• 대한치과의사협회지
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• 제55권10호
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• pp.696-705
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• 2017

Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.1-8
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• 2016

Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

• 생물정신의학
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• 제8권1호
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• pp.85-95
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• 2001

This study was designed to examine the effects of two antidepressant drugs on the expression of c-fos mRNA in cultured embryonic rat hippocampal neurons. The drugs used were imipramine and amitriptyline. On the fourth day of culture, hippocampal neurons were treated with variable concentrations of each drug. Competitive RT-PCR(Reverse Transcriptase-PCR) analysis was used to quantify the c-fos mRNA expression induced by each drug. Experimental results showed that acute and direct treatment with imipramine and amitriptyline with relatively low concentrations(imipramine ${\leq}10{\mu}M$, amitriptylne ${\leq}10{\mu}M$) had no inductive effect on the expression of c-fos mRNA in the rat hippocampal neurons. However, after treatment with relatively high concentrations(imipramine ${\geq}100{\mu}M$, amitriptyline ${\geq}100{\mu}M$) c-fos mRNA was not detected. These findings suggest the followings. Firstly, the action mechanisms of these drugs on the hippocampal neurons might not be mediated by c-fos but by other immediate-early genes(IEGs). Secondly, their actions may be mediated indirectly via other areas of the brain. Thirdly, the expression of c-fos might be inhibited by high concentrations of these drugs, or the high concentrations could induce cell death. Finally, though cell death remains to be confirmed, the inhibition of c-fos induction or cell death could play a role in the cognitive impairments known to be adverse effects of some antidepressants. This study is believed to be a first step toward understanding the mechanisms of learning and memory. Further studies are needed to investigate the expression of various IEGs and changes in the hippocampal neurons of rat resulting from chronic treatment with antidepressant drugs.

• Journal of Ginseng Research
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• 제45권6호
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• pp.706-716
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• 2021

Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.

• 대한약리학회지
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• 제31권3호
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• pp.299-311
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• 1995

혈소판은 혈전기전의 중요요소로, monoamine성 신경전달물질의 대사에 있어서 신경계와 유사점을 가지고 있다. 따라서 항우울약물인 amitriptyline (AMT)과 sertraline (SRT)의 혈소판응집 억제와 이에 의한 세포내 신호전달 물질의 함량변동 및 단백인산화에 대한 영향을 chlorpromazine (CPZ)과 비교연구함으로써, 이들 약물의 혈소판응집 억제작용의 효능을 검정하고, 항 혈소판 및 항우울 작용기전의 일단을 규명하고자 하였다. SRT, CPZ 및 AMT은 thrombin (0.25 unit/ml)에 의한 혈소판응집을 억제하였으며, 각각의 IC50은 $4.37{\times}10^{-5}\;M$, $5.76{\times}10^{-5}\;M$ 및 $1.15{\times}10^{-4}\;M$이었다. 이러한 억제효과는 A23187$(1.0\;{\mu}M)$및 PMA(320 nM)에 의한 혈소판응집에 대해서도 유사하게 나타났다. thrombin은 혈소판응집과 아울러 thromboxane $B_2$ 및 $prostaglandin\;E_2$ 생성을 유의하게 증가시켰으며, 이러한 arachidonic acid 생성은 CPZ, AMT 및 SRT에 의하여 현저하게 억제되었다. CPZ, AMT 및 SRT은 cAMP 함량을 용량의존적으로 감소시켰으며, SRT, AMT $(1{\times}10^{-4}\;M)$ 및 CPZ $(3{\times}10^{-5}\;M)$은 cGMP 함량을 증가시키는 경향을 보였다. 한편, $Ins(1,4,5)P_3$ 함량은 thrombin 부하 후 10초 이내에 정점에 도달한 후 45초 이후까지 유지된다. CPZ과 AMT은 혈소판의 $Ins(1,4,5)P_3$ 함량을 현저히 증가시키며, thrombin에 의한 증가도 유의하게 증강시킨다. SRT은 혈소판의 $Ins(1,4,5)P_3$을 증가시키나, thrombin 부하 후 증강되지는 않았다. $Ins(1,4,5)P_3$ 증가에 이어서, $[Ca^{2+}]_i$은 thrombin 부하 후 20초에 최고점에 이르며, 이러한$[Ca^{2+}]_i$, 증가는 세 약물에 의하여 현저하게 억제되었다. 혈소판 단백인산화에 대해서, thrombin은 $41{\sim}43\;kDa$ 및 20kDa 단백인산화를 현저하게 증가시켰으며, 이는 AMT, SRT 및 CPZ에 의하여 억제되었다. CPZ, AMT 및 SRT 등의 세 약물은 유의한 항응집효과와 thromboxane생성억제 효과를 나타냈으며, 이들 약물에 의한 protein kinase C 활성억제 및 $Ins(1,4,5)P_3$의 함량증가는 각각 이들약물의 항응집효과 및 항우울성 작용기전과 연관될 수 있음을 시사한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권2호
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• pp.128-133
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• 2015

We present a case of an 8-year-old boy with visceral autonomic neuropathy complicated by Guillain-Barre syndrome. In this pediatric patient, gastroparesis was the major symptom among the autonomic symptoms. Due to the gastroparesis, there was no progress with the oral diet, and nutrition was therefore supplied through a nasojejunal tube and gastrojejunal tube via Percutaneous endoscopic gastrostomy (PEG). After tube feeding for 9 months, the patient's gastrointestinal symptoms improved and his oral ingestion increased. The pediatric patient was maintained well without gastrointestinal symptoms for 3 months after removal of the PEG, had repeated vomiting episodes which lead to the suspicion of cyclic vomiting syndrome. Then he started treatment with low-dose amitriptyline, which resulted in improvement. Currently, the patient has been maintained well for 6 months without recurrence, and his present growth status is normal.

• The Korean Journal of Pain
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• 제11권1호
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• pp.138-142
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• 1998

Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2001년도 International Symposium on Dietary and Medicinal Antimutgens and Anticarcinogens
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• pp.195-195
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• 2001

The inhibitory potentials of TCAs (imipramine, desipramine, amitriptyline, and nortriptyline) on phenytoin p-hydroxylation and probe metabolic pathways of each CYP isoforms were evaluated from incubation studies of human liver microsomes and cDNA-expressed cytochrome P450s in vitro in order to understand the mechanism of drug interaction between TCAs and phenytoin, a substrate of CYP2C9 and CYP2C19. (omitted)

• 약학회지
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• 제43권3호
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• pp.289-293
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• 1999

Many poly (vinyl chloride : PVC) membrane electrodes were investigated for the determination of basic drugs, chlorpromazine, amitriptyline, nortriptyline, etc. These electrodes are based on the use of the ion-association complexes of the basic drugs with eriochrome cyanine R, chromoxane cyanine, chrome azurol S and picric acid as ion-exchange sites in a plasticized PVC matrix. All ion-exchangers except picrate complex were not proper for use, because those complexes in plasticized membrane were excluded into aqueous working solution. These drug electrodes show excellent Nernstian responses in the concentration ranges $10^{-2}~10^{-6}$ mol $dm^{-3}$. Their selectivity with respect to each other, as well as their work-able pH range have been investigated. The major advantages of the proposed methods are their simplicity and speed.

• Journal of Oral Medicine and Pain
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• 제43권3호
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• pp.92-96
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• 2018

A 39-year-old male presented with severe pain in right posterior mandibular teeth and temporal area. Initially, the pain in the mandibular teeth was moderate, but the concomitant headache was unbearably severe. His medical history was non-contributory. The clinical and radiographic examination failed to reveal any pathology in the region. There was no tenderness to palpation in the temporalis and masseter muscles or temporomandibular joints. The clinical impression was migraine. The pain in the teeth and headache were aborted using ergotamine tartrate and sumatriptan succinate. Atenolol prevented further pain, while amitriptyline and imipramine had no effect. Migraine can present as non-odontogenic pain in the mandibular teeth, although not as frequently as in the maxillary teeth. A correct diagnosis is essential to avoid unnecessary dental treatments and to manage pain effectively. Clinicians should be able to identify migraine with non-odontogenic dental pain and establish a proper diagnosis through a comprehensive evaluation.