• The Korean Journal of Pain
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• 제7권1호
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• pp.69-73
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• 1994

A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

• The Korean Journal of Pain
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• 제20권2호
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• pp.190-194
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• 2007

Complex regional pain syndrome (CRPS), which is a syndrome that is defined by pain and sudomotor and/or vasomotor instability, is usually resistant to conventional treatment. Here, a case involving a 30-year-old male patient with CRPS type I who showed severe intractable right shoulder pain with allodynia and hyperalgesia despite being treated with oral medications, nerve blocks including thoracic sympathetic neurolysis, and spinal cord stimulation is described. The patient frequently visited the emergency room due to severe uncontrollable breakthrough pain. Although a favorable effect was observed in response to intermittent ketamine infusion therapies that were performed on an outpatient basis, acute exacerbation of pain occurred frequently during the night and could not be controlled. Therefore, subcutaneous ketamine infusion therapy using a patient-controlled analgesic system was attempted and found to effectively control acute exacerbation of pain during 6 weeks of infusion without serious complications.

• The Korean Journal of Pain
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• 제20권1호
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• 대한한방부인과학회지
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• 제28권3호
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• pp.30-39
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• 2015

Objectives This study aims to analyze Heart Rate Variability (HRV) in women after missed abortion compared with healthy women Methods We studied 35 women who visited Kang-Nam Kyung-Hee Korean Hospital after missed abortion from 01 January 2012 to 28 February 2015 (missed abortion group) and 35 normal women visiting medical examination center from 1 January 2014 to 31 December 2014 (Normal Group). We measured HRV of each women and investigated the difference of HRV between two groups. Results The standard deviation of NN intervals (SDNN) in Missed abortion group is lower than normal group. The square root of the mean square difference of successive NNs (RMSSD) in Missed abortion group is lower than normal group. However there was no significant difference. Total Power (TP) and Low frequency power (LF) is significantly lower in Missed abortion group compared with normal group. High frequency power (HF), Very low frequency power (VLF) and LF/HF ratio in missed abortion group is lower than normal group. but There was no significant difference. Conclusions Missed abortion group is lower in function of overall autonomic nervous system, especially sympathetic nerve.

• 대한한방부인과학회지
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• 제20권3호
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• pp.164-177
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• 2007

Purpose: The purpose of this study is to analysis on the Heart Rate Variability(HRV) of some dysmenorrhoea patients. Methods : We studied 30 patients visiting Kyung Hee University East-West Neo Medical Center from 7th Febrary 2007 to 22th Febrary 2007. Women with organic disease were excluded from this study. The severity of dysmenorrhoea were measured by Multidimensional Verbal Rating scale(MVRS), Verbal Rating scale (VRS) and Visual Analog Scale(VAS). And HRV was recorded. Results : According to comparison of Means of HRV values among the groups of None, Mild and Moderate, the points of almost all values were kept by order of Moderate group-Mild group-None group. Among these, the statistically significant things are PR, SDNN, Ln (TP), Ln (VLF), Ln (LF). According to correlation analysis between dysmenorrhoea and HRV, specially, there were many correlations in VRS2. Among these, the statistically significant things are LF norm, HF norm, LF/HF ratio(p<0.05L). Conclusion : The results suggest that HRV is related to dysmenorrhoea. We may analyze that dysmenorrhoea is related to, specially, increased activities of sympathetic nerve. We need more study for settling this.

• 한국융합학회논문지
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• 제12권2호
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• pp.61-66
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• 2021

본 연구의 목적은 지연성근육통의 통증 변화가 자율신경계와 뇌파에 미치는 영향을 알아보고자 하였다. 지연성 근육통이 유발된 28명을 대조군(n=14)과 실험군(경피신경자극과 키네시오테이핑 적용, n=14)으로 구분하였다. 중재는 지연성근육통 유발 1일 후부터 5일 동안 실시하였다. 평가는 VAS(visual analog scale), 심박변이, 뇌파를 사용하여 지연성근육통 유발 전, 유발 24시간 후, 5일 치료 후, 치료 중단 3일 후에 측정하였다. 실험 결과 지연성근육통이 발생하면 교감신경계의 활성 증가 또는 부교감신경계 활성 억제가 되며, 중재로 인한 통증 감소는 반대의 활동이 나타났다. 통증 발생 시 alpha파의 감소가 나타났으나 유의하지 않았다. 본 연구 결과 통증 변화는 자율신경계와 뇌파에 영향을 미침을 알 수 있었으며, 이러한 결과는 통증 관리와 치료 전략 개발 및 연구에 도움이 될 것이다.

• BMB Reports
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• 제54권6호
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• pp.311-316
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• 2021

Ethanol often causes critical health problems by altering the neuronal activities of the central and peripheral nerve systems. One of the cellular targets of ethanol is the plasma membrane proteins including ion channels and receptors. Recently, we reported that ethanol elevates membrane excitability in sympathetic neurons by inhibiting Kv7.2/7.3 channels in a cell type-specific manner. Even though our studies revealed that the inhibitory effects of ethanol on the Kv7.2/7.3 channel was diminished by the increase of plasma membrane phosphatidylinositol 4,5-bisphosphate (PI(4,5)P₂), the molecular mechanism of ethanol on Kv7.2/7.3 channel inhibition remains unclear. By investigating the kinetics of Kv7.2/7.3 current in high K⁺ solution, we found that ethanol inhibited Kv7.2/7.3 channels through a mechanism distinct from that of tetraethylammonium (TEA) which enters into the pore and blocks the gate of the channels. Using a non-stationary noise analysis (NSNA), we demonstrated that the inhibitory effect of ethanol is the result of reduction of open probability (P_O) of the Kv7.2/7.3 channel, but not of a single channel current (i) or channel number (N). Finally, ethanol selectively facilitated the kinetics of Kv7.2 current suppression by voltage-sensing phosphatase (VSP)-induced PI(4,5)P₂ depletion, while it slowed down Kv7.2 current recovery from the VSP-induced inhibition. Together our results suggest that ethanol regulates neuronal activity through the reduction of open probability and PI(4,5)P₂ sensitivity of Kv7.2/7.3 channels.

• The Korean Journal of Pain
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• 제36권2호
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• pp.216-229
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• 2023

Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

• 대한약리학회지
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• 제21권2호
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• pp.119-127
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• 1985

신장의 기능은 중추신경계 특히 교감신경계의 큰 영향을 받고 있으므로 ${\alpha}$-adrenoceptor의 길항제로 알려진 yohimbine을 가토의 측뇌실내로 (i.c.v.) 투여하여 신장 기능의 변동을 관찰하였다. Yohimbine 10 ${\mu}g/kg$ i.c.v. 로써 일관성인 Na 배설 증가와 함께 뇨량, 신혈류 및 사구체 여과율의 증가 경향을 볼 수 있었으나, 투여량을 증가시키면 그와 같은 작용은 소실되고 100 ${\mu}g/kg$ 과 300 ${\mu}g/kg$에 있어서는 신혈류 및 사구체 여과율의 심한 감소와 함께 현저한 항이뇨 작용과 Na 배설의 감소가 관찰 되었다. 이때 전신 혈압은 일과성으로 증가를 나타내었다. Reserpine 전처치 가토에 있어서는 100 ${\mu}g/kg$ i.c.v. yohimbine에 의한 항이뇨, Na 배설 감소작용, 신혈류 역학의 감퇴등이 소실되어 유의한 변동을 관찰할 수 없었다. 이때 전신 혈압의 상승도 소실 되었다. 일측 신장 신경을 제거하고 반대측 신장을 대조로 둔 표본에 있어서 yohimbine 100 ${\mu}g/kg$을 측뇌실내로 투여하면 대조신에서는 정상 가토에서와 같은 전형적인 항이뇨 작용이 나타났으나, 제신경(실험)신에 있어서는 신혈류 역학에는 변동이 없으나 Na 및 K 배설과 Cosm 및 뇨량의 유의한 증가를 나타냈다. 이때 신세뇨관에서의 Na 재흡수가 억제되었다. 전신 혈압의 변동은 정상 가토에서와 같이 일과성인 증가를 볼 수 있었다. 이상의 실험으로, 가토 측뇌실내 yohimbine은 신기능에 대하여 두 가지 상반되는 영향을 미치며, 첫째는 교감신경 긴장도의 증가로써 신혈류 및 사구체 여과율을 감소시켜 항이뇨 및 Na 배설 감소를 초래하는 작용과, 둘째는 신경 경로를 통하지 않고, 아마도 humoral factor를 통하여 신세뇨관에서 Na 재흡수를 억제하는 작용이 복합적으로 나타내는 것을 알 수 있었다.

• The Korean Journal of Pain
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• 제1권1호
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• pp.106-119
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• 1988

For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.