezia. Colonoscopy showed consistent findings with UC. She was finally diagnosed with UC with myositis as an extra-intestinal manifestation. She showed a dramatic response to UC treatment. Gastrointestinal symptoms were well-controlled. After 14 months, UC symptoms and muscle pain were aggravated, which were relieved after steroid and cyclosporin treatment. We report a unique case of UC initially presented with myositis, preceding gastrointestinal symptoms.

• Journal of Chest Surgery
• /
• 제44권2호
• /
• pp.148-153
• /
• 2011

Background: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. Materials and Methods: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. Results: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. Conclusion: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.

• Pediatric Infection and Vaccine
• /
• 제25권1호
• /
• pp.54-59
• /
• 2018

기생충 감염은 소아 인구에게서 드물기 때문에 진단이 어려울 수 있다. 환아는 6개월 동안 간헐적인 상복부 통증과 양손과 양측 팔 모두에 발생한 홍반성 발진을 동반한 늑막 삼출을 주소로 내원하였다. 환아는 검사상 혈청 호산구증가와 현저한 삼출성, 호산구성 흉막삼출액이 확인되었다. 동시에 폐렴 미코플라스마에 대한 높은 항체가 때문에 항생제 치료를 받았으나 흉막삼출은 호전되지 않았다. 환아의 분변에서 시행한 기생충 알의 검사상 음성이었으나 혈청 및 흉막삼출액의 기생충 특이 항원에 대한 면역효소측정법에서 폐흡충 특이 IgG에 대해 양성을 보였다. Praziquantel의 치료 후 호흡기 증상, 흉수 및 피부 증상이 호전되었다. 이에 만성 복통과 홍반성 발진을 주소로 내원한 소아 환자에서 폐흡충에 의한 흉막삼출액을 진단 및 치료하였기에 보고하는 바이다.

• Childhood Kidney Diseases
• /
• 제2권1호
• /
• pp.90-94
• /
• 1998

Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

• 대한골관절종양학회지
• /
• 제11권2호
• /
• pp.204-207
• /
• 2005

골육종은 슬관절 주위에 호발하며 족부에 발생하는 경우는 흔하지 않다. 20세 남자 환자가 수개월간 지속된 좌측 종골 부위의 통증으로 내원하였으며 종골의 골육종으로 진단하여 슬하부 절단술 및 술 후 화학요법을 시행하였다. 이에 저자들은 종골에 발생한 골육종 1례를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.