• Title/Summary/Keyword: Enhanced Pain

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Baculovirus Vector Reconstructed with Useful Genes (유용한 유전자들로 재구성된 베큘로바이러스 벡터)

  • Kim, Ji-Young;Kim, Hyun Joo;Sa, Young-Hee;Hong, Seong-Karp
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2016.05a
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    • pp.711-714
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    • 2016
  • Recombinant baculovirus was reconstructed with useful genes of polyhedron promoter, vesicular stomatitis virus G (VSVG), polyA, cytomegalovirus (CMV) promoter, enhanced green fluorescent protein (EGFP), and protein transduction domain (PTD). This reconstructed vector was infected into various cell lines and tissues. We investigated gene transfer and gene expression of this reconstructed vector in comparison to other vectors and recognized that this reconstructed vector was higher effective than any other control vector.

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Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea

  • Osman, Brian M.;Shapiro, Fred E.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.189-197
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    • 2019
  • There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for office-based cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating "the patient" into the surgical decision-making process through decision aids.

Enhanced Transdermal Delivery of Procaine Hydrochloride by lontophoresis -Comparison of Synergic Effect of High Voltage Current and Ultrasound- (이온도입에 의한 염산프로카인의 경피전달 증대 -고전압전류 및 초음파 병행의 상승효과 비교-)

  • Lee, Jong-Sook;Kim, Kyoung-Won;Lee, Jae-Hyoung;Choi, Yeong-Wook;Lee, Jae-Hwi
    • Journal of Pharmaceutical Investigation
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    • v.36 no.3
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    • pp.185-192
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    • 2006
  • The purpose of this study was to determine the effects of iontophoresis on transdermal delivery of procaine hydrochloride in healthy volunteers, as well as to the synergic effect of high voltage current or ultrasound on the efficacy of transdermal delivery of iontophoresis. Forty healthy volunteers were randomly assigned to four groups topical application group (TA), iontophoresis group (IT), pre-treatment of high voltage current stimulation with iontophoresis (HVS + IT), and pre-treatment of ultrasound application with iontophoresis (US + IT). All subjects received procaine iontophoresis on the forearm using direct current with 4 mA f3r 15 minutes. All subject was measured the duration of local anesthesia, pressure pain threshold, pain perception threshold using rectangular wave at 0.2 ms, 1 ms, 50 ms of rectangular current stimulation after procaine iontophoresis. For comparisons of the sensory characteristics and efficacy of iontophoresis between the groups, an one-way ANOVA and Kruskal-Wallis were used. The significant difference the duration of local anesthesia were found between the groups (p<0.001). The local anesthetic duration of IT, HVS+IT were significantly longer than TA. Meanwhile, the local anesthetic duration of US+IT was significantly longer than HVS+IT, IT and TA group (p<0.05). Also, the pressure pain threshold, pain perception threshold at 0.2 ms, 1 ms, 50 ms were significant difference between the groups (p<0.001). All sensory characteristics including pressure pain threshold, pain perception threshold of IT, HVS+IT was significantly increased than TA, whereas, US+1T was significantly increased HVS+1T, IT and TA (p<0.05). This study showed that the procaine iontophoresis have increase the duration of local anesthesia concomitantly pressure pain threshold and pain perception threshold of sensory nerve fibers such as $A-{\beta}$, $A-{\delta}$ and C fiber. This findings suggest that the iontophoresis enhanced the transdermal delivery of drug ions in vivo. The combination of ultrasound application and iontophoresis synergized the transdermal delivery of drug ions. It is suggests that an electric field, mechanical and heating property of ultrasound may contribute to synergic effect due to temporary changes of structure in the stratum corneum.

Suppression by Microinjection of Bicuculline into Brain Stem Nuclei of Dorsal Horn Neuron Responsiveness in Neuropathic Rats (신경병증성통증 모델쥐에서 뇌간핵 부위에 미세 주입한 Bicuculline에 의한 척수후각세포의 반응도 억제)

  • Leem, Joong-Woo;Choi, Yoon;Lee, Jae-Hwan;Nam, Taick-Sang;Paik, Kwang-Se
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.23-29
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    • 1998
  • Background: The present study was conducted to investigate effects of microinjection of bicuculline, GABA-A receptor antagonist, into the brain stem nuclei on the dorsal horn neuron responsiveness in rats with an experimental peripheral neuropathy. Methods: An experimental neuropathy was induced by a unilateral ligation of L5~L6 spinal nerves of rats. After 2~3 weeks after the surgery, single-unit recording was made from wide dynamic range (WDR) neurons in the spinal cord dorsal horn. Results: Responses of WDR neurons to both noxious and innocuous mechanical stimuli applied to the somatic receptive fields were enhanced on the nerve injured side. These enhanced responsiveness of WDR neurons were suppressed by microinjection of bicuculline into periaqueductal gray(PAG) or nucleus reticularis gigantocellularis(Gi). A similar suppression was also observed when morphine was microinjected into PAG or Gi. Suppressive action by Gi-bicuculline was reversed by naloxonazine, ${\mu}$-opioid receptor antagonist, microinjected into PAG whereas PAG-bicuculline induced suppression was not affected by naloxonazine injection into Gi. Gi-bicuculline induced suppression were reversed by a transection of dorsolateral funiculus(DLF) of the spinal cord. Conclusions: The results suggest that endogenous opioids, via acting on GABAergic interneurons in PAG and Gi, may be involved in the control of neuropathic pain by activating the descending inhibitory pathways that project to the spinal dorsal horn through DLF to inhibit the responsiveness of WDR neurons.

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Supraspinal Nitric Oxide Synthesis Inhibition Enhanced Antinociception of Morphine in Morphine Tolerant Rats (모르핀내성시 뇌실내 NO 합성억제제 투여가 모르핀의 진통효과에 미치는 형향)

  • Song, Ho-Kyung;Jang, Yeon
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.225-230
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    • 2001
  • Background: Opioids such as morphine are widely used in the treatment for pain, but chronic treatment with morphine can be complicated by the development of tolerance. The mechnisms of tolerance were still not completely understood, but recently it has been reported that NOS inhibitors can prevent development of morphine tolerance in animals. The present study accessed the possible role of supraspinal NO on antinociceptive effect of morphine in morphine tolerance using a highly specific inhibitor of the neuronal isoform of NOS, 1-(2-trifluoromethylphenyl) imidazole (TRIM). Methods: Thirty two male SD rats (300 g) were prepared with intracerebroventricular (icv) and IV cannulae. We administrated IV morphine, 3 mg/kg, daily for 4 days, resulting in tolerance. On the fifth day, a challenge dose of morphine, 3 mg/kg, was administered following pretreatment with icv TRIM, $10{\mu}g$. We also evaluated the antinociceptive effect of icv TRIM alone and the effect on a single dose of morphine (3 mg/kg) in morphine nave rats. Antinociception from morphine was determined by response to intraplantar injection of 5% formalin $100{\mu}l$ was qualified as the number of flinches in the first 0-10 min (first phase), 10-40 min Phase IIa, and 40-60 min (Phase IIb). Results: Pretreatment with icv TRIM significantly enhanced the antinociceptive effects of systemically administered morphine in morphine tolerant rats. The antinociceptive effect of morphine in opioid nave rats was also significantly increased by pretreatment with icv TRIM. Conclusions: Our results further support the hypothesis that supraspinal NO modulates morphine-sensitive nociceptive process in morphine tolerance due to chronic intravenous administration.

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Traditional Korea Medicine for Enhanced Recovery after Surgery (ERAS) in Inpatients after Gynecological Surgery: Retrospective Analysis (부인과 수술 후 한방 조기 회복 치료를 받은 입원 환자에 대한 후향적 분석)

  • Kim, Hae-Won;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.3
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    • pp.142-161
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    • 2019
  • Objectives: The purpose of this study is to report the effect and safety of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of the hospitalized patients in TKM hospital. Eighty-six patients were enrolled who received TKM for ERAS after gynecological surgery from January 2015 to April 2018. We performed statistical analysis by using SPSS ver. 25.0. To prove the effect and safety of TKM for ERAS, we analyzed symptoms and Hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and serum creatinine (Cr) with glomerular filtration rate (GFR). In addition, we checked other adverse reactions that the patients complained to prove the safety of TKM for ERAS. Results: Among symptoms of pain, there was a statistically significant decrease in abdominal pain, lower back pain, and shoulder pain. Other symptoms showed statistically significant improvement in fatigue, abdominal tympanosis, operation-site discomfort, dizziness, urinary discomfort, throat discomfort, constipation, dyspepsia and colporrhagia. Anemia in both ferritin combination treatment group and herbal medicine only group showed significant improvement. There was no liver damage or renal damage by TKM. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and safe. The further study of TKM for ERAS with more patients is needed.

Effects of Cervical Sensorimotor Control Training on Pain, Function and Psychosocial Status in Patients With Chronic Neck Pain (목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향)

  • Min, In-gi;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.36-46
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    • 2021
  • Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

Differential Expression of microRNAs Following Electroacupuncture Applied to ST36 and GB34 in Rat Models of Chronic Pain (족삼리 양릉천 전침 자극 후 흰쥐 통증 모델에서 microRNA의 차등 발현)

  • So-Hee, Kim;Vishnumolakala, Sindhuri;Sungtae, Koo
    • Korean Journal of Acupuncture
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    • v.39 no.4
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    • pp.132-141
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    • 2022
  • Objectives : Some acupoints are commonly utilized to treat a variety of diseases. The acupoints appear to have a wide range of effects caused by several mechanisms. The purpose of this study is to investigate into the potential role of microRNAs (miRNAs) in the multipotent effects of individual acupoint stimulation. Methods : We examined the miRNA expressions in the dorsal root ganglia (DRG) of neuropathic or inflammatory pain rats following ST36 and GB34 electroacupuncture (EA) stimulation. Neuropathic pain was induced by L5 spinal nerve ligation. Inflammatory pain was induced by knee joint injection of Complete Freund's adjuvant (CFA). EA was given under gaseous anesthesia with the same parameters (1mA, 2Hz, 30 min) in 5 consecutive days. Pain behaviors and miRNA expressions were analyzed. Results : In rats with neuropathic and inflammatory pain, EA treatments significantly enhanced the paw withdrawal threshold and weight-bearing force. After nerve injury, 36 miRNAs were upregulated in the DRG of neuropathic rats, while EA downregulated 10 of them. Furthermore, 14 miRNAs were downregulated following nerve damage, while one was increased by EA. 15 miRNAs were increased in the DRG of inflammatory rats following CFA injection, while 5 were downregulated by EA. Furthermore, 17 miRNAs were downregulated following CFA injection, while 7 were increased by EA. The miRNAs rno-miR-335, rno-miR-381-5p, rno-miR-1306-3p, and rno-miR-1839-3p were regulated by EA in both models. Conclusions : In two pain models, EA applied to ST36 and GB34 regulated miRNA expression differently. There appeared to be both acupoint-specific and non-specific miRNAs, and miRNA regulation of differential protein expression may modulate a variety of EA mechanisms.

Enhanced Recovery after Cancer Surgery using Dokhwaljihwang-tang-gami : A Case Series (독활지황탕가미를 이용한 암 수술 후 조기 회복 : 연속 증례 보고)

  • Jung, Nu-ri;Choi, Yu-jin;Kim, Ki-tae;Shin, Seon-mi;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.41 no.2
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    • pp.248-255
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    • 2020
  • Objectives: Fatigue, malnutrition, and weight loss are common complaints after undergoing surgery for cancer. These symptoms can be associated with Yin-Deficiency (陰虛) of Exhaustion syndrome (虛勞). Therefore, this study aimed to determine if it is possible to use Dokhwaljihwang-tang, which originates from Yukmijihwang-tang, for enhanced recovery after cancer surgery. Methods: After cancer surgery, Dokhwaljihwang-tang-gami was administered three times a day, in 80-120 ml doses at a time. Results: In four cases of gastric, colorectal, and thyroid cancer, enhanced recovery was achieved using Dokhwaljihwang-tang-gami to treat general weakness, fatigue, and pain in the surgical site after cancer surgery. Conclusions: Dokhwaljihwang-tang can be used for enhanced recovery after cancer surgery.

Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial

  • Ismail, Eman A.;Sayed, Jehan A.;Bakri, Mohamed H.;Mahfouz, Reda Z.
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.134-141
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    • 2017
  • Background: Postoperative pain is a common, distressing symptom following arthroscopic knee surgery. The aim of this study was to compare the potential analgesic effect of dexmedetomidine after intrathecal versus intra-articular administration following arthroscopic knee surgery. Methods: Ninety patients undergoing unilateral elective arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The intrathecal dexmedetomidine group (IT) received an intrathecal block with intrathecal dexmedetomidine, the intra-articular group (IA) received an intrathecal block and intra-articular dexmedetomidine, and the control group received an intrathecal block and intra-articular saline. The primary outcome of our study was postoperative pain as assessed by the visual analogue scale of pain (VAS). Secondary outcomes included the effect of dexmedetomidine on total postoperative analgesic use and time to the first analgesic request, hemodynamics, sedation, postoperative nausea and vomiting, patient satisfaction, and postoperative C-reactive protein (CRP) levels. Results: Dexmedetomidine administration decreased pain scores for 4 h in both the intrathecal and intra-articular groups, compared to only 2 h in the control patient group. Furthermore, there was a significant reduction in pain scores for 6 h in the intra-articular group. The time to the first postoperative analgesia request was longer in the intra-articular group compared to the intrathecal and control groups. The total meperidine requirement was significantly lower in the intra-articular and intrathecal groups than in the control group. Conclusions: Both intrathecal and intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery. Less total meperidine was required with intra-articular administration to extend postoperative analgesia to 6 h with hemodynamic stability.