• 정신신체의학
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• 제3권1호
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• The Korean Journal of Pain
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• 제13권2호
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• pp.251-254
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• 2000

A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

• The Korean Journal of Pain
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• 제26권2호
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• pp.160-163
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• 2013

Malignant peripheral nerve sheath tumors (MPNSTs) are very rare sarcomas derived from various cells in the peripheral nerve sheath. Malignant peripheral nerve sheath tumors have a known association with neurofibromatosis type 1. Diagnosis of MPNSTs is difficult in patients with chronic pain, when MPNST occurs at an overlapping area of chronic pain. Therefore, the diagnosis can be missed unless clinicians pay attention to the possibility of this disease. Here in, we report a case of concurrent malignant peripheral nerve sheath tumor with complex regional pain syndrome type 1. A 44-year female patient, who was diagnosed with complex regional pain syndrome (CRPS) type 1 in her left ankle, visited our clinic because of aggravated pain. The cause of the aggravated pain was revealed as concurrent MPNST in the left common peroneal nerve territory, which overlapped the site of pain from CRPS.

• Journal of Chest Surgery
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• 제28권4호
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• pp.398-400
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• 1995

Kawasaki s disease is a multisystemic disorder that is an important cause of cardiovascular disease in children. We experienced a case of coronary artery aneurysm secondary to Kawasaki s disease. The patient was 12-year-old female presented as exertional dyspnea & chest pain[NYHA classII . Her coronary angiogram showed saccular aneurysms at proximal right coronary artery and proximal left anterior descending artery. CABG was performed by use of double internal mammary artery.Postoperative E.K.G. showed a normal pattern.She discharged at postoperative 10th day without problem. 4 months after discharge, she had no dyspnea & chest pain in exertion[NYHA class I .

• Journal of Yeungnam Medical Science
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• 제26권1호
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• pp.38-43
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• 2009

Kimura's disease is an idiopathic chronic condition, associated with a high-titer of IgE and peripheral eosinophilia. It frequently presents as a solitary or multiple lesions in the head and neck area. During the perioperative period, anesthesiologists should understand the anatomical structures of the patient who has Kimura's disease involvement of the head and neck, especially the airway. It is important to pay attention to the occurrence of signs and symptoms of acute allergic reactions related to a high-titer of IgE and eosinophilia. We report our experience with anesthetic management in an 18-year-old patient with multiple neck masses due to Kimura's disease.

• 사상체질의학회지
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• 제34권4호
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• pp.81-88
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• 2022

Objectives The purpose of this case study is to report the improvement of hand foot and mouth disease after using Galgeunhaegi-tang Methods A Taeumin patient suffering from painful hand foot and mouth disease was treated with herb medicine Galgeunhaegi-tang, acupuncture and cupping therapy. Rhei radix et rhizoma was added or removed from herb medicine according to patient's stool condition. Severity of pain and general symptom was measured using Numerical Rating Scale(NRS), and the picture of patient's hand and foot was taken. Results & Conclusions After taking Galgeunhaegi-tang, symptoms including pain, rash, blisters, and general conditions improved as patient's stool condition improved from constipation to normal. In conclusion, this case report shows that Galgeunhaegi-tang can be effective to Taeumin hand foot and mouth disease patients.

• The Korean Journal of Pain
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• 제35권1호
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• pp.14-21
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• 2022

The coronavirus disease 2019 (COVID-19) pandemic, which has been rampant since the end of 2019, has evidently affected pain management in clinical practice. Fortunately, a COVID-19 vaccination program is currently in progress worldwide. There is an ongoing discussion that pain management using steroid injections can decrease COVID-19 vaccine efficacy, although currently there is no direct evidence to support this statement. As such, the feeling of pain in patients is doubled in addition to the co-existing ill-effects of social isolation associated with the pandemic. Thus, in the COVID-19 era, it has become necessary that physicians be able to provide high quality pain management without negatively impacting COVID-19 vaccine efficacy. Steroids can alter the entire process involved in the generation of adaptive immunity after vaccination. The period of hypophysis-pituitary-adrenal axis suppression is known to be 1 to 4 weeks after steroid injection, and although the exact timing for peak efficacy of COVID-19 vaccines is slightly different for each vaccine, the average is approximately 2 weeks. It is suggested to avoid steroid injections for a total of 4 weeks (1 week before and after the two vaccine doses) for the double-shot vaccines, and for 2 weeks in total (1 week before and after vaccination) for a single-shot vaccine. This review focuses on the basic concepts of the various COVID-19 vaccines, the effect of steroid injections on vaccine efficacy, and suggestions regarding an appropriate interval between the administration of steroid injections and the COVID-19 vaccine.

• Journal of Oral Medicine and Pain
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• 제8권1호
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• pp.69-76
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• 1983

Background variables in 203 patients with TMJ pain dysfunction showing no bony change, ranging from 11 to 76 of age, were studied by use of the modified form of self-administered questionnaires deviced by Carlsson et al intended to give a review of the patient's history. All the patients were identified in the Dept. of Oral Diagnosis and Oral Diagnosis and Oral Medicine, Seoul National University Hospital, during the period from Feb. 1983 to Nov. 1983. The questions concerning general somatic and psychic health, educational and social condition were dealt with in this article. The obtained results were as follows : 1. The main symptoms reported by 203 patients were difficulties in opening the mouth wide(74.4%), clicking of TMJ(70.9%), chewing difficulties(69.0%), and pain on movement of mandible(57.6%) 2. The most fequently reported medical symptoms or histories were stomach disease (21.2%), insominia(15.3%), ENT disease(13.8%) and skin disease (12.8%) 3. Seventy-eight percent of the patients denied having had a nervous or psychic disorders while 4% were currently under treatment for such disorders. 4. Eleven percent of 203 patients with TMJ dysfunction thought their family situation was distressing(8.4%) or very troublesome(3.4%).

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.9-15
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• 2010

Purpose: To evaluate, in patients with degenerative disc disease (DDD), the efficacy of using spinal stabilizing exercises for the reversal? of atrophy of the multifidus and psoas major, reductions in pain and disability, and for increases in paraspinal muscle strength. Methods: Nineteen patients diagnosed with DDD participated for 10 weeks in a spinal stabilization exercise program. Pain and disability were measured before and after exercise using, respectively, a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated using CENTAUR. Both before and after exercise we used computed tomography (CT) too measure cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper & lower endplate of L4. Results: After 10 weeks of a spinal stabilization exercise program, pain was significantly decreased from $5.7{\pm}0.9$ to $2.5{\pm}0.9$ (p<0.01); the ODI score decreased from $16.7{\pm}4.9$ to $7.3{\pm}3.1$. Paraspinal muscle strength was significantly increased (p<0.01) and the CSAs of the left and right multifidus and psoas major muscles were significantly increased (p<0.01). Conclusion: Spinal stabilization exercise is effective in reversing atrophy in DDD patients, in reducing pain and disability, and in increasing paraspinal muscle strength. It is an effective treatment foro aiding rehabilitation in these cases.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.127-129
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• 2018

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.