• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.68-73
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• 2009

Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.

• Korean Journal of Animal Reproduction
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• v.14 no.2
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• pp.147-154
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• 1990

To study effects of intratesticular injection of AgNO3 and latic acid solution(ALS) on castration, 50 heads of crossbred(Large Yorkshire$\times$Landrace) pigs were used. ALS(1% or 5% in concentration) was injected(0.2ml or 0.5ml in amout) to testes of pigs(weighing 7.7kg) unilaterally or bilaterally and changes of scrotum size, residual concentration of Ag, and steroid concentration in the blood were measured. The results obtained are summarized as follows : 1. The size of testis became swollen significantly(p<0.01) on the 3rd day after the treatment and then reduced to the same size before the treatment on the 26th day. 2. The residual concentration of Ag in the bilaterally treated pigs was similar to that of the control pigs, while it was lower in the unilaterally treated pigs than in the control pigs except the 1%-0.2ml treated pigs whose concentration was similar to that of the control pigs. 3. In 92 days after the bilateral injection, the testosterone concentration was higher significantly(p<0.01) in the 5%-0.5ml treated pigs than in the control pigs. However, in 120 days it was lower significantly(p<0.05) in the treated pigs than in the control pigs. 4. In 92 days after the bilateral treatment, the androstenedione concentration was lower significantly(p<0.01) in the 1%-0.5ml treated pigs than in the control pigs and it was also lower significantly(p<0.05) in the 1% or 5% treated pigs than in the control pigs on the 120th day after the treatment.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.183-187
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• 2020

Perineural cysts are usually discovered incidentally; only approximately one percent of such cysts are symptomatic. Symptomatic cervical perineural cysts, of which only five case reports have been found in the literature, are extremely rare and there is no consensus regarding treatment. When a cervical perineural cyst is discovered in a patient with cervical radiculopathy without the cause of other apparent compression, the cyst can be considered as a possible cause of cervical radiculopathy. In such cases, non-surgical conservative treatment can be considered before any surgical intervention. We reported the successful treatment of case of a 40-year-old woman with a symptomatic cervical perineural cyst by oral steroids and transforaminal epidural steroid injection.

• 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.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.251-254
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• 2005

Spondylolysis, also known as stress injury of pars interarticularis, is a common cause of back pain in athletes, particularly children and young adults. Repeated minor traumas during flexion and extension of the spine are thought to result in bony failure due to excessive bone resorption. These lesions are common in the low back, with the majority found at the L5 vertebra. In the majority of cases of spondylolysis, non-operative treatments are recommended, such as NSAIDs, physiotherapy and bracing. Only if symptoms do not respond to conservative treatments should surgical intervention be considered. Recently, pars interarticularis injections for diagnostic and therapeutic purposes have been found to allow significant pain relief from spondylolysis for long periods. Here, the case of a 57-year-old man with spondylolysis, who suffered from back pain, which was not relieved by an epidural steroid injection, but in whom pars interarticularis injections of local anesthetic and steroid induced complete transient pain relief, following by moderate long-term relief, is presented.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.448-451
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• 2012

Invasive pulmonary aspergillosis (IPA) has emerged as a severe infection in patients with immunocompromised hosts. However, recently, several IPA cases, without an apparent predisposition to immunodeficiency, has been reported. A 72-year-old woman was admitted for evaluation of general weakness and poor oral intake. She reported no medical history, except for intraarticular injection of a corticosteroid for joint pain for the duration of two months. A chest radiography revealed multiple cavitary nodules in both lungs. Examination of specimens, obtained by percutaneous needle biopsy, led to a diagnosis of invasive aspergillosis. Brain magnetic resonance imagining revealed numerous peripheral thin enhancing cystic nodules in both cerebral hemispheres. We initiated intravenous administration of amphotercin B. However, the patient died after nine days. Here, we report an invasive aspergillosis case, which involves the lungs and brain after a short period of steroid injection.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.46-49
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• 2007

Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

• The Korean Journal of Pain
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• v.32 no.3
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• pp.187-195
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• 2019

Background: Steroid injections are commonly used in pain clinics to relieve pain and treat inflammation. In Korea, these steroid injections are well known as 'ppyeojusa', which means to inject into the bone in Korean. Some patients often have a negative perception of this treatment method due to inaccurate information about the treatment and side effects of steroids. The purpose of this study is to investigate patients' perception and knowledge of ppyeojusa. Methods: A questionnaire about ppyeojusa was completed by patients who visited one of the pain clinics in nine university hospitals, from August 1 to September 10, 2017. Results: Three-hundred seventy-four patients completed the survey. Eighty-five percent of patients had had ppyeojusa, and 74% of the respondents had heard of ppyeojusa from the mass media, friends or relatives. Only 39% of the patients answered that this injection was safe without side effects if properly spaced. Of the patients surveyed, 21% responded that ppyeojusa are "injections into the bone"; while 15% responded that ppyeojusa are "terrible injections that melted 'the bone if used a lot'". Half of the patients did not know what the active constituent is in ppyeojusa. If steroid injections are advised by the pain specialists, 89% of the patients would consent. Conclusions: Most pain clinic patients have heard of ppyeojusa. Most patients obtained information about ppyeojusa from mass media, rather than their physicians. Therefore, it is likely that most patients have inaccurate knowledge.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.