• Title/Summary/Keyword: persistent pain

Search Result 303, Processing Time 0.028 seconds

The Diabetic Frozen Shoulder: Arthroscopic Release (당뇨병성 동 견관절의 관절경 하 박리술)

  • Han Chang-Whan;Kim Jin-Young;Kim Weon-Yoo;Sung Jin-Hyung;Yoo Jae-Duk;Rho Sang-Hyun
    • Clinics in Shoulder and Elbow
    • /
    • v.2 no.1
    • /
    • pp.74-83
    • /
    • 1999
  • In diabetics, the frozen shoulder has been difficult to treat. They tend to respond poorly to manipulation. In this report we present the rationale and results of arthroscopic selective capsular release for those patients. Nine patients, who were diabetics, developed frozen shoulders which failed to respond to conservative management. They had persistent pain, stiffness, and limited function. An arthroscopic release was performed by progressively releasing the anterior structures from superior to inferior. Postoperatively physiotherapy was carried out daily to maintain the range of movement. At a follow up of 12 to 37 months the patients were assessed using the American Shoulder Society scheme. In addition, the patients were assessed preoperatively and postoperatively on four criteria: pain, external rotation, abduction and function. We found that the patients were statistically significantly improved in all four categories. Three of the nine patients had no pain, full range of motion compared with the opposite side and full function. There was one poor result of no improvement. The remaining five patients had improved but still had residual abnormalities. We consider arthroscopic release to be an effective treatment for the resistant diabetic frozen shoulder.

  • PDF

Facilitation of AMPA receptor-mediated steady-state current by extrasynaptic NMDA receptors in supraoptic magnocellular neurosecretory cells

  • Pai, Yoon Hyoung;Lim, Chae Seong;Park, Kyung-Ah;Cho, Hyun Sil;Lee, Gyu-Seung;Shin, Yong Sup;Kim, Hyun-Woo;Jeon, Byeong Hwa;Yoon, Seok Hwa;Park, Jin Bong
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.20 no.4
    • /
    • pp.425-432
    • /
    • 2016
  • In addition to classical synaptic transmission, information is transmitted between cells via the activation of extrasynaptic receptors that generate persistent tonic current in the brain. While growing evidence supports the presence of tonic NMDA current ($I_{NMDA}$) generated by extrasynaptic NMDA receptors (eNMDARs), the functional significance of tonic $I_{NMDA}$ in various brain regions remains poorly understood. Here, we demonstrate that activation of eNMDARs that generate INMDA facilitates the ${\alpha}$-amino-3-hydroxy-5-methylisoxazole-4-proprionate receptor (AMPAR)-mediated steady-state current in supraoptic nucleus (SON) magnocellular neurosecretory cells (MNCs). In $low-Mg^{2+}$ artificial cerebrospinal fluid (aCSF), glutamate induced an inward shift in $I_{holding}$ ($I_{GLU}$) at a holding potential ($V_{holding}$) of -70 mV which was partly blocked by an AMPAR antagonist, NBQX. NBQX-sensitive $I_{GLU}$ was observed even in normal aCSF at $V_{holding}$ of -40 mV or -20 mV. $I_{GLU}$ was completely abolished by pretreatment with an NMDAR blocker, AP5, under all tested conditions. AMPA induced a reproducible inward shift in $I_{holding}$ ($I_{AMPA}$) in SON MNCs. Pretreatment with AP5 attenuated $I_{AMPA}$ amplitudes to ~60% of the control levels in $low-Mg^{2+}$ aCSF, but not in normal aCSF at $V_{holding}$ of -70 mV. $I_{AMPA}$ attenuation by AP5 was also prominent in normal aCSF at depolarized holding potentials. Memantine, an eNMDAR blocker, mimicked the AP5-induced $I_{AMPA}$ attenuation in SON MNCs. Finally, chronic dehydration did not affect $I_{AMPA}$ attenuation by AP5 in the neurons. These results suggest that tonic $I_{NMDA}$, mediated by eNMDAR, facilitates AMPAR function, changing the postsynaptic response to its agonists in normal and osmotically challenged SON MNCs.

Effects of Audio-visual Entertainment and Soft Tissue Mobilization on Pressure Pain Thresholds, Psychophysiological parameters, and Brain waves in University Students with Tension-type Headache (긴장성 두통이 있는 대학생들에게 시청각적 엔터테인먼트와 연부조직 가동술이 압력통각역치, 바이오피드백, 뇌파에 미치는 영향)

  • Jung, Dae-In;Lee, Eun-Sang;Kim, Hyun-Joong
    • Journal of Korea Entertainment Industry Association
    • /
    • v.14 no.7
    • /
    • pp.539-548
    • /
    • 2020
  • TTH(tension-type headache) is the most common primary headache among adults. Long-term headaches cause chronic headaches and have a better impact on daily life. The purpose of this study is to compare the contributions to TTH through AVE(audio-visual entertainment) and STM(soft tissue mobilization) suitable for management of pathogenic and psychogenic factors of TTH. The participants of this study were from 30 people who complained of intermittent or persistent headaches for more than 6 months, and 10 participants each in the AVE group, STM group, and AVE plus STM group. In the assigned group, a total of 12 sessions were performed three times a week for 4 weeks after the baseline, followed by post-test. Outcome measures measured PPTs(pressure pain thresholds), psychophysiological parameters, and EEG(electroencephalogram). The measured results were analyzed for interaction between time and group through a two way rmANOVA(repeated measurement variance analysis). As a result of the PPTs, interaction was found in the results of the right trapezius (p<.05), and the more improvement was observed in the AVE group. Therefore, through AVE based on psychological factors rather than direct access to the muscles of pathogenic factors, a positive impact on the PPTs was shown, but the average value of the psychophysiological parameters and brain waves that were not statistically significant. The amount of change was observed. Through this, it is suggested that audio-visual stimulation could be considered in the management of TTH.

Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.6
    • /
    • pp.576-584
    • /
    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

Clinical Evaluation about the Immediate Implant Replacement after Tooth Extraction (발치 직후 시행된 즉시 임플란트 식립술에 관한 임상적 평가)

  • Yang, Eun-Young;Chun, Sang-Deuk;Rho, Jae-Hwan;Lee, Seung-Eun;Song, Jae-Chul;Chin, Byung-Rho
    • Journal of Yeungnam Medical Science
    • /
    • v.20 no.1
    • /
    • pp.45-52
    • /
    • 2003
  • Background: Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. Materials and Methods: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. Results: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. Conclusion: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.

  • PDF

Analysis about Associated Factors of Nonunion Following Tibiotalar Arthrodesis (경거골유합술 후 발생하는 불유합과 관련된 인자에 대한 분석)

  • Lee, Jun Young;Kim, Bo Sun;Lee, Jung Woo
    • Journal of Korean Foot and Ankle Society
    • /
    • v.21 no.3
    • /
    • pp.98-103
    • /
    • 2017
  • Purpose: The aim of this study was to analyze the factors related to nonunion in tibiotalar arthrodesis. Materials and Methods: Eighty cases of ankle arthritis treated with tibiotalar arthrodesis in our hospital from November 2008 to November 2015 with more than one year follow up were analyzed. Simple anteroposterior and lateral radiographs after 6 and 12 months of surgery were analyzed. Union was defined as more than 50% connection of the trabecular bone at the ankle joint surface in the anteroposterior and lateral radiographs. The nonunion group was defined as no signs of union with persistent pain 9 months after surgery. The surgical approach, type of used screw, preoperative and postoperative ankle alignment, body mass index (BMI), bone mineral density, and patients' prior history were compared between the two groups. Results: There were 69 union cases and 11 nonunion cases. In the patient factors, the gender and BMI was related to nonunion (p<0.05). The mean preoperative and postoperative ankle alignment in the nonunion group was $9.93^{\circ}{\pm}6.92^{\circ}$ and $5.43^{\circ}{\pm}3.35^{\circ}$ respectively, and $9.80^{\circ}{\pm}7.55^{\circ}$ and $5.63^{\circ}{\pm}3.45^{\circ}$ in the union group, respectively; the difference was not statistically significant (p>0.05). In the technical factors, the transfibular approach showed a better relationship but the association was not significant (p<0.05). In 40 cases of the transfibular approach, 12 cases used cancellous screws, and 4 cases showed nonunion due to screw breakage. Conclusion: Technical factors, such as the surgical approach and the type of screw used can be a risk factor in nonunion. In addition, patients' factors, such as gender and BMI, must be considered to reduce the nonunion rate.

Operative Treatment of the Tarsal Tunnel Syndrome Caused by Tarsal Coalition (족근골 결합에 의한 족근관 증후군의 수술적 치료)

  • Kwon, Duck-Joo;Park, Sang-Wook
    • Journal of Korean Foot and Ankle Society
    • /
    • v.11 no.2
    • /
    • pp.238-243
    • /
    • 2007
  • Purpose: Study was to evaluate the operative results for tarsal coalition with tarsal tunnel syndrome. Materials and Methods: From Jan. 2005 to Mar. 2006, among a number of patients who were diagnosed with tarsal tunnel syndrome caused by tarsal coalition and treated surgically, 5 patients were closely observed for more than 12 months. All cases were talocalcaneal coalition and there were two male and three female patients with a mean age of 36 years (22-50 years). We used the Takakura rating scale as clinical evaluation. Results: All five patients had a burning pain in the sole or extended to toes and showed positive Tinel's sign. Sensory disturbances were observed in the distribution of the medial plantar nerves in four patients and in the area of the medial and lateral plantar nerves in one. Atrophy and weakness of the plantar muscles were seen in two patients. The mean Takakura scale in preoperative and postoperative was 3.4 points (1 to 5 points), 8.6 point (6 to 10 points). The mean follow up was 14.4 months (12 to 16 months). The postoperative results were excellent in two patients, good in two and fair in one. As postoperative complications, there were persistent swelling in one patient and a flexion disturbance of Hallux in one. Conclusion: The coalition resection performed on tarsal tunnel syndrome caused by tarsal coalition could improve a level of pains and neurological symptoms significantly. However, since there were some undesirable complications, a detailed explanation to patients is required prior to surgical treatment and study of such complications may be required.

  • PDF

Cholelithiasis Complicated with Biliary Sludge and Urolithiasis in a Dog (개의 담낭 슬러지와 요 결석증을 동반한 담석증)

  • Lee, Seung-Gon;Kim, Dong-Gun;Lee, Joon-Seok;Kwak, Ho-Hyun;Nam, Hyun-Sook;Woo, Heung-Myong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
    • /
    • v.23 no.3
    • /
    • pp.325-328
    • /
    • 2006
  • A 10-year-old intact female Miniature Schnauzer dog was referred with the primary complaint of persistent anorexia, remittent fever, vomiting and abdominal pain. Hemogram suggested a chronic inflammatory disease. Serum biochemistry showed moderate hepatobiliary cellular damage with severe cholestasis. Abdominal radiography and ultrasonography revealed hepatomegaly, choleliths and sludges in gall bladder and small stones in urinary bladder. Based on diagnostic findings, the case was diagnosed as cholelithiasis complicated with biliary sludge and urolithiais. Using cholecystectomy and cystectomy, choleliths and uroliths were removed from gall bladder and urinary bladder, respectively. The clinical condition was dramatically improved after surgery.

Survival of Arcobacter butzleri under the heat and freezing storage (열처리와 냉장저장에 따른 Arcobacfer butzleri의 생존성)

  • Lee, Min-Hwa;Choi, Chang-Sun
    • Journal of Food Hygiene and Safety
    • /
    • v.26 no.1
    • /
    • pp.31-35
    • /
    • 2011
  • Arcobaeter butzleri is one of the aerotolerant Campylobaeter species which cause persistent diarrhea, abdominal pain, nausea and vomiting in human. The aim of this study was to determine the growth and survival of A. butzleri under the heat treatment or freezing storage condition. In heat treatment, two Korean isolates of A. butzleri were treated at 40 to $80^{\circ}C$ for various times. In freeze treatment, two Korean isolates of A. butzleri were kept at 4, -20 and $-70^{\circ}C$ from 1 to 15 d. The survivability of the A. butzleri Korean isolates significantly decreased at higher than $60^{\circ}C$ heating condition but it didn't show any significant difference in $40^{\circ}C$ treated group. Under the cold stress condition, survivability of A. butzleri were significantly decreased at $-20^{\circ}C$ storage. Like other foodborne pathogens, survivability of A. butzleri was controlled by heat and freezing treatment.

A Case of Retronychia on Toenail (발톱에 발생한 역행조갑 환자의 치험례)

  • Choi, Seok-Min;Kim, Chul-Han;Kang, Sang-Gue;Tark, Min-Seong
    • Archives of Plastic Surgery
    • /
    • v.37 no.2
    • /
    • pp.178-181
    • /
    • 2010
  • Purpose: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. Methods: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. Results: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. Conclusion: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.