• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.95-98
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• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• The Korean Journal of Pharmacology
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• v.19 no.2
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• pp.1-8
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• 1983

Prostaglandin(PG) is ubiquitously distributed in most mammalian tissue and their actions are complicated. Especially in autonomic nervous system, there are evidences indicating that PGs act as neuromodulators i.e., PGs, which are released in the vicinity of autonomic neuroeffector junctions, influence the release and the response of the neurotransmitter. Present study was undertaken to elucidate the interrelationship between $PGF_{2\alpha}$ and adrenergic ${\alpha}_2-receptor$ function in electrical field stimulation induced contractile response of vas deferens in rat. Male rat, weighing 150{\sim}200\;g, was sacrificed and vas deferens was obtained. The isolated vas deferens strip was placed between two platinum electrodes in temperature controlled $(37^{\circ}C)$ muscle chamber containing Tyrode's solution and the electrical field stimulation(EFS) induced contraction was recorded with Grass Polygraph(Model 7) via force displacement transducer (FT .03, Grass). The results are summarized as follows: 1) Electrical field stimulation for 1sec( 1 msec, 40 cps) induced contraction of vas deferens was completely blocked by tetrodotoxin. 2) Bretylium caused marked inhibition of the EFS-induced contraction, hut tyramine and cocaine augmented the contraction. 3) EFS-induced contraction was inhibited or little affected in distal portion of vas deferens by norepinephrine or methoxamine, but the contraction was rather augmented by the ${\alpha}-agonists$ in proximal portion. 4) Clonidine inhibited the EFS-induced contraction proportionally to the concentration in distal portion, which was blocked by yohimbine pretreatment, but in the presence of $PGF_{2\alpha}$ the blockade by yohimbine was reversed. 5) Indomethacin pretreatment reduced the effect of clonidine, but addition of $PGF_{2\alpha}$ after washing-out the indomethacin caused the contraction to the control level. From these results it is suggested that PG synthesis is a necessary step and the PG itself has a permissive role in ${\alpha}_2-adrenoceptor$ action in rat vas deferens.

• Journal of Sasang Constitutional Medicine
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• v.22 no.2
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• pp.123-134
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• 2010

1. Objectives: This study reports two cases of repetitive episodic tension-type headache patients who were each constitutionally typed as the Taeeum type and the Soyang type and respectively treated with Yanggyeoksanhwa-tang and Galgeunhaegi-tang. 2. Methods: The patients' subjective and objective symptoms were observed daily, and the VAS scores for the main symptoms were recorded daily throughout hospitalization period. When deemed necessary, other assessment tools were engaged (Migraine-Specific Quality of Life questionnaire, Migraine Disablity Assessment questionnaire, Headache Impact Test-6, etc.). 3. Results: The Soyang Type patient's headache improved by the end of hospitalization, with a dramatic drop in the VAS score from VAS 10 to VAS 2. The Taeeum Type patient's headache also showed improvement, with an equally dramatic decrease in the VAS score from VAS 10 to VAS 2. 4. Conclusion: Although the two patients were experiencing the same symptoms of repetitive episodic tension-type headache, they were each given different medicinal interventions in accordance to their respective constitutional types. This series of cases is notable in that the two widely different medications (Yanggyeoksanhwa-tang and Galgeunhaegi-tang) were applied to specifically conforming pathologies (the Sogal symptomatology and the Ganyeol symptomatology, respectively) to produce equally dramatic improvements.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.2
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• pp.131-140
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• 2014

Objectives This study was aimed at comparing clinical effectiveness among trigger point treatment, Self-exercise treatment, trigger point - self-exercise cooperative treatment for neck pain caused by traffic accidents. Methods 63 patients with neck pain by traffic accidents were divided into 3 groups. Different types of treatments were carried out for each groups ; group A with trigger point, group B with self-exercise, group C with trigger point and self-exercise cooperative treatment. 3 groups were also treated with general acupuncture and herb-medicine treatment. Pain threshold, visual analogue scale (VAS), and neck disability index (NDI) were checked on a daily basis. SPSS ver. 18.0 for Windows was used for analysis of data. The effectiveness of treatment of each groups were verified by using paired test and one-way repeated-measures ANOVA test, and the comparison of VAS, NDI and pain threshold were demonstrated by independent samples t-test. Results 3 groups all showed significant difference in pain threshold, VAS and NDI after 8 days later. Group C showed more improvement in pain threshold, VAS and NDI than shown in group A and B. In the first period (from pre-treatment to 4th day treatment) group C showed significant difference in NDI and pain threshold but not in VAS as compared to group A and B. In the second period (from 4th treatment to 8th day treatment), Group C showed significant difference in pain threshold, VAS and NDI as compared to group A and B. Conclusions Trigger point - self-exercise cooperative treatment is proved to be more helpful to improve the unstability and reduce neck pain than trigger point treatment or self-exercise treatment only, therefore eventually leading to better satisfaction for patients with neck pain.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.27-34
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• 2005

Objectives : To evaluate the pain improvement of the frozen shoulder patients taken the electro-acupuncture therapy using Visual Analogue Scale. Methods : The 38 frozen shoulder patients visited department of Acupuncture & Moxibustion in National Medical Center from 1st September 2004 to 28th February 2005 had taken the electroacupuncture therapy or body-acupuncture therapy more than 3 times.(Electroacupuncture group was 24 persons and body-acupuncture group was 14 persons.) We evaluated their improvement of shoulder pain using Visual Analog Scale(VAS) at each visit. Then we analyzed the pain improvement comparing with two groups. Results : Both VAS scores of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group and body-acupuncture group have significantly improved. VAS score at third visit of electroacupuncture group was significantly lower than that of body-acupuncture group (p=0.0057). The decreased VAS score after first visit of electroacupuncture group was also significantly higher than that of body-acupuncture group(p=0.0225). Conclusion : The pain of electroacupuncture group decreased more than body-acupuncture group at early visit. But the total decreased VAS scores of two groups was not significantly different.

• Journal of Acupuncture Research
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• v.23 no.5
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• pp.39-54
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• 2006

Objectives : Herniation of Nucleus Pulpous (HNP) of Lumbar is one of the most common causes of low back pain. The aim of this study is to investigate the effectiveness of acupuncture, bee venom acupuncture (BVA), and bee venom Pharmacopuncture (BVP) therapy for HNP. Methods : We separated 35 patients with HNP of L-spine into three groups; Acupuncture treated group, BVA treated group, and BVP treated group, and monitored for 30 days. 4 grades of recovery degree, score of Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) were examined for comparison. Results : 1. Visual Analogue Scale of low back pain and radiating pain showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_2, VAS0_3 evaluations. 2. ODI of disability of daily activities showed significant decrease in BVA and BVP groups compared to the Acupuncture group at VAS0_1, VAS0_2, and VAS0_3 evaluations. 3. Compared to the Acupuncture group, BVA and BVP groups were improved in S.L.R.T and R.O.M of L-spine as confirmed by the physical examination. 4. Treatment efficacy was more apparent in acute cases as ODI was significantly lower than chronic cases. Conclusion : BVA and BVP therapies can be used in addition to the acupuncture therapy for highly effective treatment of HNP. Further clinical studies are required to verify these findings.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.411-417
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• 2019

Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.381-389
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• 2004

Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

• Journal of Korea Entertainment Industry Association
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• v.14 no.4
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• pp.355-363
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• 2020

To investigate the relationship between breathing pattern disorder and pain in patients with chronic low back pain(CLBP). One hundred four patients were measured the End-tidal CO₂(EtCO₂) and respiration rate(RR) using capnography. Also, The Breathing-hold time(BHT), Nijmegen Questionnaire(NQ), and Thoracic excursion examinated. There was a significant correlation between EtCO₂ and BHT, thoracic excursion(r=.302, r=.281)(p<.01), and a low negative correlation with RR, VAS(r=-.253, -200)(p<.05). There was a significant correlation between NQ and RR(r=.237)(p<.05). There was a low correlation between thoracic excursion and VAS(r=-.370)(p<.01). There was a significant difference in the EtCO₂, RR, BHT, thoracic excursion, and VAS between the thoracic and diaphragm breathing pattern(p<.05). There were no significant differences in the NQ(p>.05). There was a correlation between EtCO₂ and BHT, thoracic excursion, RR, VAS in patients with CLBP. In addition, There was a correlation between RR and NQ, thoracic excursion, and VAS. As a result, it was found that there is a close relationship between breathing pattern disorder and pain. There was a significant difference in the EtCO₂ level, RR, BHT, thoracic excursion and VAS value in the comparison of thoracic breathing pattern and diaphragm breathing pattern. This is a meaningful result of suggesting a breathing pattern treatment approach in the rehabilitation and pain management of chronic low back pain patients in clinical practice.

• Journal of Acupuncture Research
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• v.25 no.3
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• pp.29-39
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• 2008

Methods : We investigated 28 cases of patients with thoracolumbar compression fracture. We divided patients into two groups : We treated one group with complex oriental medical treatment focusing on Bee Venom Acupuncture therapy, and did the other group with complex oriental medical treatment focusing on acupuncture therapy. To investigate the effectiveness of treatment applied for two groups, we used Visual Analog Scale(VAS) and Oswestry Low-back Pain Disability Index(ODI). We compared the VAS score and ODI score of two groups statistically. Results : 1. Female is prominent in distribution of sex, the average age bracket is 70's, and the largest group was Faccidental fall in the distribution of cause. 2. In regard to level of injury, T12 was found to be most prominent, followed in turn by L1, L2. In regard to grade of clinical symptoms, Grade III was most prominent, followed by Grade IV, Grade II. 3. As a result of evaluation by using VAS score and ODI score, treatment score at final was significantly different from that at the baseline in each group. 4. After treatment, Bee Venom acupuncture therapy group showed significant difference on VAS score and ODI score compared with acupuncture therapy group. Conclusions : Bee Venom acupuncture therapy can be available for relieving symptoms related with thoracolumbar compression fracture.