• Title/Summary/Keyword: injection back

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Comparison of effectiveness for fluoroscopic cervical interlaminar epidural injections with or without steroid in cervical post-surgery syndrome

  • Manchikanti, Laxmaiah;Malla, Yogesh;Cash, Kimberly A;Pampati, Vidyasagar;Hirsch, Joshua A
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.277-288
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    • 2018
  • Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

Bilateral Avascular Necrosis of the Femoral Head After Epidural Steroid Injection for the Management of Low Back Pain (요통 치료를 위한 경막외 스테로이드 주입후 발생한 양측 무혈성 대퇴골두괴사)

  • Kim, Dong-Gin;Roh, Seon-Ju;Ban, Jong-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.117-120
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    • 1992
  • Non traumatic aseptic necrosis of the head of the femur is well documented with respect to its clinical roentgenographic and pathological aspect, but not with respect to etiology. A number of reports have associated various diseases and conditions with necrosis of the femoral head. Prominent among these are alcoholism, steroid therapy and hemostatic disorder. The increased incidence of avascular necrosis of bone associated with long-term corticosteroid therapy has aroused much interest. The pathogenesis of cortisone-induced avascular necrosis is as yet unproved. But cortisone-induced fatty liver with hyperlipidemia, leading to systemic embolization of fat and avascular necrosis of bone has much experimental support. We present a case of bilateral avascular necrosis of the femur head following several epidural steroid injections in a 30 year old male patient who had low back pain with radiation to both legs for 1 year and who had Cushinoid appearance for several months. One week later, he had a total replacement of both hip operation.

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Evaluation of Reinforcing Effects of Pressure-Injected Grouting Nail in Weathered Rock (풍화암 사면에서의 압력분사 그라우팅 네일 보강 효과 연구)

  • Hwang, Young-Cheol;Kim, Nak-Young
    • Journal of the Korean GEO-environmental Society
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    • v.3 no.1
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    • pp.47-55
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    • 2002
  • The slope reinforcing method utilized in this paper reinforces the ground overall by means of filling borehole as well as permeating grout material into ground by injecting it through the grouting pipe. In order to reflect these characteristics to design, not only the ground reinforcing effect by the structural material itself but also the ground strength improvement effect by the grouting injection must be quantitively evaluated. But precedent research of it has been insufficient. Therefore, the slope reinforcing method was applied to the weathered rockmass slope situated in the highway in order to analyze reinforcing effect and the instrumentation of slope was performed. Through analysis of this field test, the slope reinforcing method was proved to be effective and back analysis method based on instrumentation values of slope was proposed to apply to reinforcing design. In this paper, the effectiveness of reinforcing method was certified through proposed back analysis.

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Acute Health Effects among Soldiers Involved in the Cleanup Operation Following the Hebei Spirit Oil Spill in Taean, Korea (허베이스피리트호 원유유출의 방제작업에 참여한 군인의 급성건강영향)

  • Hong, Jee-Young;Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.910-914
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    • 2010
  • A collision between a barge and an oil tanker of Hebei Spirit caused the release of an estimated 12,547 tons of light crude oil into the Yellow Sea off the west coast of Taean-gun, Korea on December 7, 2007. This study was aimed to evaluate exposure conditions and acute health effects in soldiers participating in the Hebei Spirit oil spill cleanup activities and the association between these and the nature of the work and use of protection devices. The sample comprised 2,624 soldiers stratified by working area and number of working days. We divided working area into the coast of Taean-gun(highly polluted area) and other areas affected by Hebei Spirit oil spill. And we divided number of working days into 1-7 days, 8-14 days, 15-21 days and above 22 days. Data were obtained via a structured, self-administered questionnaire and included information on working area, type of working, number of working days, use of protective materials, and acute health effects. Acute health effects were classified into 5 groups: neurological, respiratory, dermatologic, ophthalmic and other symptoms. Data analysis was performed using unconditional logistic regression used to compute odds ratios and 95% confidence intervals. On logistic regression analysis, working on the coast of Taean-gun was significantly associated with increased risk of acute health problems: headache, dizziness, nausea, general fatigue, insomnia, flushed face, sore throat, dry throat, runny nose, cough, sputum, skin irritation, sore eyes, injection of conjunctiva, tear, and low back pain. Furthermore soldiers working more than 21 days were significantly associated with increased risk of acute health problems: insomnia, flushed face, sore throat, runny nose, cough, sputum, tear, low back pain and fever. Accordingly, the exposure to the oil and the subsequent cleanup efforts were suggested to inflict acute health problems on soldiers participating in the Hebei Spirit oil spill cleanup activities.

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The Clinical Reaction Study on 64 Cases with Essential Bee Venom Treatment (분리정제봉약침(Essential Bee Venom) 시술환자 64례에 대한 임상적 반응 보고)

  • Jeon, Yong-Tae;Go, Ung;Kim, Sung-Moon;Jeong, Hae-Chan;Han, Kuk-In;Shin, Seon-Ho;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.165-170
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    • 2016
  • Objectives The purpose of this study was to observe clinical reactions (itching, pain, etc.) after Essential Bee Venom (EBV) treatment. Methods This study was conducted 64 patients who had been injected with EBV in Korean Medicine Hospital of Woosuk University and Haeundae Ja-Seng Hospital of Korean Medicine from October 5, 2015 to February 20, 2016. We checked clinical reactions of treatment region. Results 8 patients (12.5%) complained of localized itching and 4 patients (6.3%) complained of localized pain after EBV injection. In itching reaction of patients, 2 patients (15.4%) occurred itching in head and neck, 4 patients (12.9%) occurred in lumbar and back. In pain reaction of patients, 2 patients (6.5%) occurred pain in lumbar and back, 1 patient (11.1%) occurred pain in upper limb. All clinical reactions were happened within 7 treatment times. Conclusions This study suggested EBV treatment can cause clinical reaction like itching and pain. Clinical reactions were more common in inpatients than outpatient, and all reactions were happened within 7 treatment times. Doctors should recognize physical reaction caused by EBV and explain to patient. Further studies are needed to more improved treatment.

Bibliographic Studies on the Tetrodotoxin(TTX) (복어 독(Tetrodotoxin)에 관한 문헌적 고찰)

  • Hwang, Tae-Joon;Kwon, Gi-Rok;Choe, Ick-Seon
    • Journal of Pharmacopuncture
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    • v.3 no.2
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    • pp.1-25
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    • 2000
  • We were trying to study the validity of Puffer fish's poison(Tetrodotoxin- TTX) to make a traditional Korean Medical treatment. The following conclusions were made after literary studies. 1. The first record of the puffer fish dates back 2000 years ago in the Chinese text Book of Mountain and Sea and other texts from the similar period. 2. Puffer fish's poison IS known as tetrodotoxin which is an amino perhydroquinazoline compound. It has a chemical formula of $C_{11}H_{17}N_3O_8$ in the hemiacetal structure and has the molecular weight of 319. 3. Tetrodotoxin (TTX) plays a role as potent neurotransmitter blocker by blocking the $Na^+$ -gate channel which hinders the influx of $Na^+$ ion into the cell. 4. Symptoms of the puffer fish poisoning ranges from blunted sense in the lips and tongue, occasional vomiting in the first degree to sudden descending of the blood pressure, apnea, and other critical conditions in the fourth degree. Intoxication of the puffer fish poison progresses at a rapid pace as death may occur after an hour and half up to eight hours in maximum. Typical death occurs after four to six hours. 5. Ways to treat the puffer fish poisoning include gastric irrigation, induce vomiting, purgation, intravenous fluid injection, and correcting electrolytic imbalance and acidosis. In cases of dyspnea, apply oxygen inhalation and conduct artificial respiration. 6. Tetrodotoxin (TTX) may be applied in treating brain disorders, ocular pain, excess pain in the large intestine and ileum, and relieving tension of the skeletal museles, neuralgia, rheumatism, arthritis, and etc. 7. In terms of Oriental medicine, the puffer fish poison has characteristics of sweet, warm, and poisonous. It's known efficacies are to tonify weakness, dispel damp, benefit the lower back, relieve hemorrhoid, kills parasites, remove edema, and so forth. And the puffer fish eggs processed with ginger are said to be effective against tuberculosis and lung cancer, thus, it's validity must be investigated and further research should be followed.

Osteoporotic Vertebral Compression Fracture Associated with Pregnancy and Lactation in Young Women (젊은 여성에서 임신 및 수유와 연관된 골다공증성 척추 압박골절)

  • Shin, Woo-Jin;Suh, Seung-Pyo;Yeom, Ji-Ung;Kim, Yun-Seong
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.266-271
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    • 2021
  • Osteoporosis associated with pregnancy and lactation is a rare disease that can cause osteoporotic vertebral compression fracture (OVCF). Patients usually complain of severe back pain, which is easily mistaken for pain due to pregnancy, childbirth, and lactation, making a rapid diagnosis and treatment difficult. The authors diagnosed OVCF related to pregnancy and lactation through a physical examination, simple radiography, whole-body bone scan, magnetic resonance image, bone marrow density, and blood tests in a 29-year-old female patient and a 31-year-old female patient who presented with low back pain. This paper reports two cases of symptom improvement through a teriparatide injection, wearing thoracic lumbar sacral orthosis and taking calcium and vitamin D with a review of the literature.

Effects of Simulation-Based Training on the Clinical Competence and Confidence of Nursing Students in Intravenous Injection Performance and the Satisfaction of Clients (시뮬레이션 기반 정맥주사 교육이 간호학생의 임상수행능력과 수행자신감 및 대상자 만족도에 미치는 효과)

  • Jeong, Hyeon-Cheol;Choi, Na-Young;Kim, Mi-Seon;Jeon, Mi-Yang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2600-2606
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    • 2012
  • Purpose: This study was conducted to examine the effect of simulation-based training on the clinical competence and confidence of nursing students in intravenous injection performance and the satisfaction of clients. Methods: This study employed a randomized control posttest non-synchronized design. The participants were 90 second-year nursing students(31 multimedia group, 28 IV model group, 31 IV computerized systems group) of S-University in Seoul, Korea. Each group was given 30 minutes for five trial injections, then the students performed intravenous injections on the back of hands of the clients, and the results were measured. Results: There were significant differences in competence of clinical performance among the three groups showed no significant differences in confidence before and after intravenous injections. While there was no significant difference in the satisfaction of clients among the three groups, there were significant differences in the satisfaction of clients resulting from the success or failure of intravenous injections(p=<.001). Conclusion: This study shows that simulation-base training contributes to the enhancement of competence and confidence of nursing students in clinical performance. It would be helpful to use various simulation-based training media as another choice of education in different fields.

Monitoring of Fracture Occurrence During Carbon Dioxide Injection at the Meruap Oil Reservoir, Indonesia (인도네시아 머루압 유전에 이산화탄소 주입 시 균열대 생성 여부 모니터링)

  • Kim, Dowan;Byun, Joongmoo;Kim, Kiseog;Ahn, Taewoong
    • Geophysics and Geophysical Exploration
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    • v.19 no.1
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    • pp.37-44
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    • 2016
  • $CO_2$-EOR (Carbon Dioxide-Enhanced Oil Recovery), one of the enhanced oil recovery methods, helps to not only enhance the production of oil, but also store carbon dioxide in underground. However, if micro fractures occur when during the injection of $CO_2$, it is difficult to make permanent storage of $CO_2$ in reservoir and can cause contamination of groundwater and soil. Therefore, in this study, we performed microseismic monitoring to investigate the occurrence of fractures during the $CO_2$ injection at the Meruap oil reservoir, Indonesia. To pick the first arrivals of microseismic events, Improved MER (Modified Energy Ratio) method was used. After picking the first arrivals, hodogram analysis was carried out by using the data recorded at three component geophones to calculate the back azimuth of events. Finally, locations of microseismic events were decided by using the results of first arrival picking and hodogram analysis. Estimated locations showed that all microseismic events were occurred at surface and any fracture did not occur around the reservoir. Moreover, by analyzing noise characteristic, we confirmed that almost of picked first arrivals were due to the repetitive mechanical noise.

Effects of Intake Gas Mixture Cooling on Enhancement of The Maximum Brake Power in a 2.4 L Hydrogen Spark-ignition Engine (수소 내연기관의 흡기 냉각 방법에 따른 최고 출력 향상에 관한 연구)

  • Kim, Yongrae;Park, Cheolwoong;Oh, Sechul;Choi, Young;Lee, Jeongwoo
    • Journal of the Korean Institute of Gas
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    • v.25 no.5
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    • pp.11-18
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    • 2021
  • Since hydrogen has the lower minimum ignition energy than that of gasoline, hydrogen could be also appropriate for the IC engine systems. However, due to the low ignition energy, there might be a 'back-fire' and 'pre-ignition' problems with hydrogen SI(Spark-ignition) combustion. In this research, cooling effects of intake gas mixture on the improvement of the maximum power output were evaluated in a 2.4 L SI engine. There were two ways to cool intake gas mixtures. The first one was cooling intake fresh air by adjusting inter-cooler system after turbocharger. The other one was cooling hydrogen fuel before supplying by using heat ex-changer. Cooling hydrogen was performed under natural aspired condition. The result showed that cooling fresh air from 40 ℃ to 20~30 ℃ improved the maximum brake power up to 6.5~8.6 % and cooling hydrogen fuel as -6 ℃ enhanced the maximum brake power likewise.