• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.65-68
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• 1998

The neuropathic pains are not well controlled by common analgesics and opioid drugs in terminal cancer patients. The types of these pains are divided within the two cages, one is due to continuous central sensitization and the other is due to paroxymal peripheral sensitization. The mechanism of continuous central sensitization is the activity of dorsal horn neurones that are activated by C-fiber input. The tricyclic antidepressants, non-tricyclic antidepressants, and oral local anaesthesia probably produce analgesic effects in neuropathic pains through suppression of this activity. The mechanism of paroxymal peripheral sensitization is the hyper-excitability of peripheral neurones. The neuropathic pains due to peripheral sensitization respond relatively the anticonvulsants and baclofen that stabilize membranes and suppress paroxymal electrical discharge. The patients was a 38-year-old female who complained of hyperthemia on upper right extremity. The symptom of this patient was improved with anticonvulsant(dilantin 600mg).

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.154-156
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• 2005

We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

• Asian Oncology Nursing
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• v.11 no.3
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• pp.229-236
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• 2011

Purpose: The purpose of this study was to examine the sensation changes in upper extremity and the quality of life for post-operative mastectomy patients. Methods: This study used a descriptive study design. The participants were 132 women who had mastectomies after being diagnosed with breast cancer and were participating in breast cancer self-help groups. The sensation changes in the arm of the surgery site was measured by the arm symptoms which were subjective uncomfortable feelings of the affected arm, and the quality of life was measured by Medical Outcomes Study Short Form-36. Collected data were analyzed by ANOVA, t-test, ${\chi}^2$-test and multiple regression with SPSS WIN 12.0 program. Results: Patients with stage IV breast cancer had severe changes in sensation of the arm. Participants with lymphedema had statistically significant changes in sensation compared to participants without lymphedema, but the quality of life was not different between the two groups. Pain by the SF 36 was statistically different between the two groups, with- and without-lymphedema. The factors in upper extremity's sensation changes which influence on quality of life were pain and heaviness. Conclusion: Nursing intervention for relieving pain and heaviness of the affected arm needs to be developed in order to improve QOL of the breast cancer survivors.

• PNF and Movement
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• v.17 no.1
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• pp.11-18
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• 2019

Purpose: This study verifies the muscle activity around the amputation site during proprioceptive neuromuscular facilitation (PNF) pattern exercise for the upper extremities on the non-amputated part in upper extremity amputees and provides basic data on effective exercise around an amputation site. Methods: Manual resistance was applied to the PNF upper extremity pattern of the non-amputated part to generate muscle activity around the amputation site. The resistance was adjusted to an intensity that could cause maximal isometric contraction. The muscle activity of the amputation site and the non-amputated part was measured using a surface electromyogram for the upper trapezius, middle trapezius, infraspinatus, serratus anterior, and pectoralis major. Results: During the scapular exercise in the painless range, the amputated side showed significantly lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. During the PNF pattern exercise in the painless range, the amputated side showed lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. When the direct scapular exercise of the amputated side was compared with the PNF pattern exercise of the non-amputated side, their muscle contraction ratios were similar. Conclusion: This study confirmed the effectiveness of the PNF pattern exercise of the non-amputated part as a way to indirectly train the injured site with no pain for rehabilitation of patients with serious body injuries, such as amputation. It is necessary to develop effective exercise programs for the rehabilitation of the amputation site based on the results of this study.

• PNF and Movement
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• v.17 no.2
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• pp.167-175
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• 2019

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder's active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder's active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.128-131
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• 1999

Stellate ganglion block is a well established method for the management of certain pain syndromes (e.g., chronic regional pain syndrome, facial pain) in the cervicothoracic region and upper extremity. The stellate ganglion resides between the C7 transverse process and the head of the first rib. Anesthetic injections for the stellate ganglion block are typically made at the level of the transverse process of either the C6 or C7 vertebrae to avoid the pleura, vessels, and nerve roots. Method of positioning the needle tip directly at the ganglion has been described, but are problematic because of the risk of injury to or injection into adjacent structures. It is necessary to know the exact anatomic position of the stellate ganglion when permanent blockade is required by means of radiofrequency thermocoagulation. Whereas fluroscopy shows only bony feature, computerized tomography also images nerves, vessels, and lung, allowing accruate needle placement. We report a case of the percutaneous radiofrequency thermocoagulation of the stellate ganglion after computerized tomography-guided localization.

• Journal of the Ergonomics Society of Korea
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• v.34 no.1
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• pp.11-18
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• 2015

Objective: The aim of this study was to understand the effects of phone weight on the typing performance and muscle recruitment in the neck and upper extremity while typing a text message with dominant hand. The iPhone4 and iPhone5 were compared due to their 28-gram differences in weight. Background: Too much use of a cellular phone can lead the musculoskeletal disorders in the upper extremity. Phone makers tend to make their new models bigger, lighter, faster and smarter. Method: Fourteen healthy volunteers without any history of neuromuscular disorders or ongoing pain who used their smartphone more than one year were recruited. A 112g phone (iPhone5) and a 142g phone (iPhone4) were used for typing the lyric of the Korean national anthem with their dominant hand. Typing duration, the typing error, the perceived fatigue, and preference was investigated. Muscle recruitment and the resting gap of neck (middle trapezius and levator scapula), shoulder (infraspinatus and mid deltoid), elbow (biceps brachii and brachioradialis), thumb (extensor and abductor policis brevis) were collected using surface electromyography. Typing error was counted and typing speed was calculated in characters per min. The data were analyzed using a paired t-test and chi-square (${\chi}^2$) analysis for the effects of phone weight on the typing performance parameters and muscle recruitment. Results: Typing text message with iPhone5 took longer but had less muscle recruitment in brachioradialis, and extensor policis brevis muscles. Lighter weight of iPhone5 made biceps brachii to rest less without increasing the mean %EMG. Conclusion/Application: Findings of this study can be valuable information for phone designers to develop more productive device and for smartphone users to prevent the musculoskeletal disorders in the upper extremities.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.213-217
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• 2006

Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• The Korean Journal of Pain
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• v.23 no.1
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• pp.70-73
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• 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.