• 대한장애인치과학회지
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• 제11권1호
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• pp.9-16
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• 2015

Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

• Journal of Acupuncture Research
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• 제18권1호
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• pp.50-60
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• 2001

In order to review the studies related to the facial pain by acupuncture, we have referred to a PubMed site by using MeSH searching word of "facial pain and acupuncture". 12 journals with 20 papers were reported on the facial pain and acupuncture. Among them, 4 papers were appeared in Am J Chin Med, 3 in Acupunct Electrother Res, 2 in Br. Dent J, J Orofac Pain and Swed Dent J respectively, and 1 in 7 journals respectively. According to the classification of the patterns, 15 papers were done by clinical studies, 2 by review and meta-analysis respectively, and 1 by experimental study. TMD was the most disease that related to facial pain and CMD, neurogenic facial pain (trigeminal neuralgia, postherpetic pain), dental pain and MPS were also appeared. Most of the studies didn't mention the acupuncture points, L14 Habkok in 4 papers and ST36 Chogsamni in a paper were only mentioned. Various modalities were applied in the trials such as classical acupuncture, electroacupuncture, TENS, SSP and auricular acupuncture. By the above results, we concluded that various acupuncture techniques are used with effectiveness on the facial pain. It would be needed further research on the acupuncture point specific and therapeutic techniques as well.

• The Korean Journal of Pain
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• 제19권2호
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• pp.282-284
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• 2006

Percutaneous radiofrequency thermocoagulation has been applied in patients with various forms of chronic pain, such as facet joint pain, cancer pain and trigeminal neuralgia. A major portion of the hip joint is innervated by the articular branches of the femoral and obturator nerves. Radiofrequency thermocoagulation of the articular branches of the obturator and femoral nerves can be a good alternative treatment for patients with hip joint pain, especially in those where surgery is not applicable. A patient suffering hip joint pain due to metastatic cancer underwent multiple radiofrequency lesioning of the femoral and obturator nerves at $80^{\circ}C$ for 120 seconds, using a Racz-Finch Kit. The patient experienced about a 50% reduction in the pain, without any numbness or other side effects.

• The Korean Journal of Pain
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• 제8권1호
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• pp.164-167
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• 1995

대상포진후 신경통으로 체성신경 차단과 함께 성상신경절 차단을 반복적으로 받아오던 64세 여자환자에서 열세번째 우측 성상신경절 차단후 반대측인 좌측에 호너씨 증후군이 발생되었다. 그 원인은 명확하지 않지만 시술 도중 환자머리의 좌측회전으로 인한 해부학적 위치변화와 술자의 부정확한 지표선정 및 주사바늘의 안쪽방향등으로 약제가 중앙선을 넘어 주입된 것으로 추정할수 있다.

• Journal of Oral Medicine and Pain
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• 제44권3호
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

• Journal of Oral Medicine and Pain
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• 제34권2호
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• pp.197-205
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• 2009

신경병성 동통은 진단과 치료가 어려워 환자와 사회전반에 부담이 큰 질병이지만 이와 관련한 국내 보고는 많지 않다. 국내 신경병성 동통 환자의 유병률 연구에 이어 시행된 본 연구에서는 진료일수, 치료비, 수술 및 약제 사용 등의 치료 양태를 조사하고 신경병성 동통의 치료 영역에서 치과의 비중을 확인하고자 하였다. 연구를 위해 2003년부터 2005년까지 건강보험심사평가원의 전산시스템에 등록된 국내 보험 환자를 대상으로 다양한 신경병성 동통 질환(삼차신경통, 당뇨병성 신경병증, 포진후 신경통, 비정형 안면통, 설인신경통, 비정형 치통, 설통)을 주상병으로 하는 환자의 진료기록을 분석한 결과 다음과 같은 결과를 얻었다. 당뇨병성 신경통이 가장 많이 내원하여 치료받았고, 환자 수는 포진후 신경통, 삼차신경통, 당뇨병성 신경통의 순서로 가장 많았다. 질병별로 각 진료과의 내원일수는 전반적으로 신경과, 신경외과, 마취통증의학과가 주로 많았는데, 특별히 증상 발현 부위가 진료과에 해당하는 경우 해당과의 내원일수가 높았다. 명세서 건당 치료비를 보면 마취과, 응급의학과가 전반적으로 많았으며, 재활의학과, 가정의학과가 높은 경향을 보였다. 치과는 삼차신경통, 비정형 안면통, 비정형 치통에서 다소 높은 치료비를 보였다. 많이 사용된 외과적 술식을 살펴보면 포진후 신경통과 당뇨병성 신경통에서는 다소 차이가 있으나 대부분 교감신경총 및 신경절 차단술, 척수신경말초지 차단술, 뇌신경 및 뇌신경말초 차단술이 주로 사용되었다. 치료약제는 비정형 치통과 설통의 경우 진통소염해열제가 절대적으로 많은 반면, 그 외 질환에서는 항전간제, 진통소염해열제, 정신신경용제가 주로 사용되었다. 이상의 결과로 보아 치과의 비중이 높은 신경병성 통증은 비정형 치통, 삼차신경통, 비정형 안면통이며, 환자의 수와 치료비의 전체적인 크기로 볼 때에는 삼차신경통의 규모가 치과에서는 가장 크다. 그러나 신경병성 동통 분야에서 여전히 구강내과를 포함한 치과의 역할이 부족한 상황이지만 치과전문의 제도 시행과 더불어 대국민 홍보와 적극적인 치료 참여를 통해 신경병성 동통 질환, 특히 삼차신경통, 비정형 치통, 비정형 안면통에 대한 치과의 역할과 비중을 높여야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.85-90
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• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권1호
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• pp.47-56
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• 2024

Background: Among the various pain-related diseases that can be encountered at the clinic, there is a neuropathic pain that is difficult to treat. Numerous methods have been proposed to treat neuropathic pain, such as taking medication, nerve block with lidocaine, or neurolysis with alcohol or phenol. Recently, a method of perineural injection using dextrose instead of lidocaine was proposed. This study was designed to compare the effects of perineural injection therapy (PIT) with buffered 5% dextrose or 0.5% lidocaine on neuropathic pain. Methods: The data were collected from the database of pain clinic from August 1st, 2019 to December 31st, 2022 without any personal information. The inclusion criteria were patients diagnosed with postherpetic neuralgia (PHN), trigeminal neuralgia (TN), complex regional pain syndrome (CRPS), or peripheral neuropathy (PN), and patients who had undergone PIT with buffered 5% dextrose (Dextrose group) or 0.5% lidocaine (Lidocaine group) for pain control. The data of patients, namely sex, age, and pain score (numerical rating scale, NRS) were collected before PIT. The data of NRS, side effects, and satisfaction grade (excellent, good, fair, or poor) were collected one week after each of the four PIT, and two weeks after the last PIT. Results: Overall, 112 subjects were enrolled. The Dextrose group included 89 and Lidocaine group included 23 patients. Because the number of patients in the Lidocaine group was too small to allow statistical analysis, the trend in Lidocaine group was just observed in each disease. There were no significant side effects except for a few bruise cases on the site of injection in all groups. The NRS in most Dextrose groups except CRPS were reduced significantly; however, the Lidocaine group showed a trend of pain reduction only in PHN. The Dextrose group except CRPS showed increased satisfaction two weeks after the final PIT. Conclusion: From the results, it is suggested that PIT with buffered 5% dextrose may have a good effect for neuropathic pain without any side effect except for patients with CRPS. This may offer a window into a new tool that practitioners can employ in their quest to help patients with neuropathic pain.

• Journal of Oral Medicine and Pain
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• 제24권4호
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• pp.467-477
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• 1999

Personality characteristics of orofacial pain patients was analyzed psychologically by means of the SCL-90-R. 36 TMD patients, 20 burning mouth syndrome(BMS) patients, 31 trigeminal neuralgia(TN) patients, 20 control I and 28 control II were subjected at Orofacial pain clinic, Department of Oral Medicine and Health Promotion Center, Pusan National University Hospital during the period from 1998 to 1999. The obtained results were as follows: 1. Mean values of T-scores on 9 basic scales in all the groups were within normal range. 2. The T-scores of SOM, O-C, ANX and HOS in TMD patient group were significantly higher than those in control I group, but there was no significant difference in all scales between TMD patient group and control II group. 3. The T-scores of SOM in BMS patient group was significantly higher than those in control I group, but there was no significant difference in all scales between BMS patient group and control II group. 4. The T-scores of SOM in TN patient group was significantly higher than those in control II group. 5. As compared with present and absent of the history of systemic diseases, there was no significant difference of the scales in TMD, BMS and TN patient groups but the T-scores of the patient groups with the history of systemic diseases tended to higher than those of the patient group without the history of systemic diseases. 6. As compared with acute and chronic groups, the T-scores of O-C, I-S, PAR, PSY in chronic BMS patient group were significantly higher than those in acute BMS patient.

• Tuberculosis and Respiratory Diseases
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• 제48권5호
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• pp.794-801
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• 2000

약제 유발성 BOOP의 경우는 약을 중단하여도 증상과 방사선학적 소견이 호전되지 않을 수 있고 부신피질스테로이드를 사용한 후 뚜렷한 호전을 보일 수 있기 때문에 BOOP를 일으킬 수 있는 약제에 대한 인지가 진단과 치료에 중요하다. 저자들은 carbamazepine에 의한 BOOP 1예를 경험하였기에 보고하는 바이다.