• Title/Summary/Keyword: Persistent Pain

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Effects of Hydrogen Peroxide on Neuronal Excitability and Synaptic Transmission in Rat Substantia Gelatinosa Neurons

  • Son, Yong;Chun, Sang-Woo
    • International Journal of Oral Biology
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    • v.32 no.4
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    • pp.153-160
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    • 2007
  • The superficial dorsal horn, particularly substantia gelatinosa (SG) in the spinal cord, receives inputs from small-diameter primary afferents that predominantly convey noxious sensation. Reactive oxygen species (ROS) are toxic agents that may be involved in various neurodegenerative diseases. Recent studies indicate that ROS are also involved in persistent pain through a spinal mechanism. In the present study, whole cell patch clamp recordings were carried out on SG neurons in spinal cord slice of young rats to investigate the effects of hydrogen peroxide on neuronal excitability and excitatory synaptic transmission. In current clamp condition, tert-buthyl hydroperoxide (t-BuOOH), an ROS donor, depolarized membrane potential of SG neurons and increased the neuronal firing frequencies evoked by depolarizing current pulses. When slices were pretreated with phenyl-N-tert-buthylnitrone (PBN) or ascorbate, ROS scavengers, t-BuOOH did not induce hyperexcitability. In voltage clamp condition, t-BuOOH increased the frequency and amplitude of spontaneous excitatory postsynaptic currents (sEPSCs), and monosynaptically evoked excitatory postsynaptic currents (eEPSCs) by electrical stimulation of the ipsilateral dorsal root. These data suggest that ROS generated by peripheral nerve injury can modulate the excitability of the SG neurons via pre- and postsynaptic actions.

악관절 과두걸림 증례에 시행된 악관절 세정술 160예의 임상효과

  • Lee, Tae-Yeong;Song, U-Sik;Baek, Gyeong-Sik;Gwon, O-Seung;Sin, Ju-Seop
    • The Journal of the Korean dental association
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    • v.37 no.6 s.361
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    • pp.445-455
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    • 1999
  • Arthrocentesis is a simple, less invasive, inexpensive, and highly efficient procedure for closed lock of the temporomandibular joint with regard to the lack of recurrence of symptoms during extended periods of follow-up and significiant improvement in pain and jaw function. It can be performed under local anesthesia. Arthrocentesis closed lock provide sustained normal joint function and marked pain relief. This study is the clinical outcome of arthrocentesis for closed lock of the temporomandibular joint. 160 patients(169 joints) who had experienced sudden-onset, persistent limited mouth opening were the subjects of this study. Arthrocentesis of the upper compartment of the affected TMJ was performed using normal saline. As results, at 3-60 months postarthrocentesis maximum mouth opening(MMO) had increased from mean of 27.7mm to 43.5mm, contralateral movements(CLM) from mean 5.74mm to 9.55mm, midline deviation during mouth opening from mean 3.04mm to 0.69mm. In 130 cases there was a history of joint noises, in 52 cases all noise had ceased after procedures.

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Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study

  • Mathala, Venkata Lakshmi;Konathala, Santosh Venkata Ramesh;Gottumukkala, Naga Venkata Satya Sruthima;Pasupuleti, Mohan Kumar;Bypalli, Vivek;Korukonda, Radharani
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.239-253
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    • 2021
  • Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.

Steroid Induced Myopathy in Dermatomyositis Patients (피부근염 환자에서 발생한 스테로이드 유발 위축)

  • Yun, Sang Moon;Kim, Kyung Ah;Kim, Yoon;Hwang, Ji Hye
    • Clinical Pain
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    • v.18 no.1
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    • pp.48-51
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    • 2019
  • Symmetrical proximal weakness and characteristic dermatologic manifestations are important in the diagnosis of dermatomyositis. We report a case of atypical presentation of dermatomyositis due to previous steroid use and also report steroid-induced myopathy which may occur from steroid administration during the course of treatment. A 77-year-old man, previous steroid user, showed rapidly progressing weakness after abruptly stopped medication. He has presented erythematous papule on face and anterior chest but no heliotrope rash and Gottron's papules were observed. Muscle enzyme (creatine kinase) concentration is increased, and needle electromyography shows increased spontaneous activity on proximal limb muscle. The muscle biopsy confirmed dermatomyositis. During the course of treatment, he revealed persistent weakness despite the continuous steroid use and stable creatine kinase level. Electrodiagnostic study suggests steroid-induced myopathy and after tapering steroid, proximal muscle strength improved. This case reports the effect of steroid use on dermatomyositis patients and a process of diagnosing coexisting steroid induced myopathy during treatment.

Bowel Perforation Treated with Acupuncture and Gami-Gamchogungang-tang: A Case Report

  • Hyun-sik Seo;Jun-yeol Kim;Han-eum Ju;Young-min Jo;Hye-ri Bae;Jung-hyo Cho
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.814-822
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    • 2023
  • Objective: This case report details the successful management of bowel perforation through traditional Korean medicine. Often, emergency surgery is required due to potential complications, such as peritonitis. In this case, the patient had previously undergone a total colectomy, making surgical treatment complicated. Methods: The patient revealed persistent abdominal pain and over 20 instances of diarrhea per day. During the course of treatment, which included two hospitalizations and one outpatient visit, acupuncture treatment and herbal medicine were administered. Throughout the treatment period, the intensity of abdominal pain and the frequency of diarrhea gradually decreased. Results: At the end of treatment, a follow-up abdominal computed tomography (CT) scan showed no evidence of perforation. Additionally, blood tests revealed no abnormalities in liver or kidney function, confirming the safety of the treatments.

Medial Ankle Impingement Syndrome due to Talar Osteochondroma and Gout Attack: A Case Report (거골 내측 결절에 발생한 골연골종과 통풍 발작에 의한 발목 내측 충돌 증후군: 증례 보고)

  • Min Gyu Kyung;Dongjun Jeon;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.31-35
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    • 2024
  • Osteochondromas are benign bone tumors typically found in the metaphyseal region of long bones. These tumors are often asymptomatic and detected incidentally. However, their occurrence in atypical sites such as the talus can pose significant diagnostic and treatment challenges. This report describes a rare case of osteochondroma of the medial tubercle of the talus, which is an unprecedented location based on a review of relevant literature. A 28-year-old male presented with worsening medial ankle pain and limping. Imaging revealed a lesion consistent with osteochondroma contributing to medial ankle impingement syndrome. Uniquely, this case also featured a coinciding gout attack in the ankle joint. Surgical removal of the lesion resulted in significant symptom relief and functional improvement. This case underscores the need to consider rare diagnoses, such as talar osteochondroma, when presented with persistent medial ankle pain and highlights the potential presence of concurrent conditions, such as gout.

Treatment of Hip Microinstability with Arthroscopic Capsular Plication: A Retrospective Case Series

  • Tatiana Charles;Marc Jayankura;Frederic Laude
    • Hip & pelvis
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    • v.35 no.1
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    • pp.15-23
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    • 2023
  • Purpose: Hip microinstability is defined as hip pain with a snapping and/or blocking sensation accompanied by fine anatomical anomalies. Arthroscopic capsular plication has been proposed as a treatment modality for patients without major anatomic anomalies and after failure of properly administered conservative treatment. The purpose of this study was to determine the efficacy of this procedure and to evaluate potential predictors of poor outcome. Materials and Methods: A review of 26 capsular plications in 25 patients was conducted. The mean postoperative follow-up period for the remaining patients was 29 months. Analysis of data included demographic, radiological, and interventional data. Calculation of pre- and postoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index was performed. Pre- and postoperative sports activities and satisfaction were also documented. A P<0.05 was considered significant. Results: No major complications were identified in this series. The mean pre- and postoperative WOMAC scores were 62.6 and 24.2, respectively. The WOMAC index showed statistically significant postoperative improvement (P=0.0009). The mean satisfaction rate was 7.7/10. Four patients with persistent pain underwent a periacetabular osteotomy. A lateral center edge angle ≤21° was detected in all hips at presentation. We were not able to demonstrate any difference in postoperative evolution with regard to the presence of hip dysplasia (P>0.05), probably because the sample size was too small. Conclusion: Capsular plication can result in significant clinical and functional improvement in carefully selected cases of hip microinstability.

Characteristics of teeth referred to a dental university hospital for endodontic reason (근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성)

  • Jeon, Su-Jin;Hwang, Soo-Jeong;Seo, Min-Seock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.143-152
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    • 2019
  • Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

Cross-sectional Study on Health Status and Symptom Recognition of Adolescents by Grade (학년에 따른 청소년의 건강상태와 증상인식에 대한 단면조사 연구)

  • Shin, Seon Mi;Park, Jeong Su;Go, Ho Yeon;Kim, Dong Su;Sung, Hyun Kyung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.6
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    • pp.403-410
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    • 2018
  • Lifestyle of adolescents cause a lot of health effects in the future. Therefore, in Korea, school health law was enacted and relevant business such as school education program is being carried out. This study was conducted to recognize symptom according to grade. A survey of youth health status was conducted at 19 middle and high schools in Seongnam city from May 2015 to December 2015. The survey made up of 14 questions which was about the health status satisfaction on the adolescent was conducted to investigate frequency by year and the respective health status of 6 grades. A total of 9,584 students responded to the survey, 58.22% answered that they were not free of constipation. 25.69% of respondents had no symptoms of headache, consequently over 70% of respondents had headache. 57.06% of respondents had no symptoms of low back pain and 34.7% had no symptoms of neck & shoulder pain, therefore over 50% of respondents had muscular skeletal symptoms. In menstrual history, only 17.95% of respondents said their period was regular and painless. In respiratory history, except cold, no nasal drop & obstruction has appeared in the group of 54.02%. And 62.97% of respondents had persistent cough usually with cold and 23.41% had cough with cold breeze even if not catch cold. In the third grade of high school students, there were many complaints of pain in various parts such as headache, back pain and shoulder pain, neck pain and menstrual pain, and there was a high rate of complaints of digestive system symptom and defecation symptom. More than half of respondent had constipation discomfort, headache and musculo-skeletal symptoms, menstrual problems and cough. In the third grade of high school students, the rate of complaints of pain complaints, digestive system symptoms, and bowel symptoms was high. Therefore, there is a need for measures and management for continuous health care and health promotion in accordance with students' symptoms and age at each grade level.

The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.724-732
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    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

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