• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.98.1-98.1
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• 2003

Bee venom (BY) has been utilized to relieve pain and to treat inflammatory diseases such as rheumatoid arthritis (RA). However, the molecular mechanism by which BV-induced anti-arthritis effect has been not reported yet. Therefore, in the present study we investigated anti-inflammatory effect of BV in a murine marcrophage cell line Raw 264.7 cell and synoviocyte obtained from RA patients. The present data showed that BV has a preventive effect on lipopolysaccharide (LPS) and sodium nitroprusside (SNP) induced induction of COX-2, cPLA2 and iNOS. (omitted)

• 대한정형외과학회지
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• 제55권1호
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• pp.1-8
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• 2020

고령화의 진행 및 근골격계 질환의 증가로 인해 여러 가지 수술적 치료 방법을 포함한 침습적인 치료 방법이 증가되고 있으나 수술적 치료 시행 전 보존적 치료는 충분히 시행되어야 한다. 보존적 치료 중에서 통증 조절을 위한 약물 치료는 오래 전부터 보존적 치료의 가장 대표적인 치료 방법으로 사용되어 왔고 여전히 가장 흔히 사용되는 방법이다. 통증 조절을 위한 약물로는 아세트아미노펜(acetaminophen), 비스테로이드성 항염증제(non-steroidal anti-inflammatory drugs), 스테로이드(steroid), 마약성 진통제(opioid), 항우울제(antidepressants) 등이 있으며 저자는 마약성 진통제 및 항우울제에 대해서 살펴보고자 한다. 통증으로 인해 말초 부위에 있는 통각 수용체에 자극이 전달되면 통증은 중추 신경계로 전달되는 상향성 경로(ascending pathway)를 거쳐 대뇌에 전달되고 대뇌는 통증을 조절하기 위해 하향성 조절 경로(descending pathway)를 통해 엔도르핀(endorphin)과 같은 내인성 마약성 진통제를 분비하게 된다. 마약성 진통제라는 것은 마약성 진통제 수용체(receptor)에 작용하는 물질을 통틀어서 일컫는 말로 마약성 진통제는 세 가지의 수용체가 존재하며 조직이나 환자의 전신 상태에 따라서 각각의 수용체에 대한 친화성이 달라진다. 이와는 달리 항우울제는 중추신경계의 시냅스에 작용하여 통증을 조절하는 상향성 경로를 조절하는 것이 주된 기전으로 만성통증과 신경병성 통증에 효과적이며 이는 마약성 진통제 계열과 효과가 유사한 것으로 알려져 있다. 본 종설에서는 이러한 마약성 진통제와 항우울제의 효과적인 사용 방법, 사용 시 유의점 및 부작용 등에 대해 다루고자 한다.

• Journal of Oral Medicine and Pain
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• 제45권1호
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• pp.12-16
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• 2020

Chronic otitis media (COM) is a chronic inflammatory disease which affects the middle ear, mastoid cavity. It presents hearing loss, ear pain, dizziness, headache, temporomandibular joint (TMJ) inflammation and intracranial complication. Intracranial complications such as skull base osteomyelitis (SBO) may occur secondary to COM due to transmission of infection by a number of possible routes. SBO is an uncommon condition with a significant morbidity and mortality if not treated in the early stages. We report a-67-year-old male patient with diabetes and untreated COM who presented atypical severe TMJ, periorbital and postmandibular pain. By computerized tomography (CT), magnetic resonance imaging (MRI) and whole body bone scan (WBBS), he was diagnosed with SBO spreading from untreated COM via infective arthritis of TMJ. Through this case, we suggest proper utilization of diagnostic imaging, especially CT or MRI for the early detection of SBO in the case of COM accompanying with the greater risk of infection developments such as diabetes.

• The Korean Journal of Pain
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• 제36권1호
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• pp.51-59
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• 2023

Background: This study investigated the effect of an excess and a deficit of spinal 5-hydroxytryptamine (5-HT) on the mechanical allodynia and neuroglia activation in a rodent pain model of carrageenan inflammation. Methods: Male Sprague-Dawley rats were implanted with an intrathecal (i.t.) catheter to administer the drug. To induce an excess or deficit of 5-HT in the spinal cord, animals were given either three i.t. 5-HT injections at 24-hour intervals or a single i.t. injection of 5,7-dihydroxytryptamine (5,7-DHT) before carrageenan inflammation. Mechanical allodynia was measured using the von Frey test for 0-4 hours (early phase) and 24-28 hours (late phase) after carrageenan injection. The changes in the activation of microglia and astrocyte were examined using immunofluorescence of the dorsal horn of the lumbar spinal cord. Results: Both an excess and a deficit of spinal 5-HT had no or a minimal effect on the intensity of mechanical allodynia during the early phase but prevented the attenuation of mechanical allodynia during the late phase, which was observed in animals not treated with i.t. 5-HT or 5,7-DHT. Animals with an excess or deficit of 5-HT showed stronger activation of microglia, but not astrocyte, during the early and late phases, than did normal animals. Conclusions: Imbalance in the descending 5-HT pathway in the spinal cord could aggravate the mechanical allodynia and enhance the activation of microglia, suggesting that the spinal 5-HT pathway plays an essential role in maintaining the nociceptive processing in balance between facilitation and inhibition in inflammatory pain caused by carrageenan inflammation.

• 대한한방부인과학회지
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• 제21권1호
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• pp.99-116
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• 2008

Purpose: This study was performed to evaluate anti-inflammatory effects of Hyulbuchukeotanggamibang water extract (HBCT). Methods: In the study of anti-inflammatory effects, HBCT was investigated using cultured cells and a murine models. As for the parameters of inflammation, levels of several inflammatory cytokines and chemical mediators which are known to be related to inflammation were determined in mouse lung fibroblast cells (mLFCs) and RAW264.7 cells. Results: Prior to the experiment, we investigated the cytotoxicity of HBCT. HBCT showed a safety in cytotoxicity on mLFCs. In experiment of anti-inflammatory effect, HBCT effected scavenging activity on DPPH free radical, superoxide dismutase and superoxide anion radical. HBCT inhibited $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, COX-2 and NOS-II mRNA expression in a concentration-dependent manner in RAW264.7 cell line, and inhibited significantly $IL-1{\beta}$, IL-6, $TNF-{\alpha}$ production at $100{\mu}g/\;ml$ in a concentration-dependent manner. Conclusion: These results suggest that HBCT can be used for treating diverse female diseases caused by inflammation such as endometriosis, pelvic pain, cervicitis, pelvic inflammatory disease and pelvic tuberculosis and so forth.

• Archives of Pharmacal Research
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• 제26권5호
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• pp.383-388
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• 2003

Bee venom is used as a traditional medicine for treatment of arthritis. The anti-inflammatory activity of the n-hexane, ethyl acetate, and aqueous partitions from bee venom (Apis mellifera) was studied using cyclooxygenase (COX) activity and pro-inflammatory cytokines (TNF-$\alpha and IL-1\beta$) production, in vitro. COX-2 is involved in the production of prostaglandins that mediate pain and support the inflammatory process. The aqueous partition of bee venom showed strong dose-dependent inhibitory effects on COX-2 activity ($IC_{50} = 13.1 \mu$ g/mL), but did not inhibit COX-1 activity. The aqueous partition was subfractionated into three parts by molecular weight differences, namely, B-F1 (above 20 KDa), B-F2 (between 10 KDa and 20 KDa) and BF-3 (below 10 KDa). B-F2 and B-F3 strongly inhibited COX-2 activity and COX-2 mRNA expression in a dose-dependent manner, without revealing cytotoxic effects. TNF-$\alpha and IL-1\beta$ are potent pro-inflammatory cytokines and are early indicators of the inflammatory process. We also investigated the effects of three subfractions on TNF-$\alpha and IL-1\beta$ production using ELISA method. All three subfractions, B-F1, B-F2 and B-F3, inhibited TNF-$\alpha and IL-1\beta$production. These results suggest the pharmacological activities of bee venom on anti-inflammatory process include the inhibition of COX-2 expression and the blocking of pro-inflammatory cytokines (TNF-$\alpha and IL-1\beta$) production.

• 대한간호학회지
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• 제14권2호
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• pp.93-111
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• 1984

The main purpose of this study is to develop a ratio scale measuring level of pain using Korean pain terms. The specific purposes of this study are to identify the degree of pain of each pain term in each subclass: to classify each subclass in terms of dimensions of pain; and to analyze factors of the Korean pain ratio scale clustering together. One hundred an4 fifty eight pain terms which were originally identified as representative terms and their synonyms were used for data collection. Fifty eight nursing professors ana sixty one medical doctors who have contacted with patients having pain were asked to rate the weight of each pain term on a visual analogue scale. Subclasses in which ranks of pain terms were same f s findings in two previous studies were 1) thermal 3 am 2) cavity pressure, 3) single stimulating pain, 4) radiation pain. and 5) chemical pain. Subclasses in which ranks of pain terms were confused were 1) incisive pressure, and 2) cold pain. Subclasses in which one new pain term was added were 1) inflammatory-repeated pain, 2) punctuate pressure, 3) constrictive pressure, 4) fatigue-related pressure, and 5) suffering-relate4 pain. Subclasses in which two new pain terms were added were 1) traction pressure, 2) peripheral nerve pain, 3) dull pain, 4) pulsation-related pain, 5) digestion-related pain, 6) tract pain, and 7) punishment-related pain. Subclass in which 3 new pain terms were included was fear-related pain. Rating scores of 5 words in 4 subclasses were significantly different between the normal group and the extreme group of subjects in terms of subjective rating. Only one word among 6 words was that newly added to the scale. Rating scores of 12 words in 9 subclasses were significantly different between doctor group and nursing professor group. Among these 12 words, only 3 were those newly added to the scale. In comparison of these 12 words, mean scores of the nursing professors were always 7 to 16 points higher than those of the medical doctors. In the analysis of judgement of subjects in terms of dimensions of pain terms, subclasses of dull pain, cavity pressure, tract pain and cold pain were suggested to be included in the miscellaneous dimension. As a result of factor analysis of the ratings given to 96 pain words using principal components analysis without iteration and with varimax rotation limiting the number of factors to 4, factors of severe pain (factor I) mild-moderate pain (factor II) , causative pain (factor III) and temperature-related pain(factor IV) were extracted with the factor loading above 0.388. When the pain words were re-arranged on the bases of factor loading above 0.368, number of factors decreased to only first two factors. Maximum score of pain word in factor II was 46.17 and the minimum score of the factor I was 45.36. Further studies are needed to identify the validity, reliability, sensitivity and practicability of this ratio scale using patients having various sources of pain.

• The Korean Journal of Pain
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• 제13권2호
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• pp.218-223
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• 2000

Background: This study was conducted to evaluate the efficacy of a parenteral nonsteroidal anti-inflammatory agent for management of post-surgical pain and its effect on hospital stay and long-term surgical outcome. Methods: Total of 40 patients undergoing lumbar discectomy were randomly assigned to two groups, receiving either 1) 30 mg intravenous ketorolac upon surgical closure, every 6 hours for 36 hours, and morphine IV PCA (intravenous patient controlled analgesia), or 2) only morphine PCA. A blinded investigator recorded; the visual analog pain scores, total postoperative narcotic consumption, complications by morphine PCA, length of hospitalization (from surgery to discharge), and long-term outcome at 6 weeks. Results: The patients who received IV ketorolac and morphine PCA reported significantly lower visual analog pain scores than patients receiving only morphine PCA. Cumulative morphine doses were significantly lower in the ketorolac group (P<0.001). There was no significant difference between groups in the frequency of side effects related to morphine PCA. Mean length of hospitalization was longer for patients receiving only morphine PCA, but there was no statistical significance. Six weeks after surgery, four (20.0%) patients who received only morphine PCA suffered persistent back pain. In contrary, all those patients who received ketorolac were free of back pain at follow-up (P<0.05). Conclusions: These results suggest that intermittent IV bolus ketorolac, when used with opioid IV PCA is more effective than opioid IV PCA alone for postoperative pain following lumbar disc surgery. However, this strategy did not contribute to early discharge from hospital after lumbar disc surgery. The effect to long-term surgical outcome was not conclusive.

• The Korean Journal of Pain
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• 제18권2호
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• pp.271-274
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• 2005

Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.

• The Korean Journal of Pain
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• 제12권1호
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• pp.64-69
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• 1999

Background: The new drug HP228 is a cytokine restraining agent with a broad spectrum of anti-inflammatory, analgesic, and antipyretic activity. Six healthy, adult, male volunteers were studied to determine the independent and interactive effects of HP228 and morphine on pain perception. Methods: Two groups of stimuli were applied to each volunteers before drug administration as control, 20 min after morphine and HP228 administration, and 20 min after combined administration of these two drugs. Two adhesive electrically-conducting pads were applied on opposite sides of the arm approximately 8 cm apart. The electrode were connected to an electrical impulse generator and 50 Hz 1 msec pulses of incrementally increasing intensity were delivered at 1 sec intervals. The analgesic endpoints were the current intensity (mA) at which the subject first detected the stimulus (THRESH), the intensity at which the stimulus was first idenfied as being painful (PAIN), and the intensity at which the subject requested that the stimulus be terminated due to discomfort (LIMIT). A second series of stimuli were applied immediately thereafter using 1-sec duration 50 Hz tetanus pulses with increasing intensities at 2~5 sec intervals. Results: There were significant differences between drug treatments (Morphine, HP228, HP228/Morphine) and control (No drugs) in any of the measurements (PAIN, LIMIT) except THRESH with the twitch and tetanus test. Conclusions: The data suggests that HP228 is an analgesic, but it does not appear to interact with morphine in an additive manner.