• Title/Summary/Keyword: 통증의 기전

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fMRI로 관측한 침의 진통 기전

  • 한재용;이수열;조민형;조장희
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.101-101
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    • 2001
  • 목적: 침에 의한 진통 기전은 동양에서 경험이나 임상적으로 그 효능이 입증되어 왔으나 서양에서 요구하는 과학적인 접근 방법에 의한 증거가 매우 희박하며, 과학적인 접근이 매우 어려웠다. fMRI를 이용하여 뇌의 기능 영상을 관측함으로 그 증거를 제시하고자 한다. 대상 및 방법: 집게손가락에 특정시간동안 온도에 의한 자극을 주면서 기능적 뇌 영상을 받고 침 자극 전후의 활성 영역을 비교함으로써 침이 통증의 진통 기전에 효과가 있음을 보여 준다. 신뢰성 있는 데이터를 위해 여러 명의 영상을 평균하여 잡음을 제거하였다.

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Management of Neuropathic Pain (신경병성 통증의 치료)

  • Kim, Yeong-In
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.274-280
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    • 1999
  • A variety of mechanism may generate pain resulting from injury to the central and peripheral nervous system. None of these mechanism is disease-specific, and several different pain mechanism may be simultaneously present in anyone patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of therapeutic options, the mainstay of which is pharmacotherapy. Selection of an appropriate rharmacologic agent is by trial and error since individual responses to different agents, doses, and serum levels are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuropathic pain. Tricyclic antidepressants are first-line agents, although other drugs, including anticonvulsants, local anesthetic antiarrhythmics, clonidine, opiates, and certain topical agents, also offer pain relief in some patient populations. The novel antidepressants venlafaxine and nefazodone are potentially useful new drugs that are better tolerated than tricyclic antidepressants. Also Gabapentine seems an interesting and promising drug for the treatment of neuropathic pain.

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명사 칼럼-우리 몸의 조기경보시스템 '통증'

  • Hwang, Gyeong-Ho
    • 건강소식
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    • v.32 no.6
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    • pp.4-5
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    • 2008
  • 우리 몸에 상처를 입었거나 상처를 입을 만한 상황에서 느끼는 유쾌하지 않은 감정까지 모두 통증의 범주에 포함된다. 잠재적인 손상을 알리는 통증 즉, 바늘에 찔리거나 불에 데이는 순간에 느끼는 것과 같은 일차적인 통증은 재빠른 회피반사를 일으켜 다가오는 더 큰 조직 손상을 미연에 방지하려는 조기경보시스템이라고 할 수 있다. 반면에 어쩔 수 없이 우리 몸이 손상을 입게 되면 통증은 반사적으로 근육 수축을 일으켜 신체를 움직이지 않게 한다. 골절상을 입었을 때의 통증처럼 움직이면 통증을 더 느끼게 되고, 움직이지 않아야 아프지 않고 뼈가 아물게 되는것이다. 이처럼 통증은 신체의 이상을 신속히 알리고 경고하는 중요한 방어기전 중의 하나이다.

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Comparisons of the Plastic Changes in the Central Nervous System in the Processing of Neuropathic Pain (신경병증성 통증의 처리 과정에 있어 중추신경계의 가소성 변화 비교)

  • Kwon, Minjee
    • Science of Emotion and Sensibility
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    • v.24 no.2
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    • pp.39-48
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    • 2021
  • According to International Associating for the Study of Pain (IASP) definition, neuropathic pain is a disorder characterized by dysfunction of the nervous system that, under normal conditions, mediates virulent information to the central nervous system (CNS). This pain can be divided into a disease with provable lesions in the peripheral or central nervous system and states with an incorporeal lesion of any nerves. Both conditions undergo long-term and chronic processes of change, which can eventually develop into chronic pain syndrome, that is, nervous system is inappropriately adapted and difficult to heal. However, the treatment of neuropathic pain itself is incurable from diagnosis to treatment process, and there is still a lack of notable solutions. Recently, several studies have observed the responses of CNS to harmful stimuli using image analysis technologies, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging. These techniques have confirmed that the change in synaptic-plasticity was generated in brain regions which perceive and handle pain information. Furthermore, these techniques helped in understanding the interaction of learning mechanisms and chronic pain, including neuropathic pain. The study aims to describe recent findings that revealed the mechanisms of pathological pain and the structural and functional changes in the brain. Reflecting on the definition of chronic pain and inspecting the latest reports will help develop approaches to alleviate pain.

Etiology and Pathogenesis of Recurrent Aphthous Stomatitis (재발성 아프타성 궤양의 원인과 기전)

  • Suh, Bong-Jik;Lee, Kyung-Eun
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.187-194
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    • 2008
  • Recurrent aphthous stomatitis is common oral disease in the world. It is characterized by multiple, recurrent, painful ulcer with circumscribed margins, erythematous haloes and yellow or grey floors. Patients with recurrent aphthous stomatitis suffer from its painful ulcer. But unfortunately, its etiology and pathogenesis is not clear and still unknown. So we review etiology and pathogenesis of recurrent aphthous ulcer and wish to propose direction of the future study.

Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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The Approaches to Postoperative Pain Management (술후 통증관리의 접근)

  • Song, Sun-Ok
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.1-7
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    • 1995
  • 효율적인 술후 통증치료를 위해서는 통증치료의 방법과 환자관리면을 동시에 고려하여야 한다. 방법은 상술한 바와 갈이 술후 통증기전에 부합되는 방법들이 예방적으로 적용되어야 하고 아울러 환자 개개인에 맞는 지속적인 균형제통이 시행되어야 한다. 그리고 환자관리면에서는 환자의 통증을 자주 평가하고 그에 동반된 처치 및 간호업무가 수반되어야 한다. 그러므로 술후 통증관리는 진통제에 대한 전문지식을 갖춘 의료인이 적합한 제통방법을 지속적으로 시행하여야 하는데 그러기 위해서는 효율적인 조직체제가 필요하다. 구미각국에서는 여러해 전부터 술후 통증관리가 통증관리센터란 체제하에서 효과적인 급성 통증치료실로 운영되어져 왔으며 현재는 병원의 중심센타로 확립된 실정이다. 우리나라도 국민의료보험이 도입된지 17년이 지났고 환자 위주의 병원환경이 마련되어야 한다는 데에는 대다수의 국민들로부터 공감대가 형성된 현시점에서 이제는 통증관리센터가 설립되어야 한다고 생각된다. 이러한 제안이 기정사실화 되기까지는 많은 논의와 임상결과에 대한 자료들이 있어야 하겠지만 무엇보다도 마취과 의사들의 술후통증관리에 대한 지속적인 관심과 연구가 뒷바침되어야 할 것으로 생각된다.

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