• The Korean Journal of Pain
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• 제8권2호
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• pp.341-346
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• 1995

Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.

• The Korean Journal of Pain
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• 제8권2호
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• pp.304-307
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• 1995

1,666 patients treated by nerve block from September 1994 to August 1995 we statistically analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Diseases and ailments were as follows: low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7%, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trigger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows: facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic ganglion block 15.4%.

• 한국임상수의학회지
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• 제23권2호
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• pp.190-193
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• 2006

개에서 방사선 검사로 확진한 둔부 골관절염 증례에 대하여 hyaluronic acid의 관절강내 주사 및 caprofen의 경구투여를 2주간 치료를 하였으나, 임상증상이 개선되지 않았다. 봉독 수침요법(5일 간격, 7회)과 압통점 치료를 병용하였다. 수침에 사용된 혈위는 이환 된 우측 환지의 5개 혈위를 사용하였다: GB30(국소혈), ST35, GB33, BL40 및 LIV08(원위혈). 수침재료(0.2 ml/혈위, 전체 1 ml/회)는 apitoxin $100{\mu}g+2%$ 리도카인 (1:1)+생리식염수로 제조하였고, 5개 혈위에 각각 0.2 ml씩 수침하였다. 또한 우측 환지의 대퇴사두근의 압통점에 2% 리도카인(0.2ml/압통점)을 매회 치료 시 각각 수침하였다. 봉침 수침 요법은 임상증상을 급속하게 개선시켰는데, 파행 및 보행실조가 7회 치료(30일) 후 소실되었으며, 우측 후지의 근육 위축이 많이 호전되었고, 치료 종료 2주 후(44일)에 방사선 검사 상 환부는 거의 정상소견을 나타내었다. 본 환축은 봉독 수침 요법과 압통점 치료의 병용으로 양호한 치료반응을 나타난 개의 둔부 골관절염의 증례이었다.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• 한국임상수의학회지
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• 제23권1호
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• pp.65-68
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• 2006

개 추간판 디스크의 2증례를 수침치료를 하였다. 증례 1은 경부 디스크(C3-C4)의 증례이었으며, 1-2차 치료에서는 덱사메타손(1 mg/ml), 3-5차 치료에서는 염산치아민(25mg/ml)을 각각 수침하였다. 사용혈위는 GV-16, GB-20, BL-10, LU-7, LI-4 및 SI-6이었다. 2-5차 치료에는 GV-6, GV-20 및 SP-6의 혈위를 추가하였다. 3-5차 치료에는 2% 염산리도카인(0.2ml)를 이용하여 견갑아래근 및 상완세갈래근의 압통점에 각각 수침하였다. 5차 치료 후 마비증상은 소실되어 치료를 중단하였으며, 5개월 후 증상의 재발은 인정되지 않았다. 증례 2는 요부디스크의 증례(L1-L2)로 1-2차 치료에는 덱사메타손 수침을 3-4차치료에는 염산치아민을 각각 수침하였다. 사용혈위는 GV-6를 주혈로, ST-36, ST-40, GB-34, ST-41 및 BL-40을 부혈로 각각 사용하였다. 또한 허리장골 늑골근 및 대퇴네갈래근의 압통점에 2% 염산리도카인(0.2ml)를 각각 수침하였다. 4차 치료 후 마비증상이 호전되어 치료를 중단하였고, 5개월 후 현재 까지 증상의 재발은 인정되지 않았다. 이상의 증례를 통하여, 덱사메타손과 염산치아민의 수침 및 리도카인을 이용한 압통점치료의 병용은 개의 경부 및 요부디스크의 증상을 효과적으로 콘트롤 할 수 있는 것으로 판단되었다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.156-160
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• 2005

Background: Frozen shoulder is not an uncommon disease, which is associated with chronic pain and joint movement limitation. However, there are numerous devices to assist in the treatment of shoulder pain, but their efficacy has not been proven and their use remains immensely controversial. Therefore, a randomized clinical study was conducted to determine the effectiveness of a low-frequency stimulator for the treatment of frozen shoulder. Methods: A randomized clinical trial was carried out on 40 patients with frozen shoulder, with 40 patients assigned to two groups; a control treatment group (group C, n = 20) and a low frequency stimulator application group (group T, n = 20). Both groups were given a routine treatment modality, such as trigger point injection, intramuscular stimulation or suprascapular nerve block etc. The level of the shoulder pain was evaluated using a 100mm VAS (visual analog scale) at each visit, with the limitation in the range of motion simultaneously evaluated. Results: All the subjects improved after treatment, with the VAS scores after termination of treatment showed a statistically significant reduction (P < 0.05). However, there was no significant difference between the two groups. One month after termination of 5 cycles of treatment, group T maintained their improved state, whereas the pain in some of those in group C reemerged, which also showed a statistically significant difference (P < 0.05). The limitation in the range of motion improved, with most subjects able to resume daily activity. Conclusions: Although the low frequency stimulation provided no more pain relief than routine treatment, the effect was significantly prolonged. From this result, low frequency stimulation can be considered to aide the therapeutic effect of classical frozen shoulder therapy.

• Journal of Yeungnam Medical Science
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• 제26권1호
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• pp.74-77
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• 2009

말초에서부터 야기된 행동장애가 존재하는지 아니면 말초 신경 손상 후의 행동장애가 심리적인 것으로 인한 것인지에 대한 논의가 계속되고 있다. 말초 신경 손상에 의해 야기된 상지의 진전에 대한 증례를 보고하고자 한다. 25세 남자환자는 자동차 사고 이틀 후 상지의 통증과 진전이 발생하였다. 뇌 및 경추의 자기공명영상 촬영상 특이소견이 없었다. 과거력상 특이 소견 없었으며 행동장애에 대한 가족력 또한 없었다. 그는 하루에 약 네 차례에서 여섯 차례 십분 이상 지속되며 악화되는 진전으로 고통 받았다. 약물 치료, 경막외주사 주입, 경추의 신경차단술, 통증유발부위 주사요법 등으로 통증 조절을 하였다. 그 결과 통증이 반 정도 줄었으며 진전의 강도, 시간, 빈도가 줄어들었다.

• The Korean Journal of Pain
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• 제37권1호
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• pp.51-58
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• 2024

Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.143-155
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• 2007

Objectives: To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Methods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group, n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. All three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significantly(p<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

• Journal of Acupuncture Research
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• 제23권5호
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• pp.177-185
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• 2006

Objectives : To observe the effect of acupuncture treatment and western medical treatment on frozen shoulder patients. Methods : 39 voluntary patients were randomly assigned to the Eastern treatment group(E group, n=22) and the Western treatment group(W group, n=17). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. Both groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment using Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 5.67 on a scale of 10. The W group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 7.73. But the difference between the two groups were insignificant according to CSA and SPADI. Conclusion : Both acupuncture and nerve block treatment significantly improved frozen shoulder. But the difference of the two treatments was insignificant.