• 대한치과마취과학회지
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• 제10권2호
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• pp.166-171
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• 2010

Background: Controlled hypotension is used to reduce bleeding and improve surgical conditions during surgery. Nicardipine and remifentanil have been used to induce controlled hypotension in healthy patients. This study compared controllability of nicardipine and remifentanil on hemodynamic stability during controlled hypotension. Methods: Forty healthy patients scheduled for orthognathic two jaw surgery were randomly allocated to nicardipine (group N) and remifentanil (group R) group. After induction of anesthesia, group N (n = 20) was infused with nicardipine to induce hypotension and group R (n = 20) was infused with remifentanil. Mean arterial pressure (MAP) and heart rate (HR) were measured over 5 minute interval. Surgical field rating and blood loss were measured after surgery. Results: HR was lower in group R than group N. MAP was maintained at 50-60 mmHg during controlled hypotension but the fluctuation of blood pressure and HR were more frequent in group N than group R. There were no significant differences in the surgical field rating and blood loss between the groups. Conclusions: Nicardipine and remifentanil enabled controlled hypotension and provided good surgical conditions, but the fluctuation of hemodynamic parameters was more frequent in nicardipine group.

• 근관절건강학회지
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• 제18권2호
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• pp.249-256
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• 2011

Purpose: The purpose of this study was to investigate electromyographic(EMG) activity of vastus medialis oblique(VMO) and vastus lateralis(VL) following the application of patellar taping during stair stepping. Methods: Both VMO-VL onset timing and VMO/VL ratio of 15 participants with patellofemoral pain syndrome (PFPS) were measured using an surface EMG uint(Myosystem 1400A, Noraxon Inc., USA). The measurements were taken under three conditions in random order of patellar taping, placebo taping, and no-taping. Data were analysed using $1{\times}3$ repeated measures ANOVA. Results: There was a significant difference with patellar taping on VMO/VL amplitude compared with the placebo taping and no-taping conditions during stair stepping, but no significant difference on VMO-VL onset timing. Conclusion: These result indicate that patellar taping on the vastus medialis oblique has effect on the VMO/VL ratio. Increased values of VMO/VL ratio may contribute to patellar realignment and explain the mechanism of pain reduction following patellar taping in participants with PFPS.

• Korean Journal of Acupuncture
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• 제21권3호
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• pp.59-76
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• 2004

Objectives : The usage of acupuncture has gained popularity for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to yangno$(SI_6)$ on the neuropathic pain was examined. Methods : A common source of persistent pain in human is a neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : EA increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 1 hr. suggesting a partial alleviation of pain. EA applied to SI6 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 1 h. However, $ST_{36}$ point did not produce any significant increase of mechanical sensitivity. The improvement of mechanical threshold was interpreted as an analgesic effect. The analgesic effort was specific to the acupuncture point since the analgesic effect on the neuropathic pain model could not be mimicked by EA applied to a point, $ST_{36}$. In addition, this analgesic effect of EA is mediated by a adrenergic mechanism of descending control of spinal cord from the brain. Conclusions : The data suggest that EA produces a potent analgesic effect on the neuropathic pain model in the rat; and 2) that EA-induced analgesia is mediated by a adrenergic mechanism of descending control in a point specific manner.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.1-10
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• 2016

Background: Patients with chronic low back pain (CLBP) functionally adapt to decreased postural control due to impaired processing of sensory information. Standing postural control has been the focus of recent research in CLBP. Change in postural control may be a risk factor for CLBP, although available studies are not conclusive. Objects: This study aimed to identify the role of partial weight supported treadmill training (PWSTT) in improving balance, dysfunction, and pain in patients with chronic low back pain. Methods: The study included 22 patients with CLBP. Patients in the control group ($n_1=8$) performed three 20 min stabilization exercise sessions per week, for 4 weeks. Patients in the full weight treadmill training group ($n_2=7$) performed treadmill training for 30 min after stabilization exercise. Patients in the PWSTT group ($n_3=7$) performed PWSTT with 20% of their body weight unloaded after stabilization exercises. By using the Biodex balance system, the dynamic balance abilities of the patients in the three groups were assessed in the quiet standing position under combined conditions of visual feedback (eyes open and closed) and platform stability (level 8). The Korean version of the Oswestry Disability Index and visual analogue scale score were used as the main measure. Results: The results of this study showed that dysfunction and pain were significantly improved in all groups. Although dynamic postural stability with eyes closed was significantly improved only in the PWSTT group (p<.05), no significant difference was found in the other groups. Conclusion: The results of this study indicate that PWSTT improved balance, dysfunction and pain in the patients with CLBP. Thus, this intervention is necessary for patients with CLBP with decreased postural control.

• 한국산학기술학회논문지
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• 제13권9호
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• pp.4045-4052
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• 2012

본 연구는 냉각 통증 모델을 이용해 간섭파전류와 경피신경전기자극간에 진통 효과를 비교하고자 하였다. 16명의 대상자는 6주기의 냉각 통증 모델 검사를 수행하였다. 대상자는 각 주기에서 차가운 물에 손을 담근 후 통증을 호소하는데 걸리는 시간을 이용하여 통증 역치와 시각적통증강도를 이용하여 통증 강도 및 통증 불편감을 측정하였다. 대상자에게 무작위로 각각 간섭파전류 주파수 50 Hz와 100 Hz, 경피신경전기자극 주파수 50 Hz와 100 Hz를 적용하였다. 본 연구에서 4가지 전기자극은 모두 통계적으로 유의하게 통증 역치가 증가하였으나 전기자극간에는 유의한 차이가 없었다. 그리고 통증 강도와 통증 불편감에서는 모두 유의한 차이가 없었다. 결론적으로 현재의 실험 조건에서 4가지 전기자극간에는 유의한 차이가 없었으나 주파수 50 Hz의 간섭파전류가 다른 전기자극보다 적용시 더 편안하였다.

• 한방재활의학과학회지
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• 제24권4호
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• pp.137-143
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• 2014

Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.

• 한국산업보건학회지
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• 제29권4호
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• pp.517-529
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• 2019

Introduction: Although shift work is an inevitable form of labor in modern society, it has been identified as a cause of many ailments, such as cancer and musculoskeletal disorders. Meanwhile, previous studies have also shown that musculoskeletal disorders account for a large proportion of total industrial accidents and a high prevalence rate of these ailments has been found in shift workers. Methods: Among the respondents to the 5th Korea Working Conditions Survey(KWCS) 3,916 shift workers(2,658 of whom have not experienced musculoskeletal pain and 1,258 who have experienced musculoskeletal pain) were asked how the work regularity of shift workers affected musculoskeletal pain. Results: The results of a dichotomous logistic regression by correcting the demographic characteristics of the study subjects showed a lower prevalence of musculoskeletal pain in the 'High' regularity group compared to the 'Intermediate' regularity group for the criterion 'Regularity of Time Fixation'. A lower prevalence of musculoskeletal pain was shown in the 'High' and 'Moderate' regularity group compared to the 'Very Low' regularity one. Conclusions: Based on these findings, it was found that musculoskeletal pain occurs less when the work regularity of shift workers is 'Very high' or 'Intermediate', and the effect of working regularity on musculoskeletal pain varies for each shift type of work. It is deemed that more precise observation and understanding are required when managing the working environment of shift workers, and further study of regarding this issue is needed.

• The Korean Journal of Pain
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• 제2권2호
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• pp.145-154
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• 1989

Pain is a common and important clinical symptom, and treatments aimed at relieving pain have a central position in medical practice. Recently Transcutaneous Electrical Nerve Stimulation (TENS) has been effectively used to control acute and chronic conditions that produce pain. But the mechanism of analgesia resulting from TENS remains obscure. In order to investigate the analgesic effect of TENS and it's action mechanism, TENS was applied in 40 rabbits with different frequencies, low frequency (2Hz) and high frequency (100Hz), for 20 minutes. And the pain threshold was measured by the temperature before and after stimulation, and an attempt was made to antagonize the stimulation effect with naloxone pretreatment (0.4 mg/kg) The results are as follows: 1) Both low frequency and high frequency TENS resulted in increasing the pain threshold significantly (Both p<0.01). 2) Naloxone pretreatment could antagonize the effect of increasing the pain threshold with low frequency TENS significantly (p<0.01), but not with high frequency TENS. Plasma beta-endorphin was measured by radioimmunoassay using an Beta-Endorphin Kit (Immunonuclear Corporation, Stillwater, Minnesota, USA) and Automatic Gamma Scintillation Counter (Micromedic System 4/2000) before and after stimulation. An attempt was made to reverse the stimulation effect with naloxone pretreatment (0.4 mg/kg). The results are as follows: 1) Low frequency TENS resulted in increasing the level of plasma beta.endorphin significantly (p<0.01), but high frequency TENS did not. 2) Naloxone pretreatment could reverse the effect of increasing the plasma beta-endorphin level with low frequency TENS significantly (p<0.01).

• Restorative Dentistry and Endodontics
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• 제38권3호
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• pp.141-145
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• 2013

Objectives: Assessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis. Materials and Methods: Thirty-six patients (20 females and 16 males) with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS) score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13. Results: The level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males. Conclusions: There was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.

• The Korean Journal of Pain
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• 제9권1호
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• pp.75-82
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• 1996

Background: Nerve blocks, including epidural analgesia, can be risky for terminal cancer pain patients in generally poor conditions. We performed this study to evaluate the efficacy of intravenous patient-controlled analgesia(PCA) to treat severe pain of terminally ill cancer patients during the last days of life. Methods: We explained the patient's poor general condition to relatives and received a written consent to administer PCA. The starting dose of opioid for PCA in cancer pain management was based on previous 24-hour dose. Previous 24-hour opioid dose was converted to intramuscular morphine equivalent. The concentration of opioid mixed into Basal Bolus $Infusor^{(R)}$ was controlled to allow for one half of the previous 24-hour equianalgesic dose to infuse continuously. Patients controlled their pain by pushing the PCA module themselves. Patients were observed by pain service team. Some discharged patients were treated at home until death. Results: Forty eight patients received PCA for last two years. The most common reason receiving a PCA was the patient's poor general condition(52.0%). The mean starting dose of PCA was $20.6{\pm}16.2$ mg of morphine. Over eighty percents of the patients were in good or tolerable state of analgesia. Half of the patients expired within one week. The mean duration of PCA was $8.7{\pm}7.0$ days. The problems during PCA were: difficulty in maintaining intravenous routes, early loss of mentality after starting PCA, hypotension and nausea. Conclusion: We concluded that PCA, if correctly, is an effective, relatively safe and readily controllable method of pain management in terminally ill cancer patients during the last days of life. For future considerations, terminal patients may expire at the comfort of their own homes after the resolution of legal problems regarding using opioid in home care.