• Journal of Physiology & Pathology in Korean Medicine
• /
• 제37권1호
• /
• pp.19-24
• /
• 2023

Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.

• The Korean Journal of Pain
• /
• 제7권2호
• /
• pp.211-216
• /
• 1994

Celiac plexus block is performed to relieve intractable upper abdominal cancer pain. Generally, celiac plexus blocks have been performed under control of X-ray fluoroscopy to determine the position of the needle tip and the spread of contrast media. During the period from March 1992 to February 1994, we have performed 21 cases of neurolytic celiac plexus block to alleviate pain of intra-abdominal malignancy. We retrospectively evaluated the location of the needle tip and the spread of contrast media. P-A views of simple abdomen demonstrated the locations of the needle tip: 66.7% of the left needle tips were in upper 3/1 of L1 (6 cases) and $T_{12}-L_1$ interspace (8 cases), 50% of the right needle tips were in upper 1/3 of $L_1$, (6 cases) and $T_{12}-L_1$ interspace (4 cases). Contrast media from the right needle spread upward to middle 1/3 of $T_{10}$ (5 cases) and middle 1/3 of $T_{11}$ (5 cases), downward to middle 1/3 of $L_1$ (6 cases) and lower 1/3 of $L_1$ (3 cases). Contrast media from the left needle were spread upward to middle 1/3 of $T_{10}$ (5 cases) and evenly to other spaces, downward to middle 1/3 of $L_1$, (4 cases) and $L_1-L_2$ interspace (6 cases). We analyze the spread of contrast media according to distance from needle tip by authors score system. Contrast media of right needle spread upward 6.1 and downward 3.4, that of left needle spread upward 6.5 and downward 3.7.

• Journal of Korean Medical Ki-Gong Academy
• /
• 제16권1호
• /
• pp.116-136
• /
• 2016

Objectives : The purpose of this study is to report a 67-year-old male patient with Herpes zoster(caseI) and a 38-year-old female patient with Herpes zoster(caseII), whose symptoms were relieved after Korean medicine treatment alone. Methods : Both patients took Yeonryeonggobondan and Pyungwee-san daily. Everytime they came to the hospital, they received acupuncture treatment, Hwidam's Su-Gi therapy and External Gigong Therapy. Acupuncture was applied by gall bladder seunggyeok(膽勝格, GB-), spleen jeonggyeok(脾正格, SP+), large intestine seunggyeok(大腸勝格, LI-) of Saam's Acupuncture Method. Hwidam's Su-Gi therapy was applied on neck. External Gigong Therapy was applied on skin lesion area. the patients' symptoms were evaluated with photographs and VAS. Results : The results were as follows: 1. In the case of a 67-year-old male patient, it took 14 days to recover the skin lesions and to reduce the pain after treatment started. And he visited 13 times during that period. 2. In the case of a 38-year-old female patient, it took 23 days to recover the skin lesions to reduce and the pain after treatment started. And she visited 10 times during that period. 3. Intensive treatment early in treating herpes zoster helped to shorten the treatment period. 4. Taking Yeonryeonggobondan and Pyungwee-san and receiving acupuncture treatment(SP+) can help to improve immunity and recover skin lesions in herpes zoster diagnosed with spleen deficiency with dampness encumbrance(脾虛濕困) and blood stasis due to qi stagnation (氣滯血瘀). 5. The combination of acupuncture treatment(GB-) and External Gigong Therapy was effective in controlling pain. 6. External Gigong Therapy is considered to be effective for the recovery of the skin as well as the pain of the herpes zoster. Conclusions : Korean medicine treatment alone has a great effect on the above two patients with herpes zoster. I hope the active research about Korean medicine treatment will be done not only for herpes zoster but also for various intractable pain diseases.

• Korean Journal of Acupuncture
• /
• 제38권3호
• /
• pp.175-181
• /
• 2021

A 57-year-old female diagnosed with L5-S1 lumbar intervertebral disc herniation, suffering from severe pain despite taking tapentadol received combined Korean medicine treatment, including acupotomy, acupuncture, pharmacopuncture, and herbal therapies for 53 days. To assess pain, Numeric Rating Scale (NRS) and lumbar range of motion (ROM) were checked daily from the day of admission. Moreover, the Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) were used to evaluate function and quality of life. After combined Korean medicine treatment, reabsorptioin of intervertebral disc was confirmed by radiological examination; pain reduced from NRS 5~7 to NRS 1~2; lumbar ROM in extention increased from 20° to 30°; and function and quality of life improved. The results suggest the possibility that a combined Korean medical treatment, including acupotomy, can be used as an alternative to opioids for pain management of lumbar vertebral disc herniation.

• Journal of Korean Neurosurgical Society
• /
• 제30권sup1호
• /
• pp.85-90
• /
• 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 Korean Neurosurgical Society
• /
• 제51권5호
• /
• pp.276-280
• /
• 2012

Objective : Gamma knife radiosurgery (GKRS) is the least invasive surgical option for patients with trigeminal neuralgia (TN). However, the indications and long term outcomes of GKRS are still controversial. Additionally, a series with uniform long-term follow-up data for all patients has been lacking. In the present study, the authors analyzed long-term outcomes in a series of patients with TN who underwent a single GKRS treatment followed by a minimum follow-up of 60 months. Methods : From 1994 to 2009, 40 consecutive patients with typical, intractable TN received GKRS. Among these, 22 patients were followed for >60 months. The mean maximum radiation dose was 77.1 Gy (65.2-83.6 Gy), and the 4 mm collimator was used to target the radiation to the root entry zone. Results : The mean age was 61.5 years (25-84 years). The mean follow-up period was 92.2 months (60-144 months). According to the pain intensity scale in the last follow-up, 6 cases were grades I-II (pain-free with or without medication; 27.3%) and 7 cases were grade IV-V (<50% pain relief with medication or no pain relief; 31.8%). There was 1 case (facial dysesthesia) with post-operative complications (4.54%). Conclusion : The long-term results of GKRS for TN are not as satisfactory as those of microvascular decompression and other conventional modalities, but GKRS is a safe, effective and minimally invasive technique which might be considered a first-line therapy for a limited group of patients for whom a more invasive kind of treatment is unsuitable.

• Journal of Oral Medicine and Pain
• /
• 제22권2호
• /
• pp.359-371
• /
• 1997

Stress is recognized as a major predisposing and/ or precipitating factor in long-lastig intractable chronic pain, such as temporomandibular disorders, headache, and other psychophysiological disorders. So it is necessary to detect physical and psychological changes induced by stress as soon as possible for positive treatment outcome. This study was performed to investigate the occurrence rate of stress symptoms according to anatomic region, type of symptom, and other personal and social factors. 859 subjects from general population answered the stress symptom questionnaire devised by the author and composed of 50 items. Data from the questionnaire were analyzed statistically with SPSS program and the results obtained were as follows : 1. Oral symptom which showed the highest frequency rate of 38.8% was vesicular lesion of the lip and cheek. The other symptoms with more 20% occurrence rate were ulcerative leion of lip and cheek, toothache, paresthesia of teeth, eruption of tongue, tongue coating and taste change in descending order. 2. In extraoral symptoms, ？데 disturbance was the item which showed the highest frequency rate of 62.0%, and the items for stiffness of suboccipital region and neck, headache, facial swelling, furuncle of face were answered more than 45% of the subjects whereas only 14.0% of the subjucts complained jaw pain under stress. 3. The better one who thought his or her health status was, the fewer items were answered and the difference of symptom frequency by dwelling place and by having hobby were shown in extraoral symptoms only. 4. For relief of stress symptoms, 79.2% of the subjects replied only to take a rest whereas not more than 13, 5% of the subjects visited dental clinic. Correlationship between symptom sites were very high.

• The Korean Journal of Pain
• /
• 제4권2호
• /
• pp.133-136
• /
• 1991

Stellate ganglion block was performed in 15 patients with intractable glaucoma by injection of 8 ml of 1y lidocaine. The followings are the changes of intraocular pressure(mmHg): Pre -block $32.26{\pm}4.44$ 10 minutes after block $36.80{\pm}4.60$ 20 minutes after block $32.61{\pm}4.41$ 30 minutes after block $28.87{\pm}4.30$ 60 minutes after block $24.73{\pm}4.37$ 120 minutes after block $26.87{\pm}3.18$ 180 minutes after block $31.40{\pm}3.76$ The pressure rose up to 10 minutes post block and significant pressure descent was noticed from 30 minutes post-block. Maximum descent was seen by 60 minutes post-block and pre-block pressure was restored by 180 minutes post-block. For the purpose of cheeking the treatment effect, similar blocks were performed in 15 patients, one time daily for 5~8 days 3 times every othor day.

• Journal of Yeungnam Medical Science
• /
• 제18권2호
• /
• pp.246-252
• /
• 2001

We report the result of a high-dose intravenous immunoglobulin therapy in a Henoch-Schnlein purpura patient with severe abdominal pain and nephrotic syndrome who did not respond to methylprednisolone pulse therapy. Kidney biopsy showed diffuse mesangial cell proliferative glomerulonephritis with fibrocellular crescent formation in approximately 50% of glomeruli. Mesangium of all glomeruli were strong positive for IgA and C3 antibodies. High-dose intravenous immunoglobulin treatment was introduced and dramatic improvement of gastrointestinal symptom and proteinuria as well as hematuria was noted. Immunoglobulin administration should be considered in Henoch-Schnlein purpura patients with steroid-resistant intractable gastrointestinal manifestation and renal involvement.

• Journal of Oral Medicine and Pain
• /
• 제41권1호
• /
• pp.16-20
• /
• 2016

Purpose: Oral lichen planus (OLP) is relatively common mucosal disease in clinical dentistry. OLP is intractable and regarded having malignant potential. Until now, there is some debate on how far OLP can be malignant, and which characteristics can be a risk factor for malignant transformation. Clinician need to know some differences between OLP and lesions similar to OLP to manage properly and suppose prognosis correctly. Therefore, the aim of this study was to divide clinical OLP into two groups and to compare the results of direct immunofluorescence (DIF) between two groups. Methods: This study was conducted on outpatients who visited at the department of Oral Medicine in Chonbuk National University Hospital from January 2007 to November 2015. Patients with DIF result were retrospectively reviewed. The selected patients were classified 'clinical typical of OLP' (CTO) or 'clinical compatible with OLP' (CCW) by modified World Health Organization diagnostic criteria of OLP and oral lichenoid lesion. Results: DIF were classified by deposition intensity or pattern of anti-human antibody and fibrinogen. The classification of fluorescence pattern in each specimen was graded as positive, possibly positive or negative. Conclusions: Both CTO and CCW had positive and possibly positive pattern. Prevalence of positive pattern was 68.8% in CTO and 52.6% in CCW and that of possibly positive pattern was 9.4% in CTO and 5.3% in CCW. Prevalence of negative was 21.8% in CTO and 42.1% in CCW.