• Title/Summary/Keyword: Head & neck pain

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Early Stage Legg-Calve-Perthes Disease in a Dog: Clinical, Surgical, Radiological, Computed Tomography and Histological Findings (초기 허혈성 대퇴골두 괴사증을 보이는 개에서 임상학적, 수술적, 방사선학적, 컴퓨터단층촬영, 조직학적 소견)

  • Thak, Min-Ae;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.366-370
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    • 2013
  • A 7-month-old Pomeranian presented with non-weight bearing lameness on the right pelvic limb. Physical examination revealed pain on extension of the right hip joint, and serum chemistry results showed an increased concentration of creatine kinase. Radiographic findings at admission included a weak radiolucent line on the right femoral head and widening of the right hip joint space, and mild displacement of the right capital femoral epiphysis was additionally identified on day 14. Computed tomography (CT) showed a decreased Hounsfield Unit measurement and a fracture line on the right femoral head. Early stage Legg-Calve-Perthes disease (LCPD) was diagnosed and femoral head and neck ostectomy was performed on the right femur. A fracture fissure and osteophytes at the epiphyseal plate of the femoral head were identified surgically. Necrosis in the femoral metaphysis and epiphysis was observed histologically. This case report describes the radiography, CT images, and surgical and histological findings in a dog with early stage LCPD.

Parathyroid Carcinoma (부갑상선암)

  • Cho Eun-Chol;Sub Jin-Hak;Chung Woong-Yun;Kim Ho-Geun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.205-209
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    • 2001
  • Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

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An Ethnographic Study of Sanhubyung experienced by Women in Korean Postpartal Culture (한국의 산후 문화와 여성이 경험한 산후병에 관한 일상생활기술적 연구)

  • 유은광
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.825-836
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    • 1995
  • This ethnogrphic exploratory study sought to de-fine the meaning of Sanhubyung, as consequence from the perspective of the women who experienced it. A convenience sample of 9 elderly women in San Francisco. and 20 postpartal women and their 20 non-professional helpers during postpartum in Seoul, Korea were observed and interviewed for 23 months from January 1991 to December 1992 at the Human Development Center in San Francisco and at the hospital and their homes in Seoul, Korea. Sanhubyung was regarded as the consequence of "Doing a Sanhujori Wrongly," as a group of symptoms or sequelae which have two types of characteristics of symptoms . chronic and acute. It can be called a culture bound syndrome in the cultural context re-lated to childbearing phenomenon in Korea. If women violate the principles of Sanhujori, such symptoms can appear at various times : during the period of postpartum itself, at any time, periodically, especially at the anniversary of the child's birth, late forties, and in old age. Acute symptoms that can be classified into immediate and late types include painful and edematous gingiva, sensitive teeth, strange sensation and pain in the knees or backache. Besides, there is a localized sense of soreness and pain ; sense of being in a draft and cold, stomach upset, GI irritation, chilling, shivering, and tiredness, pain and dazzling in the eyes. Chronic symptoms occur in the head, neck, teeth, back, hands, knees, hands and feet, arms and legs, eyes, sinews and joints, bones, and in the body or as a whole. Generally these symptoms are pain, often accompanying a feeling of being cold and in a draft, regardless of actual weather conditions. In conclusion, this findings reflect the Oriental way of thought of causal relationship of women's health and illness based on the wholistic paradigm of harmony and balance of two forces, Yin(cold) -Yang(hot). It provides a challenge to the professional sector to rethink the effect of culture on health and illness. Finally, it suggests care providers use cultural assessment for the appropriateness of the intervention and quality of care for desirable health outcomes.

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Changes in Blood Flow Velocity of Middle Cerebral Artery After Stellate Ganglion Block (성상신경절 차단후 중뇌동맥의 혈류 속도 변화)

  • Seo, Young-Sun;Kim, Sung-Hee;Hur, Chul-Ryung;Lee, Kyung-Jin;Lee, Sook-Yeoung;Kim, Chang-Ho;Kim, Chan;Lee, Young-Seok;Lee, Dong-Chul
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.57-62
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    • 1996
  • Stellate ganglion block(SGB) improves cutaneous blood flow of the head and neck region and upper extremity. For this reason, SGB has been performed in neural and circulatory disorders. But there is controversy on the cerebral blood flow regulation by sympathetic innervation. We investigated the hypothesis that cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral vasculature. In 10 volunteers, the blood flow velocity and pulsatility index(PI) of middle cerebral artery(MCA) was measured using Transcranial Doppler Flowmeter, before and 15 minutes after SGB, at block side and opposite side. The blood flow velocity of MCA at block side was increased from $62.60{\pm}7.60$ cm/s to $72.80{\pm}8.01$ cm/s(P<0.01) and the PI at block side decreased from $0.75{\pm}0.12$ to $0.60{\pm}0.11$(P<0.05). But the blood flow velocity and PI at opposite side did not change. This study demonstrated that the cerebral blood flow could be increased by SGB, the preganglionic nerve fibers of which synapse with other cervical sympathetic ganglions.

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Temporomandibular Disorder Caused by Nasopharyngeal Cancer (비인두암종에 의한 측두하악장애)

  • Byun, Young-Sub;Kim, Ki-Seo;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.395-399
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    • 2008
  • Orofacial pain and limited range of mouth opening as symptoms of temporomandibular disorder are mainly triggered by the structural and/or functional changes of temporomandibular joint and related structure itself. But careful diagnostic evaluation should be needed because they may be occurred by another pathologic conditions such as neoplasm in head and neck region. If there would be atypical pain characteristics or clinical features, systemic comorbid symptoms, or poor response to treatment, advanced imaging modalities such as CT or MRI will be mandatory for differential diagnosis. We experienced the case which was diagnosed as nasopharyngeal cancer mimicking temporomandibular disorder, and reviewed clinical considerations for proper differential diagnosis.

Antinociceptive and anti-inflammatory effects of ginsenoside Rf in a rat model of incisional pain

  • Kim, Min Kyoung;Kang, Hyun;Baek, Chong Wha;Jung, Yong Hun;Woo, Young Cheol;Choi, Geun Joo;Shin, Hwa Yong;Kim, Kyung Soo
    • Journal of Ginseng Research
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    • v.42 no.2
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    • pp.183-191
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    • 2018
  • Background: Ginseng saponin has long been used as a traditional Asian medicine and is known to be effective in treating various kinds of pain. Ginsenoside Rf is one of the biologically active saponins found in ginseng. We evaluated ginsenoside Rf's antinociceptive and anti-inflammatory effects, and its mechanism of action on adrenergic and serotonergic receptors, in an incisional pain model. Methods: Mechanical hyperalgesia was induced via plantar incision in rats followed by intraperitoneal administration of increasing doses of ginsenoside Rf (vehicle, 0.5 mg/kg, 1 mg/kg, 1.5 mg/kg, and 2 mg/kg). The antinociceptive effect was also compared in a Positive Control Group that received a ketorolac (30 mg/kg) injection, and the $Na{\ddot{i}}ve$ Group, which did not undergo incision. To evaluate the mechanism of action, rats were treated with prazosin (1 mg/kg), yohimbine (2 mg/kg), or ketanserin (1 mg/kg) prior to receiving ginsenoside Rf (1.5 mg/kg). The mechanical withdrawal threshold was measured using von Frey filaments at various time points before and after ginsenoside Rf administration. To evaluate the anti-inflammatory effect, serum interleukin $(IL)-1{\beta}$, IL-6, and tumor necrotizing $factor-{\alpha}$ levels were measured. Results: Ginsenoside Rf increased the mechanical withdrawal threshold significantly, with a curvilinear dose-response curve peaking at 1.5 mg/kg. $IL-1{\beta}$, IL-6, and tumor necrotizing $factor-{\alpha}$ levels significantly decreased after ginsenoside Rf treatment. Ginsenoside Rf's antinociceptive effect was reduced by yohimbine, but potentiated by prazosin and ketanserin. Conclusion: Intraperitoneal ginsenoside Rf has an antinociceptive effect peaking at a dose of 1.5 mg/kg. Anti-inflammatory effects were also detected.

Percutaneous Intranodular Injection Therapy of Radioactive Iodine-131 in Treatment of Benign Thyroid Nodules: A Preliminary Study (방사선 요오드-131의 국소주입에 의한 양성 갑상선 결절의 치료)

  • Ha Il-Joo;Lim Dong-Pyo;Yoon Jung-Han;JaeGal Young-Jong;Boom Hee-Seoung
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.174-178
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    • 2001
  • Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

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Conformal Radiotherapy in a Patient with Cancer at the base of the Tongue in a Previously Irradiated Area (방사선치료 조사영역 내에 발생한 설암 환자에서 입체조형방사선치료 경험 : 증례보고)

  • Cho Moon-June;Kim Ki-Hwan;Kim Byung-Kook;Song Chang-Joon;Kim Jun-Sang;Kim Jae-Sung;Jang Ji-Young
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.59-62
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    • 2001
  • Objectives: We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods: A 64-year-old male patient was diagnosed with T4N0M0 supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2N0M0. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from $7x6.4\;to\;8x8cm^2$, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results: In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion: Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

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Relationship of Orofacial Pain and Sleep Quality (수면의 질과 구강 안면 통증의 관계)

  • Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.91-99
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    • 2006
  • This study was performed to investigate about sleep quality and orofacial pain pattern between experimental and control group. 101 subjects with temporomandibular disorders without any psychologic and neurologic problem were selected from the patients presented to Wonkwang University dental hospital. Routine clinical examination for TMD was carried out, especially for the frequency of headache and the craniocervical muscles were also done by the author in the first visit. All the subjects filled out the questionnaires, that was, for the evaluation of sleep quality using Pittsburgh sleep quality index(PSQI), and for the analysis of behavioral pain scale questionnaires. Data obtained were statistically processed by the SPSS Windows program and the results of this study were as follows: 1. Subjective sleep index, sleep latency, sleep disturbance, global score in control group were significantly lower than 2. Subjective sleep index, sleep disturbance, global score in subject with headache were significantly lower than subject without headache(P<0.05). 3. Medicine taker have sleeping drug. Caffeine drinkers was significantly higher in daytime dysfunction, global score than no drinker. 4. It have more frequent head and neck pain, pain spreading, daily life difficult in poor sleeper than good sleeper.

The Effects of Muscle Energy Technique on the Shoulder Complex Range of Motion and Posture Alignment of Female College Students in their Twenties with a Round Shoulder (근에너지기법이 둥근어깨를 가진 20대 여대생의 어깨복합체 가동성과 자세정렬에 미치는 영향)

  • Im, Gyeong-eun;Jeong, Yeon-woo;Seo, Tae-hwa
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.17-25
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    • 2021
  • Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.