• Title/Summary/Keyword: radiating pain

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dissecting aortic aneurysm (DeBakey Type III) -Report of two cases- (박리성 대동맥류(DeBakey Type III)의 외과적 치험 -2예보고-)

  • 문경훈
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.443-448
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    • 1986
  • Aortic dissection is a serious disease that mortality does not approach to zero despite of medical and surgical improvement. Recently two cases of aortic dissection were treated with good results by the two other methods. Case 1 [57-Y-0-Male]; Chief complaint was chest pain radiating to the back. Preoperatively he was controlled by Minipress, dichlotride, & sodium nitroprusside. Aortography showed DeBakey Type III aortic dissection extending from just below the Lt. subclavian artery to the proximal portion of the origin of the renal artery. Through the midline long incision Flow reversal & Thrombo-exclusion method was used, and bypass course was proximal anastomosis at the ascending aorta - through the Rt. thoracic cavity - midportion of the diaphragm - posterior to the liver, stomach, & pancreas - distal anastomosis at the abdominal aorta proximal to its bifurcation. Bypass graft was preclotted 20 mm Dacron Woven Graft, and the aortic arch between the Lt. subclavian artery & Lt. common carotid artery was divided and meticulously sutured. Control aortogram which was done at 4th postoperative month revealed obstruction of the false lumen by thrombosis, and complications were not noticed. Case 2 [53-Y-0-Male]; Chief complaint was chest pain radiating to the abdomen. DeBakey Type III aortic dissection which was similar to the case 1 was detected by the aortography, and involvement of the Lt. subclavian & common carotid arteries was suspicious. Through the Lt. posterolateral thoracotomy the Ringed Intraluminal Sutureless Graft, No. 22 mm, was inserted from just below the Lt. common carotid artery to the midportion of the descending thoracic aorta under total circulation arrest using a F-F bypass, and the Lt. subclavian artery was ligated. Postoperatively hospital course was uneventful with antihypertensive drugs, and any specific complications were not noticed.

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A Man Presenting with Sudden Weakness and Pain of the Right Hand, by Non-Small Cell Lung Cancer with Brain Metastases (비소세포폐암의 뇌전이로 인한 갑작스런 수부 통증 및 마비)

  • Sung, Won Jin;Hong, Bo Young;Kim, Joon Sung;Yoo, Jae Wan;Lim, Seong Hoon
    • Clinical Pain
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    • v.18 no.2
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    • pp.88-91
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    • 2019
  • Unexplained pain and weakness, i.e., without obvious predisposing factors, are often encountered by physiatrists and efforts should be made to determine the cause. A 63-year-old male presented with radiating pain in his right arm and mild weakness of the right hand. An electrodiagnostic examination revealed distal symmetric sensory polyneuropathy in the upper and lower extremities, and denervation potentials in the forearm muscles, which were inconsistent with the cervical spine MRI images and symptoms. A predisposing undiscovered disease was revealed, i.e., squamous cell carcinoma in the lung; brain metastasis affecting the left primary motor cortex was also detected. Therefore, we concluded that the pain and weakness were related to paraneoplastic syndrome and brain metastases of the hand knob. The observed denervation potentials were characterized as trans-synaptic changes in the brain metastasis. This case highlights the importance of unexplainable focal pain and weakness in the increasing prevalence of cancer.

Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul;Kim, Deog-Ryeong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.61-64
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    • 2015
  • A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

The Effect of Acupotomy on Lumbar Herniated Intervertebral Disc: Report of a Case Series (요추 추간판 탈출증 환자에 대한 도침을 포함한 한방 복합치료 효과: 연속증례보고)

  • Kim, Hye Su;Kim, So Yun;Kim, Hyun Ji;Kim, Eun Seok;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.185-195
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    • 2015
  • Objectives : This is a case series reporting of the improvement in patients with a lumbar herniated intervertebral disc by means of acupotomy combined with oriental medicine. Methods : We treated seven patients with a lumbar herniated intervertebral disc with acupotomy combined with oriental medical treatment. We checked the numeric rating scale(NRS), oswestry low back pain disability index(ODI) and range of motion(ROM). Results : NRS and ODI decreased, and ROM improved in all cases. Conclusions : This study shows acupotomy has a meaningful effect when applied on a lumbar herniated intervertebral disc.

A Retrospective Study on Combined Traditional Korean Medicine Treatment of Cervical Radiculopathy Patients Who Underwent Ineffective Epidural Steroid Injection Treatment

  • Kim, JiSu
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.248-251
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    • 2018
  • This retrospective study reports the effects of combined traditional Korean treatment of cervical radiculopathy in patients who underwent ineffective epidural steroid injection treatment. This study analyzed cervical radiculopathy in patients who visited traditional Korean medicine hospital following an ineffective epidural steroid injection. There were 29 cases included in this study. Scores for Visual Analog Scale (VAS) and Neck Disability Index (NDI) were measured before and after combined treatment with acupuncture, herbal medicine, and chuna therapy. The results of this study showed that patient VAS scores for neck and shoulder pain were significantly reduced (p < 0.001) when comparing scores before treatment ($6.03{\pm}2.04$) with after treatment ($2.14{\pm}1.27$). In addition, the VAS score for radiating pain before treatment ($6.67{\pm}1.44$) compared with after treatment ($2.89{\pm}1.83$) showed a significant reduction (p < 0.001). Furthermore, the NDI score before treatment ($25.85{\pm}6.33$) compared with after treatment ($11.33{\pm}7.47$), also showed a significant reduction (p < 0.001). The results in this study showed the positive effects of combined traditional Korean medicine treatment in significantly reducing pain for patients with cervical radiculopathy, who had ineffective anesthesia.

Thread Embedding Acupuncture and Complex Korean Medicine Treatment for Lumbar Spinal Stenosis with Degenerative Scoliosis: A Clinical Case Report

  • Park, Yu-Kyeong;Lee, Jung Hee;Kim, Jae Soo;Lee, Yun Kyu;Lee, Hyun-Jong
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.320-324
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    • 2021
  • Lumbar spinal stenosis (LSS) is a common degenerative spinal condition that can have unpredictable improvement and worsening of symptoms which include low back pain, radiating pain, claudication, and degenerative lumbar scoliosis affecting quality of life. In this study, thread embedding acupuncture (TEA) was used as a conservative treatment for LSS in combination with complex Korean medicine treatments (acupuncture, herbal medicines, and physical therapy). The treatment was evaluated using the numerical rating scale, walking distance and duration, and inclination of radiological lumbar scoliosis according to antalgic posture. TEA was performed 27 times between June 8, 2020, and March 16, 2021. The patient showed improvement in numerical rating scale score from 7 to 2, pain-free walking distance from 10 m to 900 m, and scoliosis inclination following treatment. The findings of this study suggest that TEA may be helpful in the treatment of LSS.

Late Occurrence of Multiple Bone Metastasis in Patient with Well Controlled Advanced Pancreatic Cancer

  • Min Cheol Kim;Da Eun Jeong;Joon Hyuk Choi;Tae Nyeun Kim
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.39-42
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    • 2016
  • A 67-year-old male was admitted due to abdominal pain. Abdominal CT scan performed in a local clinic showed about 2 cm sized pancreatic tail mass with extensive liver and multiple regional lymph node metastasis. Histology of liver biopsy revealed poorly differentiated adenocarcinoma. He underwent chemotherapy with gemcitabine and erlotinib for 5 cycles followed by 8 cycles of second line chemotherapy with 5-fluorouracil and cisplatin. At 12 months after diagnosis, follow-up abdominal CT scan revealed marked reduction of tumor mass in the liver and pancreas with small residual tumor. After one month of last chemotherapy, he complained radiating pain along left leg. Blood chemistry revealed isolated elevation of alkaline phosphatase (ALP) and multiple bone metastasis were demonstrated in bone scan. Palliative radiation therapy to pelvic bone was performed for the relief of bone pain. The prognosis of advanced pancreatic cancer is extremely poor. We report late occurrence of multiple bone metastasis in a patient with well controlled advanced pancreatic cancer with chemotherapy.

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The Effect of the Acupuncture Therapy in Combination with Soyeom Pharmacopuncture Therapy on the Improvement of the Symptoms of the Patients with Herniated Intervertebral Disk of L-spine in His Initial Stage of Hospitalization (소염약침 병행치료가 요추추간판탈출증 환자의 입원초기 증상 호전에 미치는 영향)

  • Song, Hyong-Gun;Choe, Joo-Young;Kang, Jae-Hui;Lee, Hyun
    • Journal of Pharmacopuncture
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    • v.12 no.4
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    • pp.111-118
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    • 2009
  • Objectives: Herniated Intervertebral Disk(HIVD) of L-spine is one of the most common diseases that cause back pain and radiating pain. The aim of this study is to find out if the acupuncture therapy combined with Soyeom Pharmacopuncture therapy can improve the symptoms of the patients suffering from the disease more effectively than the acupuncture only therapy. Methods: We separated 30 patients into two groups. Group A was treated with the acupuncture only therapy, and Group B was treated with Soyeom Pharmacopuncture therapy in addition to the acupuncture therapy. We have observed patients for 7 days. We checked the Visual Analog Scale(VAS) for 4 times and did Straight Leg Raising Test(SLRT) twice. Results: 1. For 7 days from the admission day, the VAS score has been decreased significantly in both Group A and Group B. 2. For 7 days from the admission day, the VAS score of Group B has been appeared signifi cantly lower than that of Group A, so that we can know that patients in Group B has more rapidly improved than patients in Group A 3. From the admission day to the 3rd hospital day, the improvement index of VAS scroe of Group B has appeared significantly higher than that of Group A, but after 5th hospital day, there was no significance between the improvement index of VAS score of Group A and that of Group B. 4. For 7 days from the admission day, the SLRT(degree) has been improved significantly in both Group A and B, but there was no significance between the SLRT(degree) of Group A and that of Group B. Conclusion: We can use Soyeom Pharmacopuncture therapy with acupuncture therapy to make the patients suffering from back pain and radiating pain improve more rapidly.

The Analysis of Research Trend about Management of Low Back Pain (요통관리에 관한 연구동향 분석)

  • Hyun, Kyung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.51-60
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    • 1998
  • The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

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Effects of Korean Medical Combination Treatment for Herniated Intervertebral Lumbar Disc Patients: An Observational Study (요추 추간판 탈출증 환자에 대한 한의학적 복합치료 효과의 관찰 연구)

  • Kim, Seh Young;Park, Han Sol;Kim, Min Chul;Seo, Young Woo;Seo, Young Hoon;Lee, Sang Min;Kim, Ki Ok;Kim, Tae Hun
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.21-28
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    • 2014
  • Objectives : Lumbar disc herniations are common conditions which induce severe pain and disability. We assessed the clinical effectiveness of Korean medical combination treatment. Methods : This is an observational study. We reviewed the medical records of 46 patients with lumbar disc herniations, who attended intensive Korean medical combination treatments at Mokhuri Neck and Back Hospital, Korea during March, 2012 to October, 2012. All the patients took combination treatments of acupuncture, Chuna and herbal medicines during the hospitalization treatments. Zero to ten pain numerating rating scale(NRS) of pain and SF-36 were assessed before and after treatments. Results : During the period, 46 patients with lumbar disc herniation participated in the treatments, respectively. Average admission duration were 20.32 days(SD 9.67) in lumbar disc patients. For lumbar patients, low back pain NRS decreased from $5.84{\pm}2.58$ to $2.12{\pm}1.74$(p<0.001) and radiating pain from $6.25{\pm}2.30$ to $2.59{\pm}1.97$(p<0.001). Total SF-36 score increased significantly after treatment in lumbar disc patients(p<0.001). Conclusions : Korean medical combination treatment might be effective in reducing pain and improving life quality of patients with lumbar disc herniation.