• 생물정신의학
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• 제11권2호
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• pp.173-180
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• 2004

Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR. Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99. In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex. These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample.

• Restorative Dentistry and Endodontics
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• 제14권1호
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• pp.135-148
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• 1989

The purpose of this study was to evaluate the periodic effect of desensitizing drug such as potassium oxalate(D.D.S. # I&II), strontium chloride (ZAROSEN)$^{(R)}$, and placebo group. The 193 teeth of 93 patients who had been complained dental hypersensitivity, and were divided into three groups by application agent and desensitizing treatment was completed. The interval of observation and treatment period were immediately, 1 week, 2 week, 3 week, 4 week, before and after treatment. The data was statistically analized and the results were as followed. 1. Group I showed best desensitizing effect to the stimuli, followed by Group II, Group III. 2. There was a significant difference (p < 0.005) in desensitizing effect among the Group I, Group III and Group II, Group III but there was no significant difference (p < 0.005) in Group I, Group II. 3. The cold stimuli was most effective in desensitization and there was a significant difference (p < 0.005) in cold, air-blast, but there was no significant difference (p < 0.005) in other stimuli. 4. There was no significant difference (p < 0.005) in effect of the desensitization of the cause of exposed dentine. 5. Anterior teeth was more effective than posterior teeth in desensitization and there was a significant difference (p < 0.005) between anterior teeth and posterior teeth. 6. In analysis of stimuli on the potassium oxalate, there was a significant difference (p < 0.005) in cold, air-blast but there was no significant difference (p < 0.005) in other stimuli.

• Biomolecules & Therapeutics
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• 제25권3호
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• pp.239-248
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• 2017

Desensitization and acute tolerance are terms used to describe the attenuation of receptor responsiveness by prolonged or intermittent exposure to an agonist. Unlike desensitization of G protein-coupled receptors (GPCRs), which is commonly explained by steric hindrance caused by the ${\beta}$-arrestins that are translocated to the activated receptors, molecular mechanisms involved in the acute tolerance of GPCRs remain unclear. Our studies with several GPCRs and related mutants showed that the acute tolerance of GPCRs could occur independently of agonist-induced ${\beta}$-arrestin translocation. A series of co-immunoprecipitation experiments revealed a correlation between receptor tolerance and interactions among receptors, ${\beta}$-arrestin2, and $G{\beta}{\gamma}$. $G{\beta}{\gamma}$ displayed a stable interaction with receptors and ${\beta}$-arrestin2 in cells expressing GPCRs that were prone to undergo tolerance compared to the GPCRs that were resistant to acute tolerance. Strengthening the interaction between $G{\beta}{\gamma}$ and ${\beta}$-arrestin rendered the GPCRs to acquire the tendency of acute tolerance. Overall, stable interaction between the receptor and $G{\beta}{\gamma}$ complex is required for the formation of a complex with ${\beta}$-arrestin, and determines the potential of a particular GPCR to undergo acute tolerance. Rather than turning off the signal, ${\beta}$-arrestins seem to contribute on continuous signaling when they are in the context of complex with receptor and $G{\beta}{\gamma}$.

• 대한불안의학회지
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• 제4권1호
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• pp.55-61
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• 2008

Objective : Eye movement desensitization and reprocessing (EMDR) has been established as an effective treatment for patients with posttraumatic stress disorder (PTSD). However, the literature is unclear as to whether EMDR is effective in the treatment of other psychiatric disorders. The purpose of this study was to evaluate the potential use of EMDR in the treatment of psychiatric disorders other than PTSD by using a clinician's impression of patient response and a subjective symptom evaluation. Methods : Seventeen diagnostically heterogenous patients without PTSD underwent an average of 4.3 sessions of EMDR. Symptom severity was assessed by the Clinical Global Impression-Change Scale (CGIC), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Symptom Checklist-90- Revised (SCL-90-R) before and after EMDR. Those whose CGI-C scores were 'very much improved' and 'much improved' after EMDR were classified as 'responders.' The patients' before and after treatment scores of symptom severity and group differences were compared. Results : Twelve of the 17 participants (12/17, 71%) were classified as 'responders.' The patients' scores on all of the scales, with the exception of the trait anxiety scale and obsession-compulsion scale of the SCL- 90-R, significantly decreased after treatment. There was no difference in sociodemographic and clinical variables between the responders and non-responders. Conclusion : The results of our study suggest that EMDR can be a promising candidate for the treatment of patients with psychiatric disorders other than PTSD, and thus further controlled studies are needed to determine whether EMDR can be applied to various psychiatric populations.

• The Korean Journal of Physiology and Pharmacology
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• 제23권6호
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• pp.509-517
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• 2019

Escitalopram is one of selective serotonin reuptake inhibitor antidepressants. As an S-enantiomer of citalopram, it shows better therapeutic outcome in depression and anxiety disorder treatment because it has higher selectivity for serotonin reuptake transporter than citalopram. The objective of this study was to determine the direct inhibitory effect of escitalopram on 5-hydroxytryptamine type 3 ($5-HT_3$) receptor currents and study its blocking mechanism to explore additional pharmacological effects of escitalopram through $5-HT_3$ receptors. Using a wholecell voltage clamp method, we recorded currents of $5-HT_3$ receptors when 5-HT was applied alone or co-applied with escitalopram in cultured NCB-20 neuroblastoma cells known to express $5-HT_3$ receptors. 5-HT induced currents were inhibited by escitalopram in a concentration-dependent manner. $EC_{50}$ of 5-HT on $5-HT_3$ receptor currents was increased by escitalopram while the maximal peak amplitude was reduced by escitalopram. The inhibitory effect of escitalopram was voltage independent. Escitalopram worked more effectively when it was co-applied with 5-HT than pre-application of escitalopram. Moreover, escitalopram showed fast association and dissociation to the open state of $5-HT_3$ receptor channel with accelerating receptor desensitization. Although escitalopram accelerated $5-HT_3$ receptor desensitization, it did not change the time course of desensitization recovery. These results suggest that escitalopram can inhibit $5-HT_3$ receptor currents in a non-competitive manner with the mechanism of open channel blocking.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.347-355
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• 2023

Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy. Methods: Children in the age range of 8-12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction. Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student's t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권5호
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• pp.329-340
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• 2024

Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated. Methods: Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups. Results: Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001). Conclusion: Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

• The Korean Journal of Physiology and Pharmacology
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• 제6권2호
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• pp.81-85
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• 2002

Conventional views of synaptic transmission generally overlook the possibility of 'postfusional-control' the regulation of the speed or completeness of transmitter release upon vesicular fusion. However, such regulation often occurs in non-neuronal cells where the dynamics of fusion-pore opening is critical for the speed of transmitter release. In case of synapses, the slower the transmitter release, the smaller the size and rate-of-rise of postsynaptic responses would be expected if postsynaptic neurotransmitter receptors were not saturated. This prediction was tested at hippocampal synapses where postsynaptic AMPA-type glutamate receptors (AMPAR) were not generally saturated. Here, we found that the small miniature excitatory postsynaptic currents (mEPSCs) showed significantly slower rise times than the large mEPSCs when the sucrose-induced mEPSCs recorded in cyclothiazide (CTZ), a blocker for AMPAR desensitization, were sorted by size. The slow rise time of the small mEPSCs might result from slow release through a non-expanding fusion pore, consistent with postfusional control of neurotransmitter release at central synapses.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.219-227
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• 2001

Capsaicin. a vanillyl amide(8-methy1-N-vanilly1-6-nonenamide) with a molecular weight of 305.42, was substance, interrupting the pain conducting pathway Until recently the neurotoxic effects of Capsaicin to adult animals were thought to be limited to the peripheral nervous system. But several reports suggest the possibility of central nervous system changes after Capsaicin administration to the adult rat. Capsaicin desensitization is defined as long lasting, reversible suppression of sensory neuron activity. How fast and for how long the desensitization develops is related to the dose and time of exposure to Capsaicin, and the interval between consecutive dosing. In the long term Capsaicin treatment can lead to morphological degeneration and changes in some small sensory neurons, predominantly unmyelinated C fiber afferent nerve fibers. Clinical interest has recently been roused by evidence that Capsaicin's desensitizing action may be of therapeutic value and that an endogenous Capsaicin-1 ike substance may exist. This study summarizes the fundamental knowledge(mechanism, receptors, et al of Capsaicin) of Capsaicin for physical therapists.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1637-1641
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• 2016

Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini- review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.