• The Korean Journal of Pain
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• v.18 no.2
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• pp.151-155
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• 2005

Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.54-62
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• 2018

Background: The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery. Methods: This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery. Results: Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups. Conclusion: Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

• The Korean Journal of Pain
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• v.25 no.1
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• pp.55-59
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• 2012

Lumbar spinal stenosis is a commonly treated with epidural injections of local anesthetics and corticosteroids, however, these therapies may relieve leg pain for weeks to months but do not influence functional status. Furthermore, the majority of patients report no substantial symptom change over the repeated treatment. Utilizing balloon catheters, we successfully treated with three patients who complained persistent symptoms despite repeated conventional steroid injections. Our results suggest that transforaminal decompression using a balloon catheter may have potential in the nonsurgical treatment of spinal stenosis by modifying the underlying pathophysiology.

• Journal of Korean Foot and Ankle Society
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• v.25 no.1
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• pp.32-37
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• 2021

Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• Journal of Oral Medicine and Pain
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• v.49 no.2
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• pp.29-34
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• 2024

Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.166-178
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• 2024

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

• Journal of Industrial Convergence
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• v.3 no.2
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• pp.73-84
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• 2005

Musculoskeletal Disorders are usually caused or aggravated by poor work processes and unsuitable working conditions - that involve repetitive or forceful movements or the maintenance of constrained or awkward postures. The condition is characterized by discomfort and persistent pain. Case and Demographic Characteristics for Work-related Injuries and Illnesses Involving Days Away From Work, 2003. U.S" was examined. Causes of musculoskeletal disorders for assembly line workers were carpal tunnel syndrome(CTS), tendonitis, low back pain, and occupational stress. Recommendations of improvement for productivity are redesign of working conditions, exercise, prevent of musculoskeletal disorders and avoiding stress.

• Journal of Industrial Convergence
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• v.6 no.1
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• pp.3-16
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• 2008

Musculoskeletal Disorders are usually caused or aggravated by poor work processes and unsuitable working conditions - that involve repetitive or forceful movements or the maintenance of constrained or awkward postures. The condition is characterized by discomfort and persistent pain. An investigation on the risk factors of musculoskeletal should have done one time per three years. Cause of musculoskeletal disorders for assembly line worker was a low back pain(LBP). Recommendations of improvement for productivity are redesign of working conditions, exercise, prevent of musculoskeletal disorders and avoiding stress.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.94-97
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• 2013

Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the $1^{st}$ and $4^{th}$ (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.