• Title/Summary/Keyword: Central pain

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Anesthetic management in corticobasal degeneration with central sleep apnea: A case report

  • Shionoya, Yoshiki;Nakamura, Kiminari;Sunada, Katsuhisa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.235-238
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    • 2019
  • Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of $SpO_2$ and preparations to support postoperative ventilation are necessary.

Effects of Ipsilateral and Contalateral Stimulation of Peripheral Nerve on Flexion Reflex in Cats (동측(ipsilateral) 및 대측(contralateral) 말초신경자극이 굴근반사에 미치는 영향의 비교연구)

  • Nam, Taick-Sang;Paik, Kwang-Se;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.169-176
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    • 1983
  • It is well known that the acupuncture has been used effectively for the relief of certain types of pain. Although the precise mechanism of action of acupuncture analgesia is unknown, it is generally accepted that their analgesic properties are related to the activation of endogenous opiate system in central nervous system. And it is suggested that pain-relieving properties of acupunture may be related to a stimulation of peripheral nerve underlying the acupuncture point on the skin. However, the efficacy of acupuncture has no relationship between the site of pain and the acupuncture point. Consequently, the present study was undertaken to investigate electroacupuncture analgesia in relation to the site of peripheral nerve stimulation. Cats were decerebrated ischemically and the flexion reflex as an index of pain was elicited by stimulating the sural nerve (20V, 0.5 msec duration) and recored as a compound action potential from the nerve innervated to the posterior biceps femoris muscle in the ipsilateral hindlimb. Bilateral common peroneal nerve and contralateral superficial radial nerve were selected as the site of peripheral nerve stimulation. For the stimulation of peripheral nerve, a stimulus of 20 V intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min respectively. The results obtained are summarized as follows: 1) Both stimulation of contralateral common peronal nerve and contralateral superficial radial nerve did not change the flexion reflex and there were no significant differences between them. 2) Stimulation of ipsilateral common peroneal nerve markedly depress the flexion reflex, the effect being reversed by naloxone application. These results suggest that stimulation of ipsilateral common peroneal nerve has the analgesic effect but both stimulation of contralteral common peroneal nerve and contralateral superficial radial nerve to the pain site where flexion reflex was elicited have no analgesic effect.

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Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

  • Hung, Hsiu-Chi;Chien, Tsui-Wei;Tsay, Shiow-Luan;Hang, Hewi-Ming;Liang, Shu-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1905-1909
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    • 2013
  • Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of health-related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

The Effects of MWM Taping and Diamond Taping on the Pain, Grip Strength and Functional Activity in Patients with Lateral Epicondylitis (멀리건 테이핑과 다이아몬드 테이핑이 외측상과염 환자의 통증, 악력, 기능수행능력에 미치는 영향)

  • Yang, Seong-Hwa;Park, Hyun-Sik;Sin, Young-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.2
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    • pp.47-54
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    • 2013
  • Background: Lateral epicondylitis is the most common complaint with complex etiological and pathophysiological factors on the lateral side of elbow. Taping techniques commonly used for lateral epicondylitis. The purpose of this study was to investigate the effects of mobilization with movement taping and diamond taping on the pain, grip strength and functional activity in patients with lateral epicondylitis Methods: Twenty patients with lateral epicondylitis (mobilization with movement taping group: n=10, diamond taping group: n=10) were recruited. They were evaluated pre-treatment, after 1weeks, and after 3weeks, using visual analog scale, pain free grip strength test, patient-rated tennis elbow evaluation. Results: Analysis showed statistcally significant improvement in all time in both groups. and The mean improvement in pre-1weeks visual analog scale was significantly greater in the Diamond taping group than that in the mobilization with movement taping group. and the mean improvement in pre-1weeks pain free grip strength test was significantly greater in the mobilization with movement taping than that in the diamond taping group. Conclusion: Taping technique to patients with lateral epicondylitis can help improve pain, grip strength, functional activity and initial taping technique can be selected depending on the patient's condition and the desired goal.

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The Effects of Manual Therapy on Pain, ROM and Disability of Cervical Radiculopathy (경추 신경근병증의 통증, 관절가동범위, 경부장애에 대한 도수치료의 효과)

  • Jeon, Jae-Guk;Kim, Hyun;Park, Hyun-Sik;Joo, Tae-Sung;An, Ik-Geun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.20 no.1
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    • pp.9-14
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    • 2014
  • Background: Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient experiencing cervical radiculopathy. Methods: In this study, 30 participants who met the diagnostic criteria for cervical radiculopathy were randomized into two groups: group I (nerve mobilization group) & group II (Mckenzie exercise group). The experimental group was performed manual cervical traction and neural mobilization technique. The control group was performed manual cervical traction and cervical retraction, extension exercise. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were pain intensity (PI), cervical rotation ROM (CR) and neck disability index (NDI). Results: After 4 weeks therapy, PI, CR and NDI were significantly reduced in both groups (p<.01). The PI, CR and NDI were no significantly reduced between group I and group II (p>.01). Conclusions: Manual therapy could reduce the symptoms of cervical radiculotpathy.

The Literature Review of FibroMyalgia Syndrome (섬유근통 증후군에 대한 문헌고찰)

  • Kim Myung-Chul;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.23-37
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    • 2004
  • Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

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Antinociceptive Effect of Nicotine in Various Pain Models in the Mouse

  • Han Ki-Jung;Choi Seong-Soo;Lee Jin-Young;Lee Han-Kyu;Shim Eon-Jeong;Kwon Min Soo;Seo Young-Jun;Suh Hong-Won
    • Archives of Pharmacal Research
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    • v.28 no.2
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    • pp.209-215
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    • 2005
  • The antinociceptive effect of nicotine administered intracereboventricularly (i.c.v.) or intrathecally (i.t) in several pain models was examined in the present study. We found that i.t. treatment with nicotine (from 5 to 20 g) dose-dependently blocked pain behavior revealed during the second phase, but not during the first phase in the formalin test. In addition, i.c.v. treatment with nicotine (from 0.1 to $10\;{\mu}g$) dose-dependently attenuated pain behavior revealed during both the first and second phases. In addition to the formalin test, nicotine administered i.c.v. or i.t. attenuated acetic acid-induced writhing response. Furthermore, i.c.v. or i.t. administration of nicotine did not cause licking, scratching and biting responses induced by substance P, glutamate, TNF-${\alpha}$(100 pg), IL-$1{\beta}$(100 pg) and INF-${\gamma}$ (100 pg) injectied i.t. The antinociception induced by supraspinally-administered nicotine appears to be more effective than that resulting from spinally administered nicotine. Our results suggest that nicotine administration induces antinociception by acting on the central nervous system and has differing antinociceptive profiles according to the various pain models.

Application of Stress Hormones in Saliva in Research of Orofacial Pain Related with Stress (스트레스와 관련된 구강안면통증의 연구에 있어서 타액내의 스트레스호르몬의 활용)

  • Ryu, Ji-Won;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.201-210
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    • 2007
  • Many diseases occur by stress or effect of stress. The basis for using hormones in research of stress is the observation that most systems in the body show changes during stress and that hormonal markers in these changes are related with stress. Conceptually, the central role of sympathetic nervous system(SNS) and hypothalamus-pituitary-adrenal(HPA) axis activity in stress provides copious justification for measuring hormonal changes. Catecholamines like epinephrine and norepinephrine, cortisol, testosterone and growth hormone and so on show sensitive reaction to stress. The major advantage of salivary sample to stress research is that its sampling technique can be performed in non-stressful conditions and without physical restraint and ethical problems. Because hormone levels in saliva is a good reflection of hormone levels in plasma, application of stress hormones in saliva is very useful for research of orofacial pain related with stress.

Effects of mechanical intervention on cutaneous sensory change and pressure pain threshold in the same spinal segment of myofascial pain

  • Kim, Do Hyung;Lee, Su-Hyun;Lee, Byoung Hee
    • Physical Therapy Rehabilitation Science
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    • v.8 no.1
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    • pp.15-21
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    • 2019
  • Objective: The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention (MI) increases the trigger point threshold of the same spinal segment as well as to investigate the relationship between the amounts of change in CS pressure pain thresholds (PPT). Design: Randomized controlled trial. Methods: Thirty-nine persons with myofacial pain (MFP) were recruited in this experiment. The subjects consisted of 20 men and 19 women (age 20-39). MI was applied on the subjects using the Graston technique for 5 minutes to induce CS changes. The CS changes were measured with sensory tests by using the Von Frey Filament, and PPT changes were estimated by using the pressure threshold meter. For the observation of sensory and PPT changes with time, the test was conducted for 15 minutes including a pre, post, and after intervention session. Results: CS threshold increased significantly when MI was applied (p<0.001). On the same spinal segment, changes in the right infraspinatus PPT was observed (p<0.001) but the PPT changes in other muscles were not significantly different. Furthermore, the control group CS and PPT were not significantly different. In addition, regression analysis showed that the CS changes have a larger impact on PPT in the same spinal segment (p<0.001). Conclusions: CS changes induced by MI make to change PPT on the same spinal segment. In other words, it is possible to identify PPT changes following CS changes except for the muscle which belongs to a different spinal segment. Therefore, application of MI is necessary for the CS changes in the same spinal segment. Furthermore, it can be useful in the clinical fields as a method of providing pain control and increasing the PPT.

Effects of Omega-3 Fatty Acid on Endotoxin-induced Acute Lung Injury in Rabbits

  • Jang, Eun-A;Son, Sung-Kuk;Kang, Jeong-Hyeon;Lee, Seongheon;Kwak, Sang-Hyun
    • Biomedical Science Letters
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    • v.27 no.1
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    • pp.19-27
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    • 2021
  • This study was undertaken to clarify the effects of omega-3 fatty acid on endotoxin-induced acute lung injury. Rabbits were randomly assigned to one of four groups. Each group received intravenous infusion of saline only, saline and Escherichia coli endotoxin, omegaven infuison (0.5 mL/kg/hr) and endotoxin, lipoven (0.5 mL/kg/hr) and endotoxin respectively. Infusion of saline was started 0.5 hr before the infusion of saline or endotoxin, and omegaven and lipoven were started 2 hours after endotoxin infusion for 4 hours. The lungs of rabbits were ventilated with 40% oxygen. Mean blood pressure, heart rate, arterial oxygen tension (PaO2), and peripheral blood leukocyte were recorded. The wet/dry (W/D) weight ratio of lung and lung injury score were measured, and analysis of bronchoalveolar lavage fluid (BALF) was done. Endotoxin decreased PaO2, and peripheral blood leukocyte and platelet count. And it increased W/D ratio of lung, lung injury score and leukocyte count, percentage of PMN cells, concentration of IL-8 in BALF. Omegaven attenuated all these changes except for peripheral blood leukocyte counts. Omegaven attenuated endotoxin-induced acute lung injury in rabbits mainly by inhibiting neutrophil and IL-8 responses, which may play a central role in endotoxin-related lung injury.