• The Korean Journal of Pain
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• v.37 no.2
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• pp.91-106
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• 2024

The mechanisms of the chronic pain and depression comorbidity have gained significant attention in recent years. The complement system, widely involved in central nervous system diseases and mediating non-specific immune mechanisms in the body, remains incompletely understood in its involvement in the comorbidity mechanisms of chronic pain and depression. This review aims to consolidate the findings from recent studies on the complement system in chronic pain and depression, proposing that it may serve as a promising shared therapeutic target for both conditions. Complement proteins C1q, C3, C5, as well as their cleavage products C3a and C5a, along with the associated receptors C3aR, CR3, and C5aR, are believed to have significant implications in the comorbid mechanism. The primary potential mechanisms encompass the involvement of the complement cascade C1q/C3-CR3 in the activation of microglia and synaptic pruning in the amygdala and hippocampus, the role of complement cascade C3/C3a-C3aR in the interaction between astrocytes and microglia, leading to synaptic pruning, and the C3a-C3aR axis and C5a-C5aR axis to trigger inflammation within the central nervous system. We focus on studies on the role of the complement system in the comorbid mechanisms of chronic pain and depression.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.1-10
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• 2010

Background: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. Methods: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. Results: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. Conclusions: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.

• Journal of the Ergonomics Society of Korea
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• v.19 no.2
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• pp.15-31
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• 2000

The aim was to evaluate the prevailing ergonomic and psychosocial conditions regarding low back injury in an automobile assembly system. This study consisted of two parts. In the first part of the study, analytic biomechanical model and NIOSH guidelines were applied to evaluate risk levels of low back injury for automobile assembly jobs. Total of 246 workers were analysed. There were 20 jobs having greater back compressive forces than 300kg at L5/S1. Also, there were 44 jobs over Action Limit with respect to 1981 NIOSH guidelines. This might in part be explained by the ergonomic conditions of the company analysed generally being good, with a relatively low duration of 'combined' extreme work posture. The relationship between psychosocial factors and low back injury was examined in the second part of the study. It has recently been recognized that overall reaction to working conditions was influenced by a range of factors, some of which were physical and some psychosocial. The psychosocial environment surrounding the work place may contribute to the perception of risk and eventual ill-health. A battery of questionnaires concerning the psychosocial stress based on PWI(Psychosocial Well-being Index) and musculoskeletal pain symptoms at low back was completed by 246 workers at the same plant. Results showed that 207 out 246 workers experienced the symptoms and 27 workers were diagnosed as patients. Two groups(low stressed, high stressed) based on PWI score had no significant relationships with both symptoms and results of diagnosis. However, sensitivities for symptoms and diagnosis by PWI were 91.3% and 92.6% respectively. Finally, relationships between physical work load and psychosocial stress were analysed. Specifically, some postural factors {vertical deviation angle of forearm, horizontal deviation angle of upperarm, vertical deviation angle of thigh, etc) were highly correlated with psychosocial stress. The results illustrated that PWI scores were associated with some physical workloads. However, psychosocial stress levels couldn't be well related with the pain symptom as well as the actual incidence of low back injury since pain or discomfort regarding low back injury were more complex than that of other musculoskeletal disorders.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.1
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• pp.65-74
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• 2017

Here we investigated the central processing mechanisms of mechanical allodynia and found a direct excitatory link with low-threshold input to nociceptive neurons. Experiments were performed on male Sprague-Dawley rats weighing 230-280 g. Subcutaneous injection of interleukin 1 beta ($IL-1{\beta}$) ($1ng/10{\mu}L$) was used to produce mechanical allodynia and thermal hyperalgesia. Intracisternal administration of bicuculline, a gamma aminobutyric acid A ($GABA_A$) receptor antagonist, produced mechanical allodynia in the orofacial area under normal conditions. However, intracisternal administration of bicuculline (50 ng) produced a paradoxical anti-allodynic effect under inflammatory pain conditions. Pretreatment with resiniferatoxin (RTX), which depletes capsaicin receptor protein in primary afferent fibers, did not alter the paradoxical anti-allodynic effects produced by the intracisternal injection of bicuculline. Intracisternal injection of bumetanide, an Na-K-Cl cotransporter (NKCC 1) inhibitor, reversed the $IL-1{\beta}$-induced mechanical allodynia. In the control group, application of GABA ($100{\mu}M$) or muscimol ($3{\mu}M$) led to membrane hyperpolarization in gramicidin perforated current clamp mode. However, in some neurons, application of GABA or muscimol led to membrane depolarization in the $IL-1{\beta}$-treated rats. These results suggest that some large myelinated $A{\beta}$ fibers gain access to the nociceptive system and elicit pain sensation via $GABA_A$ receptors under inflammatory pain conditions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.283-290
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• 2020

The purpose of this study was to investigate the potential causal relationship between unmet healthcare needs and metrics related to quality of life. To examine the relationships between these variables, the study conducted an analysis by processing additional irradiated raw materials of the Korean Medical Panel. The metrics related to quality of life included six variables: athletic ability, self-care, daily activities, pain/trouble, uneasiness/depression, and subjective health conditions. Linear regression analysis revealed that the unmet healthcare needs had statistically significant negative effects on all six quality of life variables. A review of the magnitude of the linear regression β values for those variables showed that the relative level of influence on the quality of life variables decreased in the following order: pain/trouble, subjective health conditions, uneasiness/depression, daily activities, athletic ability, and self-care. Based on the results, practical applications related to strengthening working-level links between health and welfare is considered an effective policy response to the continued presence of unmet healthcare needs; such applications could contribute to improving the quality of life of those with unmet healthcare needs.

• Journal of the Korean Physical Therapy Association
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• s.3
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• pp.11-18
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• 1981

A Clinical Study of physical Therapy on the Low Back Conditions J. B. Rhee, S. K. fang, D. J, Han Low back pain usually is due primarily to a faulty mechanics, ,dis'c disease and other contributing factors .Conservative treatment of low back pain is considered to be useful with applicationes physical therapeutic measures including elimination of gravity, but surgical treatment is alternative to conservative .This study 1s conducted to analyse and evaluate efficiency of physical therapy on the low back pain on 452 cases who were treated at the Korea University Hospital, from January 1, 1978 to December 31. 1978.The results obtained in this study are summarized as follows :1. Sex distribution of total rationㄷs surveyed showed that 5l.3% in male and 487% in female.2 . In the age distrbution. the mest Liedominant age group was 25-54 years with7O.8 % .3 . The most proportion of the cases by occupation was housewife 27.7%, clerical and office workers 2l.7% , students 12.8% and labours 12.2 % respectively .4 . The most common causes of low back conditions classified, the Strain or Trau-rla revealed the highest frequency with 58.4% and thc Herniated Nucleus Pulpe-sus with 29.2 % of the total.5 . The modalities of physical therapy suitable to each cases were applied : 94.0%of all cases were treated with deep thermotherapy, 91.4 % hydrocollator steampack, 86.7% strengthening exercise of the weak muscles, pelvic traction 34.1%.6 . In regard to the duration required for the physical therapy. Herniated Nucleus Pulposus were approximately 4 weeks and strain or trauma were 2 weeks.7 . The improvement by physical therapy on lcw back conditions was classified in-to 41grades and showed following reaulits , excellent 42.5%, good 37.8%, fair 13.7% and poor 6.0% respectively.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.97-100
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• 2000

Thoracic outlet syndrome (TOS) is a combination of signs and symptoms caused by the compression of the vital neurovascular structure at the thoracic outlet region. It may stem from a number of abnormalities, including degenerative or bony disorders, trauma to cervical spine, fibromuscular bands, vascular abnormalities and spasm of the anterior scalene muscle. CPT (current perception threshold) is defined as the minimum amount of current applied transcutaneously that an individual consciously perceives. It enables quantification of the hyperesthesia that precedes progressive nerve impairment, as well as hypoesthetic conditions. We experienced a case of thoracic outlet syndrome caused by fibrosis of anterior scalene muscle. The patient was a 30 years old woman with a 3 years history of numbness on the ulnar side, progressive weakness and coldness of both hand, tiredness in the left arm, nocturnal pain in the left forearm, and pain in the left elbow, shoulder and neck. Conservative treatment, stellate ganglion block, cervical epidural block, anterior scalene block and previous operation, including both carpal tunnel release, provided no remarkable relief to the patient. A left scalenectomy and first rib resection were performed by transaxillary approach and left cervical root neurolysis was done. After surgery, we measured CPT using neurometer and found conditions worsening in the opposite arm. We performed the same procedure on right side, and followed by CPT measurement. This case suggests that CPT is a useful measurement of recovery and progression of TOS.

• Physical Therapy Korea
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• v.21 no.4
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• International Journal of Oral Biology
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• v.40 no.3
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• pp.117-125
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• 2015

The present study investigated the role of central $GABA_A$ and $GABA_B$ receptors in orofacial pain in rats. Experiments were conducted on Sprague-Dawley rats weighing between 230 and 280 g. Intracisternal catheterization was performed for intracisternal injection, under ketamine anesthesia. Complete Freund's Adjuvant (CFA)-induced thermal hyperalgesia and inferior alveolar nerve injury-induced mechanical allodynia were employed as orofacial pain models. Intracisternal administration of bicuculline, a $GABA_A$ receptor antagonist, produced mechanical allodynia in naive rats, but not thermal hyperalgesia. However, CGP35348, a $GABA_B$ receptor antagonist, did not show any pain behavior in naive rats. Intracisternal administration of muscimol, a $GABA_A$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. On the contrary, intracisternal administration of bicuculline also attenuated the mechanical allodynia in rats with inferior alveolar nerve injury. Intracisternal administration of baclofen, a $GABA_B$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. In contrast to $GABA_A$ receptor antagonist, intracisternal administration of CGP35348 did not affect either the thermal hyperalgesia or mechanical allodynia. Our current findings suggest that the $GABA_A$ receptor, but not the $GABA_B$ receptor, participates in pain processing under normal conditions. Intracisternal administration of $GABA_A$ receptor antagonist, but not $GABA_B$ receptor antagonist, produces paradoxical antinociception under pain conditions. These results suggest that central GABA has differential roles in the processing of orofacial pain, and the blockade of $GABA_A$ receptor provides new therapeutic targets for the treatment of chronic pain.

• Journal of Oral Medicine and Pain
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• v.39 no.3
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• pp.90-95
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• 2014

Purpose: To investigate viscosity and wettability of hyaluronic acid (HA) solutions according to supplementation of lysozyme and/or peroxidase, and different ionic strength and pH conditions. Methods: Solutions containing HA were prepared using distilled deionized water (DDW) and simulated salivary buffer (SSB) in different conditions. Different concentrations of hen egg-white lysozyme and bovine lactoperoxidase was added into HA solutions. HA solutions with antimicrobials in different ionic strength and pH conditions were prepared. Viscosity was measured using cone-and-plate digital viscometer at six different shear rates and wettability on acrylic resin and Co-Cr alloy was determined by contact angle. Results: The viscosity values of HA dissolved in DDW were decreased in order of HA, HA containing lysozyme, HA containing peroxidase, and HA containing lysozyme and peroxidase. The viscosity values for HA in DDW were decreased as the concentration of lysozyme and/or peroxidase increased. However, the viscosity values for HA in SSB showed no significant changes according to the concentration of lysozyme and/or peroxidase. The viscosity values of HA solutions were inversely proportional to ionic strength and pH. The contact angle of HA solutions showed no significant differences according to tested surface materials, addition of lysozyme and/or peroxidase, and different ionic strength and pH conditions. Contact angles on acrylic resin by HA solutions in all tested conditions were much higher than those by human saliva. Conclusions: The rheological properties of HA supplemented with lysozyme and/or peroxidase in different ionic strength and pH conditions were objectively confirmed, indicating the possibility of HA with lysozyme and/or peroxidase as main components in the development of effective saliva substitutes.