Journal of Yeungnam Medical Science

Original article

Anesthesiology and Pain Medicine
Quadratus lumborum block for postoperative pain management in patients undergoing ileostomy closure: a prospective, randomized controlled trial: Su Jin Kang, Soo Yeun Park, Jun Seok Park, Jinseok Yeo; J Yeungnam Med Sci. 2026;43:5. Published online December 19, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.5

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Abstract PDF: Background
Quadratus lumborum (QL) block is used for multimodal analgesia following abdominal surgery. We introduced an ultrasound-guided QL block to treat postoperative pain for ileostomy closure. This study aimed to investigate the analgesic efficacy of the QL block compared to placebo after ileostomy closure.
Methods
Fifty-seven patients undergoing elective ileostomy closure were randomized (1:1) to the placebo or QL block group in this double-blind randomized controlled trial. After general anesthesia, a unilateral QL block was performed under ultrasound guidance. Opioid consumption and numeric rating scale (NRS, 0–10) pain scores were recorded at 2, 6, 12, 24, 48, and 72 hours postoperatively. The primary outcome was the NRS pain score at rest at 6 hours. Secondary outcomes included pain scores, rescue analgesics over 72 hours, Quality of Recovery-15 scores in 24 hours, complications, and length of hospital stay.
Results
Baseline characteristics were similar among the 54 patients (27 per group) who completed the study, excluding three who dropped out. The QL block did not reduce NRS pain scores at rest at 6 hours (median [interquartile range], 5 [4–6] vs. 5 [3–6]; p=0.78). Over the 72-hour postoperative period, pain scores at rest remained comparable between the groups, while the QL group showed slightly lower movement-induced pain at certain time points. The QL group required fewer analgesics and antiemetics at certain intervals, but the total opioid use, length of hospital stay, and quality of recovery were not significantly different.
Conclusion
The QL block showed no meaningful advantage in postoperative analgesia compared to placebo for ileostomy closures.

Review articles

Anesthesiology and Pain Medicine
Acute postoperative pain control in pediatric patients: a scoping review: Eun Kyung Choi, Sang-Jin Park, Seong Wook Hong; J Yeungnam Med Sci. 2026;43:1. Published online December 10, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.1

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Abstract PDF: Acute postoperative pain results from tissue injury during surgery and subsequent inflammatory responses. The incidence of chronic postsurgical pain ranges from 10% to 30%, and its development is influenced by various clinical factors, including psychological, biological, and social determinants. Optimal management of acute postoperative pain is crucial for enhancing patient satisfaction, preventing adverse outcomes in the immediate postoperative period, and minimizing progression to chronic postoperative pain. In particular, postoperative pain in pediatric patients is often underestimated and inadequately managed because of developmental differences in pain perception, expression, and challenges in assessment. Therefore, age-appropriate and validated assessment tools that consider cognitive development and situational factors are required. Given age-related variability in pharmacokinetics and pharmacodynamics, individualized multimodal analgesic strategies with careful dose adjustments should be utilized. These approaches have demonstrated improved analgesic efficacy and enhanced recovery outcomes in pediatric surgical patients. A comprehensive understanding of pediatric pain pathophysiology, combined with appropriate methods of pain assessment and management strategies, should be selected to promote postoperative recovery and reduce morbidity.

Anesthesiology and Pain Medicine
Regional analgesia for postoperative pain control after thoracic surgery: a narrative review: Sang-Jin Park, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:80. Published online December 4, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.80

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Abstract PDF: Effective management of post-thoracotomy pain is essential to prevent pulmonary complications and reduce the risk of developing chronic pain syndrome. Although systemic opioids remain a common option, their use is limited by significant adverse effects, making regional analgesia the cornerstone of postoperative pain management. Thoracic epidural analgesia, historically regarded as the gold standard, provides potent postoperative pain relief but carries risks of hypotension and, in rare cases, severe neurological events. Thoracic paravertebral block (PVB) has emerged as the primary alternative, offering comparable analgesic efficacy and an improved safety profile, particularly in maintaining hemodynamic stability. However, PVB is technically demanding and associated with a higher failure rate and localized procedural complications such as pneumothorax. Fascial plane blocks have recently been developed to prioritize safety. The erector spinae plane block is technically simpler, using the transverse process as a “bony backstop” to minimize the risk of pleural injury; however, its analgesic potency may be lower than that of PVB. The intertransverse process block seeks to combine the efficacy of PVB with enhanced safety; however, supporting evidence remains limited. Alternative regional techniques, such as serratus anterior plane block, intercostal nerve block, and continuous wound instillation, typically provide insufficient analgesia for the comprehensive pain associated with open thoracotomy. No regional analgesic technique has demonstrated universal superiority. The optimal approach should be individualized, balancing the distinct risk–benefit profile of each block with patient comorbidities, surgical factors, and institutional expertise.

Communications

Physical therapy, Sports Therapy, and Rehabilitation
Differences in pain treatment between the healthcare systems in South Korea and Quebec and proposals for improvements: Min Cheol Chang, Mathieu Boudier-Revéret; J Yeungnam Med Sci. 2025;42:16. Published online December 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01410

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Abstract PDF

After a year of exchange in Montreal, a South Korean academic physiatrist and his Canadian colleague have reflected on the strengths and weaknesses of their respective healthcare systems. They have focused more specifically on physiatrist-delivered pain medicine treatments. This article is written based on personal perspectives. It aims to present the differences between the systems in South Korea and Quebec, highlighting the issues arising from each system and providing perspectives on potential solutions.

Citations

Citations to this article as recorded by

A Comparison of Chinese and Korean Older Adult Immigrants’ Transnational Healthcare Practices in Toronto, Canada: A Mixed-Methods Study
Leah Czukar, Lu Wang, Sepali Guruge, Janet Lum, Meira Greenbaum
Healthcare.2025; 13(19): 2493. CrossRef

Review article

Anesthesiology and Pain Medicine
Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(3):166-178. Published online June 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00339

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Abstract PDF

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Citations

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Association of postlaminectomy syndrome with cardiovascular events in patients undergoing posterior lumbar fusion
Yih-Cherng Wang, Wei-Thing Khor, Pang-Shuo Perng, Hong-Min Lin, Kuan-Yu Chi, Chih-Yuan Huang, Yu Chang
Pain Medicine.2026;[Epub] CrossRef
Safety of combined exercise and spinal cord stimulation therapy in persistent spinal pain syndrome: a case report
J. Vicente-Mampel, D. Sánchez-Poveda, M. Martínez-Soler, F. Hernández-Zaballos, J. Ferrer-Torregrosa, F. J. Sanchez-Montero
Frontiers in Pain Research.2026;[Epub] CrossRef
Short-term Effects of Combined Korean Medicine Treatment Including Acupotomy in a Patient with Failed Back Surgery Syndrome: A Case Report
Heejeon Hong, Soo Kwang An, Taewook Lee, Jihun Kim, Eunseok Kim
Journal of Acupuncture Research.2025;[Epub] CrossRef
Wet Tap-Induced Spinal Cord Stimulator Trial Failure in Failed Back Surgery Syndrome: A Case Report Highlighting Intrathecal Drug Delivery for Treatment-Resistant Pain
Shivang Patel, Matthew Thomas, Harthik Kambhampati, John Stauffer, Tony El-Hayek
Cureus.2025;[Epub] CrossRef
Persistent Spinal Pain Syndrome Typ 2 - Leitfaden für die Behandlung
Hind Chaib, Ehab Shiban
Schmerzmedizin.2025; 41(3): 24. CrossRef
[18F]FDG PET-CT Imaging of the Low Back in Persistent Spinal Pain Syndrome Type 2: A Pilot Study Towards Improved Diagnosis
Lara S. Burmeister, Richard L. Witkam, Kris C. P. Vissers, Martin Gotthardt, Dylan J. H. A. Henssen
Brain Sciences.2025; 15(7): 724. CrossRef
Spinal Cord Stimulation in an Elderly Patient With Severe Scoliosis and Failed Back Surgery Syndrome: A Case for Reconsidering Anatomical Contraindications
Shivang Patel, Jalal Ibrahim, Feross Habib, Harthik Kambhampati, Tony El-Hayek
Cureus.2025;[Epub] CrossRef
Mechanism of IFITM1 regulating epidural scar hyperplasia after laminectomy through SMAD3/CBR4 pathway
Haoran Wang, Zekai Zhu, Jun Liu
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A Case Report of Failed Back Surgery Syndrome Treated with Korean Medicine Focused on Ultrasoud-Guided Bee Venom Phamacopuncture
Moon Sun Kim, Seok-Hyeon Yoon, Youn-Seok Ko, Seung-Yun Oh, Soo-Jung Park
Korean Journal of Acupuncture.2025; 42(3): 212. CrossRef
Prevalence of Low Back Pain and Functional Disability in Post-Lumbar Laminectomy Patients: A Cross-sectional Study
Arbab Habib Ullah, Shabi ul Hassan, Arshad Ali, Kainat, Madeeha Khattak, Hammad Farooq
The Healer Journal of Physiotherapy and Rehabilitation Sciences.2025; 5(1): 209. CrossRef
Full-endoscopic Spine Surgery for the Treatment of Far-out Syndrome: A Case Series
Ryuichi WATANABE, Ryoji TOMINAGA, Kento TAKEBAYASHI, Yasushi OSHIMA, Hiroki IWAI, Hisashi KOGA
Neurologia medico-chirurgica.2025; 65(12): 583. CrossRef
Clinical Evaluation of the Effectiveness of Endoscopic Surgical Treatment in Patients with Lumbar Ligamentous-Foraminal Stenosis
B. A. Sychenikov, I. V. Basankin, A. A. Gyulzatyan, V. N. Nikolenko, M. D. Bartenev, D. D. Galinovskiy, M. O. Shkap
Innovative Medicine of Kuban.2025; 10(4): 16. CrossRef
Threshold-Anchored Mechanomyography Metrics for Patient Stratification in Spinal Decompression: Associations with Early Pain Outcomes
Muwaffak Abdulhak, Ross Jones, David Nay, Christopher Wybo
Journal of Personalized Medicine.2025; 15(12): 564. CrossRef
Using Key Predictors in an SVM Model for Differentiating Spinal Fractures and Herniated Intervertebral Discs in Preoperative Anesthesia Evaluation
Shih-Ying Yang, Shih-Yen Hsu, Yi-Kai Su, Nan-Han Lu, Kuo-Ying Liu, Tai-Been Chen, Kon-Ning Chiu, Yung-Hui Huang, Li-Ren Yeh
Diagnostics.2024; 14(21): 2456. CrossRef

Original article

Public Health, Environmental, and Occupational Health
Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis: Kiook Baek, Yu-Mi Choi, Joon Sakong; J Yeungnam Med Sci. 2024;41(3):196-206. Published online May 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00171

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Abstract PDF Supplementary Material: Background
This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019.
Methods
General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as “no or minor,” 4 to 6 was categorized as “moderate,” and 7 to 10 was categorized as “severe.” The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed.
Results
In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with “moderate” pain. Practice time, dance experience, and postural accuracy were positively associated with “severe” pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10.
Conclusion
Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.

Communications

Physical therapy, Sports Therapy, and Rehabilitation
Algorithm for multimodal medication therapy in patients with complex regional pain syndrome: Min Cheol Chang, Donghwi Park; J Yeungnam Med Sci. 2023;40(Suppl):S125-S128. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00360

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Abstract PDF

Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

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Tailoring Treatment in Complex Regional Pain Syndrome: A Comparative Study of Therapeutic Approaches in Complex Rehabilitation
Iana Andreieva, Beata Tarnacka, Adam Zalewski, Justyna Wiśniowska
Pharmaceuticals.2025; 18(8): 1114. CrossRef
Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
Donghwi Park, Jin-Woo Choi, Min Cheol Chang
Journal of Back and Musculoskeletal Rehabilitation.2024; 37(3): 687. CrossRef
Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
Russian Military Medical Academy Reports.2023; 42(4): 413. CrossRef

Review article

Anesthesiology and Pain Medicine
Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(1):22-29. Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367

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Abstract PDF

Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Citations

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Validation of the Chinese Version Breakthrough Pain Assessment Tool in Cancer Patients
Lin-Jiu Chen, Kun-Ming Rau, Pei-Chao Lin, Yi Liu, Pi-Ling Chou
Pain Management Nursing.2026; 27(2): e207. CrossRef
Evaluating the Efficacy of Fentanyl Versus Diclofenac Sodium as Transdermal Patches in Controlling Post-operative Pain in Mandibular Third Molar Surgeries: A Prospective Comparative Study
Swastik Hazra, Sapna Tandon, Hemant Mehra, Himanshu Chauhan, T. Adarsha, Dipanjan Chatterjee
FACE.2026; 7(1): 103. CrossRef
Breakthrough cancer pain management (BTcP)—gap analysis of the current Australian landscape
Wei Lee, Ahmed Nagla, Aaron Bak Ong Wong, Linda Magann, Melanie Lovell, Edward Mantle, Kate Reed, Ghauri Aggarwal, Aaron K. Wong, Chris Pene, Peter Allcroft, Gregory B. Crawford, Natasha Michael
Supportive Care in Cancer.2026;[Epub] CrossRef
A scoping review of breakthrough cancer pain: Multidimensional patient needs and influencing factors
Qingyi Li, Yanlei Sheng, Xinyu Liu, Jie Li, Lisi Zhu, Yang Yang, Luhong Hu
Asia-Pacific Journal of Oncology Nursing.2025; 12: 100780. CrossRef

Communications

Physical therapy, Sports Therapy, and Rehabilitation
Some suggestions for pain physicians working in real-world clinical settings: Jung Hwan Lee, Min Cheol Chang; J Yeungnam Med Sci. 2023;40(Suppl):S123-S124. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00255

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Abstract PDF

Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.

Citations

Citations to this article as recorded by

Protocol for lower back pain management: Insights from the French healthcare system
Lea Evangeline Boyer, Mathieu Boudier-Revéret, Min Cheol Chang
World Journal of Clinical Cases.2024; 12(11): 1875. CrossRef
Effectiveness of transcranial alternating current stimulation for controlling chronic pain: a systematic review
Min Cheol Chang, Marie-Michèle Briand, Mathieu Boudier-Revéret, Seoyon Yang
Frontiers in Neurology.2023;[Epub] CrossRef

Original article

Anesthesiology and Pain Medicine
Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study: Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo; J Yeungnam Med Sci. 2023;40(2):172-178. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00500

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Abstract PDF

Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.

Citations

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Comparison of erector spinae plane block and rhomboid intercostal block for postoperative pain management in patients undergoing unilateral breast surgery
Gülnihal Avcı, Sevim Cesur Okan, Hadi Ufuk Yörükoğlu, Can Aksu, Alparslan Kuş
BMC Anesthesiology.2026;[Epub] CrossRef
Overview of ultrasound-guided plane blocks performed within the scope of multimodal anesthesia applications in lower and upper abdominal surgeries
Mert Yetgin, Hülya Sungurtekin, Hale Yetgin
Pamukkale Medical Journal.2025; 18(4): 21. CrossRef
Surgeon-Delivered Bupivacaine Achieves Analgesic Efficacy Comparable to ESP and TAP Blocks in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Melih Can Gül, Ramazan Koray Akbudak
Surgeries.2025; 6(4): 90. CrossRef
Bilateral erector spinae plane block on opioid-sparing effect in upper abdominal surgery: study protocol for a bi-center prospective randomized controlled trial
Changzhen Geng, Li Wang, Yaping Shi, Xinnan Shi, Hanyi Zhao, Ya Huang, Qiufang Ji, Yuanqiang Dai, Tao Xu
Trials.2024;[Epub] CrossRef
Erector Spinae Plane Block with 0.375% Bupivacaine vs 0.25% Bupivacaine in Laparoscopic Cholecystectomy Patients: Effect on Postoperative Analgesia, Shoulder Tip Pain, and Postoperative Stress Markers
Mohammad Mohsin, Asna Jamal, Ali Saloda, Kharat M Batt, Shantnu Bhanwala
Research & Innovation in Anesthesia.2024; 9(1): 1. CrossRef

Resident fellow section: Teaching images

Musculoskeletal Disorders
A 40-year-old man with neuropathic pain in the entire left foot: Jae Hwa Bae, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2023;40(2):223-224. Published online August 30, 2022; DOI: https://doi.org/10.12701/jyms.2022.00486

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PDF

Case report

Physical therapy, Sports Therapy, and Rehabilitation
Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report: Myeong Geun Jeong, Bum Soon Park, Eun-Seok Son, Jang Hyuk Cho; J Yeungnam Med Sci. 2023;40(3):289-292. Published online August 5, 2022; DOI: https://doi.org/10.12701/jyms.2022.00388

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Abstract PDF

We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

Citations

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CRYSTAL ARTHRITIS IN THE DIFFERENTIAL DIAGNOSIS OF NECK PAIN: A CASE OF CROWNED DENS SYNDROME
Halise Hande Gezer, Hamza Özer, Özlem Pehlivan, Mehmet Tuncay Duruöz
Anti-Aging Eastern Europe.2025; 4(2): 128. CrossRef
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Cureus.2025;[Epub] CrossRef

Focused Review articles

Neurology
Pain in amyotrophic lateral sclerosis: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2022;39(3):181-189. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00332

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Abstract PDF

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

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Qianping Jiang, Dan Yang, Rui Jiang, Shilei Wan, Miao Wu, Dandan Xu, Jing Zhou
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European Journal of Neurology.2025;[Epub] CrossRef
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Physical therapy, Sports Therapy, and Rehabilitation
The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review: Aung Chan Thu; J Yeungnam Med Sci. 2022;39(3):206-215. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00290

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Abstract PDF

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

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Platelet-rich plasma versus hyaluronic acid injection following arthrocentesis for temporomandibular joint disorders under sedation: a comparative clinical study
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Imran J Siddiqui, Jessica Probst, Sanjay Mahadevan, Roosevelt J Desronvilles, Kyle J Dineen
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Case report

Emergency and Critical Care Medicine
Prolonged oral sildenafil use-induced Mondor disease: a case report: Han Sol Chung, You Ho Mun; J Yeungnam Med Sci. 2022;39(3):262-265. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00220

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105 Download
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Abstract PDF

Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.

Citations

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Management of Penile Mondor’s disease: insights from a scoping review
Alessio Papaveri, Angelo Cafarelli, Federico Falsetti, Luca Spinozzi, Davide Ciavarella, Enrico Sicignano, Valentina Maurizi, Michele Marchioni, Luigi Schips, Daniele Castellani, Vineet Gauhar, Carlo Giulioni
Sexual Medicine Reviews.2026;[Epub] CrossRef
Penile superficial dorsal vein thrombophlebitis following prolonged sexual activity
Ahmed Adam Osman, Hanan HassanHirei, Abdulkadir Isse Mohamed, Shuayb Moallim Ali, Amal Naleye Ali, Abdikarim Hussein Mohamed
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A case with Penile Mondor’s disease
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Focused Review articles

Anesthesiology and Pain Medicine
Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):190-199. Published online April 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00192

13,299 View
320 Download
1 Web of Science
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Abstract PDF

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Citations

Citations to this article as recorded by

Spine Pain
Vernon B. Williams
Continuum.2024; 30(5): 1344. CrossRef
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Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

Anesthesiology and Pain Medicine
The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

15,346 View
260 Download
51 Web of Science
49 Crossref

Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
Healthcare.2023; 11(16): 2355. CrossRef
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Min Cheol Chang
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Journal of Pain Research.2022; Volume 15: 4065. CrossRef

Case report

Physical therapy, Sports Therapy, and Rehabilitation
Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report: Mathieu Boudier-Revéret, Min Cheol Chang; Yeungnam Univ J Med. 2021;38(4):371-373. Published online April 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.00948

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Abstract PDF Supplementary Material

Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.

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Diagnosis and treatment of serotonin syndrome
Je Sung You, Sung Phil Chung
Journal of The Korean Society of Clinical Toxicology.2024; 22(2): 11. CrossRef

Review articles

Physical therapy, Sports Therapy, and Rehabilitation
Updates on the treatment of adhesive capsulitis with hydraulic distension: Jang Hyuk Cho; Yeungnam Univ J Med. 2021;38(1):19-26. Published online August 31, 2020; DOI: https://doi.org/10.12701/yujm.2020.00535

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Abstract PDF

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

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Letter to the editor: “Comparative efficacy of supra-scapular nerve block, posterior shoulder capsule hydro-dilatation, and shoulder interval hydro-dilatation in managing shoulder adhesive capsulitis’’
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A prospective, randomized, blinded study on the efficacy of using corticosteroids in hydrodilatation as a treatment for adhesive capsulitis of the shoulder
Joan Tomàs Gebellí-Jové, Antonio Buñuel-Viñau, Marta Canela-Capdevila, Jordi Camps, Fàtima Sabench, Petrea Iftimie-Iftimie
Shoulder & Elbow.2025; 17(3): 274. CrossRef
Comparing the Efficacy of Intra-articular Platelet-rich Plasma and Corticosteroid Injections in the Management of Adhesive Capsulitis of Shoulder
Suriya Kulothungan Karikalan, Karthik Murugan, Lionel John J
Journal of Orthopedics and Joint Surgery.2025; 7(1): 104. CrossRef
Short-Term Comparative Effectiveness of Intra-articular Corticosteroid Injection Versus Hydrostatic Distention in Idiopathic Frozen Shoulder: A Prospective Interventional Study
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Cureus.2025;[Epub] CrossRef
Effects of Hydrodilatation at Different Volumes on Adhesive Capsulitis in Phases 1 and 2: Clinical Trial Protocol HYCAFVOL
Javier Muñoz-Paz, Ana Belén Jiménez-Jiménez, Francisco Espinosa-Rueda, Amin Wahab-Albañil, María Nieves Muñoz-Alcaraz, José Peña-Amaro, Fernando Jesús Mayordomo-Riera
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Rohit Gulati, Jyotsna Agarwal, Parveen Kaur
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Effectiveness of Hydrodilatation for Adhesive Capsulitis in Patients With Pre-existing Rotator Cuff Tears
Aishwarya Prakash, Hussain Selmi, Shiva Namdeo, Tressa Amirthanayagam, Daoud Makki
Cureus.2025;[Epub] CrossRef
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Abeer Alomari, Philip Peng
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Rebecca L Cox, Jasper Tseng, Chris Williams
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A Retrospective Study of Ultrasound-guided Hydrodilatation of Glenohumeral Joint Combined with Corticosteroid Injection in Patients with Frozen Shoulder
Zeng Zeng, Jiang Zhu
Current Medical Imaging Formerly Current Medical Imaging Reviews.2025;[Epub] CrossRef
Rotator Interval vs Posterior Approach Ultrasound-guided Corticosteroid Injections in Primary Frozen Shoulder: A Meta-analysis of Randomized Controlled Trials
Francisco Javier Arrambide-Garza, Juventino Tadeo Guerrero-Zertuche, Neri Alejandro Alvarez-Villalobos, Alejandro Quiroga-Garza, Abraham Espinosa-Uribe, Felix Vilchez-Cavazos, Yolanda Salinas-Alvarez, Juan Antonio Rivera-Perez, Rodrigo Enrique Elizondo-Om
Archives of Physical Medicine and Rehabilitation.2024; 105(4): 760. CrossRef
Pharmacoacupuncture for the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Ji-Ho Lee, Hyeon-Sun Park, Sang-Hyeon Park, Yun-Kyung Song, Dong-Ho Keum, Seo-Hyun Park
Current Pain and Headache Reports.2024; 28(12): 1365. CrossRef
Frozen Shoulder: Diagnosis and Management
Sean R. Wise, Paul Seales, Alex P. Houser, Chase B. Weber
Current Sports Medicine Reports.2023; 22(9): 307. CrossRef
Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder
Huajun Xu, Yingchun Zhang, Caishan Wang
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Impact of capsular preservation on patient-reported outcomes and complication rates in total hip arthroplasty using the direct anterior approach
Vincent A. Stadelmann, Hannes A. Rüdiger, Selina Nauer, Michael Leunig
The Bone & Joint Journal.2022; 104-B(7): 826. CrossRef
Management of Patients with Adhesive Capsulitis via Ultrasound-Guided Hydrodilatation without Concomitant Intra-Articular Lidocaine Infusion: A Single-Center Experience
Yung-Chieh Chen, Shu-Huei Shen, Hong-Jen Chiou, Yung-Liang Wan
Life.2022; 12(9): 1293. CrossRef
Role of Platelet-Rich Plasma in the Treatment of Adhesive Capsulitis: A Prospective Cohort Study
Syed Imran Haider, Muhammad Zarak Awais, Muhammad Tahir Iqbal
Cureus.2022;[Epub] CrossRef
Musculoskeletal complications in patients with diabetes mellitus
Jong Han Choi, Hae-Rim Kim, Kee-Ho Song
The Korean Journal of Internal Medicine.2022; 37(6): 1099. CrossRef
Comparison of the spread pattern of medial-to-lateral and lateral-to-medial rotator interval injections: A cadaveric study
Benjamin J. Kozlowski, John Tran, Philip W.H. Peng, Anne M.R. Agur, Nimish Mittal
Interventional Pain Medicine.2022; 1(4): 100164. CrossRef
Updates on Intra-articular Corticosteroid Injection for the Treatment of Adhesive Capsulitis
Ju Heon Oh, In Ho Jung, Eun Woo Park, Jang Hyuk Cho
Keimyung Medical Journal.2022; 41(2): 51. CrossRef

Physical therapy, Sports Therapy, and Rehabilitation
Effectiveness of orthoses for treatment in patients with spinal pain: Yoo Jin Choo, Min Cheol Chang; Yeungnam Univ J Med. 2020;37(2):84-89. Published online March 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00150

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Abstract PDF

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients’ lifestyle.

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Zixiao Yang, Tejas S. Sathe, Meghal Shah, Jay Hemant Shah, David L. Hu
Annals of the New York Academy of Sciences.2025; 1546(1): 112. CrossRef
Biomechanical effects of spinal orthoses on the trunk during a sit-to-stand-to-sit task
Lauren Haworth, Philip Stainton, Claudia Danes-Daetz, Ambreen Chohan, Graham J Chapman, Jim Richards
Prosthetics & Orthotics International.2025;[Epub] CrossRef
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Obesity and metabolism.2024; 21(2): 215. CrossRef
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Effectiveness and Safety of Inelastic Versus Elastic Lumbosacral Orthoses on Low Back Pain Prevention in Healthy Nurses
Jianzhong Hu, Liyuan Jiang, Yong Cao, Jin Qu, Hongbin Lu
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World Journal of Clinical Cases.2022; 10(22): 7720. CrossRef
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Journal of Pain Research.2021; Volume 14: 1353. CrossRef
Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves
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Original article

Orthopedics and Sports Medicine
Correlation between anterior thigh pain and morphometric mismatch of femoral stem: Haksun Chung, So Hak Chung; Yeungnam Univ J Med. 2020;37(1):40-46. Published online September 16, 2019; DOI: https://doi.org/10.12701/yujm.2019.00325

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Abstract PDF

Background
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
Methods
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Results
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Conclusion
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

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Hydroxyapatite ceramic-coated femoral components in younger patients followed up for 27 to 32 years
Piyush K. Upadhyay, Nirav Shah, Vishal Kumar, Saqeb B. Mirza
Bone & Joint Open.2024; 5(4): 286. CrossRef
Mid-Term Outcomes of a Short Modular Neck-Preserving Cementless Hip Stem: A Retrospective Study With a 6-Year Minimum Follow-Up
Michele Carnovale, Daniele De Meo, Giovanni Guarascio, Paolo Martini, Gianluca Cera, Pietro Persiani, Vittorio Candela, Stefano Gumina, Ciro Villani
Arthroplasty Today.2024; 27: 101387. CrossRef

Case report

Obstetrics, Gynecology, and Reproductive Medicine
Isolated tubal torsion in the third trimester of pregnancy managed with simultaneous salpingectomy and cesarean section: Seong Nam Park; Yeungnam Univ J Med. 2019;36(1):59-62. Published online December 14, 2018; DOI: https://doi.org/10.12701/yujm.2019.00024

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Abstract PDF

Isolated tubal torsion is an uncommon cause of acute abdomen in pregnancy. Tubal torsion may occur in the absence of adnexal disease. Diagnosing tubal torsion is especially difficult in pregnancy because no precise preoperative radiological and biochemical investigations have been conducted. Most patients are diagnosed during surgery. Here, we present a case of isolated tubal torsion in a pregnant woman at 35 weeks and 6 days of gestation that was managed with salpingectomy and cesarean section simultaneously.

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Emergency Surgery for Adnexal Torsion in Late Preterm Pregnancy Causing Term Vaginal Delivery: A Case Report and Literature Review
Kentaro Taniguchi, Yuji Tanaka, Tsukuru Amano, Shunichiro Tsuji, Takashi Murakami
Cureus.2024;[Epub] CrossRef
Adnexal torsion in pregnancy: A systematic review of case reports and case series
Hamidreza Didar, Hanieh Najafiarab, Amirreza Keyvanfar, Bahareh Hajikhani, Elena Ghotbi, Seyyedeh Neda Kazemi
The American Journal of Emergency Medicine.2023; 65: 43. CrossRef
Isolated Tubal Torsion in a Term Pregnancy: Case Report and Systematic Review of Literature of the Last 10 Years
Ferdinando Antonio Gulino, Carla Ettore, Gianfranco Morreale, Stefano Siringo, Emanuele Russo, Marco D'Asta, Francesco Cannone, Giuseppe Ettore
Frontiers in Surgery.2022;[Epub] CrossRef
Laparoscopic surgery for fallopian tube torsion due to benign tumour in the third trimester of pregnancy: a case report and literature review
Jae Yoon Jo, In Ae Cho, Jeong Kyu Shin, Soon Ae Lee, Won Jun Choi
Journal of Obstetrics and Gynaecology.2022; 42(7): 2566. CrossRef

Original Article

Anesthesiology and Pain Medicine
Effect of preoperative pregabalin on postoperative pain after gastrectomy: Chan Yoon Park, Sol Hee Park, Dong Gun Lim, Eun Kyung Choi; Yeungnam Univ J Med. 2018;35(1):40-44. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.40

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Abstract PDF

Background
Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.
Methods
Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period.
Results
The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.
Conclusion
A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

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Treatment of acute postoperative pain in patients undergoing open abdominal aortic repair (current state of the problem)
Anzhelika V. Kozhanova, Georgy P. Plotnikov
Regional Anesthesia and Acute Pain Management.2022; 16(1): 45. CrossRef
Comparison of premedication with 75 mg and 150 mg pregabalin for postoperative analgesia in total hysterectomy patients - A randomised control trial
Ajish Varghese Cheruvathur, Dilshad Thondi Parambil, Saurabh Vig, Salman Mohammed Kutty Chenath, Priyadharshini Nagaraj, Krupa Mulgaonkar, S Jeevithan
Indian Journal of Clinical Anaesthesia.2022; 9(4): 467. CrossRef

Case Reports

Emergency and Critical Care Medicine
Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule: You Ho Moon, Jung ho Kim, Won joon Jeong, Sin-Youl Park; Yeungnam Univ J Med. 2018;35(1):127-129. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.127

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Abstract PDF

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

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Analysis of Misdiagnosis of FHCS Syndrome as Cholecystitis and Literature Review
旭旗申
Advances in Clinical Medicine.2022; 12(06): 5608. CrossRef

Anesthesiology and Pain Medicine
Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain: Young-ung Kim, Yong-joon Shin, Young Woo Cho; Yeungnam Univ J Med. 2018;35(1):104-108. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.104

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Abstract PDF: Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

Nephrology
Two Cases of Spinal Epidural Abscess in Hemodialysis Patients.: Young Hwan Kim, Jin Taek Yoo, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Mun Jang, Jung Choi; Yeungnam Univ J Med. 2013;30(1):36-38. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.36

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Abstract PDF: While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

Neurosurgery
A peripheral tremor associated with intractable pain after traffic accident: case report.: Joo Chul Hong, Seong Ho Kim; Yeungnam Univ J Med. 2009;26(1):74-77. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.74

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Abstract PDF: There are debates about whether peripherally induced movement disorders exist. We report a case of upper limb tremor induced by peripheral nerve injury. A 25-year-old male patient presented with pain and tremor of the left upper extremity, 2 days after a car accident. Magnetic resonance images of the brain and cervical spine were normal. His past medical history was unremarkable and there were no family members with symptoms of movement disorders. He suffered from an aggravating tremor for about 10 minutes, four to six times a day. We treated the patient with medication, epidural infusion, cervical nerve root block and trigger point injection of the trapezius muscle. The pain subsided 50% and the incidence of tremor attacks was reduced to once or twice a day. The role of peripheral trauma in the genesis of movement disorders has not been generally accepted. It is unclear whether peripheral trauma can induce dystonia and other movement disorders. It has been proposed that peripheral trauma can alter sensory input and induce cortical and subcortical reorganization that generates a movement disorder. Some studies provide evidence for central reorganization following peripheral injury.

Original Article

Orthopedics and Sports Medicine
An Epidemiologic Study of Low Back Pain of Women Working at a General Hospital.: Dong Gu Park, Myun Whan Ahn, Jong Chul Ahn, Sae Dong Kim, Jae Sung Seo; Yeungnam Univ J Med. 2007;24(2):186-196. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.186

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Abstract PDF

BACKGROUND
The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. MATERIALS AND METHODS: An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. RESULTS: The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. CONCLUSION: Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

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Effects of the Hand Acupressure and Lumbar Strengthening Exercise on Women with Lower Back Pain
Eun Young Jeon
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Review Articles

Neurosurgery
Anatomy of Low Back Pain: Seong-Ho Kim, Soo-Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S203-211. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S203

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Abstract PDF

The sinuvertebral nerve(SVN) supplies the laterodorsal outer annulus of the intervertebral disc, the posterior longitudinal ligament(PLL), the anterior 2/3 of the dural sac and the anterior vascular plexus. Many blood vessels pass through the lateral neural canal: the anterior and posterior spinal canal branches, anterior and posterior radicular branches, and veins of the anterior and posterior internal vertebral venous plexus. The PLL is assumed to play an important role in proprio- and nociception. In the neighborhood of the SVN, other small branches emanate from the rami communicantes and join the dorsal ramus and the segmental artery that enters the neural canal. The sympathetic nerve plexus inside the anterior longitudinal ligament and the SVNs provide a network of nerve fibers around the vertebral bodies and intervertebral discs. These pathways explain the sympathetic component of the innervation of a number of spinal structures. The dorsal ramus innervates the facet joints at the corresponding level and one below, before it gives off muscular and cutaneous branches.

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Kyungho Kang, Kichang Oh, Jaehyo Kim, Hongmin Chu
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Seong-Woo Yun, Kyeong-Ae Oh
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Neurosurgery
Nondestructive Neuroaugmentative Surgery for Intractable Cancer Pain: Seong-Ho Kim, Byung-Yon Choi, Soo-Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S192-202. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S192

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Abstract PDF: Pain is probably one of the most common cancer symptoms. In addition to being a major source of suffering and disability, cancer pain is extremely frightening for patients and their families. The authors propose to adjust the World Health Organization (WHO) pain management ladder from its current three-step approach to a more sophisticated five-step algorithm that includes physical and psychological modalities along the entire continuum of care and adds two more steps related to neuromodulative and neurodestructive procedures once the opioids fail. This review discusses the current surgical options for treating cancer pain, focusing on the continuous drug infusion pump currently available and briefly exploring some of the other surgical options for pain management. The introduction of intrathecal opioid administration for intractable cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose.

Anesthesiology and Pain Medicine
Ketamine : Refocused Role of Ketamine in Pain Management: Sun Ok Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S108-117. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S108

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Abstract PDF: Ketamine has used as a dissociative anesthetics from 40 years ago. Its mechanism of action is an antagonism of the N-methyl-D-aspartate (NMDA) receptors, which has an important role into the central sensitization during pain states. The role of ketamine, in lower sub-anesthetic doses, has recently gained increasing interest in pain management. There are considerable numbers of trials to use ketamine in acute or chronic pain states. Recently, Hocking et al. summarized their recent reviews of the evidence concerning ketamine’s clinical use on PAIN: Clinical Updates. In this review, the author introduce their summery with personal experience. Based on their summary, the primary role of ketamine in such subanesthetic doses is as an ‘anti-hyperalgesic’, ‘anti-allodynic’ or ‘tolerance-protective’ agent rather than as a primarily ‘analgesic’. However, to support the evidence-based clinical guideline using a ketamine in pain management, there will be needed numerous high-quality studies that access both immediate and long-term outcomes.

Original Articles

Emergency and Critical Care Medicine
Prehospital Status of the Patients with Ischemic Chest Pain before Admitting in the Emergency Department.: Hye Hwa Jin, Sam Beom Lee, Byung Soo Do, Byung Yeol Chun; Yeungnam Univ J Med. 2007;24(1):41-54. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.41

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Abstract PDF: BACKGROUND
The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). MATERIALS AND METHODS: We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. RESULTS: Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. CONCLUSION: Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.

Physical therapy, Sports Therapy, and Rehabilitation
The Effect of Gabapentin for the Clinical Symptoms in the Traumatic Neuropathic Pain.: Yeung Ki Kim, Yun Woo Cho; Yeungnam Univ J Med. 2004;21(1):82-90. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.82

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Abstract PDF: BACKGROUND
Gabapentin is widely used for the relief of neuropathic pain. But, there is no study of gabapentin in relation to traumatic neuropathic pain. The aim of this study is to assess the efficacy and effectiveness of gabapentin for the various clinical symptoms of traumatic neuropathic pain MATERIALS AND METHODS: 50 patients with traumatic nerve injury were assigned to receive gabapentin, titrated to 900 mg/day over 9 days, followed by further increases to a maximum of 2400 mg/day. Continuous pain, paroxysmal pain, allodynia and thermal evoked pain were measured in mean daily pain scores, based on the 11-point Likert scale. The primary efficacy parameter was compared from the baseline to the final study week. RESULTS: Over the 4.5 week study, this pain score decreased by 2.6 points in the continuous pain, 3.6 points in the paroxysmal pain, 3.1 points in the allodynia, and 2.5 points in the thermal evoked pain. The percentage of patients with over 50% improvement in pain scores was 33% in the continuous pain, 67% in the paroxysmal pain, 53% in the allodynia and 36% in the thermal evoked pain. There was no significant correlation between the effect of gabapentin and the time difference of the onset of symptoms and start of medication. CONCLUSIONS: This study shows that gabapentin reduced neuropathic pain in patients with traumatic peripheral nerve injury. Among the various characteristics of neuropathic pain, the reduction of paroxysmal pain and allodynia was greatest.

Physical therapy, Sports Therapy, and Rehabilitation
Microsurgical DREZotomy for treatment of intractable central pain in patient with spinal cord injury.: Zee Ihn Lee, Seong Ho Kim, Sang Ho Ahn, Sung Ho Jang; Yeungnam Univ J Med. 2002;19(1):49-54. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.49

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Abstract PDF

The central pain in patient with spinal cord injury is a common and disabling sequelae. The microsurgical DREZ(Dorsal Root Entry Zone)otomy is a surgical procedure effective in the treatment of intractable pain and spasticity in spinal cord injured patients. It consists of a microsurgical lesions performed in the ventrolateral region of the dorsal root entry zone at the selected levels. This report presents one case with incomplete paraplegia patient, who had chronic central neuropathic pain ineffective to many conservative treatments in bilateral T10 and right T11 segments and both lower extremities, is relieved from the pain after microsurgical DREZotomy. In conclusion, microsurgical DREZotomy is one method of effective treatments for spinal cord injured patients with intractable central neuropathic pain.

Citations

Citations to this article as recorded by

Comparative outcomes of microsurgical dorsal root entry zone lesioning (DREZotomy) for intractable neuropathic pain in spinal cord and cauda equina injuries
Bunpot Sitthinamsuwan, Tanawat Ounahachok, Sawanee Pumseenil, Sarun Nunta-aree
Neurosurgical Review.2025;[Epub] CrossRef

Pediatrics, Perinatology, and Child Health
Treatment of Henoch-Sch?nlein Purpura with Intravenous Immunoglobulin.: Hyo Seok Chung, Won Duck Kim, Eun Sil Lee, Kwang Hae Choi, Yong Hoon Park, Yong Jin Kim; Yeungnam Univ J Med. 2001;18(2):246-252. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.246

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Abstract PDF: We report the result of a high-dose intravenous immunoglobulin therapy in a Henoch-Sch?nlein purpura patient with severe abdominal pain and nephrotic syndrom who did not respond to methylprednisolone pulse therapy. Kidney bbiopsy showed diffuse mesangial cell proliferative glomerulonephritis with fibrocellular crescent formation in approximately 50% of glomeruli. Mesangium of all glomeruli were strong positive for IgA and C3 antibodies. High-dose intravenous immunoglobulin treatment was introduced and dramatic improvement of gastrointestinal symptom and proteinuria as well as hematuria was noted. Immunoglobulin administration should be considered in Henoch-Schnlein purpura patients with sterois-resistant intractable dastrointestinal manifestation and renal involvenment.

Review

Anesthesiology and Pain Medicine
Memory of Pain and Preemptive Analgesia.: Sun Ok Song; Yeungnam Univ J Med. 2000;17(1):12-20. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.12

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Abstract PDF: The memory of pain can be more damaging than its initial experience. Several factors are related the directions of pain memory; current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms of memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate, and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli are a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia is not obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

Original Articles

Emergency and Critical Care Medicine
Clinical Presentation of th patients with Non-traumatic Chest Pain in Emergency Department.: Jun Young Chung, Sam Beom Lee, Byung Soo Do, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 1999;16(2):283-295. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.283

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Abstract PDF: BACKGROUND
Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were 1.1+/-0.9 in non-cardiac diseases, 1.4+/-1.1 in cardiac diseases and 1.7+/-1.1 in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. CONCLUSION: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

Dentistry
Clinical Features of the Temporomandibular Disorder Patients with Occlusal Splint Therapy.: Jae Chul Song, Byung Rho Chin; Yeungnam Univ J Med. 1998;15(2):316-324. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.316

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Abstract PDF: This study was performed to evaluate the clinical features and treatment results on 55 temporomandibular disorder patients who had treated by conservative treatment using occlusal splint. The results were as follows; 1. The ratio of men to women was about 1:2.2 and most of the patients were second and third decades. 2. Pain was the most frequent symptom, followed by clicking and mouth opening limitation. 3. The number of acute and chronic groups on the basis of 6 months duration of symptoms were similar. 4. Most of patients had Angle's Class 1 molar relationships(78.2%), followed by Class 3 and Class 2. 5. Centric Relation splints were used alone for treatment of 34 patients and 21 patients were treated with Centric Relation splints and Anterior Repositioning splints. The treatment duration of the patients who had complained pain was average 9.8 weeks and 6 patients of them had slight pain continuously during follow-up. 6. Eleven patient's maximum mouth opening who had mouth opening limitation was improved from 30.7mm to 43.0mm during procedures.

Radiation Oncology
Palliative effect of radiation therapy in management of symptomatic osseous metastases: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1992;9(1):102-109. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.102

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Abstract PDF: Bone metastases represent an important and frequent clinical problem in patients with advanced cancers. Especially, painful bone metastases are common features in these patients. Radiotherapy is an effective tool for palliative aim of painful metastatic osseous lesions. Various treatment results have been previously reported. The present retrospective study was aimed to evaluate the efficacy of palliative irradiation on pain relief, with the goal of selecting appropriate irradiation dose schedule. Radiotherapy consisted of 5 times a week with a various fractional dose between 180 and 400cGy. The response of pain relief and the survival time after completion of radiotherapy are related to total dose and most of the patients have shown a similar response by the end of radiotherapy. The higher dose and the more aggressive multimodality treatment, the better pain control and the longer survival time.

Case Report

Orthopedics and Sports Medicine
Two cases of disc internal disruption syndrome.: Jong Hyeung Lee, Myun Whan Ahn, Jong Chul Ahn; Yeungnam Univ J Med. 1991;8(1):238-245. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.238

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Abstract PDF: The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggravated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus we present these case with a brief review of the concerned literature.

Original Article

Anesthesiology and Pain Medicine
Attenuation of pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum in laparoscopic cholecystectomy.: Sun Ok Song, Hae Mi Lee, Sung Soo Yun, Hwarim Yu, Soo Young Shim, Heung Dae Kim; Yeungnam Univ J Med. 2016;33(2):90-97.; DOI: https://doi.org/10.12701/yujm.2016.33.2.90

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Abstract PDF: BACKGROUND
We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. METHODS: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. RESULTS: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). CONCLUSION: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

Case Report

Gastroenterology and Hepatology
Adult intussusception caused by inverted Meckel's diverticulum treated with operation.: Sung Yun Lee, Jae Yoon Jeong, Seung Hyun Hong, Seung Min Woo, Su Heui Lee, Hyun Joo You, Dong Won Kim; Yeungnam Univ J Med. 2016;33(2):116-119.; DOI: https://doi.org/10.12701/yujm.2016.33.2.116

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Abstract PDF: Intussusception is a serious disease where part of the intestine slides into an adjacent part of the intestine. Adult intussusception is mainly due to benign or malignant neoplasm. Therefore, in most cases of adult intussusception, treatment by surgery would be preferable to conservative therapy. However, we report on a 28-year-old female patient who underwent intussusception operation delayed 3 months. Abdominal computed tomography 3 months ago showed a small bowel intussusception measuring 20 cm long. Three months later, the previously identified small bowel intussusception appeared without change. The patient underwent surgery, and ectopic gastric mucosa was observed in the biopsy. Therefore, Meckel's diverticulum was diagnosed.

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