• The Korean Journal of Pain
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• v.18 no.2
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• pp.208-209
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• 2005

Interstitial cystitis is an extremely painful and distressing condition, characterized by severe suprapubic pain, which increases with bladder filling and is relieved by voiding. The daily frequency of micturition may approach 100 times, but no incontinence is observed. The symptoms persist throughout the night, which consequently affects sleep. The etiology of this condition is still unknown, but includes infection, autoimmune response, allergic reaction, neurogenic inflammation, epithelial dysfunction and inherited susceptibility. Herein, a case of interstitial cystitis, with severe symptoms, which was successfully treated with lumbar sympathetic block, is reported.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.113-115
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• 1994

Bacterial meningitis is a rare complication of epidural block. As epidural abscess, subarachnoid infection associated with epidural catheters are related to the treatment of pain in diabetic patient whose immune responses have been impaired. A 51-year-old male with non-insulin dependent diabetes came to the pain clinic with neuropathic gain on right thigh and amputated stump of right leg. Treatment consisted of continuous epidural block and subcutaneous tunnelling and epidural morphine with bupivacaine was given on an outpatient basis. Two months later, the patient noted a diffuse frontal headache, projectile vomiting and stiffness neck. These symptoms became more aggrevated over the following 24 h and temperature went up to $38.4^{\circ}C$. A diagnostic lumbar puncture revealed CSF total protein of 747 mg/dl, glucose of 43 mg/dl, and $4320\;WBC/mm^3$. Cultures of epidural catheter tip grew hemolytic staphylococcus epidermidis. A chest x-ray and brain CT scan were negative. Antibiotic therapy with penicillin G and chloramphenicol was given for 15 days. Recovery was uneventful.

• The Korean Journal of Pharmacology
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• v.24 no.2
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• pp.189-195
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• 1988

This study aimed to investigate the autonomic innervations of human vas deferens and the effect of diazepam, a benzodiazepine sedative antianxiety drug, on the smooth muscle contractility of vas deferens. The specimens were obtained from healthy volunteers undergoing elective vasectomy with local anesthesia. The muscle preparation did not show any spontaneous contraction, but showed a good contraction induced by norepinephrine exerting the strongest response at $33^{\circ}C$. Phentolamine inhibited the norepinephrine-induced contraction concentration-dependently. Isoproterenol, a beta-adrenergic agonist evoked a considerable extent of contraction, and this contractile activity was antagonized by propranolol, a beta-adrenergic blocking agent. Acetylcholine induced a dashing contraction of the human vas deferens, and atropine, a muscarinic receptor blocking agent abolished the acetylcholine-induced contraction. Diazepam inhibited the norepinephrine-induced contraction in a concentration dependent manner. These results suggest that the smooth muscle of human vas deferens has cholinergic muscarinic and beta adrenergic receptors as well as the predominant alpha adrepergic receptor. Diazepam inhibits the motility, especially norepinephrine-induced contraction of human vas deferens.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.202-207
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• 2000

Background: Superior hypogastric plexus block has been advocated as a useful technique for the treatment of cancer related pelvic pain. The aim of this study was to evaluate the effect of neurolytic trans-intervertebrodiscal superior hypogastric plexus block for pelvic cancer pain. Methods: Twenty-eight patients with gynecologic, colorectal or genitourinary cancer who suffered intractable pain were studied. We performed superior hypogastric plexus block by trans-intervertebrodiscal approach at L5/S1 level under the C-arm fluoroscopic guide unilaterally or bilaterally. Ten ml of 100% dehydrated alcohol was injected through each needle. We evaluated the change of visual analog pain score (VAS; 0~100 mm) and daily dose of oral morphine sulphate at the time of pre-block and 7 days after the block. Results: Fourteen patients (50%) had satisfactory pain relief (VAS<30) while five patients (18%) had moderate pain control (VAS 30~60). The remaining nine patients (32%) had mild or little pain relief (VAS>60) and their daily oral morphine doses were above 160 mg. Additional pain control method may be needed for those patients who received high dose of opioid before neurolytic block. Conclusions: We conclude trans-intervertebrodiscal neurolytic superior hypogastric plexus block was effective in relieving pelvic cancer pain. Neurolytic block, earlier stage, may provide better effects for more comfortable life at the end stage for cancer patients.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.193-197
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• 1998

Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

• Clinical Pain
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• v.18 no.2
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• pp.59-64
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• 2019

Objective: This study evaluated the feasibility of ultrasound-guided lumbar nerve root block (LNRB) and S1 nerve root block by identifying spread patterns via fluoroscopy in cadavers. Method: A total of 48 ultrasound-guided injections were performed in 4 fresh cadavers from L1 to S1 roots. The target point of LNRB was the midpoint between the lower border of the transverse process and the facet joint at each level. The target point of S1 nerve root block was the S1 foramen, which can be visualized between the median sacral crest and the posterior superior iliac spine, below the L5-S1 facet joint. The injection was performed via an in-plane approach under real-time axial view ultrasound guidance. Fluoroscopic validation was performed after the injection of 2 cc of contrast agent. Results: The needle placements were correct in all injections. Fluoroscopy confirmed an intra-foraminal contrast spreading pattern following 41 of the 48 injections (85.4%). The other 7 injections (14.6%) yielded typical neurograms, but also resulted in extra-foraminal patterns that occurred evenly in each nerve root, including S1. Conclusion: Ultrasound-guided injection may be an option for the delivery of injectate into the S1 nerve root, as well as lumbar nerve root area.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.920-926
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• 1997

Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

• Journal of Life Science
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• v.28 no.2
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• pp.240-246
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• 2018

Efferent and afferent sympathetic nerves are closely related to the development of hypertension and heart failure. Catheter-based renal sympathetic denervation (RDN) is implemented as a strategy to treat resistant hypertension. We investigated whether RDN procedure causes inflammatory damage on myocardium in the early phase of sympathetic denervation. Twenty-five female swine were divided into 3 groups: normal control (Normal, n=5), sham-operated control (Sham, n=5), and RDN groups (RDN, n=15). The RDN group was further subdivided into 3 subgroups according to the time of sacrifice: immediately (RDN-0, n=5), 1 week (RDN-1, n=5), and 2 weeks (RDN-2, n=5) after RDN. There were no significant changes in the clinical parameters between the normal control and sham-operated group using contrast-media. In the myocardium, inflammatory cytokines, $IL-1{\beta}$ and $TNF-{\alpha}$ increased at the first week, and then decreased at the second week after RDN. Anti-inflammatory cytokine, IL-10 increased immediately, and then decreased at the second week after RDN. Caspase-1 activity and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) expression increased immediately after RDN until the second week. However, nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing protein 3 (NLRP3) expression did not show any significant differences among the groups. The RDN can cause acute myocardial inflammation through activation of caspase-1 and $IL-1{\beta}$. We should pay attention to protecting against early inflammatory myocardial damage after RDN.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.272-277
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• 2001

Objective : Polymethylmethacrylate(PMMA) is often used to reconstruct the spine after total corpectomy, but the exothermic curing of liquid PMMA poses a risk of thermal injury to the spinal cord. The purposes of this study are to analyze the heat blocking effect of pre-polymerized PMMA sheet in the corpectomy model and to establish the minimal thickness of PMMA sheet to protect the spinal cord from the thermal injury during PMMA cementation of vertebral body. Materials & Methods : An experimental fixture was fabricated with dimensions similar to those of a T12 corpectomy defect. Sixty milliliters of liquid PMMA were poured into the fixture, and temperature recordings were obtained at the center of the curing PMMA mass and on the undersurface(representing the spinal cord surface) of a prepolymerized PMMA sheet of variable thickness(group 1 : 0mm, group 2 : 5mm, or group 3 : 8mm). Six replicates were tested for each barrier thickness group. Results : Consistent temperatures($106.8{\pm}3.9^{\circ}C$) at center of the curing PMMA mass in eighteen experiments confirmed the reproducibility of the experimental fixture. Peak temperatures on the spinal cord surface were $47.3^{\circ}C$ in group 2, and $43.3^{\circ}C$ in group 3, compared with $60.0^{\circ}C$ in group 1(p<0.00005). So pre-polymerized PMMA provided statistically significant protection from heat transfer. The difference of peak temperature between theoretical and experimental value was less than 1%, while the predicted time was within 35% of experimental values. The data from the theoretical model indicate that a 10mm barrier of PMMA should protect the spinal cord from temperatures greater than $39^{\circ}C$(the threshold for thermal injury in the spinal cord). Conclusion : These results suggest that pre-polymerized PMMA sheet of 10mm thickness may protect the spinal cord from the thermal injury during PMMA reconstruction of vertebral body.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.1
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• pp.61-67
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• 2022

Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.