• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.156-160
• /
• 2005

Background: Frozen shoulder is not an uncommon disease, which is associated with chronic pain and joint movement limitation. However, there are numerous devices to assist in the treatment of shoulder pain, but their efficacy has not been proven and their use remains immensely controversial. Therefore, a randomized clinical study was conducted to determine the effectiveness of a low-frequency stimulator for the treatment of frozen shoulder. Methods: A randomized clinical trial was carried out on 40 patients with frozen shoulder, with 40 patients assigned to two groups; a control treatment group (group C, n = 20) and a low frequency stimulator application group (group T, n = 20). Both groups were given a routine treatment modality, such as trigger point injection, intramuscular stimulation or suprascapular nerve block etc. The level of the shoulder pain was evaluated using a 100mm VAS (visual analog scale) at each visit, with the limitation in the range of motion simultaneously evaluated. Results: All the subjects improved after treatment, with the VAS scores after termination of treatment showed a statistically significant reduction (P < 0.05). However, there was no significant difference between the two groups. One month after termination of 5 cycles of treatment, group T maintained their improved state, whereas the pain in some of those in group C reemerged, which also showed a statistically significant difference (P < 0.05). The limitation in the range of motion improved, with most subjects able to resume daily activity. Conclusions: Although the low frequency stimulation provided no more pain relief than routine treatment, the effect was significantly prolonged. From this result, low frequency stimulation can be considered to aide the therapeutic effect of classical frozen shoulder therapy.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.33 no.1
• /
• pp.1-6
• /
• 2017

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.1
• /
• pp.9-17
• /
• 2020

Background: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery. Methods: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer. Results: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013). Conclusion: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

• Journal of Chest Surgery
• /
• v.33 no.3
• /
• pp.268-272
• /
• 2000

Thoracic sympathicotomy has been used safely and successfully to treat essential hyperhidrosis. However, it has been difficult to treat compansatory hyperhidrosis after thoracic sympathicotomy and focal hyperhidrosis. The sweat glands were innervated by post-ganglionic sympathetic fibers with acetylcholic serving as the transmitter. Botulinum A toxin has been reported to block neuro-transmission at the cholinergic autonomic nerve terminals. Prospecting its effect for the sweat gland, we treated 5 patients with focal hyperhidrosis with botulinum A toxin. Three patients received bilateral thoracic sympathectomy (1 case) and sympathicotomy(2 case) via VAT. The hyperhidrosis area was marked with betadine and was subdivided into squares of 2$\times$2 cm(4$\textrm{cm}^2$) each. Botulinum A toxin was injected intracutaneously in a dosage of 2.5U/0.1ml(100U/4ml) /4$\textrm{cm}^2$. A total dose of 100U of Botulinum A toxin was injected into the affected sites. Subjective assessment of sweat production by the patients using a visual analogue scale showed a 20~70% improvement. During the follow-up period, no toxic effects were observed.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.10 no.1
• /
• pp.1-6
• /
• 2010

Background: Articaine, commercially available in South Korea from 2004, is widely being used for dental treatments. In the surgical extraction of impacted mandibular third molars, one of the most common procedures in oral and maxillofacial surgery, the anesthetic efficacy of 4% articaine and 2% lidocaine, both with 1：100,000 epinephrine, was compared. Methods: A randomized double-blind clinical trial was conducted of 80 patients for bilateral surgical extraction of mandibular third molars with informed consents. One operator carried out the routine surgical procedures using local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor. Latency, duration of anesthesia and the amount of anesthetic solution were recorded. A visual analog scale (VAS) was used to evaluate the intraoperative pain. Results: The pain VAS scores reported similar anesthetic effect with both local anesthetics. Not in the latency of anesthesia and the amount of anesthetic solution, statistically significant difference was found in the mean duration of anesthesia. Conclusions: It was concluded that 4% articaine could offer better or at least the same clinical feasibility compared to 2% lidocaine, particularly in terms of the duration of the local anesthesia for common dental treatments.

• Journal of Applied Biological Chemistry
• /
• v.62 no.4
• /
• pp.347-353
• /
• 2019

Stings of jellyfish, which frequently occur in a warm season, cause severe pain, inflammation and sometimes irreversible results such as the death. Harmful venoms from jellyfish, therefore, have been studied for finding the therapeutic agents to relieve pain or to neutralize toxic components. However, it is still unclear if and how jellyfish venom reveal neuronal toxicity even though pain induction seems to result from the activation of nociceptors such as nerve endings. In this study, using HT-22 cell line, we investigated neurotoxic effects of the venom of Chrysaora pacifica (CpV) which appears in South-East ocean of Korea. In 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, CpV significantly reduced the viability of HT-22 cells in a dose-dependent manner. Additionally, in 2',7'-Dichlorofluorescin diacetate fluorescence test under the culture condition lacking dominant inflammatory factors, CpV remarkably increased the production of intracellular reactive oxygen species (ROS). Reduced responsive fluorescence to Rhodamine123 and increased expression of intracellular cytochrome c were also observed in HT-22 cells treated with CpV. These indicate that CpV-reduced viability of HT-22 cells may be due to the activation of apoptotic signalings mediated with oxidative stress and mitochondrial dysfunction. Furthermore, removing Ca²⁺ ion or adding N-acetyl-Lcystein remarkably blocked the CpV effect to reduce the viability of HT-22 cells. The findings in this study clearly demonstrate that CpV may activate Ca²⁺-mediated ROS signalings and mitochondrial dysfunction resulting in neuronal damage or death, and suggest that blocking Ca²⁺ pathway is a therapeutic approach to possibly block toxic effects of jellyfish venoms.

• Journal of Hospice and Palliative Care
• /
• v.12 no.2
• /
• pp.88-94
• /
• 2009

Chest pain is a symptom observed commonly in outpatients and emergency room patients, and its causes are variable. Because treatment and prognosis of chest pain are different depending on its cause, it is more important than anything else to accurately diagnose the cause of chest pain. Most of patients complaining of chest pain undergo basic tests at a private local clinic or at the Internal medicine or chest surgery department of a general hospital and, they are referred to the pain clinic, with a note stating no particular finding. However, if they have sustained severe neuropathic pain in spite of nerve block, accurate diagnosis for chest pain is essential. We experienced rapidly developing spine breakdown and cord compression caused by metastatic spinal tumor in an inpatient who was being treated for chest pain, and thus, we report here in the case with literature review.

• Proceedings of the Korean Biophysical Society Conference
• /
• 2003.06a
• /
• pp.42-42
• /
• 2003

Large-conductance $Ca^{2+}$-activated potassium channels ($BK_{Ca}$ are a widely distributed and play key roles in various cell functions. In nerve cells, $BK_{Ca}$ channels shorten the duration of action potentials and block $Ca^{2+}$ entry thereby repolarizing excitable cells after excitation. $BK_{Ca}$ channel opening has been postulated to confer neuroprotection during stroke, and has attracted attention as a means for therapeutic intervention in asthma, hypertension, convulsions, and traumatic brain injury. Several natural and synthetic compounds including a steroid hormone, $\beta$-estradiol, have been identified as the activators of $BK_{Ca}$ channels. Based on the structural features of the previously reported activators of $BK_{Ca}$ channels, we designed several lead compounds, synthesized chemically, and tested their functional activity on cloned $BK_{Ca}$ channels. The $\alpha$ subunit of rat $BK_{Ca}$ channel was expressed alone or with different $\beta$ subunits in Xenopus oocytes and the effects of the compounds were tested electrophysiological means. One of the lead compounds affected the activity of the $\alpha$ subunit of $BK_{Ca}$ channel in a $\beta$ subunit-specific manner. While the activity of B $K_{ca}$ channel $\alpha$ subunit was Potentiated, the channel composed of $\alpha$ and $\beta$1 subunits were inhibited by this compound. We are currently investigating the mechanism of the $\beta$ subunit-dependent effects and planning to localize the receptor site of the lead compound.f the lead compound.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.1
• /
• pp.52-56
• /
• 2015

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

• Journal of Korean Foot and Ankle Society
• /
• v.18 no.3
• /
• pp.115-118
• /
• 2014

Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.