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하악신경차단으로 도움받은 삼차신경통환자의 영양섭취 및 간기능회복
차영덕(Young Deog Cha),김천숙(Chun Sook Kim) 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.1
It is well known that many patients with trigeminal neuralgia suffer from electric shock-like stabbing pains. The pain can be triggered by nonnoxious stimuli such as touching of the face, chewing, talking or swallowing. This 62 year old woman was urgently admitted to the internal medicine department due to abdominal distention and severe general weakness. She has suffered characteristic violent pain triggered by chewing and swallowing for little over 4 years. This resulted in poor oral feeding for prolonged period which left her severely debilitated. The large amount of ascites that developed 20 days before admission and extreme emaciation forced her to bed rest. She also suffered from Herpes Zoster. After medical treatment to improve liver function and severe pain was persisted, the patient was referred to our department for control of pain. We performed right mandibular block with 1% dibucaine 0.4 ml and the effect was excellent. After the pain had subsided, patient was able to take meals more comfortably and improved liver function returned.
차영덕(Young Deog Cha),김일호(Il Ho Kim),김유재(Yu 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.1
This is a study of decrease in both stump pain and unidentified complaints after removal of neuroma on an amputated left thigh. The patient was a 44 year old woman who received an operation after a motorcycle accident 20th of March, 1991. She started a rehabilitation program in early June of the same year. How- ever the patient complained of a squeezing pain on the amputated area. This symptom became more severe after the removal of the nails in September. The pain was perceived as a mental problem and the patient was released from the previous hospital. The pain continued and on the 9th of March, 1992, the patient was introduced to our pain clinic. The patient complained about the cold sensation and pressure pain of the amputated area at the beginning. Later she also expressed various unidentified complaints. No improvement resulted after conducting an epidural block and a lumbar sympathetic ganglion block. MMPI test showed psychological in- stability. Local injection showed some positive effects, which led to considerations concerning the possibility of neuroma. After confirming the existence of neuroma through CT and MRI, neuromectomy was performed. After the removal of neuroma, the unidentified complaints as well as the stump pain decreased
성상신경절 차단이 혈장 ACTH 및 Cortisol 치에 미치는 영향
채영근(Young Geun Choi),송장호(Jang Ho Song),임현경(Hyun Kyung Lim),한정욱(Jung Wook Han),이성근(Seong Keun Lee),차영덕(Young Deog Cha),신재규(Jae Kue Shin),류중하(Jung Ha Ryu) 대한통증학회 2002 The Korean Journal of Pain Vol.15 No.1
N/A Background: Stellate ganglion block (SGB) is a sympathetic nerve block method which has been used most frequently in pain clinics due to its wide range of indications. This study was conducted to determine the endocrinologic response to repeated SGBs. Methods: Thirteen healthy volunteers were studied. SGB was performed one hunderd times with 6 ml of 1% mepivacaine. Venous blood was drawn to measure plasma adrenocorticotrophic hormone (ACTH) and cortisol consentration before and after SGB for twenty, forty, sixty, eighty and one hundred times. The blood was drawn at 8:00 a.m. and 4:00 p.m. every sampling day. Results: The plasma concentration of eortisol at 8:00 a.m. was significantly higher after SGB one hundred times than prior to SGB. The plsma concentration at 4:00 p.m. was significantly higher after SGB forty times than prior to SGB. The ACTH concentration was significantly times at 4:00 p.m. Conclusions: After SGB, the plasma concentration of cortisol tended to increase while the ACTH levels tended to decrease. However, the effects of endocrinologic response to SGB were unclear since all values were within the normal limit.
김진수,곽수달,김정순,옥시영,차영덕,박욱,Kim, Jin-Soo,Kwak, Su-Dal,Kim, Jun-Soon,Ok, Sy-Young,Cha, Young-Deog,Park, Wook 대한통증학회 1993 The Korean Journal of Pain Vol.6 No.2
Reflex sympathetic dystrophy is a syndrome characterized by persistent, burning pain, hyperpathia, allodynia & hyperaesthesia in an extremity, with concurrent evidence of autonomic nervous system dysfunction. It generally develops after nerve injury, trauma, surgery, et al. The most successful therapies are directed towards blocking the sympathetic intervention to the affected extremity by regional sympathetic ganglion block or Bier block with sympathetic blocker; other traditional treatments include transcutaneous electrical stimulation, immobilization with cast & splint, physical therapy, psychotherapy, administration of sympathetic blocker, calcitonin, corticosteroid and analgesic agents. The purpose of this report is to evaluate and describe the effects of magnetic resonance following unsatisfactory results with traditional treatments of RSD. A 17 year old female patient, 1 year earlier, had received excision and drainage of pus at the right femoral triangle due to an injury caused by a stone. Afterwards, she experienced burning pain, knee joint stiffness, and muscle dystrophy of the right thigh, especially when standing and walking. Despite a year of number of traditional treatments such as: lumbar sympathetic block, continuous epidural analgesia, transcutaneous electrical stimulation, & administration of predisolone, her pain did not improve. Surprisingly, the patients was able to walk free from pain and difficulty after just one application of magnetic resonance. The patient has been successfully treated with further treatment of two to three times a week for approximately ten weeks. More recently, magnetic resonance has been demonstrated to produce effective results for the relief of pain in a variety of diseases. From our experiences we recognize magnetic resonance as a therapeutic modality which can provide excellent results for the treatment of RSD. It has been suggested that polysynaptic reflex which are disturbed in RSD may be modulated normally on the spinal cord level through the application of magnetic resonance.
김천숙(Chun Sook Kim),차영덕(Young Deog Cha) 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.1
N/A Psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and postoperative pain control. Nowadays this block is advocated for the man- agement of pain in the thighs, legs and lumbar area for various reasons. To relieve pain in the thigh and leg, 2l times of block were performed and observed clinically in the l7 patients at our hospital. The results were excellent for the relief of pain in metastatic cancer patients. And this block is satisfactory in the thigh pain but not in the leg pain. So we recommend psoas compartment block as a useful and simple method for the relief of pain in metastatic can- cer pain in the thigh.
미골골절이 있는 암성 회음부통증 환자에 시행한 외톨이 교감신경절 차단
이성근(Sung Keun Lee),차영덕(Young Deog Cha),석민 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2
The perineum is comprised of diverse anatomic structures with mixed sympathetic and somatic in- nervation. The coccyx is innervated by the coccygeal nerves and branches of the fifth sacral root. Recently, ganglion impar block has been introduced as an alternative means of managing intractable pain of sympathetic origin, coccygodynia by trauma, tenesmus and perineal hyperhydrosis. We managed a 59-year-old female patient who had suffered from perineal pain by metastasis of cervical cancer. Approach to impar ganglion through the anococcygeal ligament was impossible because her coccyx was hyperflexed anteriorly by old fracture. But we could perform ganglion impar block successfully by approach through the separation of sacrum and coccyx.
김천숙(Chun Sook Kim),차영덕(Young Deog Cha) 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.1
Inferior mesenteric plexus block(IMPB) is a useful nerve block for the relief of intracta- ble lower abdominal and pelvic pain caused by a lower abdominal visceral or a pelvic ma- lignancy. IMPB has been performed in the prone position. But there are many patients who can't lie in the prone position,because ascites is frequently noticed in cancer patients and they also frezuently received abdominal operations. We performed IMPB in the lateral position on two patients with lower abdominal pain. Case 1: A 77 year old female who had a right ovarian cancer with metastatic cancer of descending colon and rectum, experienced complete pain relief. Case 2: A 72 year old female who had a far advanced pancreatic cancer with intestinal obstruction due to carcinomatosis received right and left celiac plexus block and right and left IMPB.The patient was satisfied with the result of these pain blocks. Conclusion: IMAPB performed in the lateral position on two patients with lower abdomi- nal pain and their results were excellent for pain relief.