• Title/Summary/Keyword: Central pain

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Change of the Intervertebral Foraminal Pressure after Removal of the Disc Material (디스크 제거 후 추간공내 압력의 변화)

  • Hong, Chang Kie;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.144-149
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    • 2001
  • Objective : Spinal nerve root compression occurs commonly in conditions, such as herniated nucleus pulposus, spinal stenosis, intervertebral foraminal stenosis, and trauma. However, the pathophysiolosy of the symptoms and signs related to spinal nerve root compression is poorly understood. The purpose of the present study was to assess and compare the changes of various pressures of intervertebral foraminal pressure before and after decompression. Method : After laminetomy without foraminotomy was performed, pressure sensor tip of Camino parenchymal type was located at the middle-central portion of the intervertebral foramen and anterior portion of nerve root for the foraminal pressure before decompression of the intervertebral foramen. After laminectomy with foraminotomy, the same method was used for the foraminal pressure after decompression. The authors studied 40 consecutive patients (57 disc spaces) with severe constant root pain to the lower leg, pain unrelived by bed rest, and minimal tension signs, diagnosed by MRI. Results : In patients with intervertebral foraminal stenosis, the intraforaminal pressure was decreased from $86{\pm}2.23mmHg$ to $17.1{\pm}1.51mmHg$ and in patients without stenosis, from $55.9{\pm}1.08mmHg$ to $11.9{\pm}1.25mmHg$. All patients below 20mmHg after decompression showed good outcome, but 4 cases who showed poor outcome had foraminal stenosis, posterolateral type of the herniated disc, and above 30mmHg of foraminal pressure after decompression. Conclusion : These findings suggest that if the foraminal pressure falls below 20mmHg after decompression, good outcome can be anticipated. Central type of the herniated disc shows better outcome compared to the posterolateral type.

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A bioassay system for pharmacological standardization of Withania somnifera derived herbal remedies

  • Dey, Amitabha;Chatterjee, Shyam Sunder;Kumar, Vikas
    • CELLMED
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    • v.9 no.1
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    • pp.1.1-1.13
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    • 2019
  • Background: Contents of bioactive substances extractable from different parts of terrestrial plants vary enormously. Aim: To ascertain that parts of Withania somnifera other than its roots can also be used for prevention and cure of unavoidable stress triggered central hypersensitivity to pain. Material and Methods: Groups of male or female mice treated either with Withania somnifera extracts or with metformin, aspirin, imipramine, diazepam and niacin for 11 consecutive days were subjected to "foot-shock stress-induced hyperthermia" and "hot plate" tests on the 1st, 5th, 7th, and 10th days of the experiments. On the 11th day, they were subjected to tail suspension test and on 12th day pentobarbital hypnosis test. Results: Except for diazepam and imipramine, protective effects of all other tested drugs as well as of the Withania somnifera extracts against stress-induced central hypersensitivity to pain were accompanied by their preventive effects against foot-shock stress-induced body weight losses. All observed stress response suppressing effects of all test agents increased with increasing numbers of treatment days. However, mean duration of pentobarbital-induced sleep was shorter in the extracts treated groups and longer in the diazepam treated ones only. Conclusions: Reported observations reveal that pharmacological activity profile of Withania somnifera extracts in male and female mice are almost identical, and are not like those of several drugs currently often prescribed for the treatment of diabetes-associated comorbidities. Withanolides are not the only extractable bioactive constituents of Withania somnifera. The described bioassay system is well suited for pharmacological standardization of diverse types of Withania somnifera extracts.

Clinical Characteristics of Disability in Patients with Indoor Aire-Related Environmental Intolerance

  • Vuokko, Aki;Karvala, Kirsi;Suojalehto, Hille;Lindholm, Harri;Selinheimo, Sanna;Heinonen-Guzejev, Marja;Leppamaki, Sami;Cederstrom, Sebastian;Hublin, Christer;Tuisku, Katinka;Sainio, Markku
    • Safety and Health at Work
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    • v.10 no.3
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    • pp.362-369
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    • 2019
  • Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor aire-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.

Anti-nociceptive and Anti-inflammatory Properties of Ilex latifolia and its Active Component, 3,5-Di-caffeoyl Quinic Acid Methyl Ester

  • Kim, Joo Youn;Lee, Hong Kyu;Seong, Yeon Hee
    • Natural Product Sciences
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    • v.25 no.1
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    • pp.64-71
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    • 2019
  • The present study was conducted to investigate anti-nociceptive and anti-inflammatory effects of the leaves of Ilex latifolia Thunb (I. latifolia) in in vivo and in vitro. Writhing responses induced by acetic acid and formalin- and thermal stimuli (tail flick and hot plate tests)-induced pain responses for nociception were evaluated in mice. I. latifolia (50 - 200 mg/kg, p.o.) and ibuprofen (100 mg/kg, p.o.), a positive non-steroidal anti-inflammatory drug (NSAID), inhibited the acetic acid-induced writhing response and the second phase response (peripheral inflammatory response) in the formalin test, but did not protect against thermal nociception and the first phase response (central response) in the formalin test. These results show that I. latifolia has a significant anti-nociceptive effect that appears to be peripheral, but not central. Additionally, I. latifolia (50 and $100{\mu}g/mL$) and 3,5-di-caffeoyl quinic acid methyl ester ($5{\mu}M$) isolated from I. latifolia as an active compound significantly inhibited LPS-induced NO production and mRNA expression of the pro-inflammatory mediators, iNOS and COX-2, and the pro-inflammatory cytokines, IL-6 and $IL-1{\beta}$, in RAW 264.7 macrophages. These results suggest that I. latifolia can produce antinociceptive effects peripherally, but not centrally, via anti-inflammatory activity and supports a possible use of I. latifolia to treat pain and inflammation.

The Effect of Combination of Ondansetron and Droperidol on Prevention of Postoperative Nausea and Vomiting (Ondansetron과 Droperidol의 혼합 투여가 술 후 오심과 구토 예방에 미치는 효과)

  • Kim, Dong-Hee;Cho, Duk-Hyun
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.46-50
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    • 2001
  • Background: Ondansetron is both a central and peripheral serotonin (5HT) receptor antagonist and droperidol is a dopaminergic blocking drug which acts centrally at the chemoreceptor trigger zone. We assessed the efficacy and adverse effects of ondansetron, droperidol or both, in the prevention of postoperative emesis during postoperative intravenous patient-controlled analgesia (PCA) using butorphanol and ketorolac medication. Methods: We studied 60 women, aged 25-60 yrs, who underwent total abdominal hysterectomy (TAH), under general anesthesia using $N_2O-O_2$-enflurane. A bolus dose of 1 mg of butorphanol and 4 mg of ondansetron were given to patients and thereafter, PCA was started using 10 mg of butorphanol and 240 mg of ketorolac mixed into the 5% D/W solution (total volume; 100 ml, 1 ml of bolus dose, and 10 min of lockout interval). We also added ondansetron 4 mg (Group O, n = 20), ondansetron 4 mg and droperidol 2.5 mg (Group OD, n = 20), or droperidol 2.5 mg (Group D, n = 20) to the PCA drug. The severity of pain, nausea, vomiting, sedation and other side effects were assessed at 0, 1, 2, 6, 12, 24, 36 and 48 hr after awakening. Results: There was no difference in the incidence of nausea and vomiting between the three group [Group O: 4 (20%) and 3 (15%), respectively; Group OD: 1 (5%) and 1 (5%), respectively; Group D: 3 (15%) and 3 (15%), respectively]. Group O showed a lower sedation score than the other groups (P < 0.05). The pain score and other side effects did not show any difference between the groups. Conclusions: The combination of ondansetron and droperidol showed no clinical benefit compared with ondansetron or droperidol alone for prevention of postoperative nausea and vomiting during postoperative PCA using butorphanol and ketorolac.

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Changes in Sensory Function After Transcranial Direct Current Stimulation on Primary Motor Cortex Area

  • Min, Dong-Ki
    • Physical Therapy Korea
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    • v.21 no.4
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    • pp.1-8
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    • 2014
  • Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

Effects of Bee Venom Acopuncture at Sinsu($BL_{23}$) and Daejangsu($BL_{25}$) in Different Concentration on Neuropathic Pain Induced by Tibial and Sural Nerve Injury in Rats (농도 차이에 따른 신수(腎兪)($BL_{23}$).대장수(大腸兪)($BL_{25}$) 봉독약침이 백서의 신경병리성 동통모델에 미치는 영향)

  • Chiang, Suo-Yue;Bang, Sung-Pil;Kim, Jae-Hong;Wei, Tung-Sheun;Yun, Yeo-Choong
    • Journal of Acupuncture Research
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    • v.27 no.5
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    • pp.13-24
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    • 2010
  • Objectives : This study was designed to investigate the effects of bee venom acupuncture at Shinsu($BL_{23}$) and Daejangsu($BL_{25}$) on neuropathic pain induced by tibial and sural nerve injury in rats. Methods : Neuropathic pain model was made by partial resection of tibial and sural nerve. Three weeks after the neuropathic surgery, bee venom acupuncture was firstly injected at $BL_{23}$ and $BL_{25}$, then we measured withdrawal responses induced by von Frey filament and acetone stimulation. Bee venom acupunctures were injected 6times on every 2days. Measurement of withdrawal responses were conducted on the same days. After bee venom acupuncture injection, expression levels of c-Fos, nocieptin and KOR-3 were observed through using immunohistochemistry. Results : In this experiment, bee venom acupunctures at $BL_{23}$ and $BL_{25}$ decreased levels of withdrawal responses induced by von Frey filament and acetone stimulation respectively. In addtion, expression levels of c-Fos, nociceptin and KOR-3 in central gray part of brain in rats were decreased by bee venom acupuncture. Conclusions : These results imply that bee venom acupuncture was useful to treat patients with neuropathic pain, and related mechanisms were involved in opioid and their receptors such as nociceptin and KOR-3.

Study of Developmet of External Medicine Based on the Result of Prior Study and Folk Remedy Using Scolopendra subspinipes mutilans as a Single Medicine in Korea and China (한국과 중국에서의 오공을 단방으로 사용한 민간요법과 선행연구결과를 기반으로 한 외치 한약제제 개발에 대한 고찰)

  • Kim, Sin Seo;Kim, Myung Dong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.3
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    • pp.203-217
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    • 2015
  • Scolpendra subspinipes (centipede) is pungent in flavor, activates the channels to stop pain, and, removes toxins and resolves masses. So it has been used as a folk remedy. We researched folk remedies which used centipede as a single medicine and results of its prior clinical and experimental study, and figured out that centipedes are effective on ulcerative disease, herpes zoster, clavus, insect bite, inflammatory disease, furunculus, pain disease by external therapy, and oral administration is effective on anti-cancer such as hepatoma and uterine cancer, cerebrovascular disease, inhibition of atherosclerosis, sedation of central nervous system, antipyretic action, and anti-inflammation, and centipede Herb-Acupuncture is effective on inflammatory disease and pain disease. Centipede preparation materials for external therapy were sesame oil, perilla oil, vinegar, salt, and, burnt alum. Fumigation of centipede treated paronychia, pertussis, and hemorrhoids. For the external therapy, the way of centipede powder mixing with other materials has been used. It is needed that we use dusted powder to make skin absorb its ingredients more easily, and we study intensely minor ingredients to make centipede components absorbed more effectively and do pharmacological action. Also, fumigation, a kind of another external therapy, is considered to be effective treatment of upper respiratory infection like pertussis, so it needs an in-depth study on centipede fumigation.

A peripheral tremor associated with intractable pain after traffic accident : case report

  • Hong, Joo-Chul;Kim, Seong-Ho
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.74-77
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    • 2009
  • There are debates about whether peripherally induced movement disorders exist. We report a case of upper limb tremor induced by peripheral nerve injury. A 20-year-old male patient presented with pain and tremor of the left upper extremity, 2 days after a car accident. Magnetic resonance images of the brain and cervical spine were normal. His past medical history was unremarkable and there were no family members with symptoms of movement disorders. He suffered from an aggravating tremor for about 10 minutes, four to six times a day. We treated the patient with medication, epidural infusion, cervical nerve root block and trigger point injection of the trapezius muscle. The pain subsided 50% and the incidence of tremor attacks was reduced to once or twice a day. The role of peripheral trauma in the genesis of movement disorders has not been generally accepted. It is unclear whether peripheral trauma can induce dystonia and other movement disorders. It has been proposed that peripheral trauma can alter sensory input and induce cortical and subcortical reorganization that generates a movement disorder. Some studies provide evidence for central reorganization following peripheral injury.

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Expression of vesicular glutamate transporter in transient receptor potential vanilloid 1-positive neurons in the rat trigeminal ganglion

  • Han, Hye Min;Cho, Yi Sul;Bae, Yong Chul
    • International Journal of Oral Biology
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    • v.46 no.3
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    • pp.119-126
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    • 2021
  • Activation of transient receptor potential vanilloid 1 (TRPV1), a calcium permeable channel expressed in primary sensory neurons, induces the release of glutamate from their central and peripheral afferents during normal acute and pathological pain. However, little information is available regarding the glutamate release mechanism associated with TRPV1 activation in primary sensory neurons. To address this issue, we investigated the expression of vesicular glutamate transporter (VGLUT) in TRPV1-immunopositive (+) neurons in the rat trigeminal ganglion (TG) under normal and complete Freund's adjuvant (CFA)-induced inflammatory pain conditions using behavioral testing as well as double immunofluorescence staining with antisera against TRPV1 and VGLUT1 or VGLUT2. TRPV1 was primarily expressed in small and medium-sized TG neurons. TRPV1+ neurons constituted approximately 27% of all TG neurons. Among all TRPV1+ neurons, the proportion of TRPV1+ neurons coexpressing VGLUT1 (VGLUT1+/TRPV1+ neurons) and VGLUT2 (VGLUT2+/TRPV1+ neurons) was 0.4% ± 0.2% and 22.4% ± 2.8%, respectively. The proportion of TRPV1+ and VGLUT2+ neurons was higher in the CFA group than in the control group (TRPV1+ neurons: 31.5% ± 2.5% vs. 26.5% ± 1.2%, VGLUT2+ neurons: 31.8% ± 1.1% vs. 24.6% ± 1.5%, p < 0.05), whereas the proportion of VGLUT1+, VGLUT1+/TRPV1+, and VGLUT2+/TRPV1+ neurons did not differ significantly between the CFA and control groups. These findings together suggest that VGLUT2, a major isoform of VGLUTs, is involved in TRPV1 activation-associated glutamate release during normal acute and inflammatory pain.