• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.257-266
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• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.112-115
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• 2021

Objective: This study was conducted to apply skin mobilization to patients with Axillary web syndrome following breast cancer resection and to see the resulting changes in pain and joint range of motion. Design: Single case study,pre-post comparison. Methods: The subject was a female patient in her 40s who performed a mastectomy after being diagnosed with breast cancer, and then complained of uncomfortable pain from the shoulder joint to the axilla and limited range of motion. To implement a skin mobilization, the palms were adhered to the inner half of the arm, the arms were raised to a pain-free extent, and skin mobilization was performed. The skin was pulled in the direction of axilla and kept for 5 seconds 10 times for a total of 2 sets. Immediate changes in range of motion and pain were identified. Results: Following skin mobilization, there was an immediate increase in range of motion (pre 116°, post 140°) and a decrease in pain (NRS pre 5, post 2). And also uncomfortable pain, which is hard to define in words, also seems to have improved. Conclusions: Skin mobilization, which considers skin mobility for patients with Axillary web syndrome, can be considered for improving range of motion and restoring function in patients with pain due to fibrous bands around veins and lymphatic vessels, and is recommended as a new intervention method not used as a conventional treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.7.1-7.7
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• 2015

Background: Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis. Methods: We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics. Results: A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement. Conclusions: We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.240-249
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• 2022

Background: Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods: Pressure-pain thresholds (PPTs) were measured on the right infraspinatus muscle. At the end of Day 0, all participants performed an eccentric exercise of the shoulder external rotators to induce muscle soreness 24 hours after. On Day 1, participants indicated on a body chart the area of pain induced by 60 seconds of suprathreshold pressure stimulation (STPS; PPT + 20%) on the right infraspinatus muscle. Skin temperature variations in the area of referred pain were recorded with an infrared thermography camera, immediately before and after the STPS. Results: Twenty healthy, pain-free individuals (10 females) participated. On Day 0, the pre-STPS temperature was higher than the post-STPS temperature on the arm (P = 0.001) and forearm (P = 0.003). On Day 1, the pre-STPS temperature was higher than the post-STPS temperature on the shoulder (P = 0.015), arm (P = 0.001), and forearm (P = 0.010). On Day 0, the temperature decrease after STPS in females was greater than in males on the forearm (P = 0.039). On Day 1, a greater temperature decrease was found amongst females compared with males at the shoulder (P = 0.018), arm (P = 0.046), and forearm (P = 0.005). Conclusions: These findings indicate that sympathetic vasomotor responses contribute to expand pressure-induced referred pain, especially among females.

• The Korean Journal of Pain
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• v.31 no.1
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• pp.43-49
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• 2018

Background: Chronic pain reportedly exerts complex effects on immune function. Natural killer (NK) cells are lymphocytes that play a critical role in cellular and innate immunity. This study examined changes in the subset populations and cytotoxic activity of peripheral blood NK cells in patients with chronic pain. Methods: Thirty patients with chronic moderate-to-severe pain (group P) and age-matched pain-free subjects (group NoP) were enrolled. Peripheral whole blood was analyzed for the percentage and expression of NK cell surface markers (CD56 and CD16) by flow cytometry. Cytotoxic activity was assayed by evaluating CD69 expression on $CD3^-/CD56^+NK$ cells. Results: The percentage of NK cells among total lymphocytes was not significantly different between groups P and NoP ($16.3{\pm}9.3$ vs. $20.2{\pm}10.5%$). Likewise, the percentages of two major NK cell subsets, $CD56^{bright}$ and $CD56^{dim}$, were also not significantly different between the two groups. However, the percentage of $CD56^{bright}/CD16^+$ subset, was slightly but significantly increased in group P ($1.0{\pm}0.9%$; P< 0.01) compared with group NoP ($0.5{\pm}0.6%$). The cytotoxicity of NK cells was not different between the two groups, showing similar CD69 expression (P vs. $NoP=29.2{\pm}15.2$ vs. $32.0{\pm}15.0%$). These findings were not influenced by pain intensity, opioid use, or disease causing pain in group P. Conclusions: NK cell cytotoxic activity and major subset populations, with the exception of an increased percentage of the $CD56^{bright}/CD16^+$ subset, are not significantly altered in patients with chronic severe pain.

• Journal of Oral Medicine and Pain
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• v.44 no.4
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• pp.147-153
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• 2019

Purpose: The aims of this study were to investigate the expectation of patients with burning mouth syndrome (BMS) and assess the relationship between patient expectations and clinical and psychological characteristics. Methods: Eligibility was retrospectively assessed on 93 patients with BMS. A total of five questionnaires on patients' expectation for a visit, pain, sleep quality (Pittsburgh Sleep Quality Index), cognition (Pain Catastrophizing Scale) and psychological distress (Symptom Checklist-90 revised) were measured. Results: Sixty-five patients were included in this study. The top 3 priorities of expectation for a treatment visit to the Department of Oral Medicine were as following; "I want my pain to be free"; "I want to understand why it hurts"; "I want to communicate better with doctors about pain". Patients with priority of pain relief showed poor sleep quality than patients who are more interested in the disease related information. Conclusions: To improve treatment outcomes of BMS, clinicians should improve their own understanding of patients who are suffering from BMS. Inquiring about the patient expectations may be one of them, and it would contribute to the enhancement of patients' overall well-being.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.43-48
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• 1994

Twenty seven patients with hemifacial spasm were treated by facial nerve block at the foramen stylomastoideum and O'Brien block from January 1992 to March 1994. There were 16 female and ll male patients, a 1.5:1 ratio respectively. Most patients were 40~60 years old. Among the 27 patients treated by nerve blocks, 26 responded well to the facial nerve block, including two cases of O'Brien block. One patient failed to respond to the facial nerve block. Induced facial palsy disappeared within one or two months within the majority of patients. Among the 26 patients who received nerve block, 6 patients required a second block within 3 to 9 months. After successful nerve block, all patients were free of spasm for 1 to 16 months. Although the follow-up period was short in duration, these results suggest that facial nerve block is a satisfactory and reliable method in the treatment of facial spasm.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1356-1362
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• 2005

The purpose of this study os to investigative the effect of Carrageenan-Induced Pain on lower limb muscle and ligament of rat. To evaluate pain mechanism in muscle and ligament, pain was induced by the injection of 2% $0.1m{\ell}$ carrageenan into the left lower limb muscle of rats after rats were anesthesized with 3% enflurane. Rats were killed on 72 hours after pain induction under the anesthesia. anterior rectus femoris muscle and its ligament were removed from rat hind limb. Morphological changes of them were peformed by the observation of light and electron microscopes. In the light microscopic findings, the muscle cells were polyheadral and situated with each other without small gap in control group. nucleus of cell was seen along the cell margin, and muscle cell groups were divided by regular narrow gap in cross section. In the pain-induced group, muscle cell groups were divided each other by the irregular gap, and some of groups formed larger than other cell groups by the fusion. Intercellular gap of most cell groups were increased compared with control groups. And also, perimysium of muscle cell groups was swollen in cross section. In control group, muscle cells contacted each other closely and each cell was divided by perimysium. The intracellular gaps were not seen between myofibrills, and also striations were well defined between muscle cells in longitudinal section. In pain-induced group, muscle cells were divided by the small intracellular gaps. And also, muscle cell showed many a short cross or longitudinal intercellular gaps in longitudinal section. In light microscopic findings of control group, tendon was composed with many tendon fibers contacted each other closely without gap. The free margin of tendon was fused, and apso the tendon fibers did not invaded between muscles. In pain-induced group, tendon was divided small groups by intertendinous gap, and also the margin of tendon divided by small groups. In the free margin, tendon invaded into muscle cells, and also fibroblasts between tendon fibers were long and lance-shaped. From these results, it is suggested that pain induction by carrageenan injured rat skeletal muscle and ligament by the morphological changes.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.144-148
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• 2006

Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.47-54
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• 2013

Background: Lateral epicondylitis is the most common complaint with complex etiological and pathophysiological factors on the lateral side of elbow. Taping techniques commonly used for lateral epicondylitis. The purpose of this study was to investigate the effects of mobilization with movement taping and diamond taping on the pain, grip strength and functional activity in patients with lateral epicondylitis Methods: Twenty patients with lateral epicondylitis (mobilization with movement taping group: n=10, diamond taping group: n=10) were recruited. They were evaluated pre-treatment, after 1weeks, and after 3weeks, using visual analog scale, pain free grip strength test, patient-rated tennis elbow evaluation. Results: Analysis showed statistcally significant improvement in all time in both groups. and The mean improvement in pre-1weeks visual analog scale was significantly greater in the Diamond taping group than that in the mobilization with movement taping group. and the mean improvement in pre-1weeks pain free grip strength test was significantly greater in the mobilization with movement taping than that in the diamond taping group. Conclusion: Taping technique to patients with lateral epicondylitis can help improve pain, grip strength, functional activity and initial taping technique can be selected depending on the patient's condition and the desired goal.