• The Korean Journal of Pain
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• v.11 no.1
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• pp.36-40
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• 1998

Background: Recently, it has been demonstrated that endothelin(ET) and endothelin related peptides are present in the blood and plasma ET levels are increased after operation. But the causes of increasing plasma ET levels are not clearly understood. This current study was to investigate the relationship between postoperative pain and endothelin. Methods: Thirty adult patients, scheduled for upper abdominal operation under general anesthesia, were included. After operation, epidural catheterization was done for postoperative analgesia. Before induction, on complained of pain and 1 hour after analgesics administration, blood samples were obtained to measure plasma ET levels. Plasma ET concentration was determined by radioimmunoassay. Pain score was measured by visual analogue score(VAS). Mean arterial pressure(MAP) and heart rate(HR) were also recorded every sampling time. Results: There were no significant changes in plasma ET levels at the time before induction versus at the time of the pain complaints and at 1 hour after analgesic administration. Pain score was significantly reduced after epidural analgesia. There was no significant correlations between pain score and plasma ET levels. There were no significant correlation between plasma ET levels and either MAP or HR. Conclusions: These results indicate that there is lack of relationship between postoperative pain and endothelin.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.41-46
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• 1998

Background: Preoperative analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurons and therefore may preempt postoperative pain. Although preemptive analgesia has shown to decrease postinjury pain in animals, studies in human are not consistent. We studied whether epidural morphine injection before surgical incision could affect postoperative pain and analgesic demands, compared with injection after removal of specimen. Methods: Forty patients scheduled for radical subtotal gastrectomy were randomly assigned to one of two groups for prospective study in a double-blind manner. Group 1 received an epidural injection of 3 mg of morphine in 8 ml of 0.9% saline before surgical incision, and Group 2 after removal of specimen. Postoperative pain relief was provided with I.V. patient controlled analgesia (PCA) system. Numerical rating scales for pain and mood, Prince Henry Hospital scores for pain, cumulative PCA analgesic consumptions, and incidence of side effects were assessed at 2, 6, 12, 24, 48 hours after operation. Results: Cumulative PCA analgesic consumption in group 1 was significantly less than in group 2 at 2, 6 hours after surgery. Pain scores and the incidence of side effects were similar in both groups. Conclusions: Preoperative analgesia with epidural morphine showed little difference in patient controlled analgesic consumption after upper abdominal surgery compaired to intraoperative morphine.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.3
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• pp.133-140
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• 2004

The purpose of the present study was to elucidate the possible involvement of the medial vestibular nucleus (MVN) and inferior vestibular nucleus (IVN) following acute hypotension in the vestibuloautonomic reflex through vestibulosolitary or vestibuloventrolateral projections. Acute hypotension-induced cFos expression was assessed in combination with retrograde cholera toxin B subunit (CTb) tract tracing. After injection of CTb into the solitary region, CTb-labeled neurons were located prominently around the lateral borders of the caudal MVN and medial border of the IVN. The superior vestibular nucleus also had a scattered distribution of CTb-labeled neurons. After injection of CTb toxin into the unilateral VLM, the distributions of CTb-labeled neurons in the MVN and IVN were similar to that observed after injection into the solitary region, although there were fewer CTb-labeled neurons. In the caudal MVN, about 38% and 13% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. In the IVN, 14% and 7% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. Therefore, the present study suggests that acute arterial hypotension may result in activation of vestibulosolitary pathways that mediate behavioral and visceral reflexes, and vestibuloventrolateral medullary pathways that indirectly mediate vestibulosympathetic responses.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.5
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• pp.505-513
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• 1997

To search the correlations between electrical activity and c-Fos expression in the process of vestibular compensation, we examined the changes of those two parameters in the medial vestibular nuclei (MVN) of unilaterally labyrinthectomized (ULX) rats. Spontaneous nystagmus with fast component toward the intact side disappeared gradually within 48 hours. Fourty eight hours after ULX, directional preponderance of the eye movement induced by sinusoidal rotation of the whole body which represents the symmetry of bilateral vestibular functions showed less than 20% by rotation of 0.1, 0.2, and 0.5 Hz, indicating the recovery of symmetry in bilateral vestibular functions. Six hours after ULX, spontaneous electrical activity of type I neurons resulted in asymmetry between bilateral MVN, however, the asymmetry of the electrical activity was decreased 48 hours after ULX. Immunocytochemical staining revealed that ULX produced dramatic induction of c-Fos positive cells in the MVN bilaterally. The number of c-Fos immunoreactive cells in the contralateral MVN was significantly higher than those in the ipsilateral MVN (p＜0.0001) 2 hours after ULX. Thereafter, the number of c-Fos positive cells decreased bilaterally and was slightly, but not significantly higher in the ipsilateral MVN at 48 hours after ULX. The present results suggest that both electrical activity of type I neurons and c-Fos expression in MVN following ULX will reflect underlying mechanisms of recovery process of vestibular compensation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.294-305
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• 2009

Purpose: This retrospective study evaluated the changes in hyoid bone and tongue positions as well as oral cavity volume after mandibular setback by BSSRO. Materials and Methods: 18 Koreans who underwent BSSRO to correct mandibular prognathism were studied. Lateral cephalograms were taken and traced preoperatively (T0), immediately (T1) and approximately 6 months postoperatively (T2). Submentovertex radiograghs were taken and traced before surgery (T0) and about 6 months after surgery (T2). The area and volume of oral cavity, the vertical and horizontal dimensions of the hyoid bone and tongue dorsum were measured. Results: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume. The hyoid bone displaced posteroinferiorly immediately after surgery, and it tended to return to its original vertical position at 6 month after mandibular setback by BSSRO. The retropalatal space around tongue was maintained and the retrolingual space around tongue was reduced immediately postoperatively. The readaptation of tongue was not evident for that the follow up period was not long enough. No significant statistical correlations between the amounts of mandibular setback and the changes of oral cavity volume were observed. Conclusion: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume, which was most likely attributable to the posterior movement of the mandible. More subjects and long-term observations should be performed to assess the changes of oropharyngeal configuration following mandibular setback surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.229-235
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• 2010

Purpose: This study examined the significance of increased bone density according to time after implantation on maxilla using demographic data with CBCT and compared the bone density between before vs. after implantation using the Hounsfield index. Materials and Methods: Twenty-five implant site on maxilla were selected. Cone-beam computerized tomography (CBCT) scans were used for the analysis. The implant sites were evaluated digitally using the Hounsfield scale with EzImplant TM and the results were compared over time. Statistical data over time was carried out to determine the correlation between the recorded Hounsfield unit (HU) over time and gender difference using repeated ANOVA. Results: The bone density of implantation site over time showed an increase in the HU mean values. Immediately after implantation, bone density was significantly increased than bone density before implantation. Until 6 month follow-up, bone density showed stable increasement. There is no significant difference on gender. Conclusions: Using CBCT, bone density increased over time after implantation on maxilla. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density and stability of implant.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.99-103
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• 2012

Purpose: Many surgical methods for reconstruction of orbital floor fracture have been reported, which include subciliary approach, transconjunctival approach, transantral and transnasal endoscopic approach, etc. The purpose of this study is to demonstrate a surgical technique and analyze the results of transnasal endoscopic approach with Foley catheter ballooning without implantation of artificial surgical material through subciliary approach. Methods: Between February 2007 and November 2010, 29 orbital floor fracture patients, who had no herniated muscles through bone fragments, were treated through transnasal endoscopic approach with Foley catheter ballooning. Under the endoscopic view, the operator identified the opening of maxillary sinus. After widening of the opening using forceps, the operator reduced the fragmented bone with curved suction tip. Thereafter, 18-Fr Foley catheter was inserted. Four weeks after the operation, the catheter was removed. Results: Preoperatively, 6 patients had diplopias, 4 patients had limitations of extraocular motions and 3 patients had enophthalmos. After removal of the Foley catheter 4 weeks after the operation, 2 patients had diplopias, 1 patient had a limitation of extraocular motion, 1 patient has an enophthalmos and 1 patient had numbness on the cheek. These symptoms were resolved about 6 months after the surgery. Conclusion: The operative technique of Foley catheter ballooning through transnasal endoscopic approach without implantation of the artificial surgical material through subciliary approach can be considered one of the appropriate techniques for orbital floor fracture.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.205-221
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• 2018

This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.

• The Journal of Korean Academy of Prosthodontics
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• v.25 no.1
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• pp.227-242
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• 1987

This study was designed to investigate the pulpal effects of the glass ionomer cement. (Lining cement, G-C Co. Japan) For this purpose, 10 cats were selected, and Class V cavities were prepared on canines of the cats. One experimental group was filled with glass ionomer cement and the other group was filled with zinc phosphate cement . (G-C Co, Japan) The animals of the experimental and control group were sacrificed at 1,2,3,4,6, weeks after the experiment. For comparison of reparative dentin formation pattern in direction of the pulpal and fractured lateral surface, each of them was observed with scanning electron microscope. The findings led to the following conclusions; 1. Reparative dentin of the glass ionomer cement and zinc phosphate cement filling groups were formed on the internal surface of dentin as the shape of hemispherical and spherical with a rough surface. 2. Some of reparative dentin of the glass ionomer cement filling group was started to form at 1 week after experiment, and at 6 weeks after experiment, it had been increased gradually in number and size. 3. Reparative dentin of zinc phosphate cement filling group was formed vigorously, however, gradually was decreased in number and size, and disappeared at 6 weeks after experiment. 4. During the formation of reparative dentin, peritubular dentins were indistinguishable. 5. The diameter of dentinal tubules of reparative dentin has been decreased, during the reparative dentin formed, and it became very irregularly at 6 weeks after experiment.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.136-143
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• 2009

Objective: Remote cerebellar hemorrhage (RCH) is one of the rare complications occurring after supratentorial surgery, and its pathomechanism is poorly understood. We report 10 cases of RCH from our institution and review 154 cases from a database in order to delineate incidence, common presentation, risk factors, and outcomes of this complication. In addition, the means of prevention are discussed. Methods: We reviewed the medical records of 10 patients who experienced RCH after undergoing supratentorial surgery at our institution between 2001 and 2008. A database search in Medline revealed 154 cases of RCH in the English literature. Characteristic features were analyzed and compared. Results: There were 10 cases of RCH among 3307 supratentorial surgery cases, indicating a 0.3% incidence. All patients had characteristic imaging features of RCH, namely a streaky bleeding pattern in the superior folia of the cerebellum. Seven patients had a history of preoperative hypertension. Four cases were related to cerebral aneurysms, and other four developed after the removal of brain tumors. Cerebrospinal fluid (CSF) drainage apparatuses were installed postoperatively in all cases. Outcomes according to modified Rankin scale (mRS) were good in 7 patients, with 1 fatal case. Conclusion: RCH is a rare complication after supratentorial surgery, and the exact etiology still remains uncertain. Hypertension and perioperative loss of CSF seem positively correlated with RCH, but no single risk factor is totally responsible. Patients with RCH should be closely observed to improve their prognosis.