• The Korean Journal of Pain
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• v.29 no.2
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• pp.119-122
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• 2016

Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.93-97
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• 2001

Facial nerve palsy is not a serious disease, but it can be both upsetting and disabling for patients. More than half of the lesions of facial nerve palsy fall into the category termed Bell's palsy. It is very rare to find a representative case of bilateral Bell's palsy. Here we report the changes of infrared thermographic findings in bilateral Bell's palsy treated with a stellate ganglion block (SGB). A 45-year-old female patient who had a right facial palsy which developed 2 weeks before. Steroid administration and acupuncture was not effective and so she was referred to pain clinic. The right facial palsy was cured after 19th right SGB. Twenty eight days after the onset of the right facial palsy, left facial palsy also developed and cured completely with a left SGB. Serial infrared thermograms were performed. The hypothermias on the affected side improved symmetrically by the end of the treatment.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.222-225
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• 2005

Hiccups are due to an intermittent clonic spasm of the diaphragm. In most cases, hiccups are self-limiting disease, but persistent hiccups may be related to the presence of serious underlying systemic disease. Two patients who had persistent hiccups that were not controled by conventional methods and medications were referred to the pain clinic. We administered a single oral medication of gabapentin, and then the hiccups disappeared in both cases. We concluded that gabapentin should be considered as an alternative therapy to control persistent or intractable hiccup. It could be particularly useful for those patients with solid malignancies, either alone or as an "add-on therapy" with other oral agents.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.271-274
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• 1996

Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

• Clinical Pain
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• v.18 no.1
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• pp.36-39
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• 2019

Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

• Journal of muscle and joint health
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• v.27 no.1
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• pp.12-21
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• 2020

Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x² test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

• Journal of Korean Biological Nursing Science
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• v.4 no.2
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• pp.5-18
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• 2002

Purpose: Women have been often underdiagnosed and undertreated when they have as high mortality as men of ischemic heart disease, such as angina. One of the reasons of women's under treatment is associated with either vague, non-traditional symptoms or longer delay in seeking professional help when they experience ischemic heart disease. This study was conducted to investigate the characteristics of women's anginal pain induced by the treadmill test and to explore the potential relationship(s) between anginal pain and other psycho-physiologic factors. Methods: Of 22 female patients referred to treadmill test, 7 with positive finding participated in this study. Anginal pain in the past was analyzed by Rose questionnaire, whereas anginal pain induced by the treadmill test was identified by McGill pain scale, visual analogue scale and present pain index. Results: Women expressed more heaviness than sharp pain, and complained splitting more often than subjects in previous study that included both men and women. Pain intensity by VAS $3.64{\pm}3.94$, Pain rating index was $5.14{\pm}7.29$, present pain index was $1.57{\pm}1.81$, duration of pain was $5.14{\pm}4.8$ min. Exercise intensity was $6.0{\pm}4.63$ METs, exercise duration was $364.29{\pm}141.39$ sec, ST change was -2.0mm and rate of perceived exertion was $16.29{\pm}2.06$. The relationships between pain intensity and pain duration, ST segment changes were significant. Correlation among pain measures was significant. Conclusion: Generalization of these pilot findings may be inappropriate, and therefore, further larger study is needed.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.12-20
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• 2000

The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

• Journal of Hospice and Palliative Care
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• v.12 no.2
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• pp.88-94
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• 2009

Chest pain is a symptom observed commonly in outpatients and emergency room patients, and its causes are variable. Because treatment and prognosis of chest pain are different depending on its cause, it is more important than anything else to accurately diagnose the cause of chest pain. Most of patients complaining of chest pain undergo basic tests at a private local clinic or at the Internal medicine or chest surgery department of a general hospital and, they are referred to the pain clinic, with a note stating no particular finding. However, if they have sustained severe neuropathic pain in spite of nerve block, accurate diagnosis for chest pain is essential. We experienced rapidly developing spine breakdown and cord compression caused by metastatic spinal tumor in an inpatient who was being treated for chest pain, and thus, we report here in the case with literature review.

• The Journal of Korea CHUNA Manual Medicine
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• v.4 no.1
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• pp.167-171
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• 2003

Objectives: The Applied Kinesiology(A.K) doctors diagnose and treat a patient by using muscles related to 12 main meridian. The purpose of study is to make It clear what the Correlationship in SuSamUm-Kyung of 12 Joung-Kyung with Muscles in A.K is. Method: In the Lung meridian and the Heart meridian, the Sidong.Sosang-disease and the related muscles are used. In the Pericardium meridian Correlationship in the Kidney with the lower limbs and the Pericardium with the Kidney is used. Results & Conclusion: Summarized as follows 1. The Lung meridian is related to the triceps and the levator scapulae in th Sidong.Sosang-disease and the serratus anterior in the symptoms of the muscles' stiffness. 2. The Heart meridian is related to the subscapularis in The Applied Kinesiology(A.K) the referred pain of the subscapularis and KukCheon-hole of The Heart meridian. 3. The Pericardium meridian is related to the correlated muscles in the correlationship the Kidney with the lower limbs and the Pericardium with the Kidney.