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- Volume 9(1); June 2008
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- 통증의 기본원리 및 치료 원칙
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Gun-Sei Oh
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Korean J Headache. 2008;9(1):1-12. Published online June 30, 2008
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Abstract
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- The sensations w e call pain-pricking, buring, aching, stinging, and soreness-are the m ost distinctive of all the sensory modalities. Pain is a submodality of somatic sensation like touch, pressure, and position sense and serves an important protective function: It w arns of injury that should be avoid or treated. U nlike other somatic subm odalities pain has an urgent and primitive quality, a quality responsible for the affective and emotional aspect of pain perception. Moreover, the intensity w ith w hich pain is felt is affected by surrounding conditions, and the same stim ulus can produce different responses in different individuals under similar conditions. A cute, nociceptive pain results from the complex convergence of m any signals traveling up and down the neuraxis and serves to warn us of impending harm. the painful sensations ultim ately leave the periphery and travel centrally, carried by the axons of the primary sensory neurons, the dorsal root ganglia, which are relatively quiescent unless specifically stim ulated by sensory input. H owever, if inflammation or injury damages the neural structures, pain sensation (neuropathic pain) may continue long after the noxious stimuli subside. The pain response can then harm rather than help the individual. Injured dorsal root ganglia m ay become hyperexitable and display considerable spontaneous electrical activity. Such increased activity results from the expression of a dramatically different constellation of m any cell-specific m olecules in injured cells compared w ith norm al ones. U nlikely, the operation of complex neuronal circuits m ay be m arkedly altered. Chronic pain sensation result from such injury. Considerable advances have been m ade in the last decade, w hich have given some insight into the m echanisms responsible for the development of chronic pain. U nderstanding the changes that follow injury at a cellular and m olecular level m ay help lead to new therapeutic interventions.
- 통증의 약물적 치료
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Sun Young Cho, Byung-Ok Choi
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Korean J Headache. 2008;9(1):13-20. Published online June 30, 2008
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Abstract
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- Pharmacotherapy of pain remains of high im portance. D espite advances in pain m anagement research and technology, physicians are constantly challenged by patients w ith chronic pain who appear to require narcotics to function. Antipyretic analgesics are a group of heterogeneous substances including acidic and nonacidic drugs. In recent years, new antiepileptic m edications have given rise to m uch interest in pain control. Anticonvulsant drugs are effective in the treatm ent of chronic neuropathic pain but w ere not thought to be useful in m ore acute conditions such as postoperative pain. The risks and benefits of opioids for pain are discussed in the concern about the poorly m anaged pain and prescription drug abuse and addiction. The present review concentrates on the use of antipyretic analgesics, psycotropic drugs, anticonvulsants, and opioids in pain m anagement.
- 경추성두통의 해부와 중재적 시술
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Dong Eon Moon
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Korean J Headache. 2008;9(1):21-26. Published online June 30, 2008
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Abstract
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- Cervicogenic headache is pain perceived in the head but referred from a primary source in the cervical spine. The physiologic basis for this pain is convergence betw een trigeminal afferents and afferents from the upper three cervical spinal nerves. The possible sources of cervicogenic headache lie in the structures innervated by the C 1 to C 3 spinal nerves, and include the upper cervical synovial joints, the upper cervical muscles, the C2-3 disc, the vertebral and internal carotid arteries, and the dura m ater of the upper spinal cord and posterior cranial fossa. Anaesthetic blocks m ay be necessary to confirm the diagnosis of cervicogenic headache, showing that the source pain is in the neck. Differential diagnosis is sometim es a challenge because cervicogenic headache can be m istaken for other form s of unilateral headache, especially unilateral m igraine w ithout aura. R adiofrequency current is simply a tool used to create discrete thermal lesions in neural pathways in order to interrupt transmission. In pain medicine, radiofrequency lesions have been used to interrupt nociceptive pathways at various sites. W ith the development alternatives such as neuromodulation and intrathecal opioid infusion technologies. This article introduces the technique of anesthetic blockade and radiofrequency lesioning as an interventional treatment m odality of cervical pain.
- 두통과 비만
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Min Ky Kim
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Korean J Headache. 2008;9(1):27-32. Published online June 30, 2008
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- 무균성 수막염으로 시작된 Vogt-Koyanagi- Harada병 2예
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Ho-Jun Yu, Seon-Min Lee, Yong-Joo Lee, Chang-Min Lee, Jae-Il Kim
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Korean J Headache. 2008;9(1):33-36. Published online June 30, 2008
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- Tw o patients have suffered from progressive headache, febrile sense, nausea, and vomiting followed by sudden, binocular blurred vision. Lumbar puncture revealed cerebrospinal fluid pleocytosis in both patients. Brain M RI studies were norm al. O phthalmologic findings w ere anterior uveitis and retinal serous detachments. The presenting symptoms and signs resolved over a w eek period following high-dose steroid therapy. Vogt-Koyanagi-Harada (VKH) disease should be considered in the differential diagnosis of patients presenting aseptic m eningitis followed by sudden, bilateral decreased visual acuity. Korean Journal of Headache
- 급성 범부비동염에 동반된 뇌농양 1예
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Hyo Min Lee, Jin Kuk Do, Dong Kuck Lee
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Korean J Headache. 2008;9(1):37-39. Published online June 30, 2008
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- Intracranial abscesses are uncommon, serious, life-threatening infections. The abscesses can originate from infection of contiguous structures (eg, otitis m edia, dental infection, m astoiditis and sinusitis). D irect extension m ay occur through necrotic areas of osteomyelitis in the posterior w all of the frontal sinus, as w ell as through the sphenoid and ethmoid sinuses. But our patient had no direct extension on brain image
- 눈대상포진 후 나타난 SUNCT Syndrome
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Kyung Jib Kim, Jin Kuk Do, Dong Kuck Lee
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Korean J Headache. 2008;9(1):40-43. Published online June 30, 2008
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- The SUNCT refers to short-lasting unilateral neuralgiform headache with conjunctival injection and tearing. It is characterized by brief attacks of severe unilateral pain in the orbitotemporal region, associated w ith ipsilateral cranial autonomic disturbances. The syndrome is often m isdiagnosed as trigeminal neuralgia or cluster headache. A 60-year-old man had a right herpes zoster ophthalmicus. Four days later, he had first attack of pain deep in and around the right eye and temple w ith lacrimation. The pain w as sharp and throbbing, very intense and localized to the right orbital region. Reddening and w atering of the right eye consistently accompanied the pain. The headaches occurred sporadically throughout whole day, w ith an average of 20?30 individual paroxysms during 5-30 seconds. Attacks did not occur during sleep. Neurological and ophthalm ologic examinations were unremarkable. Except verapamil, therapeutic trials of gabapentin, oxycodone, indomethacin
- 비전형적인 임상 양상을 보인 지주막하 출혈에 의한 벼락두통 환자 1례
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Seo-Young Choi, Sun-Hee Kim, Seoung-Rae Jo, Sang-Jun Lee
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Korean J Headache. 2008;9(1):44-48. Published online June 30, 2008
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- Subarachnoid hemorrhage (SAH) w hich usually presented with the thunderclap headache is the disease that has significant m ortality. Therefore, the diagnosis of SAH deserves special emphasis. A 69-year-old female visited at the emergency room due to the headache. In the brain CT only ischemic change w as revealed. H owever, dark signals in the sulci on the temporo-parietal lobe w ere shown in the GRE of brain M RI. A dissecting aneurysm of the posterior cerebral artery w as detected on the digital subtraction angiography. If the patient presented w ith the thunderclap headache, a further evaluation should be proceeded in view of the fact that the dark signals of GRE can be an acute subarachnoid hemorrhage.
- 자유연제
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Korean J Headache. 2008;9(1):49-51. Published online June 30, 2008
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- 포스터
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Korean J Headache. 2008;9(1):52-58. Published online June 30, 2008
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- 회칙
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Korean J Headache. 2008;9(1):60-62. Published online June 30, 2008
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- 판권
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Korean J Headache. 2008;9(1):63-63. Published online June 30, 2008
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