• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.144-146
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• 2005

Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging[DITI], and repeated magnetic resonance[MR] image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

• Journal of Acupuncture Research
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• v.33 no.2
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• pp.77-87
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• 2016

Objectives : This is a pilot study for a large randomized controlled trial to investigate the efficacy and safety of a newly developed contrast therapy device-- alternating topical heat and cold -- for patients with chronic low back pain. The main objective of this study is to confirm the feasibility of the study design. Methods : The design was a randomized, 2-arm, parallel-group, single-blind, placebo controlled trial. Patients in each group received real or sham contrast therapy in an acupuncture point 10 times over four weeks. The primary outcome measure was pain intensity on a 100-mm visual analogue scale (VAS). The secondary outcomes were back-related dysfunction based on the Oswestry Disability Index (ODI), the Roland-Morris disability questionnaire (RMDQ), and range of motion of lumbar spine based on the modified Schober test (mSchober test), Finger-to-Floor distance (FTF distance), and Finger-to-Thigh distraction (FTT distraction). Results : A total of 30 subjects with chronic low back pain were randomly assigned to a contrast therapy group (n＝15) or a sham group (n＝15). A repeated-measures analysis of variance showed statistically significant group time interaction for VAS, RMDQ, mSchober test and FTF distance (p<0.05). The treatment group showed significant improvement in pain intensity and functional disability as compared to the sham group. Conclusion : Contrast therapy may be an effective and safe treatment for chronic low back pain.

• Journal of Korean Academy of Nursing
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• v.37 no.3
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• pp.305-312
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• 2007

Purpose: This study was to examine effects of muscle electric stimulation on chronic knee pain, activities of daily living, and living satisfaction for Korean elderly women. Methods: The design was a nonequivalent control group pretest-posttest study. Subjects were 60 (experimental: 30, control: 30) elderly women 65 years old or above with good orientation and communication. The experimental treatment was electric stimulation on both thigh quadriceps muscles for 15 minutes per time, 3 times per week, for a total of 12 weeks. Measures were the S-F McGill Pain Questionnaire and Arthritis Impact Measurement Scale for chronic knee pain, activities measurement of daily living for activities of daily living, and living satisfaction measurement for living satisfaction. Data was analyzed through the SPSS Win 12.0. Results: Chronic knee pain by S-F MPQ (t=43.563, p=.000) and chronic knee pain by AIMS (t=31.364, p=.000) were significantly decreased in the experimental group, and the activities of daily living (t=124.353, p=.000) and living satisfaction (t=71.268, p=.000) were significantly increased in the experimental group for Korean elderly women. Conclusion: Muscle electrical stimulation decreased chronic knee pain, and increased the activities of daily living and living satisfaction for Korean elderly women. Further studies for muscle electric stimulation need to be done.

• Archives of Reconstructive Microsurgery
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• v.26 no.1
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• pp.18-22
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• 2017

Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.1
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• pp.406-411
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• 2012

This study aims to examine the effect of patellar taping common to patients with patellofemoral pain syndrome on the change of knee joint location. The total number of participants is 12 patients with no pain in their knee. There are three different experiments: no-taping, placebo taping, and patellar taping. After application, they squat on their hams. As a result, both the muscle activity of vastus medialis and that of vastus lateralis increased in placebo taping compared to no-taping, which wasn't statistically significant. However, the muscle activity of vastus medialis and that of vastus lateralis decreased in patellar taping compared to no-taping, which was statistically significant. This suggests that patellar taping causing the lateral attraction of knee joint is more influential to the dynamics of knee joint than skin afferent input in placebo taping. Therefore, patellar taping is effective to change the location of knee joint, affect the muscle activity of quadriceps muscle of thigh, and thus correct the misalignments of the knee joint.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.91-97
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• 1988

Herein is a review of eigthy six surgical cases from March to August, 1986 which recieved tetracaine hydrochloride spinal anesthesia. In an attempt to relieve postoperative pain, 0.5 mg morphine sulfate was administrated into the lumbar subarachnoid space. Pruritus, a side effect of intraspinal morphine, was explored in detail. The results were as follows : 1) The incidence of pruritus was 67.4%, 65.5% in man and 71.0% in woman. 2) The time of onset of pruritus was between 30 and 120 minutes with an average of 79.1 minutes. 3) Pruritus primary occurred on the face(87.9%), especially on the nasal, perinasal and periocular areas. Other sites included the scalp, neck, chest, abdomen, shoulder, hip, thigh, flank, and whole body. 4) The severity of pruritus was classified as mild and moderate, but 4 cases(6.9%) were regarded as severe and were treated with naloxone. 5) The duration of pruritus was from 15 minutes to 19 hours with an average of 4.7 hours. 6) There was no significant difference in the prevention of pruritus between the group recieving diphenhydramine and the one which received normal saline.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.93-96
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• 2000

Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.113-115
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• 1994

Bacterial meningitis is a rare complication of epidural block. As epidural abscess, subarachnoid infection associated with epidural catheters are related to the treatment of pain in diabetic patient whose immune responses have been impaired. A 51-year-old male with non-insulin dependent diabetes came to the pain clinic with neuropathic gain on right thigh and amputated stump of right leg. Treatment consisted of continuous epidural block and subcutaneous tunnelling and epidural morphine with bupivacaine was given on an outpatient basis. Two months later, the patient noted a diffuse frontal headache, projectile vomiting and stiffness neck. These symptoms became more aggrevated over the following 24 h and temperature went up to $38.4^{\circ}C$. A diagnostic lumbar puncture revealed CSF total protein of 747 mg/dl, glucose of 43 mg/dl, and $4320\;WBC/mm^3$. Cultures of epidural catheter tip grew hemolytic staphylococcus epidermidis. A chest x-ray and brain CT scan were negative. Antibiotic therapy with penicillin G and chloramphenicol was given for 15 days. Recovery was uneventful.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.3
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• pp.415-423
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• 2006

Purpose: This study was to identify the effects of the application of elastic compression stockings during the hours of work on edema and pain of lower extremity in hospital nurses. Method: The participants were categorized into three groups, 15 for an experimental group of the application of Thigh-Length (T-L) elastic compression stocking, 15 for another experimental group of the application of Knee-Length(K-L) elastic compression stocking and 15 for a control group. The data were analyzed by $X^{2}-test$, ANOVA, Repeated Measures ANOVA and Sheffe-test using SPSS Win 12.0 program. Result: As a result of the study "There are significant differences in lower extremity edema among three groups." was partly supported. "There are significant differences in girth of ankle after work among three groups." was supported(Rt.:F=4.56, p=.016; Lt.: F=5.82, p=.006). "There are significant differences in girth of calf after work among three groups." was not supported(Rt. : F=1.76, p=.183; Lt. : F=1.94, p=.155) "There are significant differences in lower extremity pain after work among three groups." was supported(Rt. : F=95.33, p=.000; Lt. : F=81.33, p=.000). Conclusion: The results of this study revealed that the application of elastic compression stockings during the hours of work is effective for the relief of edema and pain of lower extremity in hospital nurses.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.114-117
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• 2017

A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess. At admission to our department, the patient reported aggravated low back pain. Blood test results, including the erythrocyte sedimentation rate and C-reactive protein levels, were slightly elevated. Biopsy samples of the L4, L5 vertebral bodies and disk were obtained. The material underwent aerobic, anaerobic, fungal, mycobacterial cultures and histologic examination. Results of all cultures were negative. Histologically, necrosis of the bone was evident from the number of empty osteocyte lacunae. In addition, there was no evidence of infection based on biopsy results. No antibiotic treatment was administered on discharge. Repeat computed tomography and MRI performed 12 months after IDET showed a bony defect in the L4 and L5 vertebral bodies, and a decrease in the size of the L4-5 intervertebral disc lesion. We report a case of lumbar vertebral osteonecrosis induced by IDET and discuss etiology and radiologic features.