• The Korean Journal of Pain
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• 제26권2호
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• pp.154-159
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• 2013

Femoroacetabular Impingement (FAI) arises from morphological abnormalities between the proximal femur and acetabulum. Impingement caused by these morphologic abnormalities induces early degenerative changes in the hip joint. Furthermore, FAI patients complain of severe pain and limited range of motion in the hip, but a guideline for treatment of FAI has not yet been established. Medication, supportive physical treatment and surgical procedures have been used in the treatment of the FAI patients; however, the efficacies of these treatments have been limited. Here, we report the diagnosis and treatment for 3 cases of FAI patients. Intra-articular (IA) steroid injection of the hip joint was performed in all three patients. After IA injection, pain was reduced and function had improved for up to three months.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.167-180
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• 1994

좌우 경동맥을 결찰하여 혈뇌장벽에 변화를 일으킨 백토에서 뇌압하강제(mannitol, steroid) 및 뇌압하강 방법(과호흡)의 효과를 관찰하였다. Mannitol군에서는 steroid군, 과호흡군에 비해 뇌압감소가 통계적으로 유의하게 있었으며, 시간적으로 mannitol 투여 후 25~30분까지 뇌압이 45%까지 감소하여 지속되었다. Steroid군에서는 mannitol군보다는 뇌압 절대치의 감소폭은 적었지만, 과호흡군 보다 2배 이상의 뇌압감소가 있었고, mannitol군보다 더욱 오랫동안 뇌압감소의 효과가 지속되었다. 과호흡군에서는 mannitol군, steroid군에서보다는 뇌압감소 효과가 적었으나, 과호흡 시행 후 10분까지 13.5~16.7%의 뇌압감소가 있었고, 그 이후 시간 경과에 따른 더 이상의 뇌압감소 효과는 없었다. Mannitol, steroid, 과호흡군을 모두 시행한 복합치료군에서는 mannitol 및 steroid, 과호흡을 각각 시행한 군에서보다 뇌압 감소가 더욱 현저하게 이루어져 30분까지 48~52%의 뇌압감소가 있었다. 이상의 결과로 미루어보아 뇌허혈성 뇌졸중 환자에서 mannitol 및 steroid사용과 병행하여 과호흡을 실시함으로써 뇌압감소를 위한 적절한 치료의 지표가 될 것이라 판단다.

• The Korean Journal of Pain
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• 제19권2호
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• pp.175-180
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• 2006

Background: A transforaminal epidural steroid injection has been used for the treatment of radicular arm or leg pain, which has the advantage of ventral epidural spreading compared to either an interlaminar or caudal approach. However, several factors are known to affect the epidural spread pattern of contrast dye; therefore, the injected medication can not be delivered to the target site. The objective of our study was to observe any differences in the contrast flow patterns according to several factors. Methods: A total of 34 epidurographies in 29 patients, who underwent fluoroscopically guided transforaminal epidural steroid injections, were evaluated. After confirming the location of the needle tip within the anterior superior aspect of the neural foramen in the lateral view, and at the 6 o'clock position to the pedicle in the anteroposterior view, 2 ml of contrast dye was injected. The contrast flow patterns of ventral, ventral and dorsal, and dorsal epidural filling were analyzed, according to age, gender, magnetic resonance imaging finding and history of previous back surgery. Results: Ventral contrast flow occurred in 30 out of the 34 epidurographies (88%). Both ventral and dorsal contrast flow patterns were observed 13 out of 16 (81%) patients in the older age group. Also, both ventral and dorsal contrast flow patterns were observed in 16 out of 18 (88%) patients with spinal stenosis. Conclusions: Transforaminal epidural steroid injections, performed uner fluoroscopy, provide excellent nerve root filling and ventral epidural spreading. Patients with spinal stenosis or an old age have both ventral and dorsal epidural spreading patterns.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.97-100
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• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.148-151
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• 2021

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

• The Korean Journal of Pain
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• 제20권1호
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• pp.26-30
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• 2007

Background: Epidural steroid injections (ESI) are a common treatment for spinal disorders. Previous research has shown that aspiration of the syringe is not a sensitive test for placement of an intravascular needle. Serious complications have been reported from injection of steroids and local anesthetics into the vascular space. In addition to safety concerns, the efficacy may decline with partial injection outside the desired epidural location. We hypothesized that incidence of vascular problems is increased in patients who undergo spine surgery compared with the patients who don't undergo spine surgery. We investigated the incidence of vascular problems during lumbosacral transforaminal ESI and we compared the difference of vascular problems between the patients who undergo spinal surgery and those patients who don't undergo spinal surgery. Methods: Two hundreds and three patients were consecutively recruited and they received 299 fluoroscopically guided lumbosacral transforaminal ESIs. Injection of contrast was performed under live dynamic fluoroscopy with using digital substraction analysis. The observed uptake pattern was classified into one of three categories: flashback, aspirated, and positive contrast with negative flashback and aspiration. Results: The vascular incidence rate was 20.4%. Transforaminal ESIs performed at S1 had avascular incidence rate of 27.8% compared with 17.7% for all the other lumbar injection sites. The sensitivity of spontaneous observation of blood in the needle hub or blood aspirate for predicting an intravascular injection in lumbar transforaminal ESIs was 70.4%. Conclusions: There is a high incidence of intravascular problems when performing transforaminal ESIs, and this is significantly increased in patients with previous spine surgery. Using a flash or blood aspiration to predict an intravascular injection is not sensitive therefore; a negative flash or aspiration is not reliable. Fluoroscopically guided procedures without contrast confirmation are prone to instill medications intravascularly. This finding confirms the need for not only fluoroscopic guidance, but also for contrast injection instillation when performing lumbosacral transforaminal ESIs, and especially for patients with previous spine surgery.

• 대한영상의학회지
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• 제82권1호
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• pp.162-172
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• 2021

목적 요추 후궁절제술 시행 부위 후관절 활액낭에 대해 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술을 시행 받은 환자에 관하여 후향적으로 시술의 성공률 및 임상적 효과를 분석하였다. 대상과 방법 투시유도 하 경피적 후관절 낭종파열술과 관절 내 스테로이드 주입술을 시행 받은 환자이면서, 시술 전 6개월 이내 촬영한 요추 자기공명영상 상 이전 후궁절제술 부위와 후 관절 활액낭종의 위치가 일치하는 것이 증명된 환자, 그리고 그 낭종의 위치가 신경학적 증상을 설명하는 것으로 판단되는 환자를 대상(14명)으로 하였으며 시술 후 낭종파열의 성공유무와 증상의 호전 정도를 조사하였다. 결과 시술이 반복될수록 낭종파열의 성공률은 감소하였지만(첫 시술에서는 62.5%, 그 이후의 시술에서는 0~33%), 80%의 환자가 시술 후 증상 호전을 보였다. 추적관찰 기간 내 낭종에 대한 수술률은 14.3%였다. 결론 요추 후궁절제술 시행 부위 후관절 활액낭에 대한 투시유도 하 경피적 낭종파열술 및 스테로이드 주입술은 효과적인 치료 방법으로서, 수술적 치료를 고려하기 전에 먼저 시도해 볼 수 있다.

• The Korean Journal of Pain
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• 제3권2호
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• pp.150-159
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• 1990

The patient with muscle contraction headache usually have one or more specific trigger points. These trigger points have been treated with various treatment modalities including "stretch and spray" and regional infiltration with local anesthetics with or without corticosteroids. I treated 36 patients with muscle contraction headache with regional infiltration of local anesthetics and steroid into trigger points and the results were as follows 1) The diagnosis of muscle contraction headache was possible by confirming specific trigger points by palpation. 2) Patients relieved rapidly from headache by regional infiltration of local anesthetics and steroid into the tender point. 3) Single injection was effective in relieving headache. But the curability of the single injection could not be assessed because of difficulty in follow-up study. 4) Active trigger points could be occasionally inactive, which also made difficult in assessing the effectiveness of the treatment.

• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.54-58
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• 2017

Lymphangioma is a congenital malformed lymphatic tumor that rarely involves the tongue. In our clinic, a 10-year-old female presented with lymphangioma circumscriptum involving the right two-thirds of the tongue. We administered an intralesional combination injection of triamcinolone, bleomycin, and bevacizumab as a treatment. Almost complete remission after combination therapy was achieved without complications such as edema, swallowing difficulties or recurrence. Bevacizumab, an inhibitor of vascular endothelial growth factor, was effective for the treatment of lymphangioma of the tongue in this case. No recurrence was noted at the 1-year follow up.

• The Korean Journal of Pain
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• 제4권1호
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• pp.56-59
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• 1991

Piriformis syndrome is a syndrome of low back and leg pain thought to be due to chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. We have utilized an alternative approach using cauaal steroid in local anesthetics injection in the treatment of piriformis syndrome. I it was a very effective method without any complications.