• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제34권2호
• /
• pp.200-206
• /
• 2008

A variety of mechanisms may generate pain resulting from injury to the peripheral nervous system. None of these mechanisms is disease-specific, and several different pain mechanisms may be present simultaneously in any one patient. Diagnosis of neuropathic pain is often easily made from the information gathered on neurologic examination and from patient history. Evidence of sensory disturbances elicited by examination combined with laboratory tests confirming injury to peripheral nerve establishes the diagnosis of neuropathic pain. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if dentist has a complete understanding of the therapeutic options. Pharmacologic therapy has been the mainstay of treatment. Selection of an appropriate pharmacologic agent is by trial and error since individual response to different agents, doses, and serum level are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuripathic pain. If pharmacologic treatment is not effective, nerve block using lidocaine, steroid and alcohol and neurectomy must be considered for treatment option.

• 여성건강간호학회지
• /
• 제7권2호
• /
• pp.188-202
• /
• 2001

This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

• Molecules and Cells
• /
• 제25권2호
• /
• pp.242-246
• /
• 2008

To assess the role of $\alpha_{1G}$ T-type $Ca^{2+}$ channels in neuropathic pain after L5 spinal nerve ligation, we examined behavioral pain susceptibility in mice lacking $Ca_{V}3.1$ (${\alpha}_{1G}{^{-/-}}$), the gene encoding the pore-forming units of these channels. Reduced spontaneous pain responses and an increased threshold for paw withdrawal in response to mechanical stimulation were observed in these mice. The ${{\alpha}_{1G}}^{-/-}$ mice also showed attenuated thermal hyperalgesia in response to both low-(IR30) and high-intensity (IR60) infrared stimulation. Our results reveal the importance of ${\alpha}_{1G}$ T-type $Ca^{2+}$ channels in the development of neuropathic pain, and suggest that selective modulation of ${\alpha}_{1G}$ subtype channels may provide a novel approach to the treatment of allodynia and hyperalgesia.

• The Korean Journal of Pain
• /
• 제14권2호
• /
• pp.199-206
• /
• 2001

Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제15권1호
• /
• pp.35-37
• /
• 2015

Atypical facial pain (AFP) is a type of facial pain which does not fulfill any other diagnosis. It has several features such as no objective signs, no obvious explanation of the cause and poor response to treatments. We report a case of a female patient with AFP on the left maxillary area. The pain was increased by cold innocuous stimulation and thermography showed that the temperature on the painful area was significantly decreased. The pain was successfully alleviated by stellate ganglion block (SGB). Therefore, SGB can be effectively used to treat AFP.

• 감성과학
• /
• 제14권4호
• /
• pp.503-512
• /
• 2011

최근 HCI 분야에서 정서 인식은 정서 지능을 구현하기 위한 핵심적인 단계 중의 하나이다. 생체신호를 이용하여 정서 인식을 시도하는 연구들이 시도되고 있으나, 기본 정서 이외의 다른 정서에 대한 연구는 거의 이루어지지 않았다. 본 연구의 목적은 무료함, 통증, 그리고 놀람의 세 가지 정서 간 자율신경계 반응의 차이를 확인하는 것이다. 실험자는 217명의 실험참여자(남 96명)들을 대상으로 시/청각 자극을 조합하여 무료함과 놀람 정서를 유발하였고, 혈압기를 이용하여 통증 정서를 유발하였다. 정서 자극이 제시되는 동안 피부전기활동, 피부온도, 심전도와 광혈량도를 측정하였고, 실험참여자들이 경험한 정서 범주와 강도를 정서평가척도 상에 평정하게 하였다. 정서 자극에 대한 평가 결과, 사용된 정서 자극은 평균 92.5%의 적합성과 5.43의 효과성을 보였는데, 이는 각 정서 자극이 해당 정서를 효과적으로 유발한 것을 의미한다. 자율신경계 측정 결과, 피부전기활동, 피부온도, 심박률, 심박률의 저주파수 성분과 평균 혈류량은 안정 상태와 정서 상태 간의 유의한 차이를 보였다. 또한 각 정서에 의해 유발된 자율신경계 반응은 정서 간에도 유의한 차이가 있는 것으로 나타났다. 이러한 결과는 정서이론의 확장과 자율신경계 반응 측정 지표를 활용하여 정서를 인식하는 알고리즘 및 인간 정서를 변별하는 컴퓨터 시스템 개발에 응용 가능할 것이다.

• 동국한의학연구소논문집
• /
• 제5권
• /
• pp.15-31
• /
• 1996

The purpose of this study was to generalize the conception of chronic pelvic pain(CPP)through the literature of oriental medicine and occidental medicine. The results are obtained as follows. First, chronic pelvic pain(pain of more than 6 months duration) may include pain of gynecologic, gastroenterologic, urologic, neurologic, and musculoskeletal origin. In this study, the etiology of chronic pelvic pain may remain obscure and the relationship between certain types of pathology, such as endometriosis or adhesions, and the pain response may be inconsistent and often inexplicable. Second, the causes of CPP through the literature of oriental medicine were reviewed as pains due to a wind-pathogen, a cold, disorder of Qi, disorder of blood stasis, a improper diet, disorder of fluid, and deficiency type etc... And the charateristic pains were concerned with a aching pain, a heavy pain, a distending pain. a pain due to mass in the abdoman, a pain likes pulling etc... The degree and classification of charateristic pains in current of time were dependent on subjective factors. Third. in oriental medicine, it wasn't to be suggested concretely recognition of etiological factor in pain. But they recognised that facters were influenced by pain. For example, diretic peripheral demages were concerned with a blood stasis, a phlegm, a damp phlegm, heart, and the pains that were occurrenced by sevn emotions were concerned with a stagnancy of Qi or a stagnancy of liver-Qi.

• The Korean Journal of Pain
• /
• 제24권2호
• /
• pp.100-104
• /
• 2011

Background: Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods: This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results: The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS ($x^2$ = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions: MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome.

• The Korean Journal of Pain
• /
• 제35권2호
• /
• pp.173-182
• /
• 2022

Background: Neurokinin-1 (NK1) and calcitonin gene-related peptide (CGRP) play a vital role in pain pathogenesis, and these proteins' antagonists have attracted attention as promising pharmaceutical candidates. The authors investigated the anti-nociceptive effect of co-administration of the CGRP antagonist and an NK1 antagonist on pain models compared to conventional single regimens. Methods: C57Bl/6J mice underwent sciatic nerve ligation for the neuropathic pain model and were injected with 4% formalin into the hind paw for the inflammatory pain model. Each model was divided into four groups: vehicle, NK1 antagonist, CGRP antagonist, and combination treatment groups. The NK1 antagonist aprepitant (BIBN4096, 1 mg/kg) or the CGRP antagonist olcegepant (MK-0869, 10 mg/kg) was injected intraperitoneally. Mechanical allodynia, thermal hypersensitivity, and anxiety-related behaviors were assessed using the von Frey, hot plate, and elevated plus-maze tests. The flinching and licking responses were also evaluated after formalin injection. Results: Co-administration of aprepitant and olcegepant more significantly alleviated pain behaviors than administration of single agents or vehicle, increasing the mechanical threshold and improving the response latency. Anxiety-related behaviors were also markedly improved after dual treatment compared with either naive mice or the neuropathic pain model in the dual treatment group. Flinching frequency and licking response after formalin injection decreased significantly in the dual treatment group. Isobolographic analysis showed a meaningful additive effect between the two compounds. Conclusions: A combination pharmacological therapy comprised of multiple neuropeptide antagonists could be a more effective therapeutic strategy for alleviating neuropathic or inflammatory pain.

• The Korean Journal of Pain
• /
• 제4권2호
• /
• pp.147-151
• /
• 1991

Cervical epidural steroid injection, although not as familiar to many anesthesiologists, can be useful in the management of patients with acute and chronic neck, shoulder and arm pain. My clinic personally contacted and interviewed thirty patients with cervical radiculopathy who received cervical epidural steroid injection. Twenty seven percent of the patients had a excellent response(greater than 75% improvement) and fifty percent of the patients had a good response (greater than 50% improvement) to an injection of steroid into the cervical epidural space. We have concluded that cervical epidural steroid injection was very effective in the management of cervical radiculopathy and represented a possible alternative to surgery. Many anesthesiologists should add to their armamentarium the use of such techniques in the management of cervical radiculopathy.