• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.125-133
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• 2017

Intramuscular hemangioma (IMH) is a rare vascular disease involving skeletal muscle, comprising only 0.8% of hemangiomas. About 10% to 15% of IMHs occur in the head and neck region, mostly involving the masseter muscle. IMH occurs mostly in childhood, but is often not found until unexpected enlargement, pain, or cosmetic asymmetry occurs in adulthood. Several non-surgical treatments including cryotherapy, sclerosant injection, and arterial ligature have been described, but complete surgical resection is the curative intervention. In this report, we present two rare cases of IMH. One IMH case in a 48-year-old male occurred in the masseter muscle feeding from the transverse facial artery. Embolization of the distal branch of the facial artery was first conducted, and then the buccal mass was removed surgically via the intraoral approach. A second IMH case in a 58-year-old female occurred in the orbicularis oris muscle feeding from the superior labial artery, and the mass was excised surgically without embolization.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.97-100
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• 2000

Thoracic outlet syndrome (TOS) is a combination of signs and symptoms caused by the compression of the vital neurovascular structure at the thoracic outlet region. It may stem from a number of abnormalities, including degenerative or bony disorders, trauma to cervical spine, fibromuscular bands, vascular abnormalities and spasm of the anterior scalene muscle. CPT (current perception threshold) is defined as the minimum amount of current applied transcutaneously that an individual consciously perceives. It enables quantification of the hyperesthesia that precedes progressive nerve impairment, as well as hypoesthetic conditions. We experienced a case of thoracic outlet syndrome caused by fibrosis of anterior scalene muscle. The patient was a 30 years old woman with a 3 years history of numbness on the ulnar side, progressive weakness and coldness of both hand, tiredness in the left arm, nocturnal pain in the left forearm, and pain in the left elbow, shoulder and neck. Conservative treatment, stellate ganglion block, cervical epidural block, anterior scalene block and previous operation, including both carpal tunnel release, provided no remarkable relief to the patient. A left scalenectomy and first rib resection were performed by transaxillary approach and left cervical root neurolysis was done. After surgery, we measured CPT using neurometer and found conditions worsening in the opposite arm. We performed the same procedure on right side, and followed by CPT measurement. This case suggests that CPT is a useful measurement of recovery and progression of TOS.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.359-366
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• 2007

Trigeminal neuralgia is a condition associated with severe episodic lancinating facial pain subject to remissions and relapses. Trigeminal neuralgia is often associated with blood vessel cross compression of the root entry zone or more rarely with demyelinating diseases and occasionally with direct compression by neoplasms of the posterior fossa. If initial medical management fails to control pain or is associated with unacceptable side effects, a variety of surgical procedures offer the hope for long-lasting pain relief or even cure. For patients who are healthy without significant medical co-morbidities, direct microsurgical vascular decompression [MVD] offers treatment that is often definitive. Other surgical options are effective for elderly patients not suitable for MVD. Percutaneous retrogasserian glycerol rhizotomy is a minimally invasive technique that is based on anatomic definition of the trigeminal cistern followed by injection of anhydrous glycerol to produce a weak neurolytic effect on the post-ganglionic fibers. Other percutaneous management strategies include radiofrequency rhizotomy and balloon compression. More recently, stereotactic radiosurgery has been used as a truly minimally invasive strategy. It also is anatomically based using high resolution MRI to define the retrogasserian target. Radiosurgery provides effective symptomatic relief in the vast majority of patients, especially those who have never had prior surgical procedures. For younger patients, we recommend microvascular decompression. For patients with severe exacerbations of their pain and who need rapid response to treatment, we suggest glycerol rhizotomy. For other patients, gamma knife radiosurgery represents an effective management strategy with excellent preservation of existing facial sensation.

• Clinical Pain
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• v.19 no.2
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• pp.116-119
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• 2020

Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.99-119
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• 2006

Endothelin (ET) is a 21 amino acid peptide with multifunctional effects on the vasculature as well as a variety of other cell types such as respiratory, gastrointestinal, urogenital, endocrine, central nervous systems, and others. Endothelin has emerged as a modulator by autocrine and paracrine actions for many cellular activities, including vasoconstriction, cell proliferation, hormone production, neurotransmitter and/or neuromodulator. The endothelin family consists of three closely related peptides, ET-1, ET-2, and ET-3 derived from separate genes, such as chromosome 6, 1, and 20, respectively. ET-1 is the predominant isoform produced in the cardiovascular system and about which most is known. Endothelin receptors are seven-transmembrane GTP-binding protein-coupled receptors, which are classified into endothelin-A (ETA) and endothelin-B (ETB) receptors. Interestingly, recent evidence is accumulating to suggest that ET -1 may contribute to a variety of pain states such as allodynia and hyperalgesia in animals and humans. Therefore, in this review the biological characteristics and contraction-related mechanism of endothelin-1 in mammalian cells will be summarized. Especially, we focus on multifunctional roles for ET-1 in noxious stimulation-induced pain for the study of pain specialized physical therapy.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.778-780
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• 2010

A 48-year-old female complained of edema and pain in her left neck. She underwent acupuncture therapy for 1 month in a local oriental medicine clinic because of her arm pain. Computer tomography showed left internal jugular vein thrombosis. The patient's condition improved after antibiotic medication and anticoagulation. The patient is currently in outpatient department follow-up and doing well. To the best of our knowledge, this is the first report of an internal jugular vein thrombosis secondary to acupuncture.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.209-212
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• 2018

Superior mesenteric artery (SMA) aneurysms are rare and often fatal. A 72-year-old man had previously been admitted to the emergency room with epigastric pain and heart murmur. The echocardiographic diagnosis was vegetation on the aortic and mitral valves, with moderate regurgitation from both valves due to infective endocarditis. No aneurysm was detected on abdominal computed tomography, and emergency double-valve replacement was performed. On postoperative day 25, the patient experienced abrupt abdominal pain, and computed tomography revealed a mycotic SMA aneurysm. Open surgical repair of the SMA aneurysm was performed using the femoral vein, and the patient's postoperative course was uneventful.

• Journal of Oral Medicine and Pain
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• v.45 no.2
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• pp.44-47
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• 2020

The case of pseudo-aneurysm of internal maxillary artery (IMA) in oral and maxillofacial region is known to be very rare. The etiology of this case was regarded as IMA injury by radiofrequency ablation (RFA) and such incidence was not reported previously. One case of false aneurysm in the IMA was referred from local dental clinic to our department. Left facial swelling was observed with severe trismus immediately after radiofrequency procedure for masseteric nerve block in local dental clinic. Despite of medication and surgical intervention, the swelling did not subside and there was massive bleeding and pulsation on one of the follow ups. The traumatic vascular disorder was suspected and finally diagnosed with angiography and treated by embolization procedure. RFA targeting masseteric nerve or trigeminal ganglion may cause traumatic injury to adjacent anatomic structures such as IMA, resulting in pseudo-aneurysm. Clinicians must be aware of potential damages of RFA. Angiography enables the solid diagnosis for pseudo-aneurysm, and selective embolization can be optimum treatment method.

• Journal of the Optical Society of Korea
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• v.19 no.2
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• pp.169-174
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• 2015

Muscle vibration measurement has long been an unique scientific study, in general, and the direct reaction of animals to feel pain (algesia), either from vascular or muscle contraction, is a complex perceptual experience. Thus this paper proposes a way to measure animal algesia quantitatively, by measuring the changes in muscle vibration due to a pinprick on the surface of the skin of a Spodoptera litura larva. Using the laser optical triangulation measurement principle, along with a CMOS image sensor, linear laser, software analysis, and other tools, we quantify the subtle object point displacement, with a precision of up to $10{\mu}m$, for our chosen Spodoptera litura larva animal model, in which it is not easy to identify the tiny changes in muscle contraction dynamics with the naked eye. We inject different concentrations of formalin reagent (empty needle, 12% formalin, and 37% formalin) to obtain a variety of different muscle vibration frequencies as the experimental results. Because of the high concentrations of reagent applied, we see a high frequency shift of muscle vibration, which can be presented as pain indices, so that the algesia can be quantified.

• Journal of Oral Medicine and Pain
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• v.23 no.3
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• pp.249-255
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• 1998

Mucoceles of the minor salivary glands are the most common cystic lesions affected the oral mucosa. They are believed to be the result of trauma to the salivary duct caused, for example, by biting the lip, cheek, or tongue. Surgical excision has been the most common treatment for these lesions, but occasional recurrences develop after excision because surgical trauma may damage the surrounding minor salivary glands Although various alternative nonsurgical approaches, such as steroid infection, application of gamma-linolenic acid, have also been reported, they are not used routinely, Lasers, particularly the carbon dioxide laser, have been used in the management of mucoceles. Although this treatment requires specialized equipment. Cryotherapy is another effective nonsurgical method for treating mucoceles. Clinically, cryotherapy has primarily been applied to the treatment of leukoplakia and hyperplastic, granulomatous, vascular, and pigmented lesions. Limited information, however, is available on the application of cryotherapy in salivary gland lesions, including mucoceles. A simple and easy cryotherapy to treat a mucocele on the lower lip is described. A 25 years old female patient with a mucocele on the lower lip was treated by direct application of liquid nitrogen with a cotton swab. The lesion was exposed to 4 or 5 cycles composed of freezings of 10-30 s and thawings of double the freezing times. No anesthesia was required. The lesion nearly disappeared without scar 10 days after the cryotherapy. Cryotherapy has become an established nonsurgical method, characterized by its simple application, therapeutic effectiveness, painless during the procedure and low incidence of secondary infection and hemorrhage.