• The Korean Journal of Pain
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• 제27권3호
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• pp.219-228
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• 2014

Background: A lipo-prostaglandin E1 agonist is effective for the treatment of neurological symptoms of spinal stenosis when administered by an oral or intravenous route. we would like to reveal the therapeutic effect of an epidural injection of lipo-prostaglandin E1 on hyperalgesia in foraminal stenosis. Methods: A total of 40 male Sprague-Dawley rats were included. A small stainless steel rod was inserted into the L5/L6 intervertebral foramen to produce intervertebral foraminal stenosis and chronic compression of the dorsal root ganglia (DRG). The rats were divided into three groups: epidural PGE1 (EP) (n = 15), saline (n = 15), and control (n = 10). In the EP group, $0.15{\mu}g{\cdot}kg-1$ of a lipo-PGE1 agonist was injected daily via an epidural catheter for 10 days from postoperative day 3. In the saline group, saline was injected. Behavioral tests for mechanical hyperalgesia were performed for 3 weeks. Then, the target DRG was analyzed for the degree of chromatolysis, chronic inflammation, and fibrosis in light microscopic images. Results: From the fifth day after lipo-PGE1 agonist injection, the EP group showed significant recovery from mechanical hyperalgesia, which was maintained for 3 weeks (P < 0.05). Microscopic analysis showed much less chromatolysis in the EP group than in the saline or control groups. Conclusions: An epidurally administered lipo-PGE1 agonist relieved neuropathic pain, such as mechanical hyperalgesia, in a rat foraminal stenosis model, with decreasing chromatolysis in target DRG. We suggest that epidurally administered lipo-PGE1 may be a useful therapeutic candidate for patients with spinal stenosis.

• The Korean Journal of Pain
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• 제22권1호
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• pp.21-27
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• 2009

Background: The neuropathic pain arising from nerve injury is difficult to treat and the therapeutic effects of opioid drugs remain debatable. Agonists acting at the ${\alpha}_2$ adrenergic and opioid receptors have analgesic properties and they act synergistically when co-administered in the spinal cord. The lack of subtype-selective pharmacological agents has previously impeded the synergistic effects that are mediated by the adrenergic receptor subtypes. Methods: We created neuropathic pain model by ligating the L5 spinal nerve in Sprague-Dawley rats (n = 18). We divided the rats into three groups (n = 6 for each group), and we administered intraperitoneal morphine (1 mg/kg, 3 mg/kg, 5 mg/kg) and then we measured the mechanical allodynia with using von-Frey filaments for 8 hours. We then injected morphine (5 mg/kg) intraperitoneally, twice a day for 2 weeks. We measured the tactile and cold allodynia in the morphine group (n = 9) and the saline group (n = 9). After 2 weeks, we decapitated the rats and harvested the spinal cords at the level of lumbar enlargement. We compared the ${\alpha}_2$ subtype mRNA expression with that of control group (n = 6) by performing real time polymerase chain reaction (RTPCR). Results: Intraperitoneal morphine reduced the neuropathic pain behavior in the dose-dependent manner. Chronic morphine administration showed an antiallodynic effect on the neuropathic pain rat model. The rats did not display tolerance or hyperalgesia. The expression of the mRNAs of the ${\alpha}_{2A}$, ${\alpha}_{2B}$, ${\alpha}_{2C}$ subtypes decreased, and morphine attenuated this effect. But we could not get statistically proven results. Conclusions: Systemic administration of morphine can attenuate allodynia during both the short-term and long-term time course. Morphine has an influence on the expression of ${\alpha}_2$ receptor subtype mRNA. Yet we need more research to determine the precise effect of morphine on the ${\alpha}_2$ subtype gene expression.

• The Korean Journal of Pain
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• 제34권1호
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• pp.27-34
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• 2021

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major reason for stopping or changing anticancer therapy. Among the proposed pathomechanisms underlying CIPN, proinflammatory processes have attracted increasing attention. Here we assessed the role of prostaglandin D2 (PGD2) signaling in cisplatin-induced neuropathic pain. Methods: CIPN was induced by intraperitoneal administration of cisplatin 2 mg/kg for 4 consecutive days using adult male Sprague-Dawley rats. PGD2 receptor DP1 and/or DP2 antagonists were administered intrathecally and the paw withdrawal thresholds were measured using von Frey filaments. Spinal expression of DP1, DP2, hematopoietic PGD synthase (H-PGDS), and lipocalin PGD synthase (L-PGDS) proteins were analyzed by western blotting. Results: The DP1 and DP2 antagonist AMG 853 and the selective DP2 antagonist CAY10471, but not the DP1 antagonist MK0524, significantly increased the paw withdrawal threshold compared to vehicle controls (P = 0.004 and P < 0.001, respectively). Western blotting analyses revealed comparable protein expression levels in DP1 and DP2 in the spinal cord. In the CIPN group the protein expression level of L-PGDS, but not of H-PGDS, was significantly increased compared to the control group (P < 0.001). Conclusions: The findings presented here indicate that enhanced PGD2 signaling, via upregulation of L-PGDS in the spinal cord, contributes to mechanical allodynia via DP2 receptors in a cisplatin-induced neuropathic pain model in rats, and that a blockade of DP2 receptor activation may present a novel therapeutic target for managing CIPN.

• The Korean Journal of Pain
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• 제19권2호
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• pp.152-158
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• 2006

Background: Complex regional pain syndrome (CRPS) is a painful, disabling disorder for which no proven treatment has been established. The purpose of this investigation was to assess the evidence of the efficacy of spinal cord stimulation (SCS) in the management of pain in CRPS patients. Methods: Between March 2004 and June 2006, 11 patients with CRPS were treated with SCS. The visual analog scale (VAS) score for pain (0⁣-10) and pain disability index (PDI) were obtained in all patients prior to treatment, and 1, 3 and 6 months post-implantation. Results: All 11 patients, 5 men and 6 women, with a median age and duration of CRPS of 44 years and 48.8 months, respectively, successfully received a lead implantation for SCS. The mean VAS pain score prior to the treatment was 85.5 out of 100 mm. After SCS implantation, the mean VAS pain scores were 49.5, 57.0 and 56.0 at 1, 3 and 6 months after the procedure, respectively. The mean pain score for allodynia was decreased by 50%, with a significant reduction of the PDI also observed after the treatment. Conclusions: Our current study suggests that SCS implantation is a safe and effective method in the management of CRPS patients.

• The Korean Journal of Pain
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• 제20권1호
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• The Korean Journal of Pain
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• 제32권1호
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• The Korean Journal of Pain
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• 제30권3호
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• pp.229-230
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• 2017

• 산업융합연구
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• 제20권10호
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• pp.209-218
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• 2022

마사지 치료는 1회 치료만으로 통증을 경감시키고 스트레스를 이완시킵니다. 그러나 아직까지 1회 마사지 치료의 효과에 대한 객관적인 데이터를 확인한 연구가 없었습니다. 그래서 본 연구에서는 마사지 치료와 동일한 효과가 있는 것으로 보고된 척추 마사지 기구로 1회 치료를 실시하여 통증 경감과 스트레스 이완의 효과의 증거를 확인하고자 하였습니다. 10년 전부터 시각적상사척도 4점의 요통이 있었던 45세 남자 환자 1인을 대상으로 척추 마사지 기구를 실시한 1차 실험과 침상안정을 실시한 2차 실험을 실시하였습니다. 시각적상사척도 측정과 실시간으로 심박 변이도를 측정하여 자율신경계를 확인하였고 총 5회 혈액검사를 실시하여 스트레스 관련 혈액검사(코르티솔, 에피네프린, 노르에피네프린)를 실시하였습니다. 침상안정을 취한 2차 실험에 비해 척추 마사지 기구로 1회 치료를 받은 1차 실험에서 유의미한 통증 감소효과를 보였습니다. 또한 1차 실험에서 자율신경계 활성도 및 부교감 신경계의 활성도가 증가되어 있었으며 혈중 에피네프린과 노르에피네프린이 감소되어 있었습니다. 이것은 기존의 마사지 치료 효과와 동일한 결과이며 1회 척추 마사지 기구를 통해 얻어지는 효과의 증거라 사료됩니다.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.157-161
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• 2014

A 49 years old male patient who suffered from deterioration of posterior neck pain, left hand numbness, left lower limb pain and gait disturbance for 3 years visited our outpatient department. He had been diagnosed as non-dysraphic cervical intradural lipoma and operated in August 1990. On the radiologic images, we found the regrowth of non-dysraphic cervical intradural lipoma from C2 to C7 level, which surrounds and compresses the cervical spinal cord. Previous subtotal laminectomy from C2 to C7 and severe cervical lordosis were also found. Appropriate debulking of lipoma mass without duroplasty was successfully done with intraoperative neurophysiological monitoring (IONM). We are following up the patient for 24 months via outpatient department, his neurologic symptoms such as hand numbness, gait disturbance, left lower limb pain and posterior neck pain have improved. We describe a rare case of regrowth of non-dysraphic cervical intradural lipoma.

• 척추신경추나의학회지
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• 제6권2호
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• pp.87-96
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• 2011

Objective : The purpose of this study is to report the improvement after oriental medical treatment about a patient who has spinal cord infarction with monoplegia and pain of lower extremity and dysuria. Methods : We diagnosed that symptoms as Wejeung, and employed oriental medical treatment, acupuncture, herbal medicine and moxibustion. This study was measured by MMT(Manual Muscle Testing), VAS(Visual Analogue Scale) and the number of Nelaton Catherization. Results : After oriental medical treatment, power and pain of lower extremity and dysuria were improved. Conclusions : There is no specific treatment for spinal cord infarction in western medicine and the prognosis is not so good. But in the case of this patient, power and pain of lower extremity and dysuria were improved remarkably through oriental medical treatment. Further clinical studies are needed to verify the findings.