• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.4
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.1
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• pp.113-125
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• 2024

Objectives : The purpose of this study is to report the effect of Korean-Western medicine combination treatment administered to two patients with acute herpes zoster. Methods : During hospitalization, the two patients were treated with Hyeonggaeyeongyotang-gagam, Hwangryunhaedok-tang wet dressing, pharmacopuncture, acupuncture, and other western medications including antiviral and analgesic agents. Photographs of skin lesions, numeric rating scale(NRS), and visual analog scale(VAS) were used to assess the improvement of symptoms. Results : At the time of discharge, both patients showed remarkable improvement in skin lesions, NRS for pain, and VAS for pruritus and insomnia. Conclusions : The results demonstrated that Korean-Western medicine combination treatment may be effective for treating herpes zoster.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.271-274
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• 2005

Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.

• Microbiology and Biotechnology Letters
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• v.41 no.2
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• pp.253-262
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• 2013

In this study, we analyzed the anti-oxidative and anti-inflammatory activities of seven medicinal herbs. All extracts of the tested herbs, Euryale ferox Salisbury, Echinops setifer Iljin, Amomum cardamomum Linne, Tetrapanax papyriferus, Illicium verum Hook. f., Typha orientalis Presl, and Piper longum Linne, exhibited potent anti-oxidative activity as confirmed by DPPH radical scavenging capacity. Lipopolysaccharide (LPS) induced nitric oxide (NO) production, in the RAW 264.7 cell line, was also ameliorated by all extracts' treatments in a dose dependent manner. NO suppressive activity originated from the inhibition of inducible nitric oxide synthase (iNOS) protein expression by the extracts. Three extracts, E. ferox S., I. verum Hook. f., and P. longum L., possessed suppressive activity against, not only iNOS, but also cycloxygenase 2 (COX-2) protein expression. These three extracts may then serve as potential candidates for non steroidal analgesic inflammation drugs (NSAIDs). Furthermore, all extracts induced anti-oxidative enzyme, heme oxygenase 1, protein expression. Taken together, these results provide an important new insight into the fact that various medicinal herbs possess potent anti-oxidative and anti-inflammatory activities and might be utilized as promising agents in the field of health products. Further studies for the identification of the active compounds from medicinal herbs are clearly needed.

• Advances in Traditional Medicine
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• v.7 no.1
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• pp.34-40
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• 2007

The present study was carried out to elucidate the potential of Muntingia (M.) calabura leaves chloroform extract (MCCE) as antinociceptive, anti-inflammatory and antipyretic agents using various animal models. The dried powdered leaves of M. calabura (20 g) were soaked in chloroform for 72 h and the supernatant obtained was then evaporated to dryness. The crude dried extract (0.912 g), dissolved in dimethyl sulfoxide (1:20; w/v) and considered as a stock solution (100% concentration/strength), was then diluted to the concentrations of 10 and 50% and used together in all experimental models. The MCCE was found to show significant (P < 0.05) antinociceptive and antipyretic activities, but less remarkable anti-inflammatory activity. Only the antinociceptive activity of MCCE measured using the abdominal constriction test and in the first phase of the formalin test occurred in a concentration-dependent manner. The anti-inflammatory activity of 50 and 100% concentrations MCCE was observed only at the range of time interval of 60 - 120 and 60 min, respectively. Based on the results, we conclude that the M. calabura leaves chloroform extract possessed remarkable antinociceptive and antipyretic, but less effective anti-inflammatory, activities and thus justifies the Peruvian folklore claims of its medicinal values.

• Korean Journal of Pharmacognosy
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• v.43 no.2
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• pp.137-146
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• 2012

Dipsaci Radix (Dipsacaceae) has been used as a tonic, an analgesic, anti-inflammatory and anti-complement agents in traditional herbal medicine for the therapy of low back pain, knee pain, rheumatic arthritis, traumatic hematoma, and bone fractures. A high-performance liquid chromatography-electrospray ionization-mass spectrometric method (HPLC-ESI-MS) was developed for the simultaneous quantitation method of the five compounds from the herbal drug: asperosaponin VI and asperosaponin XII (terpene glycosides), sweroside, loganin and dipsacus A(iridoid glycosides). HPLC separation of the analytes was achieved on a C18 column ($150{\times}2.0$ mm i.d., 5 ${\mu}m$) using the aqueous methanol containing 5 mM ammonium acetate with gradient flow of the mobile phase. Detection of the analytes was performed by positive ion electrospray ionization, and selected ion monitoring was used for data acquisition using m/z corresponding molecular adduct ion, $[M+NH_4]^+$ and $[M+H]^+$. Calibration graphs showed good linearity ($r^2$=0.9997) over the wide range of the analytes; intra- and inter-day precisions (RSD, %) were within 9.1% and the accuracy between 94.0-111.0%. Recoveries of the analytes through the assay procedure were in the range of 93.7-110.8%. Analytical results of the herbal drugs of Dipsaci Radix (17 samples) show wide distribution of the five marker compounds and clear difference of the species from Phlomidis Radix (4 samples). The developed method would provide a practical guide for the quality control of the herbal drug.

• Journal of Pharmaceutical Investigation
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• v.26 no.4
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• pp.245-256
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• 1996

Solid lipid nanoparticles (SLN) have been developed as a new drug delivery system. Although many particulate drug carriers, such as microsphere, liposome, niosome, emulsion, etc. have been introduced, they have some disadvantage; low efficiency of incorporation and stability, lack of reproducibility, and so on. Meanwhile, SLN as a new drug delivery system is known to entrap rugs with a high efficiency and a good reproducibility. Moreover, small size SLN can circulate in blood for a prolonged time. Although many preparation methods were introduced, microfluidization method is recommended to be the most useful. This study was attempted to prepare and evaluate ketoprofen-incorporated SLNs (keto-SLN), which were prepared by two methods, ultrasonication and microfluidization. Keto-SLN was evaluated by measurement of particle size and zeta potential, efficacy of entrapment, sedimentation volume, in virto release pattern. The mean particle size was about $0.1\;{\mu}m$, and the size was dependent on the type and the amount of emulsifier. Zeta potential was negative, $-9{\sim}-13mV$ and entrapment efficacy was very high and stability was good for at least 60 days in the respect of particle size and sedimentation volume ratio. Analgesic effect was also determined as well as pharmacokinetic parameters. The former was comparable to that of that of ketoprofen loaded suspension (keto-sus) and the latter revealed that consistent with the delayed release of keto-SLN. $T_{max}$ was longer than keto-sus. Therefore, keto-SLN was favourable dosage forms in the field of drug delivery system such as anti-cancer, analgesics and anti-inflammatory agents.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.3
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• pp.307-312
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• 1998

This study was performed to investigate the mechanism of central analgesic effects of antidepressants. Thirty four male rats were anesthetized with pentobarbital sodium (40 mg/kg, ip). A stainless steel guide cannula and a PE tube (PE10) were implanted into the lateral ventricle and cisterna magna area. Stimulating and recording electrodes were implanted into the incisor pulp and anterior digastric muscle. Electrodes were led subcutaneously to the miniature cranial connector sealed on the top of the skull with acrylic resin. The jaw opening reflex was used in freely moving rats, and antidepressants were administered intracisternally in order to eliminate the effects of anesthetic agents on the pain assessment and evaluate the importance of the central action site of antidepressants. After 48 hours of recovery from surgery, digastric electromyogram (dEMG) of freely moving rats was recorded. Electrical shocks (200 ${\mu}sec$ duration, 0.5-2 mA intensity) were delivered at 0.5 Hz to the dental pulp every 2 minute. Intracisternal administration of $15\;{\mu}g$ imipramine suppressed dEMG elicited by noxious electrical stimulation in the tooth pulp to $76{\pm}6%$ control. Intracisternal administration of $30\;{\mu}g$ desipramine, nortriptyline, or imipramine suppressed dEMG remarkably to $48{\pm}2,\;27{\pm}8,\;or\;25{\pm}5%$ of the control, respectively. Naloxone, methysergide, and phentolamine blocked the suppression of dEMG produced by intracisternal antidepressants from $23{\pm}2\;to\;69{\pm}4%,\;from\;32{\pm}5\;to\;80{\pm}9%,\;and\;from\;24{\pm}6\;to\;77{\pm}5%$ of the control, respectively. These results indicate that antidepressants produce antinociception through central mechanisms in the orofacial area. Antinociception of intracisternal antidepressants seems to be mediated by an augmentation of descending pain inhibitory influences on nociceptive pathways.

• The Korean Journal of Pain
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• v.32 no.4
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• pp.256-263
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• 2019

Background: Antinociceptive anti-inflammatory drugs have many adverse effects. The goal of this investigation is to study the probable anti-inflammatory and analgesic effects of verapamil and N-acetylcysteine (NAC) in experimental rats. Methods: Adult male Wistar rats were randomly divided into 4 groups in the antinociceptive study, each containing 6 rats; the normal control group, which received saline (1 mL/kg); the diclofenac group, which received diclofenac sodium (5 mg/kg); the NAC group, which received NAC (125 mg/kg); and the verapamil group, which received verapamil (8 mg/kg). In the anti-inflammatory study, 5 groups were used, the 4 previous groups with the addition of an edema control group, received saline and were subjected to formalin test. Hot plate latency time was recorded for antinociceptive evaluation. Paw edema thickness and biochemical parameters were recorded for anti-inflammatory evaluation. Results: Administration of NAC showed significant prolongation of hot plate latency time at 1 hour when compared to the control group while verapamil showed a significant prolongation of hot plate latency time at 1 and 2 hours when compared to the control group and NAC group values. Administration of NAC and verapamil significantly decreased paw edema thickness at 2, 4, and 8 hours when compared to edema control values. Regarding biochemical markers, NAC and verapamil significantly decreased serum nitric oxide synthase, C-reactive protein, and cyclooxygenase-2 levels compared to the edema control value. In accordance, a marked improvement of histopathological findings was observed with both drugs. Conclusions: NAC and verapamil have antinociceptive and anti-inflammatory effects comparable to diclofenac sodium.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.11-15
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• 2021

In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.