• The Korean Journal of Pain
• /
• 제26권3호
• /
• pp.242-248
• /
• 2013

Varicella (chickenpox) is a highly contagious airborne disease caused by primary infection with the varicella zoster virus (VZV). Following the resolution of chickenpox, the virus can remain dormant in the dorsal sensory and cranial ganglion for decades. Shingles (herpes zoster [HZ]) is a neurocutaneous disease caused by reactivation of latent VZV and may progress to postherpetic neuralgia (PHN), which is characterized by dermatomal pain persisting for more than 120 days after the onset of HZ rash, or "well-established PHN", which persist for more than 180 days. Vaccination with an attenuated form of VZV activates specific T-cell production, thereby avoiding viral reactivation and development of HZ. It has been demonstrated to reduce the occurrence by approximately 50-70%, the duration of pain of HZ, and the frequency of subsequent PHN in individuals aged ${\geq}50$ years in clinical studies. However, it has not proved efficacious in preventing repeat episodes of HZ and reducing the severity of PHN, nor has its long-term efficacy been demonstrated. The most frequent adverse reactions reported for HZ vaccination were injection site pain and/or swelling and headache. In addition, it should not be administrated to children, pregnant women, and immunocompromised persons or those allergic to neomycin or any component of the vaccine.

• The Korean Journal of Pain
• /
• 제8권2호
• /
• pp.324-327
• /
• 1995

Central serous chorioretinopathy is a relatively benign condition of young to middle-aged men, characterized by serous detachment of central retina as a consequence of focal leakage of fluid from the choriocapillaris through a defect in the retinal pigment epithelium. Approximately 80% of central serous chorioretinopathy undergo spontaneous resolution within 6 months. However 20 to 30% of patients with central serous chorioretinopathy have one or more recurrences and undergo chronic courses. In these cases laser photocoagulation is used to burn the leakage site directly, but there is no evidence that it reduces the chance of permanent loss of visual function and recurrence. We have administered stellate ganglion blocks (SGB) on a 43 year old male patient with central serous chorioretinopathy with multiple recurrences and experienced good results. We therefore recommend SGB as an effective treatment for central serous chorioretinopathy in conjunction with other ophthalmological treatments.

• The Korean Journal of Pain
• /
• 제25권3호
• /
• pp.161-167
• /
• 2012

Background: Neck and shoulder pain (NSP) is fairly common in adolescents, which is associated with a high prevalence of NSP found during adulthood as well; therefore, its significance during adolescence should not be underestimated. We surveyed the prevalence of recurrent NSP, lifestyle, and risk factors in Korean high school students, and examined the influence of recurrent NSP on the quality of life. Methods: Nine hundred thirty one male students (16-19 years old) from two academic high schools in Seoul were included in this study. The survey consisted of a questionnaire to assess the prevalence of recurrent NSP, with questions regarding having an occurrence more than once a week, characteristics of NSP, activity and lifestyle of the students, and the risk factors for recurrent NSP. A 36-item Short Form questionnaire was also examined. Results: We found that 44.3% of the high school students surveyed had recurrent NSP (more than once a week) and the overall prevalence of NSP was 79.1%. The average sitting time was $10.2{\pm}2.7$ h/day. 59.0% did not sit straight, 14.7% used assisting devices during reading, and 11.9% answered that they stretched regularly. Found from their self assessed health, frequent fatigue and frequent depressed mood presented significant associations with the higher prevalence of recurrent NSP. Conclusions: Korean high school students had a high prevalence of recurrent NSP. Clinical attention is needed for the prevention and resolution of recurrent NSP found in high school students.

• The Korean Journal of Pain
• /
• 제21권2호
• /
• pp.112-118
• /
• 2008

Background: This study was conducted to quantitatively analyze proteins associated with the calcitonin gene-related peptide (CGRP) in cerebrospinal fluid (CSF) that was obtained from a rat model of chronic neuropathic pain following administration of intrathecal $CGRP_{8-37}$. Methods: Male Sprague-Dawley rats (100-150 g, 5-6 wks) were divided into two groups, sham controls and neuropathic pain models. At the time of operation for neuropathic pain model, an intrathecal catheter was threaded through the intrathecal space. At 1 or 2 wks after the operation (maximum pain state), a test dose of 1, 5, 10, or 50 nM of $CGRP_{8-37}$ was injected into the intrathecal catheter and the CSF was then aspirated. Conventional proteomics to evaluate the CSF were then performed using high resolution 2-D, gel electrophoresis followed by computational image analysis and protein identification by mass spectrometry. Results: Treatment with $CGRP_{8-37}$ effectively alleviated mechanical allodynia in a dose dependent manner. The most effective response was obtained when a dose of 50 nM was administered, but significant differences were obtained following administration of only 5 nM $CGRP_{8-37}$. Furthermore, the results of the proteomic analysis were consistent with the experimental results. Specially we detected 30 differentially expressed spots in 7 images when 2-D gel electrophoresis was conducted. The intensity of 6 of these spots (spot number: 20 and 26-30) was found decrease the $CGRP_{8-37}$ dose increased; therefore, these spots were evaluated by mass spectrometry. This analysis identified 2 different proteins, CGRP (spot numbers: 26-30) and neurotensin-related peptide (spot number: 20). Conclusions: The results of this study suggest that CGRP plays a role in chronic central neuropathic pain and is a major target of chronic neuropathic pain management.

• Physical Therapy Rehabilitation Science
• /
• 제2권2호
• /
• pp.75-80
• /
• 2013

Objective: The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis. Design: Experimental study. Methods: Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the ankle and foot. There were 3 groups of 10 subjects, control (no intervention), cold the night before bed, and cold in the morning before rising. Results: The greatest relief of symptoms was cold used at bedtime the night before the measurements. Cold used in the morning was not as effective as cold used in the evening before bed. Cold use reduced the thickness of the plantar fascia and irritation. There was a 13% reduction in plantar fascia thickness with cold the night before (p<0.05), a 44% reduction in pain and an 86 % increase in the force that could be applied to the bottom of the foot without pain (p<0.05). Conclusions: Cold applied for 20 minutes prior bedtime is effective for reduced symptomology caused by plantar fascia inflammation.

• Clinics in Shoulder and Elbow
• /
• 제10권2호
• /
• pp.167-174
• /
• 2007

목적: 석회화 건염에 대하여 보존적 치료 및 관절경을 이용한 수술적 치료 후 석회질 소실정도와 임상경과를 비교 관찰하였다. 대상 및 방법: 2002년 1월부터 2005년 4월까지 석회화 건염으로 진단받은 126예 중 6개월 이상 추시관찰이 가능하였던 주사치료 64예 및 수술 치료 12예를 대상으로 하여 석회질의 소실정도와 임상증상의 호전을 비교 관찰하였다. 126예의 평균연령은 53세, 여성이 77%였으며, 극상 건에 침범한 경우가 84%였다. 결과: 주사 치료의 경우 77%(49/64)에서 증상의 호전을 볼 수 있었다. 방사선적으로 석회질의 완전소실을 볼 수 있었던 경우는 36%(23/64)였고 불완전 소실은 17%(11/64)였으며, 석회질 크기에 변화가 없었던 경우가 47%(30/64)였다. 관절경적 치료를 시행한 석회질은 83%(10/12)에서 평균 3.9개월에 완전 소실되었다. 결론: 용해기의 급성통증은 스테로이드주사로 증상의 호전을 볼 수 있었다. 형성기의 석회화건염에 대한 관절경하 수술적 치료 시 완전제거를 시행할 필요는 없으나, 완전한 증상완화를 위해서는 석회침착물의 완전 소실을 확인하는 것이 중요한 것으로 생각되었다.

• 대한물리의학회지
• /
• 제2권2호
• /
• pp.205-212
• /
• 2007

Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

• Journal of Korean Neurosurgical Society
• /
• 제46권2호
• /
• pp.172-175
• /
• 2009

We describe a case of 36-year-old man who presented with a subacute headache preceded by a 1-month history of posterior neck pain without trauma history. Head and neck magnetic resonance imaging (MRI) studies disclosed bilateral supratentorial subdural and retroclival extradural hematomas associated with marked cervical epidural venous engorgement. Cerebral and spinal angiography disclosed no abnormalities except dilated cervical epidural veins. We performed serial follow-up MRI studied to monitor his condition. Patient's symptoms improved gradually. Serial radiologic studies revealed gradual resolution of pathologic findings. A 3-month follow-up MRI study of the brain and cervical spine revealed complete resolution of the retroclival extradural hematoma, disappearance of the cervical epidural venous engorgement, and partial resolution of the bilateral supratentorial subdural hematoma. Complete resolution of the bilateral supratentorial subdural hematoma was confirmed on a 5-month follow-up brain MRI. The diagnosis and possible mechanisms of this rare association are discussed.

• Clinics in Shoulder and Elbow
• /
• 제21권2호
• /
• pp.75-81
• /
• 2018

Background: We investigated the resolution of pain and functional recovery of shoulder after arthroscopic removal of calcific deposits in patients with chronic calcific tendinitis. Methods: We enrolled 39 patients who were treated arthroscopically for chronic calcific tendinitis that had been non-responsive to at least 6 months of conservative treatment. We evaluated clinical outcome in terms of the American Shoulder Elbow Surgeons (ASES), the Constant score, the visual analogue score (VAS) for pain. We used plain radiography to measure the size of the calcific deposits. We also analyzed the clinical outcomes in terms of whether or not a cuff repair was performed or the degree of removal of calcific deposits. Results: We found that complete resolution of pain took on average 5.7 months after the arthroscopic treatment. The ASES and the Constant score significantly improved from the 3-month follow-up, however it took 6 months until the scores reached on average 80 points or above. We found that these clinical outcomes at the final follow-up did not significantly differ by whether or not cuff repair was performed. Similarly, we found that the clinical outcomes did not significantly differ by the degree of calcium removal. Conclusions: We found that arthroscopic removal of calcification leads to improved clinical outcomes in patients with chronic calcific tendinitis. However, our findings show it takes at least 6 months for the clinical improvement to become statistically significant. We also found that concomitant cuff repairs or the degree of removal of calcification does not affect the clinical outcome of the arthroscopic treatment.

• Journal of Hospice and Palliative Care
• /
• 제1권1호
• /
• pp.23-29
• /
• 1998

목적: WHO의 통증관리원칙에 따른 통증관리의 효과가 입증되었으며 불충분한 통증관리의 문제점을 해결하려는 많은 노력이 있어 왔다. 본 연구는 말기암환자들의 통증정도와 불충분한 통증관리에 영향을 미치는 환자의 특성을 밝히고자 하였다. 방법: 1997년 6월부터 1997년 11월까지 서울대학교병원에서 말기암으로 판정받은 성인 암환자 100명을 대상으로 활동도, 전이여부 등을 포함한 인구 의학적 특성과, 사용되고 있는 진통제를 보정한 통증정도를 조사하였다. WHO의 통증관리지침에 따라 통증관리의 적절성을 평가하였으며 이에 영향을 미치는 환자의 특성을 조사하였다. 결과: 말기암판정당시 85%의 환자들이 통증이 있었으며 65%의 환자들이 중등도이상의 통증을 갖고 있었다. 말기암환자 38%가 불충분한 통증관리를 받고 있었으며 통증의 정도가 심할수록 불충분한 통증관리를 받고 있었다(P<0.001). 성별 연령, 암의 원발부위, 전이여부, 우울 및 불안 증상, 활동도는 통계적 유의성이 없었다. 결론: 통증관리지침이 제시되었음에도 불구하고 많은 말기암환자들이 충분한 통증관리를 받지 못하고 있다. 이를 해결하기 위해서 통증 평가방법과 통증관리지침에 관한 적극적인 교육 및 훈련이 필요하다.