• 대한간호학회지
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• 제39권5호
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• pp.632-640
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• 2009

Purpose: The purpose of this study was to examine the effect of DHEA (Dehydroepiandrosterone) on muscle weight and Type I and II fiber cross-sectional area of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The DHEA group (n=10) had DHEA injections daily for 14 days, and the Vehicle group (n=10) had vehicle injections daily for 14 days. Withdrawal threshold, body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected from the both hindlimbs. Body weight, food intake, activity, muscle weight and Type I, II fiber cross-sectional area of the dissected muscles were measured. Results: The DHEA group showed significant increases (p<.05), as compared to the vehicle group for muscle weight of the unaffected plantaris, and in Type II fiber cross-sectional area of the gastrocnemius muscle. The DHEA group demonstrated a higher pain threshold than the vehicle group whereas total diet intake and activity score were not significantly different between the two groups. Conclusion: DHEA administration for 14 days attenuates unaffected plantaris and gastrocnemius muscle atrophy.

• Journal of Acupuncture Research
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• 제26권3호
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• pp.165-170
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• 2009

목적 : 복합부위 통증증후군은 사고나 외상 이후 한 쪽 사지에서 시작되는 신경병증성 통증이다. 그 기전은 명확히 밝혀지지 않아 추천되는 치료도 아직 없는 실정이다. 이에 한의학적인 치료 방법을 적용하여 그 효과를 보고자 하였다. 방법 : 전통 한의학에서 이 환자의 상태는 통비로 볼 수 있다. 양쪽 무릎과 왼쪽 발의 통증을 호소하는 26세 남자 환자가 3년 전 복합부위 통증증후군 제1형으로 진단 받은 후 봉독약침, 침, 뜸으로 4주 동안 주 2회씩 치료를 받았다. 치료 효과는 DITI, VAS를 통해 평가하였다. 결과 : DITI, VAS를 통하여 환자의 통증에 호전이 있었다. 결론 : 침, 봉독, 뜸을 이용하여 복합부위 통증증후군 환자 1명을 치료한 결과 효과가 있는 것으로 나타났다.

• The Korean Journal of Pain
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• 제22권1호
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• pp.107-111
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• 2009

Neuroablation should be performed cautiously because neuropathic pain can occur following denervation of a somatic nerve. A 34-year-old man presented with severe penile pain and allodynia following a selective neurectomy of the sensory nerve that innervated the glans penis for treatment of his premature ejaculation. He was treated with various nerve blocks, including continuous epidural infusion, lumbar sympathetic block and sacral selective transforaminal epidural blocks, as well as intravenous ketamine therapy. However, all of the treatments had little effect on the relief of his pain. We performed spinal cord stimulation as the next therapy. After this therapy, the patient has currently been satisfied for 3 months.

• The Korean Journal of Pain
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• 제12권2호
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• pp.242-245
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• 1999

Gabapentin is an oral antiepileptic agent with an unknown mechanism of action. There have been many proposed uses for gabapentin, including neuropathic pain, reflex sympathetic dystrophy, postherpetic neuralgia, midscapular pain secondary to radiation myelopathy and migraine prophylaxis. This report presents patients who were treated with gabapentin when other pharmacologic interventions failed to relieve neuropathic pain 3 patients with neuropathic pain were included among these cases. All patients were started on 200 mg gabapentin. The maximum dose required for pain relief was between 800 mg and 2400 mg. Gabapentin may be a useful adjunct for treating neuropathic pain with minimum of side effects.

• The Korean Journal of Pain
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• 제13권1호
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• pp.101-104
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• 2000

Since conventional analgesics have showed limited therapertic value in the treatment of painful neuropathy, the new anticonvulsant gabapentin, has been tried and turned out to be effective and safe in the treatment for various forms of neuropathic pain. The basic pathophysiology of neuropathic pains is abnormal neuronal hyperactivity similar to epileptic seizures. Therefore, we could expect that neuropathic pain would be suppressed by anticonvulsants which inhibit abnormal excessive neuronal output and nerve conduction. This report include effective pain relief in four cases of neuropathic pain with gabapentin without any significant complications.

• The Korean Journal of Pain
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• 제11권2호
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• pp.294-298
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• 1998

The feature of neuropathic pain may occur in the absence of any apparent stimulus and be exaggerated in either amplitude or duration. Peripheral nerve injury may produce neuropathic pain and opioids have been shown to be relatively unsatisfactory for the treatment of most cases of neuropathic pain. The NMDA receptor system is involved in transmission and modulation of nociceptive information. We treated patients with severe pain, hyperaesthesia and allodynia with epidural injection of NMDA receptor antagonist, ketamine (10 mg) and morphine (0.5 mg) or other opioid. The combinations provided effective pain management in 23 patients with neuropathic pain.

• 대한간호학회지
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• 제41권4호
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• pp.520-527
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• 2011

Purpose: The purpose of this study was to examine effects of nitric oxide synthase (NOS) inhibitor on muscle weight and myofibrillar protein content of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The NOSI group (n=19) had NOS inhibitor (L-NAME) injections daily for 14 days, and the Vehicle group (n=20) had vehicle injections daily for 14 days. Withdrawal threshold, body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected from hindlimbs. Muscle weight and myofibrillar protein content of the dissected muscles were determined. Results: The NOSI group showed significant increases as compared to the Vehicle group for body weight at 15 days, muscle weight and myofibrillar protein content of the unaffected soleus and gastrocnemius. The NOSI group demonstrated a higher pain threshold than the vehicle group. Conclusion: NOSI for 14 days attenuates unaffected soleus and gastrocnemius muscle atrophy in neuropathic pain model.

• Journal of Oral Medicine and Pain
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• 제33권4호
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• pp.401-407
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• 2008

치아의 통증은 구강안면부에서 가장 흔하게 발생하는 통증이다. 대부분의 치아 통증은 치수 및 치주조직의 병적인 변화로 인한 치성 통증이지만, 구강안면부의 다른 구조물의 병적 변화 또는 다른 질병 등에 의한 통증이 치아의 통증으로 나타나는 경우도 흔히 존재하며, 이러한 통증을 '비치성치통'이라고 한다. 비치성치통은 통증의 발현 부위와 통증의 원인 부위가 일치하는 원발성 통증이 아니라, 통증의 발현 부위와 통증의 원인 부위가 동일하지 않은 이소성 통증에 속하므로 통증의 원인을 찾아 치료해야만 개선될 수 있다. 비치성 치통을 유발하는 요인에는 신경병증성 통증, 부비동질환 기원의 통증, 근막통증, 신경혈관성 통증, 심장질환, 두개 및 구강안면부 종양, 중이염 등에 의한 전이통, 심인성 원인 등이 있다. 이러한 다양한 원인에 의한 통증이 치아부위에 나타나는 경우 치아 및 치주조직에 대한 임상 및 방사선 사진 검사 상 병적인 소견이 관찰되지 않음에도 불구하고, 치아통증과 유사한 임상적 증상을 나타낼 수 있다. 그러므로, 임상가들은 비치성 치통을 유발할 수 있는 원인 및 관련 증상들에 대하여 잘 알고 있어야 하며, 세심한 병력 청취, 치아 관련 구조물 및 그 외의 구조물에 대한 정확한 임상 검사를 통해 치성 통증과 감별할 수 있어야 한다. 본 증례 보고에서는, 치아 통증과 유사한 양상을 보이는 비치성 치통으로 내원한 환자의 진단 및 치료에 관한 증례를 통해, 비치성 치통에 대한 고찰 및 진단과 치료시의 고려 사항에 대하여 살펴보고자 한다.

• The Korean Journal of Pain
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• 제13권2호
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• pp.156-163
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• 2000

Background: Peripheral nerve injury sometimes leads to chronic neuropathic pain such as causalgia. A subset of patients with causalgia have a sympathetically maintained pain which is often evoked by cooling stimuli. However, our knowledge on adrenergic receptor types responsible for cold-evoked pain that is sympathetically dependent is lacking. The present study was conducted to investigate subtypes of adrenoceptors involved in mediating cold-evoked pain that developed following peripheral nerve injury. Methods: Neuropathic surgery was performed by a unilateral ligation of L5 and L6 spinal nerves of rats. Behavioral sign of cold-evoked pain was examined for 5 min by measuring cumulative duration of time that the rat lifted its foot off a metal plate held at cold temperature ($5^{\circ}C$). Whether cold-evoked pain behavior was affected by antagonists of various subtypes of adrenoceptors, which were administered intraperitoneally before and after the ligation, was investigated. Results: After ligation, duration of foot lifting on the ligated side at cold temperature increased as compared to the pre-operative period. This increase maintained for the entire 40-day test period. Pretreatment with alpha-antagonist phentolamine produced a suppression of cold-evoked pain behavior that was not affected by beta-antagonist propranolol pretreatment. Prazosin, alpha-1 antagonist, suppressed cold- evoked pain behavior when treated either before or after nerve ligation. On the other hand, alpha-2 antagonist yohimbine was without effect on cold-evoked pain behavior whether it was treated before or after the ligation. Conclusions: The results suggest that peripheral nerve injury develops cold-evoked pain that is sympathetically dependent, and that alpha-1 adrenoreceptor plays a critical role for the generation of this type of pain in its initiation as well as maintenance.

• 생물정신의학
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• 제18권3호
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.