• The Korean Journal of Pain
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• 제27권1호
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• pp.23-29
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• 2014

Background: Nefopam has shown an analgesic effect on acute pain including postoperative pain. The reuptake of monoamines including serotonin and noradrenaline has been proposed as the mechanism of the analgesic action of nefopam, but it remains unclear. Although alpha-adrenergic agents are being widely used in the perioperative period, the role of noradrenergic modulation in the analgesic effect of nefopam has not been fully addressed. Methods: Changes in the antinociceptive effect of intrathecal (i.t.) nefopam against formalin-elicited flinching responses were explored in Sprague-Dawley rats pretreated with i.t. 6-hydroxydopamine (6-OHDA), which depletes spinal noradrenaline. In addition, antagonism to the effect of nefopam by prazosin and yohimbine was evaluated to further elucidate the antinociceptive mechanism of i.t. nefopam. Results: Pretreatment with i.t. 6-OHDA alone did not alter the flinching responses in either phase of the formalin test, while it attenuated the antinociceptive effect of i.t. nefopam significantly during phase 1, but not phase 2. The antagonist of the alpha-2 receptor, but not the alpha-1 receptor, reduced partially, but significantly, the antinociceptive effect of i.t. nefopam during phase 1, but not during phase 2. Conclusions: This study demonstrates that spinal noradrenergic modulation plays an important role in the antinociceptive effect of i.t. nefopam against formalin-elicited acute initial pain, but not facilitated pain, and this action involves the spinal alpha-2 but not the alpha-1 receptor.

• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.379-386
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• 2000

This study is aimed to determine the cardiovascular function response to maximal exercise of chronic low back pain patients(N=13) and normal group(N=13). by using BRUCE PROTOCOL, subjects underwent tredmill exercise test. Their cardiovascular function responses during rest and after maximal exercise were compared The responses were analyzed using t-test for SPSS 7.0 program. The Cardiovascular function variables employed at rest time(Vo2, HR. Vo2/kg, VE, Vco2.) and all out time(Vo2peak. HRpeak, Vo2peak/kg, VEpeak. Vco2peak). Result show that : 1 There was no significant difference in Vo2 between chronic low back pain patients and normal group at rest time. However significant difference in Volpeak was observed after maximal exercise( p<.05). 2. There was no significant difference in HR between chronic low back pain patients and normal group at rest time. No significant difference in HRpeak likewise observed. 3. There was no significant difference in Vo2/kg between chronic low back pain patients and normal group at rest time. However significant difference in Vo2peak/kg was observed after maximal exercise load(p<.05). 4. There was no significance in VE between chronic low bark pain patients and normal group at rest time. However significant difference in VEpeak observed after maximal exercise load(p<.05).

• 대한간호학회지
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• 제35권7호
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• 정신신체의학
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• 제3권1호
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• The Korean Journal of Pain
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• 제25권1호
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• pp.1-6
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• 2012

Background: Curcumin has been reported to have anti-inflammatory, antioxidant, antiviral, antifungal, antitumor, and antinociceptive activity when administered systemically. We investigated the analgesic efficacy of intrathecal curcumin in a rat model of inflammatory pain. Methods: Male Sprague Dawley rats were prepared for intrathecal catheterization. Pain was evoked by injection of formalin solution (5%, $50{\mu}l$) into the hind paw. Curcumin doses of 62.5, 125, 250, and $500{\mu}g$were delivered through an intrathecal catheter to examine the flinching responses. The $ED_{50}$ values (half-maximal effective dose) with 95% confidence intervals of curcumin for both phases of the formalin test were calculated from the dose-response lines fitted by least-squares linear regression on a log scale. Results: In rats with intrathecal administration of curcumin, the flinching responses were significantly decreased in both phases. The slope of the regression line was significantly different from zero only in phase 2, and the $ED_{50}$ value (95% confidence interval) of curcumin was $511.4{\mu}g$ (23.5-1126.5). There was no apparent abnormal behavior following the administration of curcumin. Conclusions: Intrathecal administration of curcumin decreased inflammatory pain in rats, and further investigation to elucidate the precise mechanism of spinal action of curcumin is warranted.

• 대한의생명과학회지
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• 제24권3호
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• pp.239-244
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• 2018

Recently, many researches regarding the natural products which alternate with chemical products have been done. Among them, boswellia is well known for effect on anti-oxidative effect and inflammation. The aim was the effect boswellia of formalin- induced orofacial and temporomandibular joint (TMJ) pain on experimental animals was investigated. Experiments were carried out using subcutaneous (SC) pain model and TMJ pain model that were induced by the injection of 5% formalin into the right vibrissa pad (SC, $50{\mu}L$) or TMJ ($30{\mu}L$) of rats, respectively. In both models, formalin (5%), formalin after distilled water (vehicle), formalin after boswellia extract (p.o., concentrations of 15, 30 mg/kg) (n=6). The number of scratching on the injected region was scored during the 9 successive periods of 5 min intervals following injection of formalin. Oral administration of boswellia (15, 30 mg / kg) reduced formalin-induced SC orofacial pain behavioral responses. SC orofacial pain behavioral responses was significantly reduced at 20~35 min. In the experimental group injected into temporomandibular joints, the pain response was significantly reduced by $276.2{\pm}8.20$ and $78.3{\pm}4.7$ after oral administration of boswellia (15, 30 mg / kg) at $398.3{\pm}24.8$ times. As a result of the passage of time, the oral administration of boswellia showed a significant effect of reducing the temporomandibular joint pain 30 minutes after the injection of formalin. This study confirmed that oral administration of boswellia modulated the pain behavior in both models. In conclusion, boswellia extract may be a potential therapeutic treatment for orofacial pain.

• The Korean Journal of Physiology and Pharmacology
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• 제25권4호
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• pp.365-374
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• 2021

The mammalian target of rapamycin (mTOR) plays a role in various cellular phenomena, including autophagy, cell proliferation, and differentiation. Although recent studies have reported its involvement in nociceptive responses in several pain models, whether mTOR is involved in orofacial pain processing is currently unexplored. This study determined whether rapamycin, an mTOR inhibitor, reduces nociceptive responses and the number of Fos-immunoreactive (Fos-ir) cells in the trigeminal nucleus caudalis (TNC) in a mouse orofacial formalin model. We also examined whether the glial cell expression and phosphorylated p38 (p-p38) mitogen-activated protein kinases (MAPKs) in the TNC are affected by rapamycin. Mice were intraperitoneally given rapamycin (0.1, 0.3, or 1.0 mg/kg); then, 30 min after, 5% formalin (10 μl) was subcutaneously injected into the right upper lip. The rubbing responses with the ipsilateral forepaw or hindpaw were counted for 45 min. High-dose rapamycin (1.0 mg/kg) produced significant antinociceptive effects in both the first and second phases of formalin test. The number of Fos-ir cells in the ipsilateral TNC was also reduced by high-dose rapamycin compared with vehicle-treated animals. Furthermore, the number of p-p38-ir cells the in ipsilateral TNC was significantly decreased in animals treated with high-dose rapamycin; p-p38 expression was co-localized in microglia, but not neurons and astrocytes. Therefore, the mTOR inhibitor, rapamycin, reduces orofacial nociception and Fos expression in the TNC, and its antinociceptive action on orofacial pain may be associated with the inhibition of p-p38 MAPK in the microglia.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.190-198
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• 2003

Expression of c-fos, an immediate early gene, has accepted to be a marker of functional activity in neurons. This study was aimed to investigate the effects of cold therapy on the expression of spinal cord c-fos in rats of carrageenan-induced muscle pain. Muscle pain was induced in male Sprague-Dawley rats by intra-muscular injection of gastrocnemius with $2\%$ carrageenan. The paw withdrawal latency (PWL) and tail flick test (TFT) responses to heat stimuli were used to detect secondary hyperalgesia produced by the muscle pain and measured to assess the effects of cold. The expression of c-fos was determined in the lumbar regions of the spinal cord by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry assays. The secondary hyperalgesia to heat simuli (PWL and TFT) were significantly reduced in cold therapy compared with that in the controls. In RT-PCR assays the expression of c-fos mRNA was down-regulated in the lumbar spinal cord in cold group. In addition, Fos immunoreactivity in the dorsal horn of the lumbar spinal cord was decreased in cold group. These results suggested that application of cold attributed to increase PWL and TFT responses and to decrease expression of the c-fos produced by muscle pain.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.126-134
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• 2022

Purpose: This study aimed to propose an efficient treatment approach for infection with different candida species. Methods: Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups. Results: Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam. Conclusions: Patients with oral mucosal pain should be tested for the presence of Candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans.

• 국제물리치료학회지
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• 제5권2호
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• pp.701-707
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• 2014

This study was carried out survey to compare using status of physical therapy for elderly persons between urban and rural area in Honam. There were 16 places consisting of general clinics, departments of family medicine, pain medicine, and orthopedics that run outpatient physical therapy. This study distributed 636 questionnaires in total and collected 400 responses. Regionally, 200 responses out of 311 questionnaires from Gwangju and 200 responses out of 325 questionnaires from Jeollanam-do and Jeollabuk-do were collected. Regionally speaking, Gwangju was 62% while Jeollanam-do and Jeollabuk-do regions were 88%, indicating patients in rural areas employed more public transportation, which was statistically significantly different. There was a difference between urban and rural areas with regard to questions regarding improvement with physical therapy. Factors related to the number of physical therapy visits per week that showed a significant difference between urban and rural areas found by the linear regression analysis result were working hours, whether the patient exercised or not, and pain stress. This result suggest that it is necessary to reduce working hours and pain stress experienced by rural elderlies as well as to encourage regular exercise via national polices.