• Title/Summary/Keyword: Central pain

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Attenuated Neuropathic Pain in CaV3.1 Null Mice

  • Na, Heung Sik;Choi, Soonwook;Kim, Junesun;Park, Joonoh;Shin, Hee-Sup
    • Molecules and Cells
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    • v.25 no.2
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    • pp.242-246
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    • 2008
  • To assess the role of $\alpha_{1G}$ T-type $Ca^{2+}$ channels in neuropathic pain after L5 spinal nerve ligation, we examined behavioral pain susceptibility in mice lacking $Ca_{V}3.1$ (${\alpha}_{1G}{^{-/-}}$), the gene encoding the pore-forming units of these channels. Reduced spontaneous pain responses and an increased threshold for paw withdrawal in response to mechanical stimulation were observed in these mice. The ${{\alpha}_{1G}}^{-/-}$ mice also showed attenuated thermal hyperalgesia in response to both low-(IR30) and high-intensity (IR60) infrared stimulation. Our results reveal the importance of ${\alpha}_{1G}$ T-type $Ca^{2+}$ channels in the development of neuropathic pain, and suggest that selective modulation of ${\alpha}_{1G}$ subtype channels may provide a novel approach to the treatment of allodynia and hyperalgesia.

Analgesic Effect of Centipede Venom Iontophoresis for Myalgia (왕지네 Venom을 사용한 이온토포레시스가 근육통에 미치는 영향)

  • Park Ji-Whan;Park Sang-Ock
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.1-12
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    • 1998
  • This study was to determine whether iontophoresis application of centipede venom would produce analgesic effect for clinical practice. Sixty patients suffered from musculoskeletal diseases who lived in Taejon city were analyzed by double-blind central study. After pre treatment, post treatment, post 20 minutes, post 40 minutes iontophoresis using centipede venom, we assessed the response to pin-prick sensation with Endomed 582 in myalgia patients. The results were as follows, control group showed pain threshold of 1.76, 2.03, 2.01, 2.02mA after treatment, but the pain threshold of 1.76, 2.21, 3.85, 3.87mA after iontophoresis application in study group. The pain threshold of Notermans pain score after 20-minute and 40-minute centipede venom iontophoresis group using centipede venom was higher than that after non-centipede venom iontophoresis group. The results showed that by the increasing the analgesic effect in the centipede venom iontophoresis group, especially in time of post 20 minutes after iontophoresis treatment. So we considered that the iontophoresis using centipede venom could be reduced pain of myalgia in musuloskeletal disease patients.

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Cervical Epidural Block Can Relieve Persistent Hiccups -Case report- (경부 경막외 신경차단을 이용한 2주간 계속된 딸꾹질의 치료 경험 -증례보고-)

  • Lee, Kyung-Jin;Park, Won-Sun;Chun, Tae-Wan;Kim, Chan;Nam, Yong-Taek
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.131-134
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    • 1995
  • Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.

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Effects of Posteroanterior Mobilization on the Cervical Spine in Patient with Chronic Whiplash-Associated Disorders

  • Park, Si Eun;Kim, Ji Sung;Choi, Wan Suk
    • Journal of International Academy of Physical Therapy Research
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    • v.8 no.1
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    • pp.1122-1127
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    • 2017
  • The purpose of this case study was to identify the effects of posteroanterior (PA) mobilization on the cervical spine in a patient with chronic whiplash-associated disorder (WAD). The subject of this study was a 58-year-old woman who sustained a chronic WAD as a result of a motor vehicle accident two years prior. The subject has progressively worsening neck pain and stiffness. The subject was determined to have a grade IIb WAD the use of the Modified Quebec Classification. The intervention was central and unilateral PA mobilization on the spinous process of C4 and C5. The PA mobilizations were performed at the end of range to Maitland grade IV. The PA mobilization was conducted once daily for a total of eight days. Two sets of measurements were done one before and one after the intervention. Neck pain, cervical stiffness, range of motion and lordosis of the cervical spine were measured. Experimental intervention decreased the neck pain, and increased the neck stiffness and cervical ROM (range of motion) such as flexion, extension, lateral flexion and rotation. X-ray photographs also represented that cervical curvature increased from $35^{\circ}$ to $40^{\circ}$. This study suggested that PA cervical mobilization applied to hronic WAD is effective in decreasing pain, increasing cervical ROM and cervical curvature.

Acute Phase Protein Lipocalin-2 Is Associated with Formalin-induced Nociception and Pathological Pain

  • Jha, Mithilesh Kumar;Jeon, Sangmin;Jin, Myungwon;Lee, Won-Ha;Suk, Kyoungho
    • IMMUNE NETWORK
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    • v.13 no.6
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    • pp.289-294
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    • 2013
  • Lipocalin-2 (LCN2) is an acute-phase protein induced by injury, infection, or other inflammatory stimuli. LCN2 binds small hydrophobic ligands and interacts with cell surface receptor to regulate diverse cellular processes. The role of LCN2 as a chemokine inducer in the central nervous system (CNS) has been previously reported. Based on the previous participation of LCN2 in neuroinflammation, we investigated the role of LCN2 in formalin-induced nociception and pathological pain. Formalin-induced nociceptive behaviors (licking/biting) and spinal microglial activation were significantly reduced in the second or late phase of the formalin test in Lcn2 knockout mice. Likewise, antibody-mediated neutralization of spinal LCN2 attenuated the mechanical hypersensitivity induced by peripheral nerve injury in mice. Taken together, our results suggest that LCN2 can be therapeutically targeted, presumably for both prevention and reversal of acute inflammatory pain as well as pathological pain.

An Analysis of Nursing Research on Pain Reported in Korea from 1970 to 1994 (통증 개념을 다룬 국내 간호 연구 분석)

  • 박정숙;박청자
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.30-44
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    • 1995
  • This study aimed at analyzing the trend of re-search on pain in Korea, suggesting direction future pain research, and contributing to the use of pain interventions in nursing practice. Research studies on pain were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, and from theses and dissertations, which were conducted between 1970 and 1994. The total number of the studies was 93. These studies were analyzed for 1) time of publication or presentation, 2) thesis for a degree or nondegree, 3) research design, 4) characteristics of subjects used in each study, 5) measurement tool, 6) types of correlated variables, 7) Korean terms for pain 8) types of nursing interventions, and 9) results of studies. The findings of the analysis can be summerized as follows : 1) The number of studies related to pain has increased rapidly since the early 1980's. The number of experimental research studies related to pain has increased chronologically, but the number of survey research studies related to pain was highest from 1981 to 1985, after that it decreased slowly. 2) The subjects in 19 studies were healthy people and, in 73 studies, patients with various illnesses. Thirty two studies were conducted with surgical patients. 3) Sixty one pain research studies were done for a thesis for a degree and 32 were nondegree research studies. 4) As measurement tools for pain, self- report pain scales were used in 54 studies and more than two tools were used in 28 studies. In the experimental studies, the trend was to use more than two tools. And in the nonexperirnental studies, the trend was to use self-report pain scales only. 5) There were 11 correlational studies. In these studies, the trend was to study anxiety, depression and variables such as intravenous infusion as related to pain.6) In the thirty six experimental studies, the effects of 16 types of nursing interventions weretested. Teaching and information, and relaxation technique were the most popular interventions for pain. 7) In eighteen methodological studies, the majority were studies testing the validity and re-liability of Dr. Lee's Korean Pain Rating Questionnaire. The following suggestions are made based on the above findings : 1) The patterns of these studies related to pain in Korea need to be compared with trends in other countries. 2) Meta - analysis should be done to analyze and integrate the results of various studies. 3) This analysis of pain research is needed to identify the present trend of pain research and to suggest the direction of future pain research, so these patterns of studies should be done in 5 to 10 year intervals. 4) More replicated pain research is needed to prove the effect of nursing interventions and more qualitative research on pain is needed to identify indepth the meaning of pain. 5) Pain researchers should make an effort to apply research result in various clinical settings and try to carry out team research with clinical nurses or with other multidiscipinary researchers.

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Effect and Tolerability of Nasal Spray of Salmon Calcitonin in the Relief of Pain due to Bone Metastasis (전이성골암에 의한 통증에 대한 Salmon Calcitonin($Miacalcic^{(R)}$) 비강분무의 효능 및 안정성)

  • Lee, Soo-Yong;Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Hong, Seok-Il;Choi, Soo-Yong;Jang, Jin-Dae
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.72-77
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    • 1996
  • Metastaic bone tumors are usually accompanied with severe pain. The treatment modalities for this pain are so variable that patients are sometimes afraid of using them. Salmon calcitonin has a function to increase beta-endorphines followed by increasing the blood level of prostaglandin and thromboxan A2, which results in analgesic effect. This drug also has been known to decrease bone resorption. There were a few reports that parenteral use of salmon calcitonin decrease the pain from metastatic bone tumor. We wanted to know the effectiveness and tolerability of nasal spray of salmon calcitonin in relieving bone pain with metastatic tumor. We analyzed the effectiveness in the aspects of pain, sleep, performance status, mobility, supplementary analgesic use. The biologic effect of salmon calcitonin was analysed with CBC, Ca/P, BUN/Cr, uric acid. Simple radiography, alkaline phosphatase, osteocalcin, pyrilink-K were used as parameters for bone change. Eighteen cases of metastatic bone tumors took nasal spray of salmon calcitonin($Miacalcic^{(R)}$, 200IU/day) for 4 weeks, to relieve bone pain. With Wilcoxon Matched-Pairs Signed Ranks Test, we could find pain decreased significantly at 3 week and mobility become improved at 4 week of salmon calcitonin use. Other parameters didn't show any significant changes. We think the analgesic effect is mainly due to effect not on the local bone lesion but on the central nervous system, and that increased dose of salmon calcitonin can induce earlier and stronger analgesic effect.

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Morphine: Patient Knowledge and Attitudes in the Central Anatolia Part of Turkey

  • Colak, Dilsen;Oguz, Arzu;Yazilitas, Dogan;Imamoglu, Inanc Goksen;Altinbas, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4983-4988
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    • 2014
  • Background: In Muslim majority countries (MMC) opioid use for pain management is extremely low. The underlying factors contributing to this are not well defined. Aim: The aim of this study was to survey the attitudes of cancer patients towards morphine use for pain management in a MMC and identify the factors that influence patient decisions to accept or refuse morphine as treatment for cancer pain. Settings/participants: Patients were questioned whether they had pain or not, the severity and the medications for pain management. Questions included what type of medication they thought morphine was, whether or not they would be willing to take morphine if recommended for pain management and the basis for their decision if they were against morphine use. Results: Four hundred and eighty-eight patients participated in the study. Some 50% of the patients who refused morphine use and 36.8% of the patients who would prefer another drug, if possible, identified fear of addiction as the basis for their decision. Reservation of morphine for later in their disease was the case for 22.4% of the patients who refused morphine use. Only 13.7 % of the patients refusing morphine and 9.7% of the patients who preferred another drug, if possible, cited religious reasons as the basis for this decision. Conclusions: Identifying the underlying factors contributing to low opioid use for pain management in MMC is important. Once the underlying factors were identified, all efforts should be taken to overcome them as they are barriers to improving patient pain management.

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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Effects of single-dose, low-level laser therapy on pain associated with the initial stage of fixed orthodontic treatment: A randomized clinical trial

  • Qamruddin, Irfan;Alam, Mohammad Khursheed;Abdullah, Habiba;Kamran, Muhammad Abdullah;Jawaid, Nausheen;Mahroof, Verda
    • The korean journal of orthodontics
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    • v.48 no.2
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    • pp.90-97
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    • 2018
  • Objective: The aim of this study was to assess the analgesic effect of a single application of low-level laser therapy (LLLT) on spontaneous pain and pain on chewing after placement of initial archwires. Methods: Forty-two patients (26 women, 16 men) were randomly recruited for this split-mouth randomized clinical trial. Each patient received super-elastic nickel-titanium (NiTi) initial archwires (0.012, 0.014, 0.016, and 0.018-inch [in]) in the maxilla for leveling and alignment for an interval of 4 weeks between archwires. One side of the mouth was randomly designated as experimental, while the other side served as placebo. After insertion of each archwire, the experimental side was irradiated with a diode laser for 3 seconds each on 5 points facially and palatally per tooth, from the central incisor to first molar. On the placebo side, the laser device was held the same way but without laser application. A numerical rating scale was used to assess the intensity of spontaneous and masticatory pain for the following 7 days. The Mann-Whitney U test was used to compare pain scores between sides. Results: Patients in the LLLT group exhibited significantly lower mean scores for spontaneous pain after insertion of the initial two archwires (0.012-in and 0.014-in NiTi; p < 0.05), while there was no significant difference for 0.016-in and 0.018-in wires between the LLLT and placebo groups. LLLT significantly reduced chewing pain scores (p < 0.05) for all archwires. Conclusions: A single dose of LLLT considerably lessened postoperative pain accompanying the placement of super-elastic NiTi wires for initial alignment and leveling.