• The Korean Journal of Pain
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• v.34 no.4
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• pp.509-533
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• 2021

Background: Postherpetic neuralgia (PHN) is a refractory complication of herpes zoster (HZ). To prevent PHN, various strategies have been aggressively adopted. However, the efficacy of these strategies remains controversial. Therefore, we aimed to estimate the relative efficacy of various strategies used in clinical practice for preventing PHN using a network meta-analysis (NMA). Methods: We performed a systematic and comprehensive search to identify all randomized controlled trials. The primary outcome was the incidence of PHN at 3 months after acute HZ. We performed both frequentist and Bayesian NMA and used the surface under the cumulative ranking curve (SUCRA) values to rank the interventions evaluated. Results: In total, 39 studies were included in the systematic review and NMA. According to the SUCRA value, the incidence of PHN was lower in the order of continuous epidural block with local anesthetics and steroids (EPI-LSE), antiviral agents with subcutaneous injection of local anesthetics and steroids (AV + sLS), antiviral agents with intracutaenous injection of local anesthetics and steroids (AV + iLS) at 3 months after acute HZ. EPI-LSE, AV + sLS and AV + iLS were also effective in preventing PHN at 1 month after acute HZ. And paravertebral block combined with antiviral and antiepileptic agents was effective in preventing PHN at 1, 3, and 6 months. Conclusions: The continuous epidural block with local anesthetics and steroid, antiviral agents with intracutaneous or subcutaneous injection of local anesthetics and a steroid, and paravertebral block combined with antiviral and antiepileptic agents are effective in preventing PHN.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.210-215
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• 2019

Background: This study was undertaken to evaluate early clinical outcomes of ultrasound-guided suprascapular nerve block (SSNB) using a proximal approach, as compared with subacromial steroid injection (SA). Methods: This retrospective study included a consecutive series of 40 patients of SSNB and 20 patients receiving SA, from August 2017 to August 2018. The visual analogue scale (VAS), American Shoulder Elbow Surgeon's score (ASES), University of California, Los Angeles score (UCLA), the 36 health survey questionnaire mental component summary (SF36-MCS), physical component summary (PCS), and range of motion (forward elevation, external rotation, and internal rotation) were assessed for clinical evaluations. Results: Compared with the baseline, VAS, and ranges of motion in the SSNB group significantly improved at the 4-week follow-up (VAS scores improved from $6.7{\pm}1.6$ to $4.3{\pm}2.4$, p<0.001; all ranges of motion p<0.05), while other variables showed no statistically significant differences. All clinical variables were significantly improved in the SA group (p<0.05). However, all clinical scores at the 4-week follow-up showed no significant difference between groups. Conclusions: Ultrasound-guided SSNB using proximal approach provides significant pain relief at 4-weeks after treatment, with statistically significant difference when compared with SA, suggesting that SSNB using proximal approach is a potentially useful option in managing shoulder pain. However, in the current study, it was less effective in improving shoulder function and health-related quality of life, compared with SA.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.78-84
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• 1989

Steroid and local anesthetics were injected into the epidural space through the posterior sacral foramen or lumbar approach in 4 patients for the purposes of relieving severe low back pain and radiculopathy. These patients were referred from other sections dealing with low back pain and radiculopathy, because one could not tolerate the surgical stress due to a heart problem, another two did not want the operation and the last had post-laminectomy status. All patients were satisfied with the results subjectively.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.1-14
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• 1983

The most common cause of the decannulation difficulty is the trauma. This may be accidental, iatrogenic such as prolonged intubation, high tracheostomy, secondary infection, formation of granulation tissue, improper use of cannula and wide resection of anterior tracheal wall. Another common cause is psychologic dependency. Treatments may be categorized into dilatation with or without injection of steroid, dilatation and prolonged stent, luminal augmentation and resection of the stenosis with primary reanastomosis. Recently authors experienced a case of the decannulation difficulty in a 2 - year - old which was developed after tracheostomy for the removal of bronchial foreign body and was treated with a silicon T -tube stent with good result.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.10-13
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• 2008

Purpose: To evaluate the efficiency of needling and injection technique without steroid for symptomatic calcific tendinitis of the shoulder. Material and Methods: We chose 12 symptomatic calcific tendinitis patients, whose ages ranged from 35 to 64. Procedure ware dry needling and injection of prolotherapic agent near the lesion. Results: All the case revealed prominent improvement without limitation of shoulder function, especially in active painful stage. Conclusion: Sonographic injection technique for calcific tendinitis would be one of the good modality not only for symptomatic relieve but also good functional recovery.

• Archives of Plastic Surgery
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• v.42 no.1
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• pp.68-72
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• 2015

For recent years, use of autologous fat injection has increased significantly in facial contouring surgery. Along with such increase in use, complications like atypical mycoplasma infection have been also on the increasing trend. The authors report two cases of Mycobacterium chelonae infection that occurred after autologous fat injection. Patients were treated as infection that resistant to common antibiotics and results were negative to routine culture and Gram staining. Acid-fast bacillus stain, polymerase chain reaction (PCR) test and mycobacterial cultures were conducted for diagnosis under suspicion of atypical mycoplasma infection. Then, combination antibiotics therapy, surgical treatment, and steroid injection were performed for treatment. Both patients were diagnosed with Mycobacterium chelonae in PCR test. They were positive to mycobacterial cultures. Combination antibiotics therapy was repeated to improvement of symptom. However, they could not be free from side effects such as deformation in facial contour, scar and pigmentation even after full recovery. When chronic wound infections after autologous fat injection, we must suspect atypical or mycobacterial infection and conduct examinations for a early diagnosis and proper antibiotic therapy that is effective to the nontuberculous mycobacteria.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.18-23
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• 2010

Background: Complications following lumbar transforaminal epidural injection are frequently related to inadvertent vascular injection of corticosteroids. Several methods have been proposed to reduce the risk of vascular injection. The generally accepted technique during epidural steroid injection is intermittent fluoroscopy. In fact, this technique may miss vascular uptake due to rapid washout. Because of the fleeting appearance of vascular contrast patterns, live fluoroscopy is recommended during contrast injection. However, when vascular contrast patterns are overlapped by expected epidural patterns, it is hard to distinguish them even on live fluoroscopy. Methods: During 87 lumbar transforaminal epidural injections, dynamic contrast flows were observed under live fluoroscopy with using digital subtraction enhancement. Two dynamic fluoroscopy fluoroscopic images were saved from each injection. These injections were performed by five physicians with experience independently. Accuracy of live fluoroscopy was determined by comparing the interpretation of the digital subtraction fluoroscopic images. Results: Using digital subtraction guidance with contrast confirmation, the twenty cases of intravascular injection were found (the rate of incidence was 23%). There was no significant difference in incidence of intravascular injections based either on gender or diagnosis. Only five cases of intravascular injections were predicted with either flash or aspiration of blood (sensitivity = 25%). Under live fluoroscopic guidance with contrast confirmation to predict intravascular injection, twelve cases were predicted (sensitivity = 60%). Conclusions: This finding demonstrate that digital subtraction fluoroscopic imaging is superior to blood aspiration or live fluoroscopy in detecting intravascular injections with lumbar transforaminal epidural injection.

• 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.

• Animal cells and systems
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• v.11 no.2
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• pp.117-124
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• 2007

The present study demonstrates the changes in body weight (BW) and plasma sex steroid hormone profiles during artificial maturation induced by human chorionic gonadotropin (HCG) or salmon pituitary extract (SPE) injections in cultured eel, Anguilla japonica, kept in seawater for 3 months. In the weekly SPE-injected female group, BW was relatively stable during vitellogenesis. Following induction of vitellogenesis, females exhibited a rapid increase of BW, and the oocytes were observed to be in the migratory nucleus stage at the end of the experiment. Plasma testosterone (T) and $estradiol-17{\beta}$ ($E_2$) levels increased slightly during vitellogenesis and peaked at an average of 5.82 ng/mL and 4.76 ng/mL, respectively, at the end of the experiment. In the weekly control and HCG-injected female groups, BW slowly decreased during the experimental period, and the oocytes of the two groups were observed to be at the primary yolk globule stage. In the weekly HCG-injected female group, plasma T and $E_2$ levels increased slightly during vitellogenesis and decreased afterward. In the control female group, however, plasma T and $E_2$ levels were not altered during the experimental period. Furthermore, plasma $17{\alpha},20{\beta}-dihydroxy-4-pregnen-3-one$ (DHP) was not detected in all experimental groups. Fertility and hatching rates of SPE-injected females were significantly higher in those that ovulated 15 h after DHP injection than 18 h. These results indicate that long rearing in seawater increases responsiveness to SPE in ovarian maturation of the Japanese eel, resulting in shortened period from completion of vitellogenesis by sex steroid hormone production.

• Journal of Pharmacopuncture
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• v.4 no.2
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• pp.35-47
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• 2001

Objectives : Through the literatures on the effets of Bufonis Venenum, we are finding out the clinical possibility and revealing the more effective to intractable diseases. Methods : We investigated the literatures of Oriental Medicine and experimental reports about Bufonis Venenum. Results : 1. Bufonis Venenum is made of bufonidae bufo bufo gargarizans cantor or bufo melanostictus schneider of white serum which secreted from parotid gland or dermato gland, and it is dried for using. 2. In oriental medicine, Bufonis Venenum has been mainly used on the tumors, cacanthrax and dermatic disease, and then it has been clinically used on infantile athrepsia, tetanus, sore throat, toothache, and so on. 3. The pharmacological effects of Bufonis Venenum are cardiotonic, respiration stimulation, depressor or vasopressor, topical anesthcsia, hallucination, striped muscle stimulation, antiasthmatic, antibacterial, antiinflammatory, anticancer, diuretic, immuno effects, etc. 4. Bufonis Venenum is largely divided in ether binding steroid compound, hydroxyl steroid compound, carboxyl or aldehyde steroid compound, indole compound, and adrenaline, cholesterole, etc. 5. Symptoms of Bufonis Venenum poisoning in digestive system are vommitig, abdominal pain, diarrhea, dehydration, in circulatory system are palpitation, shock, bradycardia, in nervous system are vertigo, somnolentia, muscle-tendon reflex weakness, and critical conditions to tissue necrosis and heart attack. 6. Ways to treat Bufonis Venenum poisoning include gastric irrigation with $0.2~0.5\%$ potassium permanganate fluid and atropine $0.5{\sim}1.0mg$ subcutaneous injection. From the chinese book of Bon Cho Gang Moke(本草綱目), if white serum of Bufonis Venenum enter the eyes, it happens the edema and pain. And then washed the eyes by juice of Lithospermi Radix(紫草) that the edema is removed. Conclusions and Discussion : The results from above literary studies show that prescriptions and Aqua-acupuncture of Bufonis Venenum could be clinically used to sedative, anticonvulsant, antibacterial, antiinflammatory, anticancer and topical ataralgesia. However it is expected that pharmacological and side effects of Bufonis Venenum are further studied.