• The Korean Journal of Pain
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• 제34권1호
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• pp.58-65
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• 2021

Background: Supraspinal delivery of neurotensin (NTS), which may contribute to the effect of a systemically administered agonist, has been reported to be either pronociceptive or antinociceptive. Here, we evaluated the effects of systemically administered NTSR1 agonist in a rat model of neuropathic pain and elucidated the underlying supraspinal mechanism. Methods: Neuropathic pain was induced by L5 and L6 spinal nerve ligation in male Sprague-Dawley rats. The effects of intraperitoneally administered NTSR1 agonist PD 149163 was assessed using von Frey filaments. To examine the role of 5-HT neurotransmission, a serotonin (5-HT) receptor antagonist dihydroergocristine was pretreated intrathecally, and spinal microdialysis studies were performed to measure the change in extracellular level of 5-HT in response to PD 149163 administration. To investigate the supraspinal mechanism, NTSR1 antagonist 48692 was microinjected into the rostral ventromedial medulla (RVM) prior to systemic PD 149163. Additionally, the effect of intrathecal DHE on intra-RVM PD 149163 was assessed. Results: Intraperitoneally administered PD 149163 exhibited a dose-dependent attenuation of mechanical allodynia. This effect was partially reversed by intrathecal pretreatment with dihydroergocristine and was accompanied by an increased extracellular level of 5-HT in the spinal cord. The PD 149163-produced antinociception was also blocked by intra-RVM SB 48692. Direct injection of PD 149163 into the RVM mimicked the maximum effect of the same drug delivered intraperitoneally, which was reversed by intrathecal dihydroergocristine. Conclusions: These observations indicate that systemically administered NTSR1 agonist produces antinociception through the NTSR1 in the RVM, activating descending serotonergic projection to release 5-HT into the spinal dorsal horn.

• 대한치과의사협회지
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• 제48권9호
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• pp.688-695
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• 2010

Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

• The Korean Journal of Pain
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• 제13권1호
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• pp.105-110
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• 2000

Central neuropathic pain may occur in 10~20% of the patients after spinal cord injury. The central pain syndrome include spontaneous continuing and intermittent pain as well as evoked pain. The pain is evoked by non-noxious stimulation of the region (allodynia) and repeated stimulation (wind-up phenomenon). Four patients were referred suffering from severe pain, allodynia and hyperaesthesia after spinal cord injury. They had received conventional treatment with non-steroidal anti-inflammatory drugs, steroid, anticonvulsant, antidepressant and rehabilitation which failed to provide pain relief. We administered combination of low doses of morphine and ketamine (10 mg) through the epidural catheter with other conventional therapy. Satisfactory pain relief was achieved in each patient. The reduction of pain was not associated with severe side effects. The most bothersome side effect of ketamine was dizziness in one patient, only caused by bolus injection (ketamine 10 mg with normal saline 10 ml). This suggests synergy from this combination that provides an alternative treatment for central pain.

• 대한약침학회지
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• 제6권2호
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• pp.159-164
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• 2003

Results : 1. The most important concept of IMS is chronic pain illness that may develop into hypersensitivity of the nerves, i.e., neuropathy. 2. Muscle shortening may be triggered by stress, including emotional, physical, external, and internal factors. 3. Muscle shortening increases mechanical tension on the muscles as well as inducing abrasion of the tissues by stretching ligament, tendon, cartilage, bone, and etc. 4. Pain from neuropathy is normally manifested on musculoskeletal system and spasm or shortening play as the central axis of this pain. 5. Neuropathy often appears at the nerve root level and the most important decisive factor of radiculopathy is muscle shortening. 6. Spondylosis is the most common cause of radiculopathy. 7. The most significant treatment principle of IMS is to relieve muscle shortening and remove stimulating determinant from the vertebrae. 8. Dry needling is quite effective for treating various pain caused by muscle shortening.

• The Korean Journal of Pain
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• 제18권2호
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• pp.229-231
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• 2005

The most common and cumbersome complication of herpes zoster is postherpetic neuralgia, which typically presents as neuropathic pain. However, the painful symptoms of the postherpetic period might be associated with other causes, such as skin lesions of the herpes zoster. We report a case of a hypertrophic scar that developed in the lesion of an acute herpes zoster patient and was accompanied by pain.

• The Korean Journal of Pain
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• 제21권3호
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• pp.224-228
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• 2008

Ulnar nerve compression in the cubital tunnel is a common entrapment syndrome of the upper limb. Pulsed radiofrequency lesioning (PRFL) has been reported as a treatment method for relieving neuropathic pain. Since the placement of the electrode in close proximity to a targeted nerve is very important for the success of PRFL, ultrasound seems to be well suited for this technique. A 36-year-old woman presented with complaints of numbness and pain on the medial aspect of the elbow and the pain radiated down to the $4^{th}$ and $5^{th}$ fingers for 10 years after she suffered an elbow contusion, we then scheduled this woman for the ultrasound guided PRFL of the ulanr nerve. The initial ultrasound examination demonstrated a swollen nerve, loss of the fascicular pattern and an increased cross sectional area of the ulnar nerve. After confirmation of the most swollen site of the nerve via ultrasound, two sessions of PRFL were performed. The postprocedural 10 cm visual analog scale score decreased from 8 to 1 after the two sessions of PRFL.

• 종양간호연구
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• 제9권2호
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• pp.145-154
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• 2009

Purpose: The purpose of this study was to obtain information about the experiences of sensations after breast cancer surgery characterized by prevalence, frequency, and severity, distresses, and disturbances in ADL using the BSAS (Breast Sensation Assessment Scale) and to develop the standardized Korean BSAS. Methods: Thirty two women from 3 to 100 days after breast cancer surgery (BCS) completed Roberta's BSAS. The 18 sensations of BSAS were translated using the references of Lee's Korean Pain Rating Scale and English-English, English-Korean dictionaries and the consultation from two native Americans, one bilingual permanent resident of the States, and one nursing professor. The Korean-translated BSAS has high reliability in test-retest. Likert type 4-point scale and 100 mm VAS were used for assessment. Results: Certain sensations remained prevalent (tender, pull, pain), frequent (numb, nag, throb), severe (throb, shoot, numb), causing distress (throb, penetrate, shoot), and influencing on ADL (throb, penetrate, nag). The most frequently experienced sensation other than BSAS was itching. There was little difference in the prevalence of symptom experiences between sentinel lymph node biopsy and axillary lymph node dissection. Conclusion: The women after BCS are suffering from neuropathic sensations. The Korean- translated BSAS could be used in effectively assessing breast sensations after BCS in Korean women.

• The Korean Journal of Pain
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• 제23권3호
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• pp.207-210
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• 2010

Fabry disease is an X-linked lysosomal disease caused by deficiency of ${\alpha}$-galactosidase, in which early diagnosis may be missed due to the wide variety of clinical symptoms presenting during disease progression. A 13 year-old boy visited our pain clinic complaining of pricking and burning pain in the toe tips of both feet. Continuous epidural infusion for pain management was performed because of oral analgesics ineffectiveness. The patient underwent ${\alpha}$-galactosidase A (GLA) enzyme analysis based on the clinical impression of Fabry disease from pain with a peripheral neuropathic component and history of anhidrosis. He was diagnosed with Fabry disease after confirming mutation of the GLA gene through a screening test of GLA activity. Enzyme replacement therapy was initiated and pain was tolerated with oral analgesics.

• 정신신체의학
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• 제1권1호
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• pp.52-58
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• 1993

Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

• 정신신체의학
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• 제7권2호
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• pp.252-255
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• 1999

최근 만성 통증 환자가 증가하고 있다. 특히 정신과 외래환자에서는 40% 이상이 통증으로 고통을 받고 있다. 그런데 한국인의 질병관과 질병에 대한 태도와 관련되어 나타나는 비정상 질병행동은 통증 환자에게 만성화 경향을 재촉하고 치료에 많은 어려움을 야기시키고 있다. 본 심포지움은 근관절계, 신경계질환, 만성 내과질환과 관련된 만성 통증을 어떻게 효율적으로 치료 할 것인가를 조명해 보고자 한다. 이로서 자문-조정 정신의학에서 만성 통증환자에 대한 효과적인 대처 요령을 습득하고자 한다.