• Journal of Korean Neurosurgical Society
• /
• v.57 no.5
• /
• pp.376-378
• /
• 2015

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.16 no.2
• /
• pp.138-151
• /
• 2003

Although the use of acupuncture for pain has increased in recent years, the mechanisms of acupuncture analgesia (AA) remains obscure. The lack of suitable experimental animal models for persistent pain, which show clear AA, has been the major stumbling block in the investigation of the physiological mechanisms of AA. In the present study, we test AA in two knee arthritis model induced by injection of CFA or carrageenan as a chronic pain model. After induction of arthritis, the rat subsequently showed a reduced stepping force of the affected limb for the next several days. Electroacupuncture (EA) was applied to an acupuncture point each on the contralateral forelimb for 30 minutes under enflurane anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next several hours. EA produced a significant improvement of stepping force of the foot lasting for at least 2 hours when applied to LR2 In CFA model, and applied to ST36 in carrageenan model, but both points did not produce any significant effects in each other model. These data suggest that EA produce analgesic effect in knee arthritic pain and the analgesic effect is specific to the acupuncture point.

• Journal of Oral Medicine and Pain
• /
• v.43 no.2
• /
• pp.52-55
• /
• 2018

In the present case study, we reported a female patient with sialodochitis fibrinosa in which a conservative ultrasound (US)-guided irrigation method was used to relieve her symptoms. A 30-year-old female patient visited Kyung Hee University Dental Hospital with chief complaints of persistent swelling and discomfort in the left facial area. Her primary symptom was facial swelling that was accompanied by neuropathological symptoms, such as itching, tingling, and warmth that usually continued for 3 to 4 days. During clinical examination of orofacial area, mild swelling and fever were noted in the left face including parotid region, and mild induration could be felt at the corresponding site; sialadenitis of the left parotid gland was tentatively diagnosed. Herein, we performed intraductal irrigation of the left parotid gland in three times per month and prescribed some medication. Thus, her signs and symptoms have been improved, and she did not experience a recurrence for 12-month follow-up to date. This study can support the usefulness of the US-guided irrigation method to treat the sialodochitis fibrinosa without remarkable side effects.

• Molecules and Cells
• /
• v.23 no.3
• /
• pp.259-271
• /
• 2007

Investigation of molecular and cellular mechanisms of synaptic plasticity is the major focus of many neuroscientists. There are two major reasons for searching new genes and molecules contributing to central plasticity: first, it provides basic neural mechanism for learning and memory, a key function of the brain; second, it provides new targets for treating brain-related disease. Long-term potentiation (LTP), mostly intensely studies in the hippocampus and amygdala, is proposed to be a cellular model for learning and memory. Although it remains difficult to understand the roles of LTP in hippocampus-related memory, a role of LTP in fear, a simplified form of memory, has been established. Here, I will review recent cellular studies of LTP in the anterior cingulate cortex (ACC) and then compare studies in vivo and in vitro LTP by genetic/pharmacological approaches. I propose that ACC LTP may serve as a cellular model for studying central sensitization that related to chronic pain, as well as pain-related cognitive emotional disorders. Understanding signaling pathways related to ACC LTP may help us to identify novel drug target for various mental disorders.

• Clinical Pain
• /
• v.19 no.2
• /
• pp.138-141
• /
• 2020

Clay-shoveler's fractures are rare stress-type avulsion fractures of the spinous processes especially in sports. There have been two case reports that discussed clay-shoveler's fractures in golf. A 36-year-old beginner golfer presented with a pain in the back after practicing golf swing. No fractures were detected using cervical radiography; however, computed tomography (CT) and magnetic resonance imaging (MRI) revealed T2~T3 spinous process fractures. The patient was treated conservatively and his pain subsided. The mechanism of injury is speculated to that of clay-shoveler's fractures. Therefore, if a golfer suffers persistent pain in the cervicothoracic region, clay-shoveler's fracture is one possibility to consider.

• The Korean Journal of Pain
• /
• v.13 no.2
• /
• pp.218-223
• /
• 2000

Background: This study was conducted to evaluate the efficacy of a parenteral nonsteroidal anti-inflammatory agent for management of post-surgical pain and its effect on hospital stay and long-term surgical outcome. Methods: Total of 40 patients undergoing lumbar discectomy were randomly assigned to two groups, receiving either 1) 30 mg intravenous ketorolac upon surgical closure, every 6 hours for 36 hours, and morphine IV PCA (intravenous patient controlled analgesia), or 2) only morphine PCA. A blinded investigator recorded; the visual analog pain scores, total postoperative narcotic consumption, complications by morphine PCA, length of hospitalization (from surgery to discharge), and long-term outcome at 6 weeks. Results: The patients who received IV ketorolac and morphine PCA reported significantly lower visual analog pain scores than patients receiving only morphine PCA. Cumulative morphine doses were significantly lower in the ketorolac group (P<0.001). There was no significant difference between groups in the frequency of side effects related to morphine PCA. Mean length of hospitalization was longer for patients receiving only morphine PCA, but there was no statistical significance. Six weeks after surgery, four (20.0%) patients who received only morphine PCA suffered persistent back pain. In contrary, all those patients who received ketorolac were free of back pain at follow-up (P<0.05). Conclusions: These results suggest that intermittent IV bolus ketorolac, when used with opioid IV PCA is more effective than opioid IV PCA alone for postoperative pain following lumbar disc surgery. However, this strategy did not contribute to early discharge from hospital after lumbar disc surgery. The effect to long-term surgical outcome was not conclusive.

• The Journal of Internal Korean Medicine
• /
• v.40 no.6
• /
• pp.1051-1062
• /
• 2019

Objectives: Chest pain presents diagnostic and therapeutic challenges because of its various etiologies. Many patients have chest pain from unknown causes and persistent chest pain in spite of standard treatment. The purpose of this study was to investigate the effectiveness of a Korean herbal medicine called Pyungjinsujeom-san (PSS) in relieving chest pain. Methods: We reviewed the electronic medical records of patients who visited the Korean Medical Clinic of Cardiology at Kyunghee University Hospital at Gangdong from January 2009 to July 2019, with the chief complaint of chest pain and who were treated with PSS. The mean severity of chest pain measured on the Numerical Rating Scale was compared before and after the administration of PSS. Results: The mean severity of chest pain of 20 patients decreased significantly from 6.80±1.61 to 1.35±0.9 after taking PSS (p<0.001). Most patients had symptoms of phlegm and food retention, including indigestion, postprandial fullness, and epigastric pain.Conclusions: These results suggest that PSS may be effective in relieving chest pain from various causes, particularly in patients with symptoms of phlegm and food retention.

• The Korean Journal of Pain
• /
• v.1 no.2
• /
• pp.154-163
• /
• 1988

In 1983, Sten H$\ddot{a}$kanson first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of 100 patients during a follow-up period of 1~6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (H$\ddot{a}$rtel route) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1~13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.40
• /
• pp.21.1-21.5
• /
• 2018

Background: The purpose of this study was to evaluate the clinical outcomes of treatment of non-odontogenic atypical orofacial pain using botulinum toxin-A. Methods: This study involved seven patients (seven females, mean age 65.1 years) who had non-odontogenic orofacial pain (neuropathic pain and atypical orofacial pain) and visited the Seoul National University Bundang Hospital between 2015 and 2017. All medication therapies were preceded by botulinum toxin-A injections, followed by injections in the insignificant effects of medication therapies. Five of the seven patients received intraoral injections in the gingival vestibule or mucosa, while the remaining two received extraoral injections in the masseter and temporal muscle areas. Results: In five of the seven patients, pain after botulinum toxin-A injection was significantly reduced. Most of the patients who underwent surgery for dental implantation or facial nerve reconstruction recovered after injections. However, the pain did not disappear in two patients who reported experiencing persistent pain without any cause. Conclusions: The use of botulinum toxin-A for the treatment of non-odontogenic neuropathic orofacial pain is clinically useful. It is more effective to administer botulinum toxin-A in combination with other medications and physical therapy to improve pain.

• Journal of Veterinary Clinics
• /
• v.31 no.3
• /
• pp.246-249
• /
• 2014

A 9-year-old intact female Shih-Tzu was presented with abdominal pain and abdominal distension. Since the animal's birth, the owner had never observed proestrous bleeding in the patient. Ultrasonography revealed segmental enlargement of the genital system. An ovariohysterovaginectomy was performed to remove the genital mass. The vagina was grossly dilated as a result of being filled with a solid black-green substance. A vaginogram was performed. Based on the surgical findings and vaginogram results, an imperforate hymen was diagnosed. One month from the first surgery, a stump pyocolpos developed between the sutured site and the obstructed portion. The persistent hymen was removed by endoscopy. However, peritonitis and sepsis developed after the procedure, and the dog died. Therefore, During operation of persistent hymen, a cruciate incision over the hymen strongly recommended to avoid additional post operative complications.