• 정신신체의학
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• 제7권1호
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• pp.51-60
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• 1999

본 연구에서는 불안과 우울감과 같은 정서상태가 만성적인 통증 인지와 상관관계가 있는지를 알아보고자 PTSD 환자군의 압통에 대한 역치와 불안증상, 우울증상의 정도를 측정하였고, 불안, 우울증상의 정도와 압통역치의 상관관계를 대조군과 비교하였다. 연구대상 환자군은 1997년 10월부터 1998년 3월까지 중앙대학교 의과대학 부속필동병원 및 용산병원 신경정신과에 입원한 환자와 외래환자들 중에서 PTSD에 진단된, 20-60세에 해당되는 성인 남자환자 23명을 대상으로 하였다. 결과는 다음과 같다. 1) PTSD 환자군에서 통계적으로 의미있게 높은 우울증상과 불안증상을 보였다(p<.05). 2) 압통에 대한 역치는 환자군에서 유의하게 높은 결과를 보였다(p<.05). 이런 결과를 보인 요인으로는, 환자군의 불안증상보다는 만성적인 우울증상이 통증역치의 증가에 부분적으로나마 영향을 주었을 것으로 추정되며 그외에 환자군에서의 opiate system의 이상, 환자군의 질병역할, 환자군이 처한 여러 사회환경적인 상황의 영향 등과 같은 여러 요인이 관련되었을 것이라고 생각한다. 결론적으로 PTSD의 만성 통증은 감정, 특히 우울증과 관련이 있을 것으로 보였으나, 그 인과관계에 대한 결론을 내리기에는 미흡한 점들이 있다. 앞서 언급한 여러 제한점들을 보완한 향후 연구를 통해 정서적 증상과 동통과의 보다 특이적인 연관성을 규명하는 연구가 필요할 것이라 생각한다.

• 대한물리치료과학회지
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• 제7권2호
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• pp.533-543
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• 2000

This study was designed to evaluate the analgesic effect of low power GaAsAl laser on the pain threshold of mechanical stimulation using different treatment points, acupuncture point (zusanli) and non-acupuncture points(back). Furthermore, we investigated the analgesic effect of low power GaAsAl laser using the different duration and intensity of laser in mechanical stimulation induced pain behavior. The results were summarized as follows: 1. The threshold of mechanical stimulation was significantly increased by GaAsAl laser stimulation into zusanli point after 15 and 30 min after laser stimulation(P<05). However, the laser stimulation into non-acupoint did not affect the pain threshold of mechanical stimulation. with dose dependent manner. 2. In order to investigate the analgesic effects of BV depending upon different intensities of laser stimulation, the experimental animals were divided into three groups: 3 mW treated group, 6 mW treated group and 10 mW treated group. The low power GaAsAl laser stimulation was applied into zusanli acupoint for 30 min with different intensity of laser stimulation. Six and ten mW of laser stimulation significantly increased the pain threshold of mechanical stimulation at 15 min after laser stimulation as compared to that of control group(P<.05). Moreover, the analgesic effect of 10 mW laser stimulation was maintained for 30 min after laser stimulation (P<.05). 3. Finally, we tested the analgesic effect of 10 mW laser stimulation using different duration such as 10 min, 30 min or 1 hr after application of mechanical stimulation. In 30 min treatment group, the pain threshold of mechanical stimulation was increased at 15min and 30min after laser stimulation(P<.05). However, laser stimulation for 60 min dramatically increased the pain threshold of mechanical stimulation at 0 min after laser stimulation and the analgesic effect of laser stimulation was observed until 1 hr after laser stimulation. In conclusion, these data apparently demonstrate that low power GaAsAl laser has analgesic effect on mechanical induced pain model in rats. In addition, the treated point, intensity and duration of laser stimulation should be concerned before clinical application for pain management purpose.

• The Journal of Korean Physical Therapy
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• 제26권6호
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.243-250
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• 2012

임플란트 수술이나 발치 같은 침습적인 치과치료로 인한 삼차신경 손상의 증가는 최근 치과계의 가장 민감한 문제의 하나로서 향후 법적인 문제로 까지 이어질 수 있다. 그러므로 신경손상에 대한 객관적이고 신뢰성 있는 평가 즉, 정량적 감각신경 검사(quantitative sensory testing)의 필요성이 강조되고 있으며, 온도역치 검사는 QST의 필수 항목으로 구강영역에서도 신뢰성이 입증되어 있다. 국내에서는 삼차신경손상과 관련한 온도역치 검사에 대한 보고가 아직 없기에, 본원에서 시행한 일부 증례의 온도역치 검사의 결과를 평가하고자 하였다. 2011년 5월부터 2012년 10월까지 단국대학교 치과대학 부속 치과병원 구강내과에 내원한 삼차신경손상이 의심되는 환자중 온도역치 검사를 시행한 18명의 환자 자료를 분석하였다. 환자들의 냉인지역치(cold detection threshold, CDT)는 이환측이 비이환측에 비해 유의하게 낮았으나 온인지역치(warm detection threshold, WDT), 냉통각역치(cold pain threshold, CPT), 열통각역치(heat pain threshold, HPT)는 통계적 차이를 보이지 않았다. 향후 더 많은 피검자를 대상으로 온도 자극과 관련하여 감각저하나 감각과민, 통각저하나 통각과민 같은 유형별 비교 연구가 필요하다.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.97-105
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• 2002

The purpose of this study was to investigate the effectiveness of the low-intensity ultrasound (noblelife) treatment on the pain points of upper trapezius muscle. The study recruited 20 patients who had trigger points in one side of the upper trapezius. The effectiveness of the low-intensity ultrasound treatment was assessed with subjective pain intensity using visual analog scale (VAS) and pressure pain threshold (PPT). The PPT was measured by pressure threshold algometer. Before and after the treatment, changes of pain were evaluated. Wilcoxon test for VAS data and paired t-test for PPT data were used for statistical significance. Compared to the pain intensity before the treatment, the pain intensity after treatment was significantly decreased (p<.05). Low-intensity ultrasound could be safely used in clinical application and at home for the treatment of patients with pain in upper trapezius muscle.

• Journal of Pharmaceutical Investigation
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• 제36권3호
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• pp.185-192
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• 2006

The purpose of this study was to determine the effects of iontophoresis on transdermal delivery of procaine hydrochloride in healthy volunteers, as well as to the synergic effect of high voltage current or ultrasound on the efficacy of transdermal delivery of iontophoresis. Forty healthy volunteers were randomly assigned to four groups topical application group (TA), iontophoresis group (IT), pre-treatment of high voltage current stimulation with iontophoresis (HVS + IT), and pre-treatment of ultrasound application with iontophoresis (US + IT). All subjects received procaine iontophoresis on the forearm using direct current with 4 mA f3r 15 minutes. All subject was measured the duration of local anesthesia, pressure pain threshold, pain perception threshold using rectangular wave at 0.2 ms, 1 ms, 50 ms of rectangular current stimulation after procaine iontophoresis. For comparisons of the sensory characteristics and efficacy of iontophoresis between the groups, an one-way ANOVA and Kruskal-Wallis were used. The significant difference the duration of local anesthesia were found between the groups (p<0.001). The local anesthetic duration of IT, HVS+IT were significantly longer than TA. Meanwhile, the local anesthetic duration of US+IT was significantly longer than HVS+IT, IT and TA group (p<0.05). Also, the pressure pain threshold, pain perception threshold at 0.2 ms, 1 ms, 50 ms were significant difference between the groups (p<0.001). All sensory characteristics including pressure pain threshold, pain perception threshold of IT, HVS+IT was significantly increased than TA, whereas, US+1T was significantly increased HVS+1T, IT and TA (p<0.05). This study showed that the procaine iontophoresis have increase the duration of local anesthesia concomitantly pressure pain threshold and pain perception threshold of sensory nerve fibers such as $A-{\beta}$, $A-{\delta}$ and C fiber. This findings suggest that the iontophoresis enhanced the transdermal delivery of drug ions in vivo. The combination of ultrasound application and iontophoresis synergized the transdermal delivery of drug ions. It is suggests that an electric field, mechanical and heating property of ultrasound may contribute to synergic effect due to temporary changes of structure in the stratum corneum.

• Journal of Oral Medicine and Pain
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• 제32권2호
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• pp.219-225
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• 2007

본 연구는 측두장애환자의 주 증상인 턱관절 및 주위 조직의 통증 처치에 있어 capsaicin도포에 따른 영향을 평가하고자 실험 결과에 영향을 미칠 수 있는 전신질환이 없는 건강한 성인 20명에서 냉찜질 적용, 0.025% capsaicin 크림, 0.075% capsaicin 크림 도포후 $Neurometer^{(R)}$ CPT/C (Neurotron, Baltimore, Maryland, USA)로 전류인지역치와 동통내성역치를 측정하여 다음의 결과를 얻었다. 1. C 신경섬유에서 측정된 전류인류인지역치가 기준치에 비하여 0.075% capsaicin 크림도포후에 유의하게 증가하여 감각감퇴를 보였으며, 냉찜질과 0.025% capsaicin 크림도포 및 0.075% capsaicin 크림 도포후에는 capsaicin 크림 도포후에 유의한 감각감퇴를 나타내었다. 2. $A{\beta}$ 신경섬유의 동통내성역치는 기준치에 비하여 냉찜질과 0.075% capsaicin 크림에서 유의하게 증가하였으며, $A{\delta}$ 신경 섬유에서는 기준치에 대하여 냉찜질과 0.025% capsaicin 크림도포시가 유의하게 증가하였고, C 신경섬유 측정시는 기준치에 비하여 0.025% capsaicin 크림도포시에 유의하게 증가하였다. 3. 동통내성역치시의 견디는 통증정도를 표시한 가시상 척도상에서는 0.075% capsaicin 크림 도포후에 C 신경 섬유측정시가 7.18로 기준치의 6.48에 비하여 유의하게 높았다.

• Journal of Acupuncture Research
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• 제19권3호
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• pp.77-87
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• 2002

Like acupuncture, magnetic therapy has been known to yield effectiveness when it is applied to relieve from fatigue, musculoskelectal diseases, sore sites, rheumatic arthritis and chronic pain syndromes. However, combined application of acupuncture and magnet has not yet been studied. This study is designed to investigate effectiveness of acupuncture therapy when in the magnetic field for the pain relief. Magnetic field was made by magnetic ring ($7{\psi}{\times}2.3{\psi}{\times}1.5mm$). Twenty-one male swimmers with latent muscular pain at the GB21 area in the university course of physical education in Daegu were chosen and divided into three groups; 1) acupuncture treatment group (n=7), 2) acupuncture treatment with iron ring group (n=7), 3) acupuncture treatment with magnetic ring group (n=7). Manual Acupuncture was given to the GB21 point for 20 minutes. The degree of pressure pain threshold (PPT, $kg/cm^2$) in GB21 was measured with algometer. Before acupuncture treatment, the PPT values were $6.08{\pm}1.69$, $6.39{\pm}1.72$ and $5.59{\pm}1.11$ in acupuncture treatment group, acupuncture treatment with iron ring group, acupuncture treatment with magnetic ring group, respectively. After acupuncture treatment, the PPT values were $6.48{\pm}2.33$, $6.31{\pm}1.31$ and $6.59{\pm}1.80$, respectively. Pressure threshold was significantly increased in the acupuncture treatment with magnetic ring group compared to the other groups. Based on these results, acupuncture treatment with magnetic ring produced better effects on pain threshold, and these effects can be considered to be associated with the currents or voltages induced by the acupuncture needle and magnetic ring at present.

• 대한약침학회지
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• 제8권2호
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• pp.83-90
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• 2005

Objective : This study was performed to compare needle acupuncture combined herbal acupuncture therapy with only needle acupuncture therapy in VAS and pain threshold. Methods : We used pressure algometer to evaluate the change of pain threshold before and after treatment. The numberical value of pressure algometer is obtained twice and averaged by identical acupuncturist. Visual analogue scale(VAS) was used to estimate the efficacy of needle acupuncture combined herbal acupuncture therapy. Result : The following results were obtained; 1. The significant difference in VAS was showed before and after treatment in only needle acupuncture therapy. 2. The significant difference in pain threshold and VAS was showed before and after treatment in needle acupuncture combined herbal acupuncture therapy. 3. In the pain threshold, the significant difference between only needle acupuncture and needle acupuncture combined herbal acupuncture therapy was not showed. 4. Needle acupuncture combined herbal acupuncture therapy showed the more effective change of VAS than only needle acupuncture therapy. Conclusions : In the pain control, needle acupuncture combined herbal acupuncture therapy is more effective than only needle acupuncture therapy.

• Journal of Acupuncture Research
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• 제29권4호
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• pp.25-34
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• 2012

Objectives : This study was conducted to investigate the effects of fixed-intensity and varied-intensity electroacupuncture in pain and sensory threshold concerning parameters visual analogue scale(VAS), brief pain inventory(BPI) and quantitative sensory testing(QST), among chronic tension headache patients. Methods : Thirty patients with chronic tension headache were randomly assigned to three groups and received different kinds of electroacupuncture at $ST_{36}$ and $ST_{37}$. Group A received fixed-intensity electroacupuncture(fixed-EA), group B received varied-intensity electroacupuncture (varied-EA), and group C received only acupuncture treatment without electrical stimulation as a control group. The intervention was given three times per week, and continued in two weeks. All the experiments were conducted blindly. Results : Fixed-EA group showed a significant decrease of VAS and BPI compared to the baseline measurement, while both varied-EA and control group did not. Of the parameters of QST, subtraction of heat pain threshold(HPT) and cold pain threshold(CPT) slightly increased in all groups, but this was not significant. Conclusions : These results suggest that fixed-EA reduce pain and improve quality of life in patients with chronic tension headache and that acupuncture may regulate patient's pain sensitivity through changing sensory threshold.