• The Korean Journal of Pain
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• 제28권1호
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• pp.4-10
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• 2015

Etifoxine (etafenoxine, $Stresam^{(R)}$) is a non-benzodiazepine anxiolytic with an anticonvulsant effect. It was developed in the 1960s for anxiety disorders and is currently being studied for its ability to promote peripheral nerve healing and to treat chemotherapy-induced pain. In addition to being mediated by $GABA_A{\alpha}2$ receptors like benzodiazepines, etifoxine appears to produce anxiolytic effects directly by binding to ${\beta}2$ or ${\beta}3$ subunits of the $GABA_A$ receptor complex. It also modulates $GABA_A$ receptors indirectly via stimulation of neurosteroid production after etifoxine binds to the 18 kDa translocator protein (TSPO) of the outer mitochondrial membrane in the central and peripheral nervous systems, previously known as the peripheral benzodiazepine receptor (PBR). Therefore, the effects of etifoxine are not completely reversed by the benzodiazepine antagonist flumazenil. Etifoxine is used for various emotional and bodily reactions followed by anxiety. It is contraindicated in situations such as shock, severely impaired liver or kidney function, and severe respiratory failure. The average dosage is 150 mg per day for no more than 12 weeks. The most common adverse effect is drowsiness at the initial stage. It does not usually cause any withdrawal syndromes. In conclusion, etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. It potentiates $GABA_A$ receptor-function by a direct allosteric effect and by an indirect mechanism involving the activation of TSPO. It seems promising that non-benzodiazepine anxiolytics including etifoxine will replenish shortcomings of benzodiazepines and selective serotonin reuptake inhibitors according to animated studies related to TSPO.

• The Korean Journal of Pain
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• 제2권1호
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• pp.57-60
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• 1989

The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

• 대한의용생체공학회:의공학회지
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• 제36권6호
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• pp.296-301
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• 2015

Explant culture condition of dorsal root ganglion have been used to investigate the pathophysiology of peripheral nerve injury, while applying for the various clinical symptom such as trauma, pressure, and stretch. However, explant culture is usually contaminated by mitotic cells, which may observed as a newly divided cells including fibroblast or glia. The mitotic cells could be able to interrupt and change the cell signaling that make it difficult to avoid detrimental effects during the experiments. To eliminate mitotic cells, anti-mitotic reagents like mixture of uridine and 5-fluorodeoxyuridine or cytosine arabinoside were added to the cultures on the following day, but there is no research that investigate viability of anti-mitotic reagent in dorsal root ganglion explant culture. In this study, we investigate inhibition effect of cytosine arabinoside to mitotic cells in dorsal root ganglion explant culture. Also we visualized and analyzed anti-mitotic effect and toxicity of cytosine arabinoside in various concentration condition. This dorsal root ganglion explant culture condition can be applied to research that effect and mechanism of various stimulation and chemical application which affect peripheral nerve regeneration.

• BMB Reports
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• 제41권11호
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• pp.784-789
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• 2008

Mac-2BP is a ligand of the galectin family that has been suggested to affect tumor proliferation and metastasis formation. We assessed Mac-2BP expression at the transcriptional and translational levels to evaluate nerve growth factor (NGF)-induced Mac-2BP expression. A time kinetic analysis using reverse transcription-polymerase chain reaction showed that NGF-induced Mac-2BP transcript levels were 4-5 times higher than in controls. Mac-2BP enzyme-linked immunosorbent assay and immuno-fluorescence staining showed a 2-3-fold increase in intracellular and secreted Mac-2BP as a result of NGF stimulation. This increase was regulated by Akt activation and NF-${\kappa}B$ binding. p65 and p50-NF-${\kappa}B$ are major transcriptional factors in the Mac-2BP promoter region, and were shown to be regulated in accordance with the Akt activation states. Collectively, these results suggest that NGF induces Mac-2BP expression via the PI3K/Akt/NF-${\kappa}B$ pathway.

• Restorative Dentistry and Endodontics
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• 제44권4호
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• pp.40.1-40.10
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• 2019

Objectives: This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques. Materials and Methods: This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction. Results: In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia. Conclusions: The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.69-76
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• 2010

Ischemia that causes stroke induces inflammation of brain cells and apoptosis and as a result, it influences much on the functional part of a man. The needle electrode electrical stimulation (NEES) that combines acupuncture of oriental medicine with electric therapy of western medicine relieves inflammation of cells and has effect on regrowth of nerve tissues. This study was conducted to verify the influence of NEES on the occurrence of c-Fos of cerebrum after applying NEES to the meridian point, Zusanli (ST 36) of a rats with induced ischemia. Global ischemia was induced by using ligation method on common carotid artery of male Sprague Dawley (SD) rats. The ligation was maintained for 5 minutes and then suture was removed for blood reperfusion. After inducing global ischemia, NEES was done to the left and right meridian points of Joksamri of a rat for 30 minutes after 12 hours, 24 hours, and 48 hours. The findings were as follows. 1. In the result of immunohistochemical method, the number of c-Fos immune response cells significantly decreased (P<.05) in NEES group than the control group (GI) that did not get NEES. 2. In the result of western blotting, the occurrence of c-Fos after 24 hours from the inducement of ischemia significantly decreased (P<.05) in NEES group than the control group (GI) that did not get NEES. Therefore, as the effect of NEES was shown highest after 24 hours from the ischemia, it is suspected that NEES would take important role in early treatment after cerebral stroke.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• The Korean Journal of Pain
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• 제9권2호
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• pp.407-411
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• 1996

Stereotactic radiofrequency dorsal root ganglionotomy can be very useful procedures for the treatment of pain emanating from the lumbar segmental nerves. This procedure is reserved for patients who have failed conservative interventional treatments and in whom open surgical intervention is not an option. The advantages of the radiofrequency lesion method are presented, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The afferent fibers in the ventral root which are spared by dorsal rhizotomy but nerve fibers with their cells in the ganglion from either dorsal or ventral root can be destructed with stereotactic radiofrequency ganglionotomy. This technique is performed using a 100 mm cannula with a 5 mm active tip. Repeated lateral fluoroscopic view should be taken to make sure that cannlua still resides within the superior, dorsal quadrant or the foramen. With the cannula in this position, electrostimulation is performed and good paresthesia on the leg should be noted with 0.3 and 0.5 volt at 50 Hz stimulation. At 2Hz stimulation distinct dissociation between motor and sensory should be shown. Percutaneous lumbar ganglionotomy have carried out under local anesthesia on inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have been relieved of pain without serious complications.

• The Korean Journal of Pain
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• 제13권2호
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• pp.242-246
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• 2000

Radiofrequency medial branch neurotomy is an effective way of controlling pain in the posterior compartment of the spine such as the facet joint, and the interspinous ligament. However, it is difficult to determine the exact location of the medial branch. Up until now we have relied on sensory response provoked by 50 Hz stimulation. The responses elicited using this method are quite subjective and can originate from sources other than the medial branch such as the periosteum, the intermediate or lateral branch. We need a confirmed indicator to locate the medial branch reliably. We applied 2 Hz stimulation under 0.4 volts to locate the medial branch and elicited a motor response. Twitching of multifidus and muscles around the SI joint was observed. The observation of these muscles provides a much more reliable method for confirmation of the medial branch. We have treated 45 chronic nonspecific low back pain patients using radiofrequency medial branch neurotomy with this method of confirming the medial branch.

• 약학회지
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• 제41권3호
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• pp.370-380
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• 1997

The role of nitric oxide (NO) on the non-adrenergic non-cholinergic (NANC) relaxations induced by the short and prolonged electrical field stimulation (EFS) has been studied in the rabbit corpus cavernosum. In the presence of atropine and guanethidine the prolonged EFS (2-16 Hz) of corpus cavernosal strips precontracted with phenylephrine produced frequency-dependent relaxations, which were abolished by tetrodotoxin as shown in the relaxations induced gy the short EFS, indicating that their orgin is NANC nerve stimulation. $N^G$-nitro-L-arginine (L-NNA), inhibitor of nitirc oxide synthase, caused a concentration-dependent inhibition to the NANC relaxation, and at 100 M L-NNA the relaxation were virtually abolished. The inhibitory effect of L-NNA was reversed by L-arginine. Hemoglobin abolished the relaxations to NO and also caused a concentration-dependent inhibition of the NANC relaxation. The hemoglobin-resistant relaxation induced by EFS was eliminated by L-NNA. Methylene blue significantly reduced the NANC relaxation in a conentration-dependent manner. The NANC relaxation was not affected by a VIP-inactivating pepridase, alpha0chymotrypsin, whereas VIP-induced relaxation was completely abolished. NO- and VIP-induced relaxation were not affected by L-NNA. These results indicate that the NANC relaxation induced by prolonged EFS of the rabbit corpus cavernosum is mediated by NO-guanosine 3',5'-cyclic monophosphate pathway as shown in the relaxation induced by the short EFS, and that VIP release is not essential for the NANC relaxation of the rabbit corpus cavernosum and VIP is not involved the generation fo NO.