• The Korean Journal of Pain
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• v.6 no.2
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• pp.192-198
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• 1993

In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.16-20
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• 1997

Background : Hemifacial spasm commonly occurs on muscles about the eye, but may also involve or spread to the entire side of the face. There are many treatment for facial spasm, such as neuro-vascular decompression, local injection of Botulium toxin, facial nerve block at stylomastoid foramen, facial nerve block with O'Brien method. The present study was aimed to investigate the effects of facial nerve block with O'Brien method. Methods : Forty five patients with hemifacial spasm were treated by facial nerve block with O'Brien method from January 1996 to February 1997 We reviewed the charts, retrospectively. Results : Sex ratio was 1:1.7(17 male : 28 female patients). Most patients were 40~60 years old. Most patients well tolerated facial nerve block. Three patients failed to respond to the facial nerve block. We repeated the procedure within one week. Among the 45 patients who received nerve block, 35 received repeated block; 7 patients received second repeat block, 2 patients received third repeat block. After successful nerve block, all patients were free of spasm for 1 to 6 months. Average spasm-free period was 3.5 months. Conclusion : Although the spasm-free period was short, these results suggest facial nerve block with O'Brien method is a safe and comfortable method for treatment of facial spasm.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.51-54
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• 1990

There are many methods for treatment of post-herpetic neuralgia (PHN) and of these, epidural steroid or intralesional steroid injection is one of the most effective treatments. But there are some problems in the use of steroids. One of which is steroid-induced hyperglycemia. In that case, the treatment of PHN is very difficult and not so effective. So we used the low level laser therapy (LLLT), He-Ne and IR, for the treatment of post-herpetic neuralgia without any changes of blood glucose level. It seemed that LLLT was a very effective method for PHN without any systemic changes.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.88-91
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• 1994

Headache, like low back pain, is one of the most common of pain conditions. Many data suggest that nerve block can be one of effective treatments in managing headache except pure psychologic or surgical origin, because mechanism of headaches have neurologic, vascular or local tissue pathology. We experienced two types of headache; episodic tension-type headache, and benign exertional headache; successful treatment consist of nerve block and modulation of exercise, respectively.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.45-50
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• 2006

Background: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. Methods: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. Results: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. Conclusions: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.407-411
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• 1996

Stereotactic radiofrequency dorsal root ganglionotomy can be very useful procedures for the treatment of pain emanating from the lumbar segmental nerves. This procedure is reserved for patients who have failed conservative interventional treatments and in whom open surgical intervention is not an option. The advantages of the radiofrequency lesion method are presented, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The afferent fibers in the ventral root which are spared by dorsal rhizotomy but nerve fibers with their cells in the ganglion from either dorsal or ventral root can be destructed with stereotactic radiofrequency ganglionotomy. This technique is performed using a 100 mm cannula with a 5 mm active tip. Repeated lateral fluoroscopic view should be taken to make sure that cannlua still resides within the superior, dorsal quadrant or the foramen. With the cannula in this position, electrostimulation is performed and good paresthesia on the leg should be noted with 0.3 and 0.5 volt at 50 Hz stimulation. At 2Hz stimulation distinct dissociation between motor and sensory should be shown. Percutaneous lumbar ganglionotomy have carried out under local anesthesia on inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have been relieved of pain without serious complications.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.287-291
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• 1994

A 49 years old male patient was admitted to our neuro-pain clinic with symptoms of left 11th intercostal neuralgic pain and low back pain that developed 2 months prior to admission. Upon initial physical examination, motor weakness or sensory deficit were absent. Intercostal neuralgic pain improved significantly after we performed thoracic root thermocoagulation. However on the afternoon of the procedure the patient started to experience voiding difficulty, saddle anesthesia and rapidly progressing motor weakness and hypoesthesia that involved the lower back area and the lower extremities for three days. Based on these symptoms spinal cord compression was suspected and subsequently plain T-L spine X-rays and T-L spine MRI were performed. A spinal tumor that appeared metastatic in origin was seen at the T11 and T12 level. Liver ultrasonography demonstrated the presence of a $4{\times}4cm$ sized ill defined mass in the posterior segment of the right lobe. The patient was diagnosed to have hepatocellular carcinoma after needle aspiration biopsy and cytologic studies. Further orthopedic surgery was recommended but as the patient rejected any further treatment and examination, it was not possible to confirm the primary focus of the tumor. However as metastasis of a primary liver tumor to the spine is a rare occurrence, some other primary focus of metastasis or even a malignant primary tumor of the spine is more likely to explain this patient's condition.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.140-144
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• 1996

Electrical stimulation is a common method for successful pain management for both acute and a some cases of chronic pain. The incidence of cervical sprain is very high with automobile accidents. Treatment of cervical sprain is consists of analgesic drugs and physical therapy. Lower back pain is a common problem in pain clinics. back pain management are complex, so we have difficulty to choose best treatment modality. The prevalence of herniated lumbar disc(HLD) is 1~3% of lower back pain. The cases of laminectomy varies between 10~20% and postoperative pain is prolonged for several day. We applied Acupuncture like TENS (ALTENS) on the digit for cervical sprain patients and post laminectomy pain patient for three days. The result was very satisfactory. And we found that total hospital days in ALTEND groups are shorter than control group in both disease entities. In conclusion, acupuncture like TENS on finger control gate is an effective method of the pain management.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.127-130
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• 1997

A 67-year old man with a history of cardiac disease underwent epidural catheterization for pain control of postherpetic neuralgia. Patient had severe back pain and pus discharge at catheter insertion site after dischange from medical part. Patient received anticoagulant therapy with $Aspirin^{(R)}$ and $Coumadin^{(R)}$ prescribed for 15 days in medical part. Magnetic resonance imaging(MRI) showed a diffuse $T_{4-7}$ anterior epidural mass compressing the spinal cord. Emergency surgical exploration revealed a thoracic epidural hematoma without abcess formation. Operation was successful and patient recovered satisfactory without any sequelae.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.130-133
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• 2000

Epiduroscopy is a new imaging and invasive technique that has become increasingly popular in the diagnosis and therapy of spinal pain syndrome. However, the risk of epiduroscopy is a major concern due to its invasiveness. The complications include hematoma, infection, neural damage, cardiac failure and raising of intracranial pressure. We have experienced a case of severe diffuse headache and dizziness following 1 day after epiduroscopy. Emergent brain MRI finding has no remarkable sign. The patient was admitted for 5 days to be treated with bed rest, adequate hydration and pain control with analgesics. After the treatments, she was recovered without residual sequelae and discharged. We need to take greater care of the undesirable effects detected intra- and post epiduroscopy, especially sign of increased intracranial pressure. Therefore, close monitoring of intracranial pressure is necessary during epiduroscopy.