• Journal of Dental Anesthesia and Pain Medicine
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• 제20권6호
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• pp.403-408
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• 2020

Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

• 생명과학회지
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• 제22권8호
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• pp.1057-1063
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• 2012

간질은 가장 흔한 만성 신경 장애로 70% 이상의 환자에서 항전간제로 증상의 조절이 가능하다. 약물의 치료효과를 예측하는데 있어 개인이 가진 유전적 다형성이 부분적인 영향을 주는 것으로 알려지면서 항전간제의 효과에 영향을 주는 유전자 연구가 빠르게 진행되고 있다. 본 연구에서는 83명의 간질 환자를 대상으로 간질 환자의 약물대사와 관련된 것으로 알려진 유전자(CYP2C9, CYP2C19, ABCB1, SCN1A)의 다형성과 약물부작용의 관계에 대해 연구하였다. 연구 결과, 약물 이상 반응과 약물 용량의 상관관계는 통계적으로 유의한 수준은 관찰되지 않았다. 한편, carbamazepine 계열에서의 환자군에서는 SCN1A 유전자의 인트론 유전자 유전형 CC와 CT 유전형에 비해 TT 유전형에서 약물용량과 연관을 보였으며, 500 mg 이상의 용량을 투약한 환자에서는 TT 유전형에 비해 CC와 CT를 가진 유전형에서 통계적으로 유의한 상관성을 보였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.237-240
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• 2023

Dolichoectasia of the intracranial arteries is a rare condition characterized by elongated and tortuous arteries due to progressive destruction of the vessel walls. Although most patients present with cerebrovascular accidents, our patient presented with intractable facial pain along the distribution of the trigeminal nerve. Clinical examination revealed involvement of the 5th, 7th, and 8th cranial nerves, and subsequent MRI showed dolichoectasia of the left basilar artery. The patient experienced symptomatic relief after a trial of carbamazepine along with botulinum toxin injections.

• 상하수도학회지
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• 제28권2호
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• pp.235-248
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• 2014

The widespread occurrence of dissolved endocrine disrupting compounds(EDCs) and pharmaceutical active compounds(PhACs) in water sources is of concern due to their adverse effects. To remove these chemicals, adsorption of EDCs/PhACs on granular activated carbon(GAC) was investigated, and bisphenol A, carbamazepine, diclofenac, ibuprofen, and sulfamethoxazole were selected as commonly occurring EDCs/PhACs in the aquatic environment. Various adsorption isotherms were applied to evaluate compatability with each adsorption in the condition of single-solute. Removal difference between individual and competitive adsorption were investigated from the physicochemical properties of each adsorbate. Hydrophobicity interaction was the main adsorption mechanism in the single-solute adsorption with order of maximum adsorption capacity as bisphenol A > carbamazepine > sulfamethoxazole > diclofenac > ibuprofen, while both hydrophobicity and molecular size play significant roles in competitive adsorption. Adsorption kinetic was also controled by hydrophobicity of each adsorbate resulting in higher hydrophobicity allowed faster adsorption on available adsorption site on GAC. EDCs/PhACs adsorption on GAC was determined as an endothermic reaction resulting in better adsorption at higher temperature ($40^{\circ}C$) than lower temperature ($10^{\circ}C$).

• The Korean Journal of Pain
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• 제33권2호
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• pp.108-120
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• 2020

From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

• The Korean Journal of Pain
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• 제20권2호
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• pp.174-180
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• 2007

Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.

• Bulletin of the Korean Chemical Society
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• 제17권7호
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• pp.625-630
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• 1996

The cobalt-substituted polyoxotungstate [(CoPW11O39)5-] has been used as a catalyst in olefin epoxidation and alkane hydroxylation reactions. The epoxidation of olefins by iodosylbenzene in CH3CN yielded epoxides predominantly with trace amounts of allylic oxidation products. cis-Stilbene was streoselectively oxidized to cis-stilbene oxide with small amounts of trans-stilbene oxide and benzaldehyde formation. The epoxidation of carbamazepine (CBZ) by potassium monopersulfate in aqueous solution gave the corresponding CBZ 10,11-oxide product. Other transition metal-substituted polyoxotungstates (M=Mn2+, Fe2+, Ni2+, and Cu2+) were inactive in the CBZ epoxidation reaction. The cobalt-substituted polyoxotungstate also catalyzed the oxidation of alkanes with m-chloroperbenzoic acid to give the corresponding alcohols and ketones. The presence of CH2Br2 in the hydroxylation of cyclohexane afforded the formation of bromocyclohexane, suggesting the participation of cyclohexyl radical. In the 18O-labeled water experiment, there was no incorporation of 18O into the cyclohexanol product when the hydroxylation of cyclohexane by MCPBA was carried out in the presence of H218O. Some mechanistic aspects are discussed as well.

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2005년도 가을학술대회
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• pp.169-174
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• 2005

의약품은 일반적으로 치료를 목적으로 제조되었기 때문에 독특한 약리학적 작용을 띤다. 의약품잔류물이 환경 중으로 배출되어 비표적 생물(non-target organism)에 노출될 경우 의도하지 않은 독성영향이 나타날 가능성이 있다. 본 연구에서는 우리나라에서 널리 사용되는 10개의 의약품(4종의 일반 의약품 acetaminophen, carbamazepine, diltiazem, cimetidine과 6종의 설파계 항생제 sulfamethoxazole, sulfamethazine, trimethoprim, sulfachloropyridazine, sulfadimethoxine)을 대상으로 환경중 예상잔류농도와 생태 무영향농도를 예측하여 대상의약품의 생태위해성을 평가하였다. 연구대상 의약품의 예측환경농도는 0.14 ${\sim}$ 16.5 ppb이었으며, 예측환경농도와 예측무영향농도비(PEC/PNEC ratio)를 산출한 결과 acetaminophen과 suifamethoxazole이 각각 1.8과 6.3으로 나타나 이 의약품들이 물생태계에 미치는 위해성에 대한 정밀한 추가연구의 필요성이 제시되었다.

• Membrane and Water Treatment
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• 제1권2호
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• pp.93-101
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• 2010

This study examined the effects of feed water chemistry and membrane fouling on the rejection of trace organics by a loose nanofiltration membrane. One ionisable and one non-ionisable trace organics were selected for investigation. Results reported here indicate that the solution pH and ionic strength can markedly influence the removal of the ionisable trace organic compound sulfamethoxazole. These observations were explained by electrostatic interactions between the solutes and the membrane surface and by the speciation of the ionisable compound. On the other hand, no appreciable effects of solution pH and ionic strength on the rejection of the neutral compound carbamazepine were observed in this study. In addition, membrane fouling has also been shown to exert some considerable impact on the rejection of trace organics. However, the underlying mechanisms remain somewhat unclear and are subject to on-going investigation.

• 대한환경공학회지
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• 제37권3호
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• pp.182-190
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• 2015

본 연구에서는 장성에 위치한 황룡강에서 채취한 모래를 이용하여 유기물질과 의약화합물 제거효율을 평가하고 의약화합물의 제거 메커니즘을 규명하고자 하였다. 회분식 실험 및 칼럼 실험으로 대수층 함양관리기술을 모사하였으며, 모든 실험은 담양 하수처리장의 의약화합물이 포함된 최종방류수를 원수로 하여 구동하였다. 회분식 실험 및 칼럼 실험을 통해 유기물질과 의약화합물은 토양 유기물질과 미생물 활성도에 영향을 받아 제거되는 것을 보였다. 유기물질 제거는 생물학적 조건에서 잘 되는 것으로 나타났다. 중성과 양이온 의약화합물(iopromide, estrone 및 trimethoprim)의 경우에는 일반 모래, 구운 모래를 사용한 회분식 실험 모두 70% 이상의 제거효율을 나타냈다. 반면, carbamazepine의 경우는 회분식과 칼럼 실험에서 제거가 잘 이루어지지 않았다. 음이온 의약화합물 (ketoprofen, ibufrofen 및 diclofenac)의 경우 모래 표면의 SOM과 미생물 활성도에 영향을 받아 제거가 되는 것을 보였다. 회분식과 칼럼 실험을 바탕으로 생물학적 영향과 수착이 대수층 함양관리기술에서 의약화합물 제거에 주요한 메커니즘으로 나타났다.