• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.95-98
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• 2006

Objective : The aim of this study is to evaluate the feasibility, safety and effectiveness of radiofrequency neurotomy[RFN] for remnant pain after vertebroplasty for the treatment of severe compression fracture. Methods : 25 patients with remnant pain after vertebroplasty for one level severe compression fracture were treated by RFN. The severe compression fractures were defined to the vertebrae which less than 50% of their original heights have collapsed. Pain relief was evaluated at 2 weeks, 6 weeks and 3 months after the procedure using a visual analog scale[VAS]. Results : Successful outcome was determined if pain reduction exceeded 50% on the VAS at 6 weeks. Six of the 25 patients did not respond favorably to RFN [pain reduction less than 50%], and nineteen patients showed successful responses. Mean VAS score was decreased from 5.48 to 2.96 at 6 weeks. Conclusion : The radiofrequency neurotomy may be both feasible and useful treatment for the remnant pain after vertebroplasty. However long-term follow up is needed to confirm the effectiveness.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.77-81
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• 1997

Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.415-420
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• 2005

Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). Material and Method: From March 200f to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. Result: Operative time was significantly shorter in the TIPP group than CP group (for one leg $108.4\pm27.6\;min\;vs\;83_4\pm24.4\;min,\;for\;both\;legs\;184.7\pm28.4\;min\;vs\; 137.8\pm24.4\;min)$. There was signifcant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group $(5.9\pm2.2\;vs\;4.2\pm1.6)$. Mean duration of hospitalization was Significantly shorter in the TIPP group than CP group $(4.4\pm1.0\;days\;vs\;5.8\pm1.9\;days)$. Complications were pain $(15.9\%)$, remnant lesion $(9.5\%)$, and ecchymosis $(4.8\%)$ in the CP group and ecchymosis $(19.6\%),\;pain\;(7.8\%),\;and\;remnant\;lesion\;(7.8\%)$ in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. Conclusion: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.183-188
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• 2017

Background: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon. Methods: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography. Results: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively). Conclusions: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.34-38
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• 2005

Background: Over the years, disc surgery has progressively evolved in the direction of decreasing trauma and its invasiveness. Conventional open surgery has many complications, such as scarring, instability, bleeding and a relative high mortality rate. Minimally invasive spinal surgery is now an alternative to a traditional discectomy. Herein, we present an operative technique, and the early results, for a percutaneous endoscopic lumbar discectomy in herniated lumbar disc disease. Methods: 43 patients, including 27 men and 16 women, with ages ranging from 18 to 66 years, were enrolled in this study. All the patients showed a protruded or extruded soft disc herniation at the lumbar level on magnetic resonance imaging and computed tomography. A percutaneous endoscopic lumbar discectomy was applied to the patients, and clinical responses evaluated using MacNab's criteria. Results: 40 patients were regarded as showing successful responses (93.1%), and there were no severe complications, such as a hematoma, nerve injury, postoperative dysesthesia or death. One patient underwent fusion surgery for remnant back pain six month later. Conclusions: We conclude that, in properly selected patients, a percutaneous endoscopic lumbar discectomy is a safe, noninvasive and effective treatment modality for herniated lumbar intervertebral disc disease.

• Quality Improvement in Health Care
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• v.24 no.2
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• pp.15-25
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• 2018

Purpose: To compare the Appropriateness of abdominal CT to abdominal radiography as an imaging modality in terms of the diagnostic value, medical costs and decision making times for patients presented to the emergency department with nontraumatic abdominal pain. Methods: This study used the records of 530 cases presented to the emergency department(ED) with nontraumatic abdominal pain from February to March 2012. Imaging modalities were categorized into abdominal radiography and CT (radiography first or CT first) or radiography alone or CT alone. The diagnostic value, total medical costs and effect on decision making time of the each imaging modalities were compared. Especially, in retrospective review, to evaluate the predictability of the abdominal radiography, alit was assumed that all the 530 cases performed that exam as initial imaging. Results: Among 530 cases, 255 cases underwent abdominal radiography only, 28 cases underwent abdominal CT only and the remnant 247 cases underwent abdominal CT with plain abdominal radiography. The diagnostic value was higher in the cases with abdominal CT (268/275, 97.5%) than in the cases with plain abdominal radiography (19/255, 7.5%).The number of cases predicted by abdominal radiography only as initial imaging were 39/530 (7.4%). In cases where the patients performed the abdominal CT as the first imaging modality thereby omitting the abdominal radiography, the total diagnostic imaging fee was lower than in cases with plain abdominal radiography first followed by the abdominal CT (277,140 vs. 284,226(mean, Korean Won)). Although diagnostic value of the plain abdominal radiography as first imaging modality was lower than the abdominal CT, Decision making time, average duration of hospital stay was longer and the total medical costs was higher than abdominal CT. Conclusion: As an imaging modality in the ED for patients with acute nontraumatic abdominal pain, plain abdominal radiography is an avoidable procedure when viewed in terms of the diagnostic value and total medical costs and decision making times comparing with abdominal CT.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.186-191
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• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.142-145
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• 2012

Since urachal abnormalities are uncommon and have various clinical manifestations such as umbilical discharge, periumbilical pain, recurrent urinary tract infection and abdominal mass according to its structure, it is not easy to diagnose. We report our experience of a patient with urachal remnant abscess who presented with gross hematuria initially, and improved after the management with intravenous antibiotics and percutaneous drainage of abscess.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.188-193
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• 2019

Transarterial chemoembolization (TACE) is a commonly used and rapidly evolving non-invasive treatment for hepatocellular carcinoma (HCC). It is important that understanding individual anatomical variants and planning for tumor-feeding artery access to acquire adequate treatment effectiveness. In this study, we will report acquired arteriovenous malformation which interferes with TACE for HCC. A 72-year-old man with persistent abdominal pain for 2 days visited our hospital. The patient was chronic hepatitis B carrier and had a history of HCC treated with conventional TACE 10 years ago. Hypervascular nodular HCC in the liver segment 8 and aberrant right hepatic artery from the superior mesenteric artery were detected on computed tomography (CT). When first TACE was performed, the tumor-feeding artery originating from the left hepatic artery was found and embolized. There was no tumor-feeding artery from the right hepatic artery but arteriovenous malformation was found. After a month, follow up CT showed necrotic lesion and residual HCC and we performed secondary TACE. On secondary TACE, we selected the right hepatic artery and passed through arteriovenous malformation. Superselective-angiogram showed remnant tumoral staining and remnant tumor was embolized using drug-eluting bead and Adriamycin. Final angiogram showed no remnant tumoral staining and the patient was discharged without complication. We found the rare case of arteriovenous malformation adjacent to HCC, and we performed superselective TACE beyond arteriovenous malformation to treat HCC.

• Journal of agricultural medicine and community health
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• v.20 no.2
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• pp.169-174
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• 1995

The case was described of a 31 year old female who developed fusiform swelling of the right third finger at the site of puncture by sea urchin spine. We observed a radiopaque linear material suggesting a remnant spine which the size was 2.4 mm in sonography and mammography. We confirmed that it exhibits a urchin spine and distinct caseous necrosis with central calcification. Sea urchins(Echinoidea) are ubiquitous marine creatures that resemble pincushions and are covered by calcareous skeletons surrounded by numerous movable calcium carbonate spines. The sharp spines are brittle and easily detach when touched by the victim. Contact with sea urchin spines produces intense pain, some localized erythema and edema. Inflammation develops in response to retained fragments. Granulomas 1-5 mm in diameter develop rarely 2-12 months after envenomation. In treatment, hot water immersion and thorough wound cleansing are advisable. Analgesics may, be necessary after hot water immersion. Attempts to remove these spines should be performed with good lighting sources, preferably with radiological direction. Chronic granulomas usually require complete excision. Acetone has been suggested for rapid resolution of pain. No antidotes are available.