• The Journal of Korean Medicine
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• v.20 no.3 s.39
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• pp.36-44
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• 1999

Objectives: It has been well known that electroacupuncture(EA) has an analgesic effect and there is a pain control system in the central nervous system(CNS). The pain control system is composed of three major nuclei, which are periaqueductal gray(PAG), raphe nuclei, and the pain inhibitory complex located in the spinal cord. It has been suggested that the analgesic effect of EA might be the result of activation of the pain control system in the CNS. However, there may be a possibility that other nuclei are also involved in this pain modulation. Thus, we investigated whether the posterior intralaminar thalamic nuclei (PTIN) are involved in the pain modulation. Methods: To measure the level of pain, the jaw opening reflex (JOR) was used as a pain index. The magnitude of JOR is estimated by averaging the area of 10 successive responses. JOR was evoked by tooth-pulp stimulation with bipolar electrode carrying stimulus with the following parameters: intensity ranging from 420uA to 680ulA, 0.3ms duration of square pulse, and 0.5 Hz. Hapkog($LI_4$) and Taechung ($LR_3$) were the chosen acupoints. The Hapkog point was stimulated ipsilaterally at 5V, 3 Hz, for 15min in total, and the Taechung was stimulated at 2-3 V, 3 Hz, and for a total of 15 or 30 minutes. Different intensities of stimulation were given the PITN; one was given at $300{\mu}A$ and the other was at 500uA. The position stimulated in these nuclei by Paxinos Atlas was AP; from bregma $-4.0{\sim}-4.3mm,\;L; 0.5{\sim}1.8mm,\;D;\;4.8{\sim}6.3mm$. Results: The Hapkog point had a significant analgesic effect (P<0.05). However, the Taechung point had no effect. Both types of stimulation in the PITN did not reveal any analgesic effects. Conclusions: From these results, it was suggested that the posterior intralaminar thalamic nuclei are not involved in the modulation of pain.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.3
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• pp.642-650
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• 2006

As an effective non-pharmacological method of pain relief, hydrotherapy was widely used. And bath additive has been used for enhancing the efficacy of hydrotherapy, In the present study, as a bath additive, the analgesic activity of HAC, which composed of Corydalis turtschaninovii, Atractylodes japonica, and Harpagophytum procumbens(HAC), was investigated in the ventrolateral periaqueductal gray (VIPAG), lateral PAG (IPAG), central nuclei of amygdala (CeA), and the paraventricular nucleus of the hypothalamus (PVN) in mice, using writhing test and immunohistochemistry for c-Fos. Male C57BU6 mice weighing $25{\;}{\pm}{\;}2g$ (8 weeks of age) were used for this experiment. The animals were divided into five groups: the control group, the acetic acid treatment group, the acetic acid treatment and 0.01 g/L HAC-immersed group, the acetic acid treatment and 0.1 g/L HAC-immersed group, and the acetic acid treatment and 1.0 g/L HAC-immersed group. To induce somato-visceral pain in the experimental animals, a single intraperitoneal (i.p.) injection of acetic acid was administrated to each animal, and the animals of the control group received injections of equivalent doses of normal saline. The animals of the HAC-immersed groups were immersed the water with HAC powder at the respective doses deep enough to cover the mice body, and those of the control group and the acetic acid treatment group immersed the water without HAC powder at 10 min immediately after the acetic acid injection. Our present study has shown that the HAC reduced the acetic acid-induced abdominal constrictions and the acetic acid-Induced increase of numbers of c-Fos-positive cells in the VIPAG, IPAG, PVN, and CeA. The most potent analgesic effect appeared with the treatment of 1.0 g/L KB-immersed group. Based on our present results, it is very possible that HAC can be a potent therapeutic bath additive for alleviating pain without the fear of addiction to the drugs and side-effects associated with the prescription of multiple analgesic drugs.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.87-101
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• 2012

Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1483-1490
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• 2007

This study was carried out to investigate the effects of GCP treatment on the expression of NOS, c-fos, serotonin and substance P in central nerve system of monosodium iodoacetate(MIA)-induced osteoarthritic pain model. Arthritis was induced by injection of MIA(0.5 mg) into knee joint cavities of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was taken distilled water for 20 days. Treated group was taken extracts of GCP by oraly for same duration. Normal group(n=8) was infected with normal saline and was taken distilled water for 20 days. The numbers of NADPH-d positive cells in superficial dorsal horn of spinal cord of treated group($21{\pm}5$) was significantly (p<0.01) decreased compared with control($33{\pm}5$). The numbers of NADPH-d positive cell in dorsolateral periaqueductal gray matter of treated group($111{\pm}16$) was significantly(p<0.01) decreased compared with control($143{\pm}14$). The numbers of c-fos positive cells in dorsal periaqueductal gray matter of treated group($57{\pm}16$) was significantly(p<0.01) decreased compared with control($78{\pm}13$). The numbers of c-fos positive cells in paraventricular thalamic nucleus of treated group($60{\pm}15$) was significantly decreased compared with control($88{\pm}27$). The numbers of serotonin positive cells in median raphe nucleus of treated group($171{\pm}31$) was significantly(p<0.05) decreased compared with control($217{\pm}48$). On the basis of these results, we concluded that GCP treatment has inhibiting effects on the pain transmission in monosodium iodoacetate-induced osteoarthritic pain model in rat.

• Journal of Oriental Neuropsychiatry
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• v.34 no.2
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• pp.95-113
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• 2023

Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.90-97
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• 2016

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.99-119
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• 2006

Endothelin (ET) is a 21 amino acid peptide with multifunctional effects on the vasculature as well as a variety of other cell types such as respiratory, gastrointestinal, urogenital, endocrine, central nervous systems, and others. Endothelin has emerged as a modulator by autocrine and paracrine actions for many cellular activities, including vasoconstriction, cell proliferation, hormone production, neurotransmitter and/or neuromodulator. The endothelin family consists of three closely related peptides, ET-1, ET-2, and ET-3 derived from separate genes, such as chromosome 6, 1, and 20, respectively. ET-1 is the predominant isoform produced in the cardiovascular system and about which most is known. Endothelin receptors are seven-transmembrane GTP-binding protein-coupled receptors, which are classified into endothelin-A (ETA) and endothelin-B (ETB) receptors. Interestingly, recent evidence is accumulating to suggest that ET -1 may contribute to a variety of pain states such as allodynia and hyperalgesia in animals and humans. Therefore, in this review the biological characteristics and contraction-related mechanism of endothelin-1 in mammalian cells will be summarized. Especially, we focus on multifunctional roles for ET-1 in noxious stimulation-induced pain for the study of pain specialized physical therapy.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.1-8
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• 2020

The progression of aging and the increase in musculoskeletal diseases have led to an increase in invasive treatment methods, including various surgical methods, but conservative treatment should be attempted before surgical treatment in musculoskeletal diseases. Medication for pain control, such as acetaminophen, non-steroidal anti-inflammatory drugs, steroid, opioids, antidepressants, etc., is one of the most popular methods for pain control. If the pain receptors on peripheral organ are stimulated, pain is transmitted to the brain by the ascending pathway, and the brain then secretes endogenous opioids, such as endorphin, by the descending pathway for pain control. Opioids are substances that act on the opioid receptors, and there are three receptors for opioids. The affinity for each receptor varies according to the tissue and the patient's systemic status. Antidepressants work on the synapses in the central nervous system and its main mechanism is regulation of the ascending pathway. This is mainly effective in chronic pain and neuropathic pain, which is similar in effectiveness to opioids. This review focuses on the effectiveness, method of use, and side effects of opioids and antidepressants.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.1-6
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• 2001

Background: Subcutaneous injection of 5% formalin into the hind paw of the rat produces a biphasic nociceptive response. The second phase depends on changes in the dorsal horn cell function that occur shortly after an initial C-fiber discharge, spinal sensitization, or windup phenomenon. This study was performed to investigate the role of glutamate during spinal sensitization. Methods: Sprague-Dawley rats weighing 200 to 250 g were used for this study. Under light anesthesia (0.5% isoflurane) the rats were segregated in a specially designed cage and $50{\mu}l$ 0.5% formalin was injected subcutaneously in the foot dorsum of right hindlimb. Forty minutes after the formalin injection, the rat was quickly decapitated and spinal cord was removed. The spinal segments at the level of L3 (largest area) was collected and stored in a deep freezer ($-70^{\circ}C$). The mRNA gene expression of N-methyl-D-aspartate receptor (NMDAR) and the metabotropic glutamate receptor subtype 5 (mGluR5) were determined by the polymerase chain reaction. Results: The number of flinches was $19.8{\pm}2.3/min$. at one minute after formalin injection and decreased to zero after then. The second peak appeared at 35 and 40 minutes after formalin injection. The values were $17.8{\pm}2.2$ and $17.2{\pm}3.0/min$. The mRNA gene expressions of NMDAR and mGluR5 were increased by $459.0{\pm}46.8%$ (P < 0.01) and $111.1{\pm}4.8%$ (P > 0.05) respectively at 40 minutes after formalin injection. The increased rate of NMDAR was significantly higher than that of mGluR5 (P < 0.01). Conclusions: From these results it suggested that NMDAR partly contributed to the mechanism of central sensitization after the formalin test but mGluR5 did not.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.147-156
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• 2001

The purpose of this study was to identify the difference of vertical movement of mandible according to Angle's molar relationship and by skeletal factors affect to vertical movement of mandible. 172(age ranged from 20 to 30) subjects who go to college within territory of Kwangju city without any experience of temporomandibular disorder, extraction and orthodontic treatment. were selected for this study. The subjects were classified into class I(male:30, female:49), class II(male:18, female:24) and class III(male:18, female:33) according to Angle's molar relationship. The distance was measured between incisal edge of maxillary and mandibular central incisor and between bottom of central fossa of maxillary and mandibular 1st molar with ruler. The arch length and width were measured on the diagnostic cast. Cephalometrics were taken and then traced. Landmarks were identified and analyzed. 1. Maximal interincisal opening of male is larger than that of female in class I, class II and class III. Among each group maximal interincisal distance is the largest in class III. Maximal intermolar distance of male is superior to that of female in class I, class II, and class III, but there is no siginficant difference among them. 2. On maximal opening movement of Angle's classification class I and class II, total mandibular length, mandibular ramal length, madibular inferior border length and upper arch width were important variables and facial length, upper arch length and lower arch length had negative relationship to that. On maximal opening movement of Angle's class III, the upper arch length, the lower arch length and anterior facial length were important variables especially when compared with class I and II, and upper arch width had negative relationship. These results suggest that maximal opening movement is affected by facial morphology in all classes, but each group is affected by different facial skeletal variables. Accordingly, facioskeletal variables might be considered as diagnosis and treatment to improve the amount of mouth opening.