• The Korean Journal of Pain
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• v.22 no.1
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• pp.83-87
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• 2009

Case reports after accidental subdural injection during attempted epidural block have usually described extensive neuraxial blocks with a characteristic radiographic appearance on contrast injection. We experienced a case of cervical subdural injection with unusual clinical findings and radiographic appearance. A 51-year-old female patient with central herniated nucleus pulposus at cervical (C5/6) and lumbar level (L4/5, L5/S1) was referred to the pain clinic. During attempted cervical epidural block at the C6/7 interspace with fluoroscopy, injection of the 4 ml contrast showed posterior spread at cervical level. After cervical epidural steroid injection, the contrast was also confined to the posterior aspect of the spinal canal at lumbar level with fluoroscopy. In order to discriminate subdural space from epidural space, we performed transforaminal epidural injection of the 2 ml contrast at the L5/S1 interspace and we could confirm cervical epidural injection was made into the subdural space. We discuss the clinical characteristics of a subdural injection and the appearance of the cervical and lumbar subdurogram.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.3
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• pp.143-152
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• 2019

Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.218-221
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• 2005

This report describes a case of dizziness in a patient with trigeminal neuralgia that was caused by a vestibular schwannoma. A 60-year-old man with a history of pain on his left cheek, chin, molar and tongue for 5 months was diagnosed as suffering with trigeminal neuralgia of the left mandibular nerve, and this was caused by a left vestibular schwannoma. The diagnosis of the tumor was confirmed with magnetic resonance imaging (MRI), and so gamma knife surgery was performed 1 month later. At that time, the patient had been referred to the pain clinic due to allodynia on the tongue and gingival, and hypesthesia was also present on the left half of the face. Trigeminal nerve block with dehydrogenated alcohol and stellate ganglion block with 1% mepivacaine were performed and oral medication with diphenylhydantoin was started. The symptoms were alleviated after nerve block and oral medication. Dizziness, blurred vision and ataxia then developed from the 13th hospital day. We considered the symptoms as a side effect of diphenylhydantoin and we reduced the dose of diphenylhydantoin. However, the symptoms grew worse. Another brain MRI showed a slight increase of the tumor size and a mass effect with displacement of the adjacent organs, and hydrocephalus was also noted. This case shows the importance of considering the secondary symptoms that are due to brain tumor while treating trigeminal neuralgia. The changes of the brain tumors should also be considered along with the presence of new side effects.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.159-163
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• 2008

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.20-24
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• 2016

Background: Extracorporeal shock wave therapy (ESWT) is one of the treatment options used for patients with myofascial pain syndrome (MPS), although its effectiveness is controversial. The purpose of this study was to evaluate the effectiveness of ESWT in the treatment of MPS in terms of pain relief and functional improvements. Methods: We assessed 93 patients with MPS who underwent ESWT from March 2009 to July 2014. After exclusion of 25 patients with shoulder diseases, 68 patients were enrolled in the study. The mean follow-up period was 7.5 months (${\pm}4.2weeks$), and the average duration of symptoms was 5 months (range, 2-16 months). ESWT was applied to intramuscular taut bands and referred pain areas once a week for 3 weeks. Visual analog scale (VAS) pain scores and American Shoulder and Elbow Surgeons (ASES) scores were obtained at an initial assessment and at the 6-week, 3-month, and 6-month follow-up assessments. Results: VAS pain scores and ASES scores improved significantly after 3 sessions of ESWT (p<0.05). Both scores were improved, although not significantly, after 6 weeks (p>0.05). Conclusions: ESWT is an effective treatment option for patients with MPS.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.270-277
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• 2014

Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.

• Journal of Haehwa Medicine
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• v.10 no.1
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• pp.395-415
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• 2001

A general concept of Geun includes the soft organizations such as a muscle, a myofascia, a tendon and a ligament, cartilages and nerves that surround it. The main function of it is a movement of the body such as a flextion and a extension, a connection of the joints, and a construction of the body shape. Lately, we consider Geun important little by little, develop a variety of the therapeutic measures which make use of it, and apply it to the treatment in the oriental medicine, And the therapeutic measures which utilize Geun will be developed from now on. Therefore, this study reviewed and analyzed the direction of the research referred to Geun in the oriental medicine and the tendency to the experiment to grow the study referred to Geun in oriental medicine continuously and developed the new direction. This study collected 44's theses reported in the oriental medical journal and analyzed in accordance with the journal, time, form and topics. The following results were obtained in this study; 1. In the theses referred to Geun, the journal of Korean acupuncture & moxibustion society and of Korean oriental medicine have the most of them(11's theses) and at the next the journal of oriental rehabilitation medicine has 9's theses. 2. By analyzing the form of the theses, these were classified into the theoretical, experimental and clinical studies. The theoretical these occupied 39%, the experimental theses 54%, and the clinical theses 7%. 3. By analyzing the theses referred to Geun, these were classified into the muscular abnormality - such as a powerlessness, a injury, a atrophy, a disorder, and a pain - the theory of muscles along the regular meridians, the muscular organization, the therapeutic measures, the manipulation and so on. 4. The theses of the muscular abnormality occupied 30% of them referred to Geun and the theory of muscles along the regular meridians 20%, the muscular organization 12%, the therapeutic measures 12%, and the manipulation 8%. According to the above results, the study of the new field referred to Geun and the clinical report are indispensable since the field is limited and the tendency is theoretical and experimental.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.43-46
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• 2004

Two cases of trichobezoar with unusual presentation in female children are described. The first case is a 7-year-old female with a 3-day history of abdominal pain, obstipation, and emesis. She developed intestinal obstruction and showed double bezoars in the stomach and intestine respectively. She had been in a habit of biting or sucking hairs before sleeping from infancy until 5 years of age. The other patient is a 6-year-old girl referred for an epigastric mass, emotional disturbance and trichotillomania. In spite of the psychological treatment, 4 laparotomies were necessary due to repeated recurrences.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.447-455
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• 1998

A 42-year old male patient was referred to the Department of Oral Medicine, Kyungpook National University Hospital due to the chief complaint of limite mouth opening. Three years ago, the patient was diagnosed as an infarction of both cerefellar hemispheres, acute obstructive hydrocephalus and acute epidural hematoma of frontal lobe at the department of neurosurgery.Both of the infarcted cerevellar hemispheres and the epidural hematoma of frontal lobe were removed with suboccipital and frontal craniectomu. After the brain surgery jaw opening range was decreased progressively and ultimately mouth opening became almost impossible. Spasmodic and rhythmic contractions of the masseter muscles occurred intermittently during daytime as well as sleeping. Food intake was available only through Levin -tube. Actibe jaw opening exercise was prescribed with the aids of tongue blades. A moist hot pack and indomethacin phonophesis were also applied 20 minutes three times a day to decrease discomfort muscle activities. After a month of treatments, the opening range was increased to 5mm at the premolar area and oral food intake was possibel. The L-tube was removed and the patient was discharged.

• Journal of Oral Medicine and Pain
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• v.8 no.1
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• pp.61-67
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• 1983

Authors observed a corpse which is died from "Charring", caused by air disaster, for the purpose of individual identification. This is an identifide case of the charred corpse due to the fire while landing of KAL 747 Jumbo(HL 7445) at Kimpo airport Nov.1980. It was referred to author in the state of carbonization by high degree of heat-as unknown body entirely. But teeth condition and treated condition were well preserved under mouth closing and by the comparative examination of antermortem dental records, dental radiographs, the individual identification was simply accomplished. Therefore, it brought repeatedly a recognition of the practical effectiveness of dental identification and importance or dental records.