• Journal of ILASS-Korea
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• v.18 no.4
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• pp.176-181
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• 2013

In this study, injection quantity, rate and spray image of multiple injections which are important design parameters for a piezo type injector have been investigated. Interval of injections and a number of injections in multiple injection strategy has been controlled to verify interaction of each injection. Spray characteristics of multiple injections have been researched through optical process with a high speed camera in a high pressure chamber. In addition, a method of RMS(Root Mean Square) process has been used for comprehending the distribution of injection easily. As a result, in case of piezo type injector, characteristics of injection quantity according to charging voltage and the difference of injection quantity between single and triple injection were confirmed. Also, injection rate for increasing injection duration was confirmed. And spray characteristics of multiple injections were improved; multiple injections were possible in a shorter time interval between each injection. With this study, a possibilities of more accurate multiple injection control would be expected.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.93-97
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• 2021

Background: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon. Methods: Seven upper limb specialists, two general orthopedic specialists, and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye. Results: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral. Conclusions: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.185-195
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• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.72-76
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• 2006

Background: The objective of this study was to describe the extent of pain relief after an epidural steroid injection in the patients suffering from chronic low back pain from herniated disks or lumbar spinal stenosis. Methods: The study was prospectively designed for patients suffering with lumbar spinal stenosis (LSS) and herniated disks (HD) who were referred to a hospital-based pain clinic for epidural steroid injections (ESI). The pain was assessed with using a visual analog scale at baseline, two weeks after the first ESI and two weeks after the third ESI. Results: Eighty patients were enrolled, and all of them provided pain ratings before and after the injections. The LSS patients seemed to improve less than did the HD patients. The results showed no significant differences in the triamcinolone dosage and the frequency of injections for determining the efficacy of ESI. Conclusions: The LSS patients tended to have a less effective respond to ESIs than did the HD patients. The unsatisfactory response to ESI by the LSS patients underscores the need for randomized controlled trials of performing ESI in this population.

• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.11-17
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• 2017

Purpose: To determine the effects of neck and back touch on Ultrasonic Vocalization (UV) and the Rat Grimace Scale (RGS) in rats touched by the human hand as an intervention for reducing pain and anxiety associated with intramuscular injections. Methods: This study was a randomized, controlled, pre-test/post-test design study. Twenty male Sprague-Dawley rats were assigned to either the experimental or control groups (n= 10 rats/group). The experimental group was touched in a manner similar to massaging the rat's neck and back twice a day for one week. The two groups received two intramuscular injections. The 22kHz and 50kHz UV and the RGS scores were measured before and after each intramuscular injection. Results: The 22kHz UV and RGS score were significantly higher in the control group than in the experimental group when the first intramuscular injection was administered; whereas, no difference between the experimental and the control groups were observed when the second intramuscular injection was administered. There was no statistical difference in the 50kHz UV between the two groups when the first and second injections were administered. Conclusion: This study found that touching was an effective intervention method to reduce negative emotions and pain in rats receiving their first intramuscular injection.

• The Korean Journal of Pain
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• v.23 no.3
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• pp.202-206
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• 2010

Magnetic resonance image (MRI) is the most sensitive imaging test of the spine in routine clinical practice. Unlike conventional x-ray examinations and computed tomography scans, high-quality magnetic resonance images can be assured only if patients are able to remain perfectly still. However, some patients find it uncomfortable to remain still because of pain. In that condition, interlaminar cervical epidural injections can reduce pain and allow the procedure. When using air with the "loss of resistance" technique in epidural injections to identify the epidural space, there is the possibility of injected excessive air epidurally to mimic a herniated disc. We describe a case report of epidural air artifact in a cervical MRI after cervical epidural injections.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.340-343
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• 2017

Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient's clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.112-117
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• 2014

Local steroid injections are widely used for diagnostic and therapeutic purposes in the management of carpal tunnel syndrome. The median nerve injury is the most serious complication in association with carpal tunnel injections although the incidence is low. A median nerve injury will be presented with shooting pain at the injection time along with other sensory distortion, motor weakness and muscle atrophy. The management includes a conservative treatment and a surgical exploration. Carpal tunnel injections should be used at a minimum only. If such steroid injection is required, an appropriate needle positioning is vital for the nerve injury prevention. The patient should not be heavily sedated and should be encouraged to inform experiences of numbness/paresthesia during the procedure immediately.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.132-136
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• 2021

Local anesthetic (LA) injection outside the sheath in epineural or paraneural connective tissue is considered safe practice among regional anesthesiologists. There is limited evidence as to whether neurological complications occur if LA is injected inside the sheath (subepineural - intraneural). We performed ultrasound guided injections at the level of undivided sciatic nerve in four amputated lower limbs. In two specimens, LA was injected in epineural connective tissue (paraneural tissue) and in another two specimens by penetrating the outer nerve sheath (hyperechoic epineurium). Ultrasonography demonstrated an increase in the size of nerve and macroscopic findings revealed fascicular tracings with sub-epineural injections. Limbs were sent for histological analysis in formalin containers. Pathologist performed the analysis which demonstrated an intact perineurium and a breach in the epineurium. We conclude that sub-epineural injections are unsafe and injection should be done in paraneural tissue to ensure safety and avoid unwanted neurological sequelae after the block.

• Journal of ILASS-Korea
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• v.27 no.2
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• pp.101-108
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• 2022

Performance and emissions with different diesel injection methods were analyzed in a natural gas-diesel, dual-fuel engine under low-load conditions. Natural gas was supplied to intake port during the intake stoke to form a natural gas-air premixed mixture for all methods. Diesel was injected directly into the cylinder during the compression stroke in three ways: early injections, late injections, and a combination of early and late injections. The early injections had the highest thermal efficiency among the three methods owing to its highest combustion efficiency. The wide dispersion of diesel before the combustion initiation also allowed superior emissions characteristics.