• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• 정신신체의학
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• 제15권1호
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• pp.7-13
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• 2007

항우울제는 정신과 의사뿐만 아니라 많은 비정신과 의사들에 의해 사용되어지는 정신과 약물이다. 특히 기질적 원인이 뚜렷한 신체질환과 관련된 우울증과 통증에 대하여 오래전부터 삼환계 항우울제가 사용되어 그 효과가 입증되어 왔으며 최근 새롭게 사용되는 세로토닌 관련 항우울제의 효과가 보고되면서 사용의 폭이 더욱 넓어지고 있다. 여기에서는 신체질환에 대한 우울증의 영향과 항우울제 치료, 통증에 대한 항우울제의 진통 효과와 몇 가지 정신신체질환에 대한 항우울제 사용에 대하여 지금까지의 연구 문헌을 검토 및 정리하였다. 우울증이 정신신체질환의 치료 결과에 미치는 영향에 대해서는 아직도 논란중이지만 기존의 신체질환 치료와 함께 적절한 항우울제의 병합 또는 보조적 사용으로 긍정적인 치료 결과와 환자의 삶의 질을 향상시키는 것으로 생각된다.

• The Korean Journal of Pain
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• 제12권1호
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• pp.123-127
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• 1999

Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

• The Korean Journal of Pain
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• 제12권1호
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• pp.132-135
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• 1999

Although the vast majority (about 70%) of patients with cancer will have pain directly related to neoplastic invasion into pain-sensitive bone and soft tissue structures,as many as 20% of the adults will have pain caused directly by cancer therapy. Treatment related pain problems are important for several reasons; their appearance may be confused with more omnious pain syndromes associated with tumor recurrence or progression that may be directly lead to death of the patient; when severe, compliance with recommandations for further therapy may be adversely affected. Now, we report a case of postsurgical pain syndrome after radical neck dissection in a patient with tonsilar cancer. The pain after radical neck dissection result from injury to the cervical plexus,cranial nerve,and cervical sympathetics. In our case, we ruled out soft tissue infection and tumor recurrence,and successfully treated with gasserian ganglion block with pure alcohol in the patient having neuropathic pain in the mandible and preauricular region after radical neck dissection.

• The Korean Journal of Pain
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• 제12권1호
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• pp.8-15
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• 1999

Following peripheral nerve injury, rats will show a tactile allodynia and hyperalgesia. But the mechanism of allodynia is still obscure. The present studies, using rats rendered allodynia by loosely constrictive ligation of the common sciatic nerve (Bennett Model) and tight ligation of L5 & L6 spinal nerve (Chung Model), aimed to investigate the changes of metabotrophic glutamate receptor type 5 on the development of tactile allodynia. Male Sprague-Dawley rats (130~200 g) were anesthetized with halothane, the rats were randomly divided into one of these three groups, Group 1 (Sham operation), Group 2 (Bennett model) and Group 3 (Chung model). Seven days after surgical procedure, the animal was reanesthetized and decapitated. The spinal cord was quickly removed and stored at deep freezer for polymerase chain reaction (RT-PCR). In Group 2&3, rats showed that tactile allodynia checked by up-down method with calibrated 8 von Frey hair. The level of gene expression of mGluR5 mRNA was significantly increased in group 2 and 3. These increases was significantly different from sham operation, group 1. It was also showed that the increasing patterns of group 2 and 3 in the gene expression were similar correlation with the results of the threshold for tactile allodynia on von Frey hair test. Even though there were some differences between Bennett model and Chung model, these results suggested that mGluR5 had partly attributed to making a tactile allodynia from these models.

• The Korean Journal of Pain
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• 제24권2호
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• Mass Spectrometry Letters
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• 제6권3호
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• pp.65-70
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• 2015

N-Alkyl/benzyl substituted isatin derivatives are intermediates and synthetic precursors for the preparation of biological active heterocycles. N-alkyl/benzyl isatins have showed various biological activities, such as cytotoxicity, antiviral, caspase inhibition, cannabinoid receptor 2 agonists for the treatment of neuropathic pain, etc. In this study, N-alkyl/benzyl isatin derivatives were synthesized from isatin and alkyl/benzyl halides in presence of K₂CO₃ in DMF and excellent to quantitative yields (~95%) were obtained. Isatins and benzyl-isatins were condensed with fluorescein hydrazide to form fluorescein hydrazone. All the compounds were subjected to their fragmentation behavior study using LC/MSⁿ. N-Alkyl substituted isatin derivatives fragmented at nitrogen-carbon (N-C) bond, hence gave daughter ion as [RN+H]⁺. Whereas, N-benzyl substituted isatin derivatives fragmented at carbon-carbon (C-C) bond of alkyl chain which linked with nitrogen molecules, therefore gave N-methyl fragments [RNCH₂]⁺. This study demonstrated that, isatin moiety present in a small/large molecule or in a matrix of reaction mixture with/without N-alkyl/benzyl substituents can be identified by mass spectroscopic fragmentation behavior study.

• 구강회복응용과학지
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• 제28권2호
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• pp.171-178
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• 2012

보툴리눔 독소 주사는 이마, 눈가 주름치료 등 미용성형분야 뿐만 아니라 구강 악안면 분야에서는 만성 편두통(chronic migraine), 근육긴장이상(dystonia), 경직(spasticity), 측두하악장애(temporomandibular disorders, TMD)의 치료 등에 사용되어 왔다. 최근 보툴리눔 독소 주사가 운동신경에서 마비효과 뿐만 아니라 감각신경에서 말초감작과 신경원성염증과 관련되는 substance P, CGRP, glutamate 등 비콜린성 신경전달물질의 유리를 차단하여 통증신호를 차단하는 역할을 한다는 가설이 제기되고 있다. 따라서 본 연구는 쥐, 토끼 등 동물 신경 손상 모델에 대한 실험과 치과 치료 후 발생한 신경 손상 환자에서 보툴리눔 독소의 진통 효과 및 작용 기전을 살펴보고자 한다.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.151-154
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• 2010

The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.

• 한방재활의학과학회지
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• 제30권2호
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• pp.173-181
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• 2020

The purpose of this study is to report the effects of electroacupuncture and bee venom (BV) acupuncture for a patient suffering with idiopathic peripheral neuropathy. There was a one patient who was diagnosed as idiopathic peroneal neuropathy and tibial neuropathy received electroacupuncture and BV acupuncture at acupoints on peroneal and tibial nerve pathway. The evaluation of clinical outcome was done by range of motion (ROM), manual muscle test (MMT), perimeter of lower leg, neuropathy pain scale (NPS). After treatment, the patient showed improvement in ROM and MMT. The patient's perimeter of lower leg was increased, NPS was decreased. This study suggests that the treatment of acupoints on the damaged nerve pathways could be an effective treatment for peripheral neuropathy, although further studies will be needed.