• Title/Summary/Keyword: pain resolution

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Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury

  • Kim, Hee-Yul;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.467-469
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    • 2010
  • We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/$mm^3$. She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.

Anaplastic Large Cell Lymphoma of the Duodenum in a Teenage Girl: Misdiagnosed as an Intramural Duodenal Hematoma

  • Sriphongphankul, Hansa;Tanpowpong, Pornthep;Ruangwattanapaisarn, Nichanan;Thirapattaraphan, Chollasak;Treepongkaruna, Suporn
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.571-575
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    • 2019
  • We report a case of a 13-year-old girl who presented with a 2-month history of intermittent abdominal pain. Laboratory examination showed hepatitis and pancreatitis. Because of persistent vomiting, computed tomography (CT) was performed, which revealed a circumferential soft tissue density in the duodenal wall, causing partial obstruction. Supportive therapy failed. Repeat CT showed no significant change from the initial study. The patient underwent upper endoscopy, which revealed a mass in the second portion of the duodenum, which occluded most parts of the lumen. The histopathological finding was consistent with an anaplastic large cell lymphoma, a rare form of small bowel neoplasm. After the third course of chemotherapy, complete resolution of the mass was noted, and her symptoms were relieved.

Treatment of Recalcitrant Plantar Wart Unresponsive to Cryotherapy with Acupuncture and Moxibustion: A Case Report

  • Shim, Soo Bo;Sung, Hyun Kyung;Lee, Hye Lim
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.238-243
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    • 2021
  • Objectives: Plantar wart is a common viral skin disease caused by human papillomavirus infection and poses a therapeutic challenge in the paediatric patient population. Acupuncture and moxibustion are effective treatments for a wide range of skin conditions. Case report: This study presents the case of a 9-year-old girl for whom complete resolution of recalcitrant warts was achieved with acupuncture and moxibustion treatment. Results: After 20-week treatment, the wart lesions and pain were completely resolved. At the 6-month follow-up, the lesions remained fully resolved. Conclusion: This result suggests that acupuncture and moxibustion could be effective therapeutic strategies for plantar warts.

Lower Level Laser Therapy on Postherpetic Neuralgia (대상포진후 신경통의 저출력 레이저치료)

  • Kim, Hae-Kyu;Kim, Seong-Tae;Jung, Jin-Woo;Keoun, Jae-Young;Kim, In-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.258-262
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    • 1992
  • Herpes zoster is an acute infectious viral disease which affects the posterior spinal root ganglion of the spinal nerve. A single posterior spinal root ganglion or a small number of adjacent ones may be affected, usually on the same side. The corresponding ganglia of the cranial nerve may also be similarly affected. The causative virus, varicella zoster, belongs to the group of host-specific DNA viruses. Postherpetic neuralgia is a continuation of herpes zoster in older patients. Although spontaneous resolution of herpes zoster may be expected in most patients, a significant number experience intractable pain. Postherpetic neuralgia is one of the most difficult problems encountered by physicians. There are many methods for management of postherpetic neuralgia, but there is no method that results in complete remission. Laser has lately come into use to reduce several acute or chronic pains. In order to determine the degree of pain relief by laser, 27 patients of postherpetic neuralgia were irradiated with He Ne, Infrared, and $CO_2$ combine scan moded lasers two to three times per week. The results were as follows: 1) The most frequent site was thoracic vertebral nerve area. 2) Patients younger than 70 years of age showed an improvement rate of 57% vs 27% for those patients older than 70 years of age. 3) Laser therapy proved effective of those patients who received the laser treatment within one month of the onset of the disease. 4) For those patients who received treatment within one month of the disease and reflecting a 50% improvement rate, the average irradiation time was 5.7.

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Prolotherapy in Orthopedic Field (정형외과 영역에서의 증식치료)

  • Shon, Min Soo;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.101-110
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    • 2011
  • To describe the background, mechanism, clinical results and complications of prolotheapy based on the literature review. Prolotherapy is a minimally invasive injection-based treatment of chronic musculoskeletal pain, including ligament and joint laxity. The mechanism of this injection-based technique is to initiate a local inflammatory response with resultant tissue healing. The used proliferants are classified by bio-mechanism to act in three different ways as osmotic, irritants, and chemotatics. The most commonly used proliferant is hyperosmolar (10~25%) dextrose to act by osmotic rupture of cells. High resolution ultrasound imaging of musculoskeletal structure provide a more accurate diagnosis. Also ultrasound-guided intervention provides a more high efficacy and low rate of complications. The most common complication is local pain at the injected site, that is self-limited and good responsive to anti-inflammatory agents. Other complications are rare. It is reported that prolotherapy appears safe when performed by an experienced clinician. Prolotherapy has grown in popularity and has received significant recent attention. However there are limited evidence-based data supporting the indication and efficacy of prolotherapy in the treatment of chronic musculoskeletal pain or soft tissue injuries. Future studies are necessary to determine whether prolotherapy can play an independent and definitive role in a treatment for chronic musculoskeletal pain.

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Take advantage of ESWL in comparison measurement of Proximal stone against Mid Ureteral Stone according to its provability of pulverization (ESWL을 이용한 Proximal, Mid Ureteral Stone의 쇄석시 각 조건에 대한 쇄석율의 비교 측정)

  • Kang, Kwang-Soo;Lee, Sang-Bok;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.4 no.1
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    • pp.11-17
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    • 2010
  • A urolithiasis, also called calculus, is one of the brutal illnesses, which has constantly harassed humanbeings from time immemorial. However, there is no appropriate method of prevention so far. So, Urological therapy must be followed upon those patients. The biggest problem of urolithiasis is usually causing harsh pain, fever, and throw up. The pain would be more intensified when something came through the ureter or the moment of convulsion caused beyond transmission of urinary calculus. Even strong painkillers, such as fentanyl and Pethidine, can not handle those harshly pain easily. Therefore, a prompt action of medical check up and its therapy must be required to those patients. This thesis paper has put the accent on the specific therapy, known as ESWL (Extracorpereal Shock Wave Lithotripsy), which have generated quite optimum resolution to patients, who received harsh pain from Proximal ureteral stone and Mid ureteral stone and because of its low provability of pulverization. The results of the experiment confirmed that the stone, located between Proximal and Mid ureter, has lower provability of pulverization than distal ureter, because its accuracy rate on shock wave, in respect of breathing, are low. However, decrease in discharge interval have enhanced provability of pulverization. it can also intensify probability of pulverization and its safety by discharging high power with appropriate intervals, and that is more efficient than discharging low power with frequent time.

The Effects of Cystic Tyroid Lesions by Ethanol-Instillation (갑상선 낭종 환자에서 Ethanol 경화술의 효과)

  • Lee Hui-Seop;Kim Sang-Woon;Lee Soo-Jung;Shim Min-Chul;Kwun Koing-Bo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.18-23
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    • 1995
  • We analyzed the results of ethanol sclerotherapy in 47 patients with cystic thyroid lesion. Cytologic study showed all of the lesions to be benign. The patients were followed clinically and ultrasonically I month and 3 or more months after ethanol sclerotherapy. If the cystic lesions recurred, repeated treatment was offered. In 4 patients with pure cystic lesion, all of the patents had almost total resolution of the cystic lesions. In 43 patients with mixed cystic lesion, 16(37.2%) patients had almost total resolution of the cystic lesions, 10(23.3%) patients showed a decrease' in the cystic lesion of <50%, but 11(25.6%) patients it did not change in size. Overall, in 30(63.8%) patients the cystic lesion decreased in size. Eleven patients who were not effective by sclerotherapy or follicular proliferation by cytology were converted to surgery. Although no severe complication were observed, there were complication of severe pain in I patient and a drunken feeling in I patient. If the malignancy must be excluded by repeated cytologic examination of aspirated fluid, we consider instillation of ethanol into the cystic lesions of the thyroid to be a simple, safe, economical and effective treatment.

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A Case of Esophageal Achalasia Misconceived as Laryngopharyngeal Reflux Disease (인후두 역류질환으로 오인된 식도 이완불능증 1예)

  • Noh, Seung Ho;Lee, Yong Woo;Park, Jin Su;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.43-47
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    • 2017
  • Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.

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A Case of Showing Granuloma Following a Sea Urchin Sting (성게 가시에 의하여 육아종이 발생한 1례)

  • Lim, Hyun-Sul;Kim, Gyu-Hoi;Kim, Doo-Hie;Kim, Jung-Ran;Kim, Yong-Min;Lee, Hyeon-Kyeong
    • Journal of agricultural medicine and community health
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    • v.20 no.2
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    • pp.169-174
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    • 1995
  • The case was described of a 31 year old female who developed fusiform swelling of the right third finger at the site of puncture by sea urchin spine. We observed a radiopaque linear material suggesting a remnant spine which the size was 2.4 mm in sonography and mammography. We confirmed that it exhibits a urchin spine and distinct caseous necrosis with central calcification. Sea urchins(Echinoidea) are ubiquitous marine creatures that resemble pincushions and are covered by calcareous skeletons surrounded by numerous movable calcium carbonate spines. The sharp spines are brittle and easily detach when touched by the victim. Contact with sea urchin spines produces intense pain, some localized erythema and edema. Inflammation develops in response to retained fragments. Granulomas 1-5 mm in diameter develop rarely 2-12 months after envenomation. In treatment, hot water immersion and thorough wound cleansing are advisable. Analgesics may, be necessary after hot water immersion. Attempts to remove these spines should be performed with good lighting sources, preferably with radiological direction. Chronic granulomas usually require complete excision. Acetone has been suggested for rapid resolution of pain. No antidotes are available.

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Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

  • Ku, Jeong-Kui;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Korean Dental Science
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    • v.8 no.1
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    • pp.1-9
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    • 2015
  • Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.