• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.573-582
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• 2013

PURPOSE: The purpose of this study was to establish the reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI), which was translated into Korean for long-term wheelchair users. This index measured 15 functional activities, including transfer, self-care, wheelchair mobility and general activities. METHODS: To assess test-retest reliability, 23 long-term wheelchair users completed this self-administered index twice within the same day. Reliability was determined by the intraclass correlation coefficient (ICC), and Cronbach's alpha was used to measure internal consistency. To examine concurrent validity, 21 long-term wheelchair users completed the questionnaire, and we examined the correlation between the index score and the shoulder range of motion measurements. RESULT: The results showed that the intraclass correlation for test-retest reliability of the total index score ranging from .88 to .99 was good to excellent. Additionally, Cronbach's alpha was .96. The internal consistency indicated excellent. Concurrent validity showed negative correlations of total index score to range of motion measurements of shoulder flexion (rho=-.58), extension (rho=-.09), abduction (rho=-.59), external rotation (rho=-.07) and internal rotation (rho=-.3), suggesting a relationship of total index score to loss of shoulder range of motion. CONCLUSION: The Korean WUSPI shows not only high reliability and internal consistency, but also concurrent validity with loss of shoulder flexion and abduction.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.245-247
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• 2011

There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.89-92
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• 2005

The effects of acupuncture are complex and how it works is not entirely clear. Research suggests that the needling process, and other modalities used in acupuncture, may produce their complex effects on a wide variety of ways in the brain and the body. For example, it is theorized that stimulated nerve fibers transmit signals to the spinal cord and brain, thus activating parts of what is called the central nervous system. The spinal cord and brain then release certain hormones responsible for making us feel better overall and, more specifically, feel less pain. In fact, a study using images of the brain confirmed that acupuncture increases our pain threshold, which may explain its ability to produce long-term pain relief. Also, acupuncture may increase blood circulation and body temperature. It may also affect white blood cell activity (responsible for our immune function).

• The Korean Journal of Pain
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• v.19 no.2
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• pp.175-180
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• 2006

Background: A transforaminal epidural steroid injection has been used for the treatment of radicular arm or leg pain, which has the advantage of ventral epidural spreading compared to either an interlaminar or caudal approach. However, several factors are known to affect the epidural spread pattern of contrast dye; therefore, the injected medication can not be delivered to the target site. The objective of our study was to observe any differences in the contrast flow patterns according to several factors. Methods: A total of 34 epidurographies in 29 patients, who underwent fluoroscopically guided transforaminal epidural steroid injections, were evaluated. After confirming the location of the needle tip within the anterior superior aspect of the neural foramen in the lateral view, and at the 6 o'clock position to the pedicle in the anteroposterior view, 2 ml of contrast dye was injected. The contrast flow patterns of ventral, ventral and dorsal, and dorsal epidural filling were analyzed, according to age, gender, magnetic resonance imaging finding and history of previous back surgery. Results: Ventral contrast flow occurred in 30 out of the 34 epidurographies (88%). Both ventral and dorsal contrast flow patterns were observed 13 out of 16 (81%) patients in the older age group. Also, both ventral and dorsal contrast flow patterns were observed in 16 out of 18 (88%) patients with spinal stenosis. Conclusions: Transforaminal epidural steroid injections, performed uner fluoroscopy, provide excellent nerve root filling and ventral epidural spreading. Patients with spinal stenosis or an old age have both ventral and dorsal epidural spreading patterns.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.309-318
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• 2011

Objectives : To evaluate the effect of foot orthotic in patient with chronic pain and pelvic obliquity in standing. Methods : Four cases of functional spinal scoliosis, were investigated for the changes in the calcaneal stance position angle, pelvic height, pelvic angle, Cobb's angle and walking pattern. Standing full spine X-ray for measuring the pelvic height, pelvic angle, Cobb's angle were checked before and after application of foot orthosis. The foot orthosis was composed of polyprophylen and chamude cover. Results : 1. There was no change in resting calcaneal stance position. 2. Difference of pelvic height and pelvic angle was reduced after application of a foot orthosis. 3. Cobb's angle in 2 cases was reduced after application of a foot orthosis. 4. Walking balance was improved. 5. Visual analogue scale was decreased. Conclusions : The study showed that foot orthosis seemed to be effective for chronic pain, spinal curve, pelvic obliquity and walking balance.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.12 no.1
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• pp.143-153
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• 1999

Background: The vasoreactivity of cerebral artery is currently the subject of increasing interest Transcranial Doppler The purpose of this study was to investigate the analgesic effect of acupuncture in a model of neuropathic pain produced by segmental spinal nerve injury (SSI) in rats. The left L5 and L6 spinal nerves of Sprague-Dawley rats were tightly ligated, and one week later, manual or electro-acupuncture was applied for 30 minutes to the contralateral hindlimb (right side) while the animal was lightly anesthetized with halothane. The mechanical threshold of the paw for ipsilateral (left side) hind limb flinching was determined prior to and 0.5, 1, 2, 4, and 24 hours after termination of acupuncture. The mechanical threshold for flinching was significantly elevated for about 4 hours after manual acupuncture applied to the BL. 60 (Kunlun) point or electro-acupuncture to the BL. 60 and BL. 40 (Weizhong) points. However, manual acupuncture applied to the ST. 36 (Zusanli) point was not effective. Furthermore, systemic naloxone pretreatment had no effect on the acupuncture induced threshold elevation. These data suggests that acupuncture produces a point specific, naloxone independent analgesia in a rat neuropathic pain model. ※ This paper is supported by a grant from the '1996 Jusan Foundation of Wonkwang university.)

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1394-1398
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• 2001

Objective : The purpose of this non-randomized prospective study was to evaluate the safety and efficacy of continuous intravenous nalbuphine-ketorolac-droperidol(CIA) versus continuous infusion of epidural morphine-bupivacaine(CEA) for pain control after lumbar spinal surgery. Methods : Twenty-one patients who underwent spine surgery including laminectomy, fusion with fixation were assigned to receive an intravenous bolus of nalbuphine 5mg and ketorolac 15mg, followed by a continuous infusion of nalbuphine 25mg, ketorolac 105mg, and droperidol 5mg mixed with normal saline 98cc(2cc/hr). Twenty patients received a bolus infusion of morphine 2mg and 0.125% bupivacaine 8cc followed by a continuous intravenous infusion of 100cc 0.125% bupivacaine and morphine sulfate 8.0mg(2cc/hr). Pain score was measured on a visual analogue scale(VAS). It's safety and efficacies were compared with the results of continuous infusion of epidural morphine-bupivacaine, which was reported previously by same authors. A continuous infuser was used to give epidural morphine-bupivacaine and intravenous nalbuphine-ketorolac-droperidol. Results : In general, mild pain, pain less than 3 VAS scores, was observed postoperatively from 30minutes to 72hours in CEA group, and from 6 hours to 72 hours in CIA group. The early postoperative pain was controlled easily in 6 hours in CEA group, compared to CIA group(p<0.05). However, there was no statistical significance in 72 hours on pain scores between CEA and CIA groups after 6-12hours of pain managements. Pruritus, nausea and vomiting, and urinary retention were more frequent in CEA group. Conclusion : CIA and CEA are considered effective methods in postoperative pain managements. However, adequate doses in early intravenous infusion and continuous intravenous analgesia with nalbuphine-ketorolac-droperidol will be needed for better control in early postoperative pain with less side effects.

• The Korean Journal of Pain
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• v.23 no.2
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• pp.147-150
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• 2010

Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.191-194
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• 2013

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.24 no.4
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• pp.255-264
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• 2017

Purpose: The purpose of this study was to develop a smartphone app for use in patient controlled analgesia (PCA) education and to identify PCA knowledge and pain management following lower extremity orthopaedic surgery under spinal anesthesia in patients who received smartphone app education. Methods: Participants were 150 patients in an orthopaedic hospital located in Busan. The measurement variables used in this study were PCA knowledge, pain management and pain level. For data analysis, SPSS/WIN 21.0 program was used in the analysis of the relation of frequencies. In addition, percentage, mean and standard deviation, t-test, ANOVA, Duncan, Pearson's correlation coefficients were also assessed. Results: The score for knowledge regarding PCA was $4.27{\pm}1.64$. The correlations between knowledge and pain management (button push times