• Clinical Pain
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• 제19권2호
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• pp.116-119
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• 2020

Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

• Clinical Pain
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• 제18권2호
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• pp.88-91
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• 2019

Unexplained pain and weakness, i.e., without obvious predisposing factors, are often encountered by physiatrists and efforts should be made to determine the cause. A 63-year-old male presented with radiating pain in his right arm and mild weakness of the right hand. An electrodiagnostic examination revealed distal symmetric sensory polyneuropathy in the upper and lower extremities, and denervation potentials in the forearm muscles, which were inconsistent with the cervical spine MRI images and symptoms. A predisposing undiscovered disease was revealed, i.e., squamous cell carcinoma in the lung; brain metastasis affecting the left primary motor cortex was also detected. Therefore, we concluded that the pain and weakness were related to paraneoplastic syndrome and brain metastases of the hand knob. The observed denervation potentials were characterized as trans-synaptic changes in the brain metastasis. This case highlights the importance of unexplainable focal pain and weakness in the increasing prevalence of cancer.

• Clinical Pain
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• 제18권2호
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• pp.70-75
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• 2019

Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

• Korean Journal of Acupuncture
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• 제39권4호
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• pp.199-204
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• 2022

The objective of this study was to evaluate the effects of Korean medicine treatment (including acupuncture, herbal medication, and pharmacopuncture) for postoperative pain after cervical surgery in a patient with a cervical (C2) extension teardrop fracture. We measured the patient's cervical range of motion, neck disability index score and numerical rating scale score to evaluate the effects of Korean medicine treatment on postoperative pain after cervical surgery. After 43 days of inpatient treatment, the patient's neck disability index score decreased from 75.5 to 46.67 and the numerical rating scale decreased from 6 to 2. Furthermore, recovery was observed for cervical range of motion. In conclusion, this case suggests that Korean traditional medicine treatment may effectively reduce postoperative pain after cervical surgery for cerviecal extension teardrop fracture.

• 한방재활의학과학회지
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• 제29권4호
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• pp.15-27
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• 2019

Objectives This study was performed to evaluate anti-obesity effects of Crataegus pinnatifida (CP) on high-fat-diet induced obese mice. Methods The experimental animals were divided into four groups: normal diet (NOR) group, high fat diet (HFD) group, HFD+Xenical (XEN) group, and HFD+CP (CP) group. NOR group was fed a normal diet and the other three groups were fed high fat diet during the experiment. After the first two weeks of diet, XEN group and CP group were administered with XEN or CP for seven weeks, respectively. After that, we measured body weight, liver weight, fat weight, food intake, and serum concentrations of lipids and liver enzymes. Also the liver, intestine, fat tissue was removed to estimate the obesity-related mRNA expressions and the stool sample was collected to analyze the gut microbiota. Results We found that body weight, fat weight, and triglyceride level were decreased significantly in CP group compared to HFD group. Also CP significantly suppressed gene expressions associated with lipogenesis and inflammation, and increased gene expressions of browning of white adipose tissue and mitochondrial biogenesis. Moreover, it shifted the microbial diversity closer to that of NOR group and increased Firmicutes/Bacteriodetes ratio. Conclusions These results suggest that CP decrease body weight, fat weight and serum triglyceride. Also it inhibit inflammation and adipogenesis, altering gut microbial diversity and abundance. In conclusion, CP could be used as a therapeutic drug for obesity via gut microbiota modulation.

• 한방재활의학과학회지
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• 제29권4호
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• pp.143-149
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• 2019

The purpose of this study is to report the effect in treating a patient with delayed union of 4th toe distal phalanx fracture with a combination of Korean Medicine treatment. We treated the patient with acupuncture, cupping, pharmacopuncture, moxibustion and herbal medicine, from March 3, 2018 to June 25, 2018 (total 33 times). The numeric rating scale (NRS), X-ray were applied as outcome measures. After complex Korean medicine treatment was carried out, delayed union of 4th toe distal phalanx fracture was improved and pain was reduced. This result shows that Korean medicine treatment may be an effective option for delayed union. Further clinical studies are needed to clarify the effect of Korean medicine treatment on delayed union.

• 한방재활의학과학회지
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• 제31권3호
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• pp.73-84
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• 2021

Objectives The objective of the study is to review the Korean traditional medicine treatment used in cruciate ligament injury. Methods According to patients, treatment methods, research design, evaluation tools, outcome, we searched for studies which performed Korean traditional medical treatment on patient with cruciate ligament injury. Results In 11 studies, total number of patents were 78. Patients were conducted with 11 kinds of treatment, which is acupuncture, herbal medicine, pharmacopuncture, electro-acupuncture, burning acupuncture, moxibustion, physiotherapy, exercise, Chuna and cupping. The most commonly used measurement was visual analog scale. Conclusions Throughout the study, we could organize Korean traditional medicine treatment for patient with cruciate ligament injury. However it is difficult to figure out among the 11 intervention which interventions were effective in improving symptom. Therefore, further researches like randomized clinical trial and systematic review is needed in order to enhance the evidence of the Korean traditional medicine.

• 한방재활의학과학회지
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• 제32권2호
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• pp.105-121
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• 2022

Objectives This study was conducted to evaluate the effect of electro-acupuncture for sciatica. Methods We searched 13 online databases (Kmbase, Research Information Sharing Service [RISS], National Digital Science Library [NDSL], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies, Koreantk, DBpia, PubMed, Cochrane, EMBASE, Medline, China National Knowledge Infrastructure [CNKI], J-stage) to find randomized-controlled clinical trials (RCTs) that used electro-acupuncture for sciatica. Efficacy rate and visual analogue scale (VAS) were mainly analyzed as a main evaluation criteria. Results Among 583 articles that were searched, 24 RCTs were finally selected and 18 RCTs were statistically analyzed. Electro-acupuncture was more effective than acupuncture in terms of efficacy rate (p<0.00001) and VAS (p<0.00001). Also, Electro-acupuncture was more effective than western medication in terms of efficacy rate (p=0.0005). However, the effectiveness of electro-acupuncture was not identified compared to physical therapy (p=0.42). Electro-acupuncture significantly improved efficacy rate when combined with physical therapy than physical therapy alone (p<0.0001). In addition, electro-acupuncture plus Chuna manual therapy compared to Chuna manual therapy alone showed positive results for efficacy rate (p=0.05) and VAS (p<0.0001). Conclusions Based on results, the effectiveness of electro-acupuncture for sciatica was identified. However, this study has limitations because the RCTs included in this study were small in number and published in a particular region. Although this study could be a groundwork for well designed research for sciatica.

• 한방재활의학과학회지
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• 제32권1호
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• pp.133-144
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• 2022

The objective was to propose effectiveness of conservative treatments including Korean medical treatments for symptomatic Schmorl's nodes (SNs). We conducted retrospective study that analyzed the medical records of two patients with the symptomatic SNs. They were treated by conservative treatments including Korean medical treatments for 3 weeks. We evaluated numeric rating scale (NRS), Oswestry disability index (ODI) and EuroQol-5 dimension (EQ-5D) index. After treatment, NRS, ODI were decreased and EQ-5D index was increased. We performed literature search to analyze the mechanisms of its treatment and evaluate clinical trials. There were three major mechanisms: (1) Improving constructive stability of vertebrae, (2) alleviating pain, and (3) controlling autoimmunity. When comparing operative treatment (OT) trials and conservative treatment (CT) trials, we couldn't find conclusive basis that support which one is more effective. As OT trials reported some severe adverse events, CT trials reported mild adverse events. The conservative treatments that we used encompasses those mechanisms and is relatively safe. To obtain exact evidence of effectiveness, further studies are needed.

• 한방재활의학과학회지
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• 제31권3호
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• pp.85-93
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• 2021

Objectives This study aims to compare the effect of an ultrasound on a guided group and an unguided group on Soyeom pharmacopuncture therapy on the facet joint in patients with acute low back pain caused by traffic accidents. Methods 21 patients with acute low back pain caused by traffic accidents from March 1, 2021 to May 31, 2021 were included in this study. The study was conducted as a retrospective study which analyzes the patient's medical records. 11 patients (Group A) received ultrasound guided Soyeom pharmacopuncture therapy and 10 patients (Group B) received unguided Soyeom pharmacopuncture therapy on the facet joint. Visual analogue scale (VAS) and Oswestry disability index (ODI) was used to evaluate improvements in functions and pain, and five point Likert scale to evaluate patient's satisfaction. Results Both groups showed a statistically significant decrease in the VAS and ODI on the 5th day of hospitalization. However, there was no statistically significant difference between the groups. Difference in the Likert scale between the groups was not statistically significant either. Conclusions We found that ultrasound guided Soyeom pharmacopuncture therapy on the facet joint showed similar efficacy compared with unguided Soyeom pharmacopuncture therapy at facet joint on acute low back pain patients caused by traffic accidents.