• Title/Summary/Keyword: 진통

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Effects of the Essential Oil from Modified SuHeXiang Wan (Storax Pill) in Mice after Inhalation, Oral Administration, and Inunction (가감소합향원(加減蘇合香元) 정유향기(精油香氣)의 흡입(吸入), 경구투여(經口投與) 및 피부도찰(皮膚塗擦)에 따른 진통효과(鎭痛效果) 비교(比較))

  • Kim, Seong-Soo;Park, Kwang-Rock;Lee, Dong-Ung;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.2
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    • pp.223-230
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    • 2008
  • 소합향원 (蘇合香元) 가감방(加減方) 정유향기의 진통효과가 투여방법에 따라 어떤 차이가 있는지를 비교, 검토함으로서 본 약재의 새로운 적용방법을 탐색해 보고자 한다. 방법 : 가감소합향원에서 추출한 정유향기를 실험동물을 대상으로 7일간 경구 (50mg/kg, 100mg/kg), 흡입 (매일 3시간씩 1일 2회), 또는 피부도찰 (10mg) 방법으로 투여하여 페닐퀴논-유도 writhing test, 아세트산-유도 writhing test 및 hot-plate test를 실시하였다. 결과 : 가감소합향원 정유향기는 페닐퀴논-유도 writhing test에서는 피부도찰이 가장 효과적 이었으며 그 효과는 양성 대조약물인 아세트아미노펜 보다 약간 더 우수하였다 (p<0.05). 아세트산-유도 writhing test에서도 피부도찰법이 가장 좋은 효과를 나타내었으며 양성대조 약물인 아미노피린보다는 좀 더 좋은 효과를 보여주었다 (p<0.05). 그러나 hot-plate test에서는 경구투여가 가장 좋은 진통효과를 나타내었는데 고용량 (100mg/kg)에서는 양성 대조약물인 아세트아미노펜보다 유의적으로 더 효과적이었으나 저용량 (50mg/kg )에서는 이보다 다소 약하였다. 이상의 연구결과, 가감소합향원의 정유향기는 피부도찰시에는 비특이적 화학자극제인 페닐퀴논이나 아세트산에 의한 통증의 완화에 보다 효과적이며, 경구투여시에는 중추신경계에 영향을 미치는 hot plate에 의한 열자극성 통증에 더 유효함을 의미한다. 결론 : 가감소합향원의 정유향기액은 향기흡입보다는 피부흡수나 경구투여방법으로 진통의 목적으로 응용될 수 있을 것으로 사료된다.

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The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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A Study of Fan Stall Warning System Motion Characteristics (축류압축기의 성능 향상과 설계에 관한 연구)

  • Cho, Hyun-Seob;Oh, Myoung-Kwan
    • Proceedings of the KAIS Fall Conference
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    • 2007.05a
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    • pp.158-161
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    • 2007
  • 본 연구는 고속으로 회전하는 축류압축기(송풍기)의 설계 및 운전에 기초가 되는 축류회전 익렬에서의 유동계산과 유동측정, 그리고 고속회전에 따른 진통해석과 안전진단을 위한 이상 진단 시스템개발에 관해 연구한 것이다. 따라서 회전날개의 진통해석, 선회실속시의 회전날개의 진통해석, 전 체계의 동력학적 해석, 그리고 회전축의 비틀림 진동 및 선회진동의 제어로 나누어 수행하였다. 또한 각각의 연구에 대하여 수치해석과 실험을 병행하여 이론해석과 설정한 모델의 타당성을 검증하였다.

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Effects of Music Therapy on Stress of Preterm Labor and Uterine Contraction in Pregnant Women with Preterm Labor (음악요법이 조기진통 임부의 조기진통 스트레스 및 자궁수축에 미치는 영향)

  • Park, Hye-Jin;Sung, Mi-Hae
    • Women's Health Nursing
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    • v.23 no.2
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    • pp.109-116
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    • 2017
  • Purpose: The purpose of this study was to test effects of music therapy on stress due to preterm labor and uterine contraction in pregnant women with preterm labor. Methods: An experimental research design was used. Participants were 35 pregnant women with preterm labor who were between 20 to 37 weeks of pregnancy: control group (n=18) received only tocolytic drugs, while experimental group (n=17) received additional music therapy. In the experimental group, Traumerei was applied before Non-Stress Test (NST) from the second day to fifth day after admission as music therapy. Results: There was a statistically significant difference in stress due to preterm labor (z=-3.368, p<.001) between the two groups. Conclusion: The music therapy is an effective method for reducing the stress of pregnant women with preterm labor.

Analysis of the Perception of Hospice and Narcotic Analgesics by Family Caregivers of Terminal Cancer Patient (말기 암 환자 보호자의 호스피스와 마약성 진통제에 대한 인식도 분석)

  • Kwak, Kyung-Sook;Chun, Sung-Ho;Ha, Jung-Ok;Lee, Kyung-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.106-111
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    • 2006
  • Purpose: In terminal cancer patients, pain control with narcotic analgesics and supportive care by hospice are very useful treatment modality. However, many patients and their caregivers are poorly compliant in using narcotic analgesics for fear of addiction and tolerance. And also many patients and family caregivers are reluctant to accept hospice, presuming that hospice means patient's condition is no longer reversible and progressively deteriorating. The purpose of this study was to evaluate and analyze the perception of using narcotic analgesics and hospice by family caregivers of terminal cancer patients who play a critical role in health care in Korean culture. Methods: A total of 54 terminal ranter patient's family caregivers participated in this study. Questionnaire consisted of 15 questions about narcotic analgesics and hospice. Results: The study revealed following results. 1) family caregivers who are not aware of hospice are more than half (56.7%). 2) 81.8% of family caregivers agreed that hospice care is beneficial to terminal cancer patients. 3) 85.1% of family caregivers were under financial burden. 4) 83.2% of patient complained pain in 24 hours. 3) while 88.5% of family caregivers believed that narcotic analgesics can control pair, 79.1% and 79.6% of them also believed that use of narcotic analgesics would result in addiction and tolerance, respectively. Conclusion: There still exist barriers to family caregivers in using narcotic analgesics for pain control. And also, terminal cancer patient's family caregivers have poor information about hospice. Therefore, educational intervention about narcotic analgesics by pharmacist and doctors are needed for proper pain control for terminal ranter patients. In addition, more precise information about hospice care should be provided for terminal cancer patients and their family caregivers.

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Effects of Medetomidine on Analgesia and Sedation in Rats (Medetomidine의 투여가 흰쥐의 진통과 진정효과에 미치는 영향)

  • Jang, Hwan-Soo;Lee, Maan-Gee
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.674-678
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    • 2010
  • The effects of medetomidine on the degree of analgesia and sedation in rats were evaluated. The rats were randomly divided into six groups: saline, 1 mL/kg (group 'Saline'); butorphanol, 2.0 mg/kg; medetomidine, 0.2, 0.4, 0.8 or 1.6 mg/kg (group 'MED0.2', 'MED0.4', 'MED0.8' and 'MED1.6', respectively). The degree of analgesia was measured in the $50^{\circ}C$ hot-water tail-flick latency test, and the degree of sedation was evaluated using the numerical sedation score (NSS) and the righting reflex. All doses of medetomidine, except MED0.2, significantly increased the analgesic effect compared to the Saline group. Variables in the MED0.4 and MED0.8 groups, but not in the MED1.6 group, were significantly increased compared to those in the MED0.2 group. However, analgesia with all doses of medetomidine was not significantly different compared to that with butorphanol. Saline and butorphanol treatments did not induce sedation and loss of righting reflex during the recording period. NSS in the MED0.4, MED0.8 and MED1.6 groups were significantly higher than that in the MED0.2 group. NSS in the MED0.8 and MED1.6 groups were not significantly different from that in the MED0.4 group. The latency to loss of righting reflex in the MED0.8 and MED1.6 groups decreased significantly compared to that in the MED0.2 group. Thus, 0.4 and 0.8 mg/kg of medetomidine provided not only reliable analgesia but also sedation to rats. In conclusion, 0.4 to 0.8 mg/kg medetomidine could be a useful chemical restraint method in rats.

Breakthrough Cancer Pain (돌발성 암성 통증)

  • Seo, Min Seok;Shim, Jae Yong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.1-8
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    • 2015
  • Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.

The Analgesic Effect and the Mechanism of Electroacupuncture on Thermal Hyperalgesia in the Rat Model of Collagenase-induced Arthritis: Mediation by Adrenergic Receptors (Collagenase-induced Arthritis Rat Model에서 Thermal Hyperalgesia에 대한 전침(電鍼)의 진통효과(鎭痛效果) 및 기전연구: Adrenergic Mechanism에 대(對)한 연구(硏究))

  • Seo, Byung-Kwan;Park, Dong-Suk;Baek, Yong-Hyeon
    • Journal of Acupuncture Research
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    • v.28 no.2
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    • pp.57-67
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    • 2011
  • 목적 : Collagenase-induced osteoarthritis(OA) 동물 모델에서 전침의 adrenergic mechanism을 연구하고자 한다. 방법 : Collagenase-induced arthritis(CIA)를 유발하기 위하여 5주령의 male Sprague-Dawley rat의 뒷다리 좌측 무릎 관절에 0.05ml의 4mg/ml collagenase solution을 intra-articular 주입하고, 다시 4일 후에 같은 부위에 같은 농도의 collagenase solution을 intra-articular boosting injection 시행한 뒤, gross, histopathological features 및 biomarker activity 변화를 관찰하였다. 예비실험을 통하여 CIA rat model에서 진통효과를 발휘하는 것으로 확인한, 족삼리(足三里) ($ST_{36}$)에 대한 저빈도 train pulse EA stimulation (2Hz, 0.07 mA, 0.3ms)을 침치료 방법으로 적용하였다. 전침의 진통기전을 확인하기 위하여, ${\alpha}1$-adrenergic antagonist (prazosin, 1 mg/kg, i.p.), ${\alpha}2$-adrenergic receptor antagonist (yohimbine, 2mg/kg, i.p.), ${\alpha}1$-adrenergic receptor agonist(phenylephrine, 2mg/kg, i.p.), ${\alpha}2$-adrenergic receptor agonist(clonidine, $40{\mu}g$/kg, i.p.)을 전침시행 20분 전에 복강 내로 전처치하였다. Tail flick unit(Ugo Basile Model 7360)을 이용하여 열자극에 대한 통증역치를 측정하였다. 결과 : 퇴행성관절염 징후(gross, histopathological features)와 통증역치의 변화가 최대값을 나타내는 CIA 유발 4주차에 저빈도 전침자극(train pulse, 2Hz, 0.07mA, 0.3ms)을 족삼리($ST_{36}$)에 적용하였으며, 족삼리 전침의 진통효과는 ${\alpha}2$-adrenergic receptor antagonist(yohimbine, 2mg/kg, i.p.)전처치에 의해 억제되었으나, ${\alpha}1$-adrenergic antagonist(prazosin, 1 mg/kg, i.p.)전처치에는 억제되지 않았다. 또 ${\alpha}2$-adrenergic receptor agonist(clonidine, $40{\mu}g$/kg, i.p.)의 전처치를 통하여 유의한 synergistic analgesic effect가 관찰되었으나, ${\alpha}1$-adrenergic receptor agonist(phenylephrine, 2mg/kg, i.p.)의 전처치는 전침의 진통효과에 synergistic effect를 미치지 않는 것으로 나타났다. 결론 : 저빈도 족삼리 전침은 CIA로 유발된 염증성 통증에 대하여 진통효과를 발휘하며, 이는 ${\alpha}2$-adrenergic receptor에 의하여 매개되는 것으로 보이며 ${\alpha}1$-adrenergic receptor는 영향을 미치지 않는 것으로 사료된다.

Analysis of Pain Records for Cancer Patients Complaining of Moderate or Severe Pain (중등도 이상의 통증을 호소하는 암환자의 통증간호기록 분석)

  • Park, Ran Hee;Cho, Ok Hee;Yoo, Yang Sook
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.270-277
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    • 2014
  • Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.

Physician's Attitude toward Treating Breakthrough Cancer Pain in Korea

  • Seo, Min Seok;Shim, Jae Yong;Choi, Youn Seon;Kim, Do Yeun;Hwang, In Gyu;Baek, Sun Kyung;Shin, Jin Young;Lee, Juneyoung;Lee, Chang Geol
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.18-25
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    • 2017
  • Purpose: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. Methods: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. Results: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. Conclusion: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.