• Journal of Dental Anesthesia and Pain Medicine
• /
• v.15 no.1
• /
• pp.31-34
• /
• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• The Korean Journal of Pain
• /
• v.31 no.2
• /
• pp.87-92
• /
• 2018

Background: An epidural steroid injection (ESI) is a commonly administered procedure in pain clinics. An unintentional lumbar facet joint injection during interlaminar ESI was reported in a previous study, but there has not been much research on the characteristics of an unintentional lumbar facet joint injection. This study illustrated the imaging features of an unintentional lumbar facet joint injection during an interlaminar ESI and analyzed characteristics of patients who underwent this injection. Methods: From December 2015 to May 2017, we performed 662 lumbar ESIs and we identified 24 cases (21 patients) that underwent a lumbar facet joint injection. We gathered data contrast pattern, needle approach levels and directions, injected facet joint levels and directions, presence of lumbar spine disease as seen on magnetic resonance images (MRI), and histories of lumbar spine surgeries. Results: The contrast pattern in the facet joint has a sigmoid or ovoid contrast pattern confined to the vicinity of the facet joint. The incidence of unintentional lumbar facet joint injection was 3.6%. The mean age was 68.47 years. Among these 21 patients, 14 (66.7%) were injected in the facet joint ipsilaterally to the needle approach. Among the 20 patients who received MRI, all (100%) had central stenosis and 15 patients (75%) had severe stenosis. Conclusions: When the operator performs an interlaminar ESI on patients with central spinal stenosis, the contrast pattern on the fluoroscopy during interlaminar ESI should be carefully examined to distinguish between the epidural space and facet joint.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.18 no.1
• /
• pp.50-60
• /
• 2005

Objective : We have studied to know effects of Ligigeopoongsan(LGS, 理氣祛風散) on mechanical allodynia, cold allodynia and c-Fos protein expression in the model of neuropathic pain of rats. Methods : The model of neuropathic pain was made by injured tibial nerve and sural never while common peroneal never was maintained. After 2weeks, we performed behavioral test for 7 days to try out mechanical allodynia using von frey filament and cold allodynia using acetone, which are calculated by counting withdrawal response on foot. Rat brains removed and sliced on 8th days. Serial sections were immunohistochemically reacted with polyclonal c-Fos antibody. The numbers of c-Fos protein immunoreactive neurons in the central gray were examined using scion image program. Results : 1. Mechanical allodynia in LGS-2, LGS-3 groups were significantly diminished compared with the control group. 2. Cold allodynia in LGS-3 group was significantly diminished compared with the control group. 3. c-Fos protein expression on the central gray LGS-2, LGS-3 groups were significantly lower than that of control group. conclusions : We have noticed that LGS(理氣祛風散) diminished mechanical and cold allodynia in the model of neuropathic pain compared with the control group. c-Fos protein expression in the central gray of that group was also decreased compared with the control group. Pain control group were LGS was accumulated time goes by. This study can be used as a basic resource on a study and a treatment of pain.

• Science of Emotion and Sensibility
• /
• v.24 no.2
• /
• pp.39-48
• /
• 2021

According to International Associating for the Study of Pain (IASP) definition, neuropathic pain is a disorder characterized by dysfunction of the nervous system that, under normal conditions, mediates virulent information to the central nervous system (CNS). This pain can be divided into a disease with provable lesions in the peripheral or central nervous system and states with an incorporeal lesion of any nerves. Both conditions undergo long-term and chronic processes of change, which can eventually develop into chronic pain syndrome, that is, nervous system is inappropriately adapted and difficult to heal. However, the treatment of neuropathic pain itself is incurable from diagnosis to treatment process, and there is still a lack of notable solutions. Recently, several studies have observed the responses of CNS to harmful stimuli using image analysis technologies, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging. These techniques have confirmed that the change in synaptic-plasticity was generated in brain regions which perceive and handle pain information. Furthermore, these techniques helped in understanding the interaction of learning mechanisms and chronic pain, including neuropathic pain. The study aims to describe recent findings that revealed the mechanisms of pathological pain and the structural and functional changes in the brain. Reflecting on the definition of chronic pain and inspecting the latest reports will help develop approaches to alleviate pain.

• The Korean Journal of Pain
• /
• v.33 no.3
• /
• pp.226-233
• /
• 2020

Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

• Journal of Oral Medicine and Pain
• /
• v.4 no.1
• /
• pp.22-30
• /
• 1979

In order to evaluate the normal eruption time of Korean permanent teeth, the uthor had examined the eruption phases of permanent central incisors in 714 malw and 581 female children aged from 4.5 to 9-year old and analysed. The eruption was divided into 3 phases; the tip of crown can be seen, the half of the crown can be easily seen, and full length of the crown can be seen. The obtained results were as follows : 1. It seemed that percentage of the erupting and erupted permanent central incisor in female by age was higher than that of male. 2. In general, percentage of the erupting and erupted lower central incisor by age was higher than that of upper first molar.

• Journal of Oral Medicine and Pain
• /
• v.12 no.1
• /
• pp.47-52
• /
• 1987

In order to evaluate the effect of signs and symptoms of temporomandibular disorders on the bite force of anterior teeth, the author estimated a feature of maintaining the maximum bite force on central incisors in Korean 34 adult females with signs and symptoms of temporomandibular disorders (TMD group) and in Korean 31 adult females within normal masticatory function far from any sign or symptom of TMD (control group), and analyzed the data statistically. The obtained results were as follows: 1. There was not a significant difference of the maximum bite force on central incisors between TMD group and control group (P>0.05). 2. The duration of maintaining the maximum bite force on central incisors in TMD group was shorter than it in control group (P<0.01).

• The Korean Journal of Pain
• /
• v.31 no.3
• /
• pp.174-182
• /
• 2018

Background: The trigeminal nucleus caudalis (Vc) is a primary central site for trigeminal transmitting. Noxious stimulation of the trigeminal nociceptors alters the central synaptic releases and neural expression of some inflammatory and trophic agents. Orexin-A and the orexin 1 receptor (OX1R) are expressed in pain pathways including trigeminal pain transmission. However, the the mechanism(s) underling orexin-A effects on trigeminal pain modulation have not been fully clarified. Methods: Trigeminal pain was induced by subcutaneous injection of capsaicin in the upper lip in rats. The effect of trigeminal pain on cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) expression in the Vc of animals was determined by immunofluorescence. Subsequently, OX1R agonist (orexin-A) and antagonist (SB-334867-A) was administrated in the Vc to investigate the possible roles of the Vc OX1R on changes in COX-2 and BDNF levels following pain induction. Results: The data indicated an increase in COX-2 and decrease in BDNF immuno-reactivity in the Vc of capsaicin, and capsaicin- pretreated with SB-334867-A (80 nM), groups of rat. However, the effect of capsaicin on COX-2 and BDNF expressions was reversed by a Vc microinjection of orexin-A (100 pM). Conclusions: Overall, the present data reveals that orexin-A can attenuate capsaicin-induced trigeminal pain through the modulation of pain effects on COX-2 and BDNF expressions in the Vc of rats.

• Journal of Oral Medicine and Pain
• /
• v.19 no.2
• /
• pp.73-79
• /
• 1994

A case of central neurilemmoma in mandible of 39 year-old Korean male was reported. The final diagnosis was determined by comprehensive evaluation of 1) clinical features of hard swelling, buccally, on right mandibular body region, 2) radiographic features of well- demarcated unilocular osteologic lesion on right mandibular body region, 3) histopathologic features of Antoni type A and Antoni type B, 4) immunohistochemical features of positive to S-100 protein.

• Journal of Acupuncture Research
• /
• v.36 no.4
• /
• pp.277-281
• /
• 2019

A patient with central post-stroke pain was treated for 4 weeks with scalp acupuncture and traditional Korean medicine (following a cerebral infarction in 2013). The patient presented at Chungju hospital in January 2019 with left side weakness and tingling, numbness in the left hemisphere, chronic pain and dysarthria. Initially, herbal medicine, acupuncture, pharmacupunture, indirect moxibustion, and physiotherapy were administered together with Western medicine, with no improvement in the patient's condition. On Day 5, scalp electroacupuncture (MS1, MS5, MS10, MS11) was introduced. The numbness feeling in the patient's head resolved, and the pain in his upper body decreased. Grip force difference between the left and right hand improved from 3 kg to 0-0.5 kg. Sleep disturbance was resolved after 4 weeks treatment, and his average numeric rating scale score for pain improved from an admission score of 10, to a discharge score of 5. The patient could walk unaided after treatment.