• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.50-53
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• 2013

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.49-56
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• 1989

Bell's palsy is not a serious disease and recovery is spontaneous in more half of the patients, but this recovery is long delayed in many instances and the cosmetic effect of an altered facial appearance is psychologically distressing. The etiology is unknown, but Kettle's ischemic hypothesis has been widely accepted. The aim of treatment is to reduce edema and improve circulation to the facial nerve. Stellate ganglion block (SGB) resulted in abolishing cerebral vascular spasm and in increasing cerebral blood flow. Thus, stellate ganglion block is effective in treatment of Bell's palsy. From 1978 to Oct. 1988, we have treated 222 patients (20 patients were recurred cases) with facial palsy by SGB and analysed the effect of SGB. We noticed that SGB was very effective in early repetitive treatment (90% recovery). This study is reported and the literature is reviewed.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.81-87
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• 2021

Purpose: To profile various clinical characteristics of sleep bruxism (SB) patients with idiopathic facial pain (IFP) in the orofacial region. Materials and Methods: We analyzed 28 SB patients among 210 patients with IFP complaints. The profiles were evaluated using patient charts including gender, age, pain duration, pain location, pain intensity and affected areas by pain. Results: SB with IFP occurred more often in females (85.7%) than males (14.3%). The mean age at presentation was 48.9 years. The most common IFP sites of SB patients were the right maxilla (28.6%) and the right mandible (25.0%). The pain complaints occurred mostly in 2 teeth or areas (50.0%), followed by 1 area (28.6%) and then in ≥ 3 teeth or areas (21.4%). The mean pain intensity was 5.9 on a visual analogue scale from 0 to 10. The pain was spontaneous in 20 patients (71.4%), and the mean pain duration was 24.4 months. Conclusion: Identification of clinical characteristics of SB patients with IFP could be useful in the diagnosis of various IFP patients and beneficial in decreasing unnecessary care to reduce IFP. Further studies with larger number of subjects and extended duration are required for more systemized diagnostic methods and development of future treatment guidelines.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.613-616
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• 2007

Background: Spontaneous hemopneumothorax is a rare disease and can be life threatening; it occurs in $1{\sim}12%$ of patients with spontaneous pneumothorax. We analyzed clinical reviews and treatments, as well as complications of spontaneous hemopneumothorax patients that were treated to aid in the optimal management. Material and Method: We studied retrospectively 30 cases with spontaneous hemopneumothorax for 11 years, from 1995 to 2006, at our hospital. Result: All the patients were male and most of the patients were under 30 years. The sides with the disorder were as follows: right in 15 cases and left in 15 cases. Patients showed mostly initial symptoms of chest pain, dyspnea and hypovolemic shock. All patients underwent a closed thoracostomy and 27 patients underwent surgery. Chemical pleurodesis was peformed because of postoperative persistent air leakage and one case was treated in the ICU due to re-expansion pulmonary edema, There were no other complications such as fibrothorax seen during the follow-up periods. Conclusion: The most important finding is proper initial management, as the spontaneous hemopneumothorax can potentially lead to a life-threatening condition. Recently, video assisted thoracoscopic surgery (VATS) is common procedure for general thoracic surgery and overcomes the weak points of performing a thoracotomy. The results of VATS are encouraging.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.26-38
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• 1996

In a normal state, sympathetic efferent activity does not elicit discharges of sensory neurons, whereas it becomes associated with and excites sensory neurons in a pathophysiological state such as injury to a peripheral nerve. Although this sympathetic-sensory interaction is reportedly adrenergic, involved subtypes of adrenoreceptors are not yet clearly revealed. The purpose of this study was to determine which adrenorceptor subtypes were involved in sympathetic-sensory interaction that was developed in rats with an experimental peripheral neuropathy. Using rats that received a tight ligation of one or two of L4-L6 spinal nerves 10~15 days previously, a recording was made from afferent fibers in microfilaments teased from the dorsal root that was in continuity with the ligated spinal nerve. Electrical stimulation of sympathetic preganglionic fibers in T13 or L1 ventral root (50 Hz, 2-5 mA. 0.5 ms pulse duration, 10 sec) was made to see if the activity of recorded afferents was modulated. About half of afferents showing spontaneous discharges responded to sympathetic stimulation, and had the conduction velocities in the A-fiber range. Most of the sympathetically induced afferent responses were excitation. This sympathetically induced excitation occurred in the dorsal root ganglion (DRG), and was blocked by yohimbine (${\alpha}_2$ blocker), neither by propranolol ($\beta$ blocker) not by prazosine (${\alpha}_1$ blocker). The results suggest that after spinal nerve ligation, sympathetic efferents interact with sensory neurons having A-fiber axons in DRG where adrenaline released from sympathetic nerve endings excites the activity of sensory neurons by acting on 2-adrenoreceptors. This 2-adrenoreceptor mediated excitation of sensory neurons may account for sympathetic involvement in neuropathic pain.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.1024-1027
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• 2002

Epiploic appendages are small, 0.5-5 cm long, peritoneal pouches containing small vessels and fat, located on the serous surface of the colon, from the cecum to the rectosigmoid junction. Pathologic states are rare in these appendages, the most frequent being is infarction either due to torsion or spontaneous. As a result of subsequent inflammatory reaction, the condition has been termed primary epiploic appendagitis. The condition is manifested by localized abdominal pain, which is often mistaken for appendicitis or diverticulitis and is usually diagnosed at surgery. With the aid of comtemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the clinician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy is no longer considered necessary. Conservative management has been shown to be safe. We report a 5-year-old male patient with epiploic appendagitis who presented with acute abdominal pain.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.317-325
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• 2007

Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.

• The Journal of Pediatrics of Korean Medicine
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• v.11 no.1
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• pp.205-226
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• 1997

Sanpoongdan(SPD) has been known effective on infantile convulsive disorders in clinical field of oriental medicine. The purpose of this study was to investigate the anti-convulsive, sedation and analgesic effects of SPD in mouse. The anticonvulsive effect was evaluated In mice treated with pentylenetetrazol, stychnine, and picrotoxin. For the sedative effect, observations were made on the sleeping time induced by thiopental sodium and pentobarbital sodium following oral administration of SPD. Furthermore, reduction of spontaneous movements and ataxia using rota rod method were evaluated. Analgesic effects on the writhing syndrome induced by acetic acid and on hindlimb pain induced by pressure were also observed. The findings were as follows : 1. The solid extracts of SPD revealed no effect on convulsions induced by pentylenetetrazol, strychnine, and picrotoxin. 2. Thiopental sodium-induced sleeping time was prolonged by the administration of the solid extracts of SPD, but this result was devoid of statistical significance. 3. The oral administration of SPD enhanced the sleeping induced by pentobarbital sodium. 4. Spontaneous movements were significantly depressed following the oral administration of the solid extracts of SPD. 5. Ataxia was not shown in rota rod method following the oral administration of the solid extracts of SPD. 6. The solid extracts of SPD showed positive analgesic effects on the acetic acid-induced writhing syndrome. 7. The solid extracts of SPD raised the threshold of the hindlimb pressure pain, but the result was not statistically significant. From the results, it can be concluded that SPD has sedative and analgesic effects.

• Journal of Korean Medical classics
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• v.29 no.2
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• pp.151-163
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• 2016

Objectives : Shanghanlon is based on the Hwangjenaegyeong(黃帝內經)'s theory. Therefore, the contents of the Naegyeong can interpret Shanghanlon's provision, Chengwuji(成無己) followed the same way. Therefore, I studied the relationship between the symptom of Shanghanlon and the defensive Gi(衛氣), I try to prove that the Naegyeong is the theoretical basis of Shanghanlon. Methods : Naegyeong explains that defensive Gi protects the outer parts of the body, and runs the outer parts of the body. So I will explain the spontaneous sweating(自汗) aversion to cold(惡寒) pain(痛症) fever(發熱) difficulty of urination(小便不利) using the function of defensive Gi. Results & Conclusions : The defensive Gi and the nutrient Gi(營氣) run together, if the defensive Gi is weak, can not protect the nutrient Gi. If the defensive Gi does not perform the function of inducing astringency(固攝), the symptom of spontaneous sweating appears. If aversion to cold is caused by the weak of defensive Gi, we use the treatment of warming the Yang(溫陽). If aversion to cold is caused by the defensive Gi can not run, we use the treatment of activating the Yang(通陽). If the Gi and Blood(氣血) is not feeding properly, the pain occurs. In this case, we use the treatment of activating the Yang(通陽). The fever is caused by the stagnation of defensive Gi. If the defensive Gi is weak, the symptom of difficulty of urination appears.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.1-8
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• 2015

Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.