• Journal of Korean Neurosurgical Society
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• v.55 no.5
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• pp.244-247
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• 2014

Objective : The aim of this study was to evaluate the microanatomy and histological features of the central myelin in the root exit zone of facial nerve. Methods : Forty facial nerves with brain stem were obtained from 20 formalin fixed cadavers. Among them 17 facial nerves were ruined during preparation and 23 root entry zone (REZ) of facial nerves could be examined. The length of medial REZ, from detach point of facial nerve at the brain stem to transitional area, and the thickness of glial membrane of central myelin was measured. We cut brain stem along the facial nerve and made a tissue block of facial nerve REZ. Each tissue block was embedded with paraffin and serially sectioned. Slices were stained with hematoxylin and eosin (H&E), periodic acid-Schiff, and glial fibrillary acid protein. Microscopy was used to measure the extent of central myelin and thickness of outer glial membrane of central myelin. Thickness of glial membrane was examined at two different points, the thickest area of proximal and distal REZ. Results : Special stain with PAS and GFAP could be differentiated the central and peripheral myelin of facial nerve. The length of medial REZ was mean 2.6 mm (1.6-3.5 mm). The glial limiting membrane of brain stem is continued to the end of central myelin. We called it glial sheath of REZ. The thickness of glial sheath was mean $66.5{\mu}m(40-110{\mu}m$) at proximal REZ and $7.4{\mu}m(5-10{\mu}m$) at distal REZ. Conclusion : Medial REZ of facial nerve is mean 2.6 mm in length and covered by glial sheath continued from glial limiting membrane of brain stem. Glial sheath of central myelin tends to become thin toward transitional zone.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.284-286
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• 2015

Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.357-362
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• 1995

Percutaneous/intrathecal chemical neurolysis of sacral nerve with 12% phenol was performed on 13 cases of hyperreflexic bladder to augment bladder capacity and to reduce bladder pressure. Urodynamic evaluations were done before and after chemical neurolysis. Mean bladder capacity increased significantly after chemical neurolysis (from 171.4 ml to 375 ml). No significant changes in bowel or injection sites were noted. The result suggests that the chemolysis of sacral nerve was available modality for hyperreflexic bladder patients, who did not respond to anticholinergic medication, before decide the more aggressive alternatives such as augmentation cystoplasty or urinary diversion.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.247-250
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• 2000

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between $L_4$ and $L_5$ and spinal stenosis in $L_4$ area. And epiduroscopic feature showed severe adhesion in $L_4$, $L_5$ and $S_1$. After we blocked $L_2$ root, pain score decreased 10 to 2. Therefore, the $L_2$ root block may be a useful diagnostic procedure as well as provide therapeutic value.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.226-229
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• 1998

Background: Treatment for frozen shoulder is various and difficult. It is important for pain clinicians to plan more effective and simpler treatment modalities. Pain clinicians have done suprascapular nerve block(SSNB) for treatment of frozen shoulder, but the effectiveness of treatment has been unsatisfactory. Shoulder joint injection(SJI) using local anesthetics and steroid mixture is a relatively simple procedure. This study was performed to compare therapeutic effects of SSNB and SJI in frozen shoulder. Methods: Eighty patients suffering from frozen shoulder were randomly divided into two groups. Group 1 had been treated with SSNB and physiotherapy for 3 weeks. Group 2 had been treated with SJI and physiotherapy for the same duration. Pain scores and treatment results were compared and analyzed at the time of 2 months after treatment started. Results: The VAS scores after SJI were lower than those of SSNB. Therapeutic results according to Haggart's classifications were significantly effective in group 2. Conclusion: These results show that SJI is more effective than SSNB for treatment of frozen shoulder.

• Korean Journal of Adult Nursing
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• v.29 no.2
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• pp.143-153
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• 2017

Purpose: Purpose of the study was to identify the effect of the Comprehensive Education Program (CEP) on intra-procedure anxiety, post-procedure uncertainty and athletic performance of back strengthening of patients undergo spinal nerve block (SNB). Methods: The participants (experimental group=33, control group=33) were recruited from a university hospital in G metropolitan city. Data were collected from July to November 2015. The experimental group was individually provided with a booklet/motion picture about the SNB and back strengthening exercise training before the SNB. This group also received a leaflet about back strengthening exercise post SNB. The Anxiety-Visual Analog Scale (A-VAS), the Mishel adapted uncertainty scale and newly created knowledge scale/athletic performance checklist were utilized as our study tools. Results: Intra-procedure anxiety score (F=25.70, p<.001), post-procedure uncertainty score (F=82.56, p<.001), post-procedure knowledge score (F=14.63, p<.001) and athletic performance rate of back strengthening (p=.003) of the experimental group showed statistically significant differences in comparison with the control group. Conclusion: This CEP is a cost and time-effective intervention for patients who undergo spinal injections, so it should be actively utilized as an educational management strategy in outpatient.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.227-231
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• 2022

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

• Journal of Korean Physical Therapy Science
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• v.4 no.3
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• pp.499-509
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• 1997

The facial nerve have a long pathway. Thus facial nerve fibers easily involved at any point along their course will lead to a facial palsy of lower motor neuron type and upper motor neuron type. The electrophysiologic examination can evaluate and anticipating that prognosis of facial nerve palsy. The electrophysiologic examination are Nerve Excitability Test(NET), Elecctroneurography(ENG), Electro-myography(EMG), Blink Reflex, and Electrogustometry et.al. The NET is very useful method for assessment of prognosis and distinguish between nerve degeneration and physiological block as early as 72 hour after onset of the facial palsy. And other examination also give objectively information of facial nerve for prognosis and treatment. Treatment goal of physiotherapy are prevent contracture and disuse atrophy of facial muscle with muscle reeducation and strengthening and maintain symmetry facial motion. The treatment better start as early as possible.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.105-107
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• 2011

Hiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location.