• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.161-166
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• 2013

Dexmedetomidine is a potent alpha-2-adrenergic agonist, more selective than clonidine, with widespread actions on the mammalian brain. A large body of recent work supports its analgesia and sympatholytic properties. Dexmedetomidine is a useful medication with many clinical applications. The medication has shown efficacy in decreasing the need for opioids, benzodiazepines, propofol, and other sedative medications. Dexmedetomidine has been used effectively for sedation during invasive procedures and in the ICU. Short-term sedation has been shown to be safe in studies, although hypotension and bradycardia are the most significant side effects. Dexmedetomidine is emerging as an effective therapeutic agent in the management of a wide range of clinical conditions with an efficacious, safe profile.

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.136-141
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• 2018

Oral cancer is a malignant neoplasm of the lips or oral cavity. Surgery, radiotherapy and chemotherapy depending on the location and stage of the tumor can be considered as important treatment modalities of oral cancer. Unfortunately, all three treatments can have both acute and chronic complications. Among them, trismus and osteoradionecrosis (ORN), unique complications of radiotherapy in the orofacial region, are particularly difficult to treat once manifested. Therefore, these two complications of radiotherapy have devastating effects on the patient's oral health and furthermore, overall quality of life. In this study, we present a case of a patient showing trismus and ORN following radiotherapy for the treatment of maxillary squamous cell carcinoma and briefly discuss this matter of trismus and ORN in the perspective of a dentist.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.15-19
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• 2019

Background and Objectives: To determine the efficacy of filling the external auditory meatus with 1% clotrimazole at a single visit for the treatment of otomycosis. Subjects and Methods: This prospective study included 40 patients who were referred to our clinic with complaints of ear itching, pain, and fullness, and were diagnosed with unilateral otomycosis. After cleaning the mycotic hyphae from the external auditory meatus, the ear canal was filled with 1% clotrimazole, using an intravenous catheter and syringe. The patients received follow-up examinations on post-treatment days 7, 15, and 45. Results: The follow-up otomicroscopic examinations revealed that 95% of the ear canals were entirely clean and that all symptoms had resolved. The post-treatment scores of pain, aural fullness and itching were significantly lower than the pre-treatment scores (p<0.01). Conclusions: Filling the external auditory meatus with 1% clotrimazole at a single visit is an easy, efficient, and cost-effective treatment for otomycosis. Additionally, high patient compliance makes this treatment superior to long-term topical therapy.

• Journal of Audiology & Otology
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• v.23 no.1
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• pp.15-19
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• 2019

Background and Objectives: To determine the efficacy of filling the external auditory meatus with 1% clotrimazole at a single visit for the treatment of otomycosis. Subjects and Methods: This prospective study included 40 patients who were referred to our clinic with complaints of ear itching, pain, and fullness, and were diagnosed with unilateral otomycosis. After cleaning the mycotic hyphae from the external auditory meatus, the ear canal was filled with 1% clotrimazole, using an intravenous catheter and syringe. The patients received follow-up examinations on post-treatment days 7, 15, and 45. Results: The follow-up otomicroscopic examinations revealed that 95% of the ear canals were entirely clean and that all symptoms had resolved. The post-treatment scores of pain, aural fullness and itching were significantly lower than the pre-treatment scores (p<0.01). Conclusions: Filling the external auditory meatus with 1% clotrimazole at a single visit is an easy, efficient, and cost-effective treatment for otomycosis. Additionally, high patient compliance makes this treatment superior to long-term topical therapy.

• Journal of muscle and joint health
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• v.1 no.1
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• pp.31-47
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• 1994

The purposes of this research are to examine the effects of muscle relaxation to the rheumatoid arthritis patients' physiological, psychological, and social adaptation, and to verify that the technique Is an effective tool for improving the patients' adaptation. This research utilized a qusi-experimental design that compares the pre-experiment measures and the post-experiment measures. The subjects of this study were 37 out-patients who were diagnosed for rheumatoid arthritis in P university hospital and K clinic between September 12, 1993 and November 30, 1993. The experimental group consisted of patients treated on Monday, Wednesday and Friday. The control group consisted of patients treated on Tuesday, Thursday and Saturday The pre-experimental survey utilized the following tools. The physiological adaptation was measured by a graphic rating scale for pain and activity of daily living. The psychological adaptation was measured by Zung's depression scale and Rosenberg's self-esteem scale : and the social adaptation was measured by Derogatis' psychosocial adjustment scale. The experimental group received muscle relaxation treatment for 15 minutes per day for the period of 2 weeks, the control group received no treatment and had quiet time. The post-experiment measurement was carried out similar to the pre-experiment survey, SPSS $PC^+$ is used to analyze the collected data. The reliabilities of the measurement tools were examined by Cronbach's ${\alpha}$ coefficients. The homogeneities between the experimental and control groups were tested by t-test and chi-square test, hypotheses were tested by t-test. This research found that the general characteristics between the groups were statistically homogenious. The physiological, psychological, and social adaptation between the groups in the pre-experimental survey were also statistically homogenious. The results of this research can be summarized as follows : 1. Concerning the Physiological adaptation, the experimental group showed a statistically lower pain score than the control group. Thus, muscle relaxation was effective to relieve the pain of rheumatoid arthritis patients (t=-2.95, p=.006). 2. Concerning the psychological adaptation, the experimental group showed a statistically lower depression score than the control group. Thus, muscle relaxation was effective to reduce the patient's depression(t=-4.00, p=.001). 3. Concerning social adaptation, the experimental group showed a statistically higher score for the health maintenance and disease control than the control groups. Thus, muscle relaxation was effective for the health maintenance and disease control (t=2.09, p=.004). This research showed that the muscle relaxation is a nursing intervention that can promote the physiological, psychological and social adaptation of the rheumatoid arthritis patients in terms of short-term and cognitive changes. However, more fundomental changes in behavior and long-term physiology could not be found through such a short-term relaxation treatment.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.183-189
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• 2007

Introduction: While uncommon, humeral head osteonecrosis is an indication for arthroplasty when the humeral head collapse is advanced. The current authors report the short-term clinical results of 7 hemiarthroplasties to treat humeral head osteonecrosis. Materials and Methods: This study focused on 7 reconstructed shoulders of 5 patients whose humeral head osteonecrosis was treated with hemiarthroplasty. The postulated causes were alcohol-induced (4 cases) and steroidinduced (3 cases). The minimum follow-up was 12 months. This study compared the preoperative and postoperative shoulder pain, range of motion, and ASES scores. The postoperative patient satisfaction was assessed. Results: The level of pain during exercise was reduced from a preoperative average of 7.6 to a postoperative average of 1.9. The range of motion, in terms of forward flexion, abduction, and external rotation, improved from preoperative averages of $105.7^{\circ}$, $80^{\circ}$, and $22.1^{\circ}$ to postoperative averages of $146.6^{\circ}$, $139.3^{\circ}$, and $44.3^{\circ}$, respectively. The ASES scores increased from a preoperative mean of 39.0 to a postoperative mean of 84.1. The patients' ratings of the outcomes were excellent (5 cases) and good (2 cases). Conclusions: These short-term results indicate that hemiarthroplasty is a reliable treatment method for humeral head osteonecrosis improving shoulder pain, range of motion, and patient satisfaction.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.176-182
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• 2017

Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

• PNF and Movement
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• v.5 no.2
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• pp.73-88
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• 2007

Purpose : The purpose of this study was to find out The effect of Low back pain on the total pattens of Proprioceptive neuromuscular facilitation(PNF). Methods : The subjects of the study were 62 low back pain patients. They were divided into two groups: 31 in the experimental group and 31 in the control group. the experimental group performed modalities and PNF total patterns three times for a week. the control group performed only modalities and ROM exercise three times for a week. Back muscle strength was measured by a back muscle strength measuring machine, the intensity of pain was measured by the Visual Analogue Scale (VAS), and the level of disability was measured by Oswestry low back pain disability index. Study measurements were compared before and after 6 weeks exercise program. The two groups of subjects were assessed by utilizing two different balance measurement: Static standing balance was measured by balance performance monitor (BPM) and Dynamic standing balance was measured by one leg standing(OLS). The scale for static standing balance was measured by using, sway area, sway path, max velocity. Results : The results of this study were as follow: 1) The score on visual analogue scale shows statistically significant increase on PNF group of post test(p<.05). 2) The score on Oswestry low back pain disability index. shows statistically significant decrease on PNF group of post test(p<.05). 3) The change sway area was statistically significant on pre-test and post-test(p<.05). 4) The change sway path was statistically significant on pre-test and post-test(p<.05). 5) The change max velocity was statistically significant on pre-test and post-test(p<.05). 6) The score on one leg standing shows statistically significant increase on PNF group of post test(p<.05). Conclusion : These results of this study indicated that Proprioceptive Neuromuscular Facilitation Total patterns which performed for six weeks had a statistically significant influence on low back pain. If the exercise for muscle strength is performed along with therapeutic stabilizing exercise, a better effect can be expected on low back pain. We hope that this study will provide a basic data for further research with a bigger group and on a long-term effect.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.119-125
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• 2008

Background: Cerebral blood vessels are innervated by sympathetic nerves from the superior cervical ganglia (SCG), and these nerves may influence the cerebral blood flow. The purpose of the present study was to evaluate the neuroprotective effect of superior cervical sympathetic ganglion block in rats that were subjected to focal cerebral ischemia/reperfusion injury. Methods: Eighty male Sprague-Dawley rats (270-320 g) were randomly assigned to one of two groups (the ropivacaine group and a control group). In all the animals, brain injury was induced by middle cerebral artery (MCA) reperfusion that followed MCA occlusion for 2 hours. The animals of the ropivacaine group received $30{\mu}l$ of 0.75% ropivacaine, and their SCG. Neurologic score was assessed at 1, 3, 7 and 14 days after brain injury. Brain tissue samples were then collected. The infarct ratio was measured by 2.3.5-triphenyltetrazolium chloride staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeled (TUNEL) reactive cells and the cells showing caspase-3 activity were counted as markers of apoptosis at the caudoputamen and frontoparietal cortex. Results: The death rate, the neurologic score and the infarction ratio were significantly less in the ropivacaine group 24 hr after ischemia/reperfusion injury. The number of TUNEL positive cells in the ropivacaine group was significantly lower than those values of the control group in the frontoparietal cortex at 3 days after injury, but the caspase-3 activity was higher in the ropivacaine group than that in the control group at 1 day after injury. Conclusions: The study data indicated that a superior cervical sympathetic ganglion block may reduce the neuronal injury caused by focal cerebral ischemia/reperfusion, but it may not prevent the delayed damage.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.423-432
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• 2022

Background: The decreased expression of mu-opioid receptors (MOR) in the amygdala may be a key molecular in chronic post-surgical pain (CPSP). It is known that miR-339-5p expression in the amygdala of a stressed rat model was increased. Analyzed by RNAhybrid, miR-339-5p could target opioid receptor mu 1 (oprm1) which codes MOR directly. So, the authors hypothesized that miR-339-5p could regulate the expression of MOR via targeting oprm1 and cause the effects to CPSP. Methods: To simulate perioperative short-term stress, a perioperative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception rat model was built. A pmiR-RB-REPORT^TM dual luciferase assay was taken to verify whether miR-339-5p could act on oprm1 as a target. The serum glucocorticoid level of rats was test. Differential expressions of MOR, GFAP, and pERK1/2 in each group of the rats' amygdala were tested, and the expressions of miR-339-5p in each group of rats' amygdalas were also measured. Results: Perioperative stress prolonged the recovery time of incision pain. The expression of MOR was down-regulated in the amygdala of rats in stress + incision (S + IN) group significantly compared with other groups (P < 0.050). miR-339-5p was up-regulated in the amygdala of rats in group S + IN significantly compared with other groups (P < 0.050). miR-339-5p acts on oprm1 3'UTR and take MOR mRNA as a target. Conclusions: Perioperative stress could increase the expression of miR-339-5p, and miR-339-5p could cause the expression of MOR to decrease via targeting oprm1. This regulatory pathway maybe an important molecular mechanism of CPSP.