• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.392-396
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• 2013

Background The typical clinical symptoms of glomus tumors are pain, tenderness, and sensitivity to temperature change, and the presence of these clinical findings is helpful in diagnosis. However, the tumors often pose diagnostic difficulty because of variations in presentation and the nonspecific symptoms of glomus tumors. To the best of our knowledge, few studies have reported on the usefulness of magnetic resonance imaging (MRI) in diagnosing glomus tumors in patients with unspecific symptoms. Methods The inclusion criteria of this study were: having undergone surgery for subungual glomus tumor of the hand, histopathologic confirmation of glomus tumor, and having undergone preoperative MRI. Twenty-one patients were enrolled. The characteristics of the tumors and the presenting symptoms including pain, tenderness, and sensitivity to temperature change were retrospectively reviewed. Results Five out of 21 patients (23%) did not show the typical glomus tumor symptom triad because they did not complain of pain provoked by coldness. Nevertheless, preoperative MRI showed well-defined small soft-tissue lesions on T1- and T2-weighted images, which are typical findings of glomus tumors. The tumors were completely resected and confirmed as glomus tumor histopathologically. Conclusions Early occult lesions of glomus tumor in the hand may not be revealed by physical examination because of their barely detectable symptoms. Moreover, subungual lesions may be particularly difficult to evaluate on physical examination. Our cases showed that MRI offers excellent diagnostic information in clinically undiagnosed or misdiagnosed patients. Preoperative MRI can accurately define the character and extent of glomus tumor, even though it is impalpable and invisible.

• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.50-55
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• 2012

Purpose: We reviewed 66 cases of the glomus tumors in the hands. The purpose of this study was to review the characteristic signs and symptoms of glomus tumors and the surgical outcomes. We made hypothesis that (1) our guideline for surgical excision are reliable and (2) our surgical technique is efficient and less harmful to the nail root. Materials and Methods: The clinical diagnosis was made with occasional radiological studies and surgical excision was performed according to our indications. Patients with electrical shock-like pain by touching (the essential symptom) and at least 2 of 4 clinical signs and symptoms (cold hypersensitivity, paroxysmal pain that radiated proximally, blue discoloration, nail deformity for dorsal tumor or a palpable nodule for pulp tumor) underwent surgical excision. Results: The duration of symptoms of the patients was about 5.3 years. No difference of prevalence was found in both hands, but the thumb and the middle finger were more affected than the other fingers. The mean follow up period was 2.4 years and none of the patients complained the same characteristic pain at the last visit. Conclusion: To the best of our knowledge, this report is the largest case series about glomus tumors in the finger tip. The clinical signs and symptoms are important to make a diagnosis of glomus tumors, and surgical excision is the treatment of choice.

• 대한약침학회지
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• 제19권4호
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• pp.359-362
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• 2016

Objectives: Loss of lumbar lordosis causing pain and curvature of the vertebral skeleton to one side is a relatively uncommon disease. To our knowledge, successful treatment of loss of lumbar lordosis with any potentized homeopathic drug diluted above Avogadro's limit (that is, above a potency of 12C) has not been documented so far. In this communication, we intend to document a relatively rare case of loss of lumbar lordosis with osteophytic lippings, disc desiccation, and protrusion, causing a narrowing of secondary spinal canal and a bilateral neural foramina, leading to vertebral column curvature with acute pain in an adolescent boy. Methods: The patient had undergone treatment with orthodox Western medicines, but did not get any relief from, or cure of, the ailment; finally, surgery was recommended. The patient's family brought the patient to the Khuda-Bukhsh Homeopathic Benevolent Foundation where a charitable clinic is run every Friday with the active participation of four qualified homeopathic doctors. A holistic method of homeopathic treatment was adopted by taking into consideration all symptoms and selecting the proper remedy by consulting the homeopathic repertory, mainly of Kent. Results: The symptoms were effectively treated with different potencies of a single homeopathic drug, Calcarea phos. X-ray and magnetic resonance imaging (MRI) supported recovery and a change in the skeletal curvature that was accompanied by removal of pain and other acute symptoms of the ailment. Conclusion: Homeopathy can be a safe, much less expensive, non-invasive, and viable alternative for the treatment of such cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.467-472
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• 2010

Eagle's syndrome is the manifestation of elongated styloid process that is not a common entity in dental clinics. Without the knowledge of this syndrome misdiagnosis can be made and therefore differential diag-nosis with other diseases of oral and maxillofacial area is required. The symptoms of elongated styloid process are cervical pain, foreign body sensation, dysphagia and pharyngeal pain. A 27 years old male vis-ited our hospital. He had cervical pain with unilateral facial nerve palsy. Along with meticulous clinical examinations, 3D-CT, Plain radiographic studies were used to make the diagnosis. In computed tomogra-phy, Lt. styloid process was elongated and fractured. Patient have undergone surgical resection of elongat-ed styloid process and have been carefully observed. Characteristically, preoperative facial nerve palsy showed rapid postoperative recovery. The other clinical symptoms that were present in the initial visit were diminished. The purpose of this article is to report a case of Eagle's syndrome presenting unilateral facial nerve palsy that was treated with transoral surgical approach with literature review.

• 대한한방부인과학회지
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• 제32권3호
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• pp.214-226
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• 2019

Objectives: The purpose of this study is to review clinical studies of Traditional Chinese medicine (TCM) on Genito-Pelvic Pain/Penetration Disorder (GPPPD) in women. Methods: Key words "Dyspareunia", "Vaginismus" were searched on Chinese National Knowledge Infrastructure Database (CNKI) on April 21th 2019. Results: 2 case reports and 7 clinical trials were collected in accordance with the selection and exclusion criteria. Among the 7 trials, 4 were controlled trials, and 3 were single-arm trials. The types of intervention were herb medication in 8 studies, and compound TCM treatment including acupuncture, moxibustion, and cupping therapy in 1 study. All 4 controlled trials were about dyspareunia and conducted by herbal medicine of TCM. The study results and methods of intervention were analyzed. Conclusions: 2 case reports described the effectiveness of compound TCM treatments (acupuncture, moxibustion, cupping therapy) and herb medicine in dyspareunia. In 4 controlled trials, 2 trials described the effectiveness of herb medicine (oral or vaginal agent) compared to western treatment in dyspareunia, and other 2 trials described no effectiveness of herbal enema compared to danazol. In 3 single-arm trials, 1 trial of dyspareunia and 2 trials of vaginismus described the effectiveness of herb medicine. All the 9 selected studies reported improved or disappeared symptoms of GPPPD, or high effective rate after TCM treatment. There was limitation that the selected studies were retrieved from only one site of CNKI, and generalized results could not be derived, further studies should be carried out. Additional well-designed clinical studies on GPPPD in women are needed in Korea.

• Journal of Acupuncture Research
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• 제32권2호
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• pp.123-130
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• 2015

Objectives : Primary dysmenorrhea is one of the most common female gynecological diseases. Acupuncture and moxibustion therapy have been used to treat dysmenorrhea in Korea. The aim of this review was to examine the effectiveness of acupuncture and moxibustion therapy for primary dysmenorrhea as described in studies in Korea. Methods : A total of 8 databases were searched, with the search concluding February 15, 2015. These were the Oriental Medicine Advanced Searching Integrated System, DBpia, Korean Studies Information Service System, National Digital Science Library, Korean Traditional Knowledge Portal, Research Information Sharing Service, and Pubmed. Randomized controlled Trails(RCTs) comparing acupuncture or moxibustion therapy with non acupoints stimulation or medication were selected. Data abstraction and assessment of methodology was conducted by authors and disagreements were resolved by discussion. Results : 7 trials were included in this review, with a total of 308 participants. 4 trials reported on acupuncture, 1 trial reported on acupress by magnet, 1 trial reported on pharmacopuncture, and the other trial reported on moxibustion. Quality of methodology was low. 2 trials showed that experimental therapy was effective for pain relief compared to the controlled group. However, 5 trials did not show a significant difference in pain relief. Conclusions : Acupuncture and moxibustion therapy may reduce period pain, however, it is needed for well designed RCTs in Korea.

• 대한약침학회지
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• 제25권4호
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• pp.301-316
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• 2022

Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.

• 대한정형외과학회지
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• 제55권3호
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• pp.261-265
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• 2020

요추 후관절 주위 낭종은 신경근을 누름으로써 요통과 방사통, 신경성 파행을 일으킬 수 있는 드문 질환이다. 34세 남자가 심한 요통 및 우측 하지 방사통을 호소하였다. 자기공명영상에서 척추관 내에서 제3-4번 요추 추간판과 제4번 요추체 후면까지 우측으로 위치한 낭종이 보였다. 영상증폭기 감시하에서 주사 바늘 흡인을 시행하여 1.5 ml의 장액성의 노란 액체가 흡인되었다. 흡인 치료 후, 증상들이 즉각적으로 소실되었다. 자기공명영상 추시 촬영에서 낭종의 재발소견이 보이지 않았다. 저자들이 아는 한 국내에서는 요추 후관절 주위 낭종에 대한 직접적 바늘 흡인 치료에 대한 보고가 전혀 없기에 이 증례를 문헌 고찰과 함께 보고하는 바이다.

• 여성건강간호학회지
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• 제2권2호
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• pp.284-297
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• 1996

A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review. The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care. The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care. The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows. 1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001). 2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001). 3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001). 4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows. 1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done. 2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge. 3. We suggest general hospitals to establish a phone-counseling system.