• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.887-893
• /
• 1990

We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.

• The Korean Journal of Pain
• /
• 제23권1호
• /
• pp.70-73
• /
• 2010

Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient’s continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.

• Journal of Oral Medicine and Pain
• /
• 제25권2호
• /
• pp.229-234
• /
• 2000

The patient, 62-years-old woman, had a constant dull pain in the right mandible and an intermittent spontaneous burning sensation of the mouth. The pain began 6 months ago. About 5 years ago, a trauma in her right mandible which was so severe that kept her in the hospital for 2 days. This was followed by mouth opening disturbance with pain for about 2 years. However, she did not have a treatment for the temporomandibular disorder symptoms. After then, she experienced the trigeminal neuralgia characterized by an electrical pain which lasted about 30 minutes in her right face and head when touching the skin or hair. After taking a year course treatment of trigeminal neuralgia, the symptom disappeared. The pain was a constant dull pain and a intermittent burning pain which are contradictory. And the pain responded to various modalities such as physical therapy, anti-inflammatory drug, carbamazepine, and amitriptyline, among which carbamazepine was most effective. The diagnosis was clinically made as an atypical trigeminal neuralgia. The term 'atypical' is used when there is something unknown and the problem is not identified. It is thought that an atypical pain may be approached in the perspective of chronic pain, neuropathic pain, and myofascial pain, the mchanisms of which are poorly understood. As the knowledge of pain physiology improves, there needs to be modification and re-evaluation. Pain disorders must be classified on the basis of an understanding of the underlying mechanism and etiology.

• The Korean Journal of Pain
• /
• 제34권2호
• /
• pp.165-175
• /
• 2021

Background: Management of pain from open wounds is a growing unmet healthcare need. However, the models available to study pain from wounds or to develop analgesics for the patients suffering from them have primarily relied on incisional models. Here, we present the first characterized and validated model of open wound pain. Methods: Unilateral full-skin excisional punch biopsy wounds on rat hind paws were evaluated for evoked pain using withdrawal responses to mechanical and thermal stimulation, and spontaneous pain was measured using hind paw weight distribution and guarding behavior. Evaluations were done before wounding (baseline) and 2-96 hours post-wounding. The model was validated by testing the effects of buprenorphine and carprofen. Results: Pain responses to all tests increased within 2 hours post-wounding and were sustained for at least 4 days. Buprenorphine caused a reversal of all four pain responses at 1 and 4 hours post-treatment compared to 0.9% saline (P < 0.001). Carprofen decreased the pain response to thermal stimulation at 1 (P ≤ 0.049) and 4 hours (P < 0.011) post-treatment compared to 0.9% saline, but not to mechanical stimulation. Conclusions: This is the first well-characterized and validated model of pain from open wounds and will allow study of the pathophysiology of pain in open wounds and the development of wound-specific analgesics.

• The Korean Journal of Pain
• /
• 제11권2호
• /
• pp.338-342
• /
• 1998

Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

• The Korean Journal of Pain
• /
• 제13권1호
• /
• pp.105-110
• /
• 2000

Central neuropathic pain may occur in 10~20% of the patients after spinal cord injury. The central pain syndrome include spontaneous continuing and intermittent pain as well as evoked pain. The pain is evoked by non-noxious stimulation of the region (allodynia) and repeated stimulation (wind-up phenomenon). Four patients were referred suffering from severe pain, allodynia and hyperaesthesia after spinal cord injury. They had received conventional treatment with non-steroidal anti-inflammatory drugs, steroid, anticonvulsant, antidepressant and rehabilitation which failed to provide pain relief. We administered combination of low doses of morphine and ketamine (10 mg) through the epidural catheter with other conventional therapy. Satisfactory pain relief was achieved in each patient. The reduction of pain was not associated with severe side effects. The most bothersome side effect of ketamine was dizziness in one patient, only caused by bolus injection (ketamine 10 mg with normal saline 10 ml). This suggests synergy from this combination that provides an alternative treatment for central pain.

• Journal of Oral Medicine and Pain
• /
• 제41권2호
• /
• pp.80-84
• /
• 2016

Non-odontogenic toothaches are frequently present and can be challenge to the dental clinician. A 41-year-old male patient with sharp and spontaneous pain on the right maxillary posterior dentition, which developed as like localized toothache 3 months ago, was finally treated with endoscope assisted sinus surgery on right maxillary sinus. Although the initial clinical characteristics are similar to odontogenic toothache in this patient, previous several treatment with the affected teeth did not alleviate the pain. Sinusitis around the facial structure is one of the common causes to make referred pain to maximally teeth and the sinus toothache resembles the pulpal or the periodontal toothache. The clinician should be well aware of various causes of the non-odontogenic toothache and be able to differentiate them.

• Tuberculosis and Respiratory Diseases
• /
• 제59권6호
• /
• pp.696-699
• /
• 2005

SPM은 기저질환이나 외상의 과거력 없이 종격동에 기포가 생기는 질환으로 주로 젊은 연령에서 발생하며, 재발은 세계적으로 소수의 증례보고 위주로 되어 있다. 저자들은 특별한 유발 요인 없는 젊은 여자환자에서 27개월 간격으로 재발한 SPM를 경험하였고, 이는 국내에 보고된 바 없으며, 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
• /
• 제31권2호
• /
• pp.139-143
• /
• 2014

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.

• Journal of Chest Surgery
• /
• 제43권6호
• /
• pp.663-668
• /
• 2010

배경: 자연성 종격동 기종은 드문 질환으로 세계적으로 보고된 환자도 적다. 주로 젊은 남자에서 발병하며 양성의 자연 치유 경과의 질환으로 어떤 특별한 이유 없이 일어난다. 폐기포 파열을 일으키는 흉강내 압력 변화 이후 나타나게 된다. 두 병원의 임상 경험을 분석하여 적정한 치료에 도움이 되고자 한다. 대상 및 방법: 후향적으로 2003년 3월부터 2010년 8월까지 자연성 종격동 기종 환자들을 연구하였다. 결과: 24명의 환자가 자연성 종격동 기종으로 진단되었다. 이들 24명의 환자는 18명의 남자와 6명의 여자로 구성되었고, 평균 나이는 18.9세였다(범위 10~33살). 초기 주요 증상은 흉부 통증(79.2%), 이후 통증(62.5%), 피하 기종(4 1.7%)이었고 유발 인자로 운동(16.7%), 기침(12.5%), 구토(12.5%) 등이었고 유발 인자가 없는 경우가 54.2%였다. 모든 환자에서 흉부 단순 촬영과 단층 촬영이 이루어졌으며, 25% 환자에서 진단을 위해 단층 촬영이 필요하였다. 백혈구 수치와 C반응 단백(CRP)가 측정되었는데 초기 평균 수치는 각각 $9,790{\pm}3,240/{\mu}L$와 $1.31{\pm}1.71mg/dL$, 최종 평균 수치는 $5,440{\pm}1,665/{\mu}L$와 $0.72{\pm}0.73mg/dL$이었다. 23명의 환자가 입원하였으며(평균 $5.0{\pm}1.8$일) 증상은 자연 치유되었으며 합병증은 없었다. 결론: 자연성 종격동 기종은 약한 염증성 증세를 보이는 양성 질환이며 종종 흉부 또는 인후 통증을 나타낸다. 바람직하지 못한 결과를 방지하기 위하여 비침습적인 검사로 이차성 원인이 배제되어야 한다. 합병증과 재발이 거의 없는 관계로 증상에 따라 외래 진료나 단기적인 입원이 합당하다고 하겠다.