• Title/Summary/Keyword: Vascular Pain

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Surgical Treatment of Takayasu`s Arteritis; Report of One Case (Takayasu`s arteritis의 수술치험 1례)

  • 전희재
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.496-500
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    • 1993
  • Takaysu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries. The end stage pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch, left common carotid artery and left subclavian artery. The patient was 27 year-old female and she was admitted because of headache and neck pain. Aortogram revealed fusiform dilatation of left common carotid artery with focal narrowing on it`s distal portion. The patient underwent surgical resection and replacement of Dacron tube graft between distal and proximal left common carotid artery. 3 months after operation, she was readmitted because of shoulder pain and headache. Aortogram revealed focal narrowing of proximal left common carotid artery and total obstruction of left subclavian artery which caused subclavian steel syndrome. Aorto-left common carotid and aorto-left subclavian bypass graft replacement were done.

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Percutaneous Radiofrequency Thoracic Sympathectomy (경피적 고주파열응고법에 의한 흉부교감신경절차단)

  • Yoon, Duck-Mi;Ishizaki, Keiji;Fujita, Tatsushi
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.74-77
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    • 1995
  • Upper thoracic sympathectomy is valuable for patients with vascular occlusive disease and other painful upper extremity diseases. We performed 10 upper thoracic sympahthectomies by percutaneous radiofrequency destruction in painful disorder of upper extremity. Patients were supine and the needle was inserted paratracheally under C-arm fluoroscope. The second and third thoracic sympathetic gangla were destructed by radiofrequency lesion generator. Each lesion was made with a tip temperature of $90^{\circ}C$, 90 seconds. Good to excellent results were achieved in all patients without any adverse effect. Seven patients revealed complete sympatholytic effect and other three patients were showen signs of partial sympathetic block. Two patients were persisted sympatholytic effect for 18month in and other 5 patients were persisted sympatholytic effect at present (follow up period: mean 5.8 mon). Percutaneous radiofrequency upper thoracic sympathectomy with anterior paratracheal approach is an effective and a safe method.

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A Study on the Tendency to Research of Scalp Acupunture (두침요법의 연구동향에 대한 고찰)

  • Kim, Min-Ki;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.17 no.1
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    • pp.113-127
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    • 2008
  • Method : We consider some books on scalp acupuncture and reports of scalp acupuncture published in korea, and survey motor cortex stimulation. The results are as follows. Result : Scalp acupuncture was based on theory of meridian pathway and functional cerebral cortex. Scalp acupunctur was used especially for CVA(Cerebral Vascular Accident) out of cerebral diseases many time. and this acupuncture shows better effect when used with different treatments than when used singly. Motor cortex stimulation is brothers to scalp acupuncture, and give medical treatment on neuropathic pain. Conclusion : The possibility of curing illness through scalp acupuncture have been shown factually and clinically. Based upon such facts, it is regarded that further scientific research along with additional clinical approaches involving scalp acupuncture should be performed.

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Treatment of Bell's Palsy by Stellate Ganglion Block (안면신경마비에 대한 성상교감신경절 차단요법)

  • Cho, Sung-Kuk;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.49-56
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    • 1989
  • Bell's palsy is not a serious disease and recovery is spontaneous in more half of the patients, but this recovery is long delayed in many instances and the cosmetic effect of an altered facial appearance is psychologically distressing. The etiology is unknown, but Kettle's ischemic hypothesis has been widely accepted. The aim of treatment is to reduce edema and improve circulation to the facial nerve. Stellate ganglion block (SGB) resulted in abolishing cerebral vascular spasm and in increasing cerebral blood flow. Thus, stellate ganglion block is effective in treatment of Bell's palsy. From 1978 to Oct. 1988, we have treated 222 patients (20 patients were recurred cases) with facial palsy by SGB and analysed the effect of SGB. We noticed that SGB was very effective in early repetitive treatment (90% recovery). This study is reported and the literature is reviewed.

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A Case Report of the Allopuinol-Associated Angiokeratoma in the Oral Mucosa (Allopurinol과 연관된 구강내 혈관각화종(Angiokeratoma)의 증례보고)

  • 이화진;최종훈;김종열
    • Journal of Oral Medicine and Pain
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    • v.23 no.3
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    • pp.257-261
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    • 1998
  • Angiokeratoma is a cutaneous vascular disorder that occurs at any sites as trunk,extremities, fingers and toes etc. Although solitary or multiple cutaneous lesions have been reported, oral lesions have been very care. A 72-year-old man who had an exophtic, essile mass with dark red, black colored which located on buccal mucosa, was treated with excisional biopsy. He had no specific systemic history except for the medication of allopurinol, for treatment of gout since 10 years. Final diagnosis was determined as angiokeratoma by evaluation of clinical and histopathological finding, and the lesion has not been recurred for two months by decrease of allopurinol. It has been emphasized that the relationship between oral mucosal disease and the complication of allopurinol. Allopurinol is widely used for gout treatment, which we will report a case on the allopurinol-associated angiokeratoma in the oral mucosa.

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A Case of Spinal Intradural Extramedullary Cavernous Angioma

  • Chung, Dae-Yeong;Shin, Yong-Hwan;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.74-76
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    • 2005
  • Cavernous angiomas represent 5 to 12% of spinal vascular malformations and usually are located at the vertebral body level with possible extension into the extradural space. The intradural intramedullary cavernous angioma occurs in about 3% of cases, whereas extramedullary localization is extremely rare. We report a case of intradural extramedullary cavernous angioma in which the patient presented with low back pain and both leg pain. The magnetic resonance imaging study showed intraspinal mass lesion at L1-2. It was removed totally through laminectomy of L1-2 and confirmed as cavernous angioma. The postoperative course was uneventful without any neurologic deficit. We report this unusual spinal malformation.

Sternal Fracture Fixation with a Steel Wire: The New "Timala" Technique

  • Timala, Rabindra Bhakta;Panthee, Nirmal
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.170-176
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    • 2021
  • Purpose: Traumatic sternal fractures are rare but quite disabling injuries. Timely fixation of sternal fractures reduces pain and prevents respiratory complications. However, the fixation technique should be simple, effective, and readily available in local circumstances. Methods: From January 2014 to March 2020, seven patients with sternal fracture/dislocation underwent steel wire fixation with the new "Timala" technique. In this technique, adjacent ribs are anchored with two steel wires to form an "X" in front of the fractured segment of the sternum. Patients were followed up clinically and radiologically. Results: Six of the patients were men and one was a female. Five of them had injuries due to falls and two were injured in road traffic accidents. Their age ranged from 18 years to 76 years, with a median age of 41 years. All seven patients experienced immediate recovery from pain and showed evidence of fracture healing on postoperative chest X-rays and clinical examinations. Conclusions: Anchoring ribs to fix the sternum with steel wire is a safe, effective, easily available, and reproducible method to fix sternal fractures or dislocations.

Surgical Treatment of Aortoiliac Arterial Occlusion: Report of 2 Cases (대동맥하단부-장골동맥의 급,만성 폐쇄성 동맥질환 2례)

  • 마중성
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.19-24
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    • 1972
  • The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

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Transient Adverse Neurologic Effects of Spinal Pain Blocks

  • Lee, Han-Il;Park, Yong-Sook;Cho, Tack-Geun;Park, Seung-Won;Kwon, Jeong-Taik;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.228-233
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    • 2012
  • Objective : Chronic neck or back pain can be managed with various procedures. Although these procedures are usually well-tolerated, a variety of side effects have been reported. In this study we reviewed cases of unexpected temporary adverse events after blocks and suggest possible causes. Methods : We reviewed the records of patients treated with spinal pain blocks between December 2009 and January 2011. The types of blocks performed were medial branch blocks, interlaminar epidural blocks and transforaminal epidural blocks. During the first eight months of the study period (Group A), 2% mepivacaine HCL and triamcinolone was used, and during the last six months of the study period (Group B), mepivacaine was diluted to 1% with normal saline. Results : There were 704 procedures in 613 patients. Ten patients had 12 transient neurologic events. Nine patients were in Group A and one was in Group B. Transient complications occurred in four patients after cervical block and in eight patients after lumbar block. Side effects of lumbar spine blocks were associated with the concentration of mepivacaine (p<0.05). The likely causes were a high concentration of mepivacaine in five patients, inadvertent vascular injection in three patients, intrathecal leak of local anesthetics in one, and underlying conversion disorder in one. Conclusion : Spinal pain blocks are a good option for relieving pain, but clinicians should always keep in mind the potential for development of inevitable complications. Careful history-taking, appropriate selection of the anesthetics, and using real-time fluoroscopy could help reduce the occurrence of adverse events.

An Unexpected Improvement of the Symptom from Herniated Intervertebral Disc during Trial of Spinal Cord Stimulation for the Post-herpetic Neuralgia -A case report- (대상포진 후 신경통에 시행된 실험적 척수자극술시 예측치 못한 추간판 탈출증 증상의 개선 -증례 보고-)

  • Ahn, Jae-Seok;Han, Seok-Hee;Kim, Tae-Hyeong;Park, Hahck-Soo;Lim, Young-Jin;Lee, Sang-Chul
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.110-113
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    • 2001
  • In controlling chronic intractable pains, the current therapeutic methods used are exercise, over the counter medication, cognitive-behavioral therapy, opioid medication, neural blockade, operation, etc., spinal cord stimulation being the last resort. Spinal cord stimulation was initiated when Shearly and others clinically tested the Gate control theory of Melzack and Wall. This had triggered the advancement of theoretic research on the mechanism and hardware necessary and has resulted in an accumulation of clinical experiences. This is known to be effective for treating sympathetic pain, arachnoiditis, failed back pain syndrome, radiculopathy, peripheral vascular disease, phantom limb syndrome, post-herpetic neuralgia, peripheral neuropathy, and angina pectoris. This report describes our experience in experimental spinal cord stimulation in patients with simultaneous post-herpetic neuralgia and herniated intervertebral disc. There wasn't any improvement in the post-herpetic neuralgia but the symptoms of a herniated intervertebral disc was much ameliorated. This was quite an unexpected result. The patient's back pain returned when the stimulation stopped.

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