• The Korean Journal of Pain
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• v.2 no.1
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• pp.66-71
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• 1989

It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

• Journal of the Korea Convergence Society
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• v.12 no.12
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• pp.323-330
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• 2021

In this study, we intended to examine the difference in brain activation due to dominant and non-dominant hands using functional near-infrared spectroscopy(fNIRS) in 10 healthy adults. Box & Block Test(BBT) was conducted under two conditions: dominant hand and non-dominant hand. During the experiment, brain activity was measured using fNIRS and signals were analyzed using nirsLAB v2019.04 software after the experiment was completed. As a result, 6 out of 10 people showed activation of the cerebral hemisphere related to the dominant hand, and only 3 out of 10 people showed activation of the cerebral hemisphere related to the non-dominant hand. In other words, both dominant and non-dominant hand cconfirmed that the cerebral hemispheres related to dominant hands were more active. Therefore, it is believed that fNIRS can be used as a fundamental data applicable to children with sensory processing disorders that are difficult to identify dominant hand.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.103-121
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• 2004

Conversion disorder and factitious disorder should be ruled out before making diagnosis of malingering. For this work, inspection of patient's behavior along with complete neurological examinations, psychological tests, and meticulous psychiatric interview are necessary. Facial expression test, thermography, dynamometry were failed differentiating conversion disorders to the malingered pain and motor symptoms, however, controlled diagnostic block showed positive result partly in patients with regional or cervical pain syndrome. Chronic pain patients who are related to the process of litigation encounter stressful life situations which lead them into various neurobehavioral and psychosocial complications. Most of suspected malingered patients would not revealed pure form rather mixed with factitious and/or conversion features. At the time of increasing number of chronic patients associated with traffic accidents or industrial injuries who are involved in litigation, psychiatrist are needed sharp eyes and tenacity for evaluating malingering or medically unexplained symptoms.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.1-6
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• 2017

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

• Korean Institute of Interior Design Journal
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• v.24 no.2
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• pp.171-179
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• 2015

The aim of this study is to figure out the preference features on design components of shop facade on the basis of the questionnaire survey on short-term memory and sensory memory of human right after an image experiment. As for a preceding research, this study examined the design features of facade into tangible elements and intangible elements, and also classified them into physical, aesthetical, marketing and symbolic components in detail. And, it extracted 5 representative elements in preceding studies including shape, material, pattern, color and sign, which is the standard of a questionnaire survey and preference analysis. The subjects of the experiment were 30 men and women who were over 20 years old majoring interior design. They were exposed to 20 images with 10 seconds respectively through a video, and were asked to respond the questionnaire promptly. The findings of preference analysis of design components of facade including shape, material, pattern, color and sign are as follows. Firstly, shape was the most interesting and attracting component, and designs applied with shape of objects such as 'web', 'drawer', 'wheel' and 'button' obtained high preference. Secondly, as for material, block, steel, exposed concrete board attracted higher preference as memorable materials than other materials. Material was affected by shape, pattern and color. Thirdly, pattern was the most lasting element. Designed pattern had higher preference than simple pattern. Fourthly, as for color, red and green with strong stimulation and attention attained priority having long lasting memory. Fifthly, when visiting a shop, sign out of 5 elements of shape, material, pattern, color and sign drew attention the most. As for the preference of location of sign, 'center top' was the most noticeable. The findings of this study could be utilized for facade design, and also could be used for commercialization considering highly preferred components, and top preference aspects of such elements. advised that to give an impression to customers is important to make a successful design for sales marketing, which, in turn, would lead customers to revisit the shop.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.223-227
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• 2006

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.93-97
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• 2009

Anatomy: Facet joint syndrome most often affects the lower back and neck and refers to pain that occurs in the facet joints, which are the connections between the vertebrae in the spine that enable the spine to bend and twist. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself.. Facet joint injection using local anesthetics is a reliable method for the diagnosis and treatment for facet syndrome. Etiology: One of many possible causes is imbalances that can occur in stress levels, hormone levels, and nutritional levels. These imbalances can adversely affect posture, which can lead to neck and back pain. The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. Syndrome: Facet joint syndrome tends to produce pain or tenderness in the lower back that increases with twisting or arching the body, as well as pain that moves to the buttocks or the back of the thighs. Other symptoms include stiffness or difficulty standing up straight or getting out of a chair. Pain can be felt in other areas such as the shoulders or mid-back area. Treatment: Non-drug treatments include hot packs, ultrasound, electrical stimulation, and therapeutic exercises. Stimulating blood flow using massage or a hot tub may also help. Alternative treatments include yoga and relaxation therapy. If your pain persists after trying these treatments, a surgical procedure called radiofrequency rhizotomy, which destroys the sensory nerves of the joint, may bring relief. Facet joint injection has been helpful in diagnosis and therapy for this facet syndrome. Radiofrequency thermocoagulation of medial branches is known to be an effective method of relieving pain caused by facet joint problems. We conclude that spasmolytic treatment of muscles connecting the two vertebral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.159-163
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• 2008

Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

• Journal of Yeungnam Medical Science
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• v.26 no.1
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• pp.74-77
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• 2009

There are debates about whether peripherally induced movement disorders exist. We report a case of upper limb tremor induced by peripheral nerve injury. A 20-year-old male patient presented with pain and tremor of the left upper extremity, 2 days after a car accident. Magnetic resonance images of the brain and cervical spine were normal. His past medical history was unremarkable and there were no family members with symptoms of movement disorders. He suffered from an aggravating tremor for about 10 minutes, four to six times a day. We treated the patient with medication, epidural infusion, cervical nerve root block and trigger point injection of the trapezius muscle. The pain subsided 50% and the incidence of tremor attacks was reduced to once or twice a day. The role of peripheral trauma in the genesis of movement disorders has not been generally accepted. It is unclear whether peripheral trauma can induce dystonia and other movement disorders. It has been proposed that peripheral trauma can alter sensory input and induce cortical and subcortical reorganization that generates a movement disorder. Some studies provide evidence for central reorganization following peripheral injury.