• 정신신체의학
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• 제7권1호
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• pp.51-60
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• 1999

본 연구에서는 불안과 우울감과 같은 정서상태가 만성적인 통증 인지와 상관관계가 있는지를 알아보고자 PTSD 환자군의 압통에 대한 역치와 불안증상, 우울증상의 정도를 측정하였고, 불안, 우울증상의 정도와 압통역치의 상관관계를 대조군과 비교하였다. 연구대상 환자군은 1997년 10월부터 1998년 3월까지 중앙대학교 의과대학 부속필동병원 및 용산병원 신경정신과에 입원한 환자와 외래환자들 중에서 PTSD에 진단된, 20-60세에 해당되는 성인 남자환자 23명을 대상으로 하였다. 결과는 다음과 같다. 1) PTSD 환자군에서 통계적으로 의미있게 높은 우울증상과 불안증상을 보였다(p<.05). 2) 압통에 대한 역치는 환자군에서 유의하게 높은 결과를 보였다(p<.05). 이런 결과를 보인 요인으로는, 환자군의 불안증상보다는 만성적인 우울증상이 통증역치의 증가에 부분적으로나마 영향을 주었을 것으로 추정되며 그외에 환자군에서의 opiate system의 이상, 환자군의 질병역할, 환자군이 처한 여러 사회환경적인 상황의 영향 등과 같은 여러 요인이 관련되었을 것이라고 생각한다. 결론적으로 PTSD의 만성 통증은 감정, 특히 우울증과 관련이 있을 것으로 보였으나, 그 인과관계에 대한 결론을 내리기에는 미흡한 점들이 있다. 앞서 언급한 여러 제한점들을 보완한 향후 연구를 통해 정서적 증상과 동통과의 보다 특이적인 연관성을 규명하는 연구가 필요할 것이라 생각한다.

• 대한핵의학회지
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• 제20권2호
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• pp.79-84
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• 1986

The opiate antagonist, naloxone, was injected for the reversal of hypotension due to Korean hemorrhagic fever, and the authors observed changes in pituitary hormones. In the hypotensive phase of the Korean hemorrhagic fever, the f-endorphin was high, and normalized granually in the diuretic and convalescent period. The naloxone raised the pulse rate and the blood pressure within 30 minutes without change in the central venous pressure. Around 30 minuted after the injection of the naloxone, the $\beta-endorphin$, ACTH and cortisol rose. The prolactin fell down 60 minutes after the naloxone injection.

• The Korean Journal of Pain
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• 제1권1호
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• pp.74-79
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• 1988

Caudal narcotic analgesia was assesses after the injection of 3mg morphine diluted in 30ml (physiologic) saline into the sacral canal in 15 Patients after upper abdominal surgery, in 20 patients after lower abdominal surgery under general anesthesia, and in 20 patients after perianal surgery under caudal block. Pain relief was evaluated by the subsequent need for systemic analgesics. All eases had considerable relief from pain an4 the morphine was effective for 12 or more hours. There were no significant differances between pain relief of the upper abdominal and lower abdominal surgery group, upper abdominal and perianal surgery group, and lower abdominal and perianal surgery group (p>0.05, p>0.05, p>0.05). It is suggested that the morphine, which was administered into the sacral, cannal, reached the subarachnoid space and produced it's effect by direct action on the specific opiate receptors in the substantia gelatinosa of th.8 posterior horn cell of the spinal cord. Consequently, whether analgesia from epidural narcotics appears to be segmental in distribution or not is still in controversy.

• 대한약리학회지
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• 제16권1호
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• pp.15-24
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• 1980

As it has been reported that opioids such as morphine and methionine-enkephalin induced antidiuresis and antinatriuresis along with decrease in renal hemodynamics when given intracerebroventricularly(ivt), the renal action of ivt naloxone, a pure antagonist of morphine, and its influence upon the morphine action were investigated in this study. Less than $0.3{\mu}M/kg$ naloxone ivt did not change renal funtion. $1{\mu}M/kg$ ivt tended to, increase urine flow rate and induce transient natriuresis. $3{\mu}M/kg$ ivt produced transient: natriuresis. $3{\mu}M/kg$ ivt produced marked diuresis and natriuresis without any changes of renal hemodynamics. $10{\mu}M/kg$ ivt produced significant increases of urine flow rate and excretion of sodium without any changes of renal hemodynamics. Morphine $0.03{\mu}M/kg$ ivt produced marked decrement in renal hemodynamics along with decreases of water and sodium excretion, as previously shown by Kang. These effects of ivt morphine were completely abolished by the pretreatment with $0.3{\mu}M/kg$ naloxone. These observations provide further evidence that opiate receptors and endorphins in the brain might play an important role in the center-mediated regulation of the renal function in the rabbit.

• The Korean Journal of Pain
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• 제10권1호
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• pp.34-41
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• 1997

Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

• The Korean Journal of Physiology
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• 제17권2호
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• pp.169-176
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• 1983

It is well known that the acupuncture has been used effectively for the relief of certain types of pain. Although the precise mechanism of action of acupuncture analgesia is unknown, it is generally accepted that their analgesic properties are related to the activation of endogenous opiate system in central nervous system. And it is suggested that pain-relieving properties of acupunture may be related to a stimulation of peripheral nerve underlying the acupuncture point on the skin. However, the efficacy of acupuncture has no relationship between the site of pain and the acupuncture point. Consequently, the present study was undertaken to investigate electroacupuncture analgesia in relation to the site of peripheral nerve stimulation. Cats were decerebrated ischemically and the flexion reflex as an index of pain was elicited by stimulating the sural nerve (20V, 0.5 msec duration) and recored as a compound action potential from the nerve innervated to the posterior biceps femoris muscle in the ipsilateral hindlimb. Bilateral common peroneal nerve and contralateral superficial radial nerve were selected as the site of peripheral nerve stimulation. For the stimulation of peripheral nerve, a stimulus of 20 V intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min respectively. The results obtained are summarized as follows: 1) Both stimulation of contralateral common peronal nerve and contralateral superficial radial nerve did not change the flexion reflex and there were no significant differences between them. 2) Stimulation of ipsilateral common peroneal nerve markedly depress the flexion reflex, the effect being reversed by naloxone application. These results suggest that stimulation of ipsilateral common peroneal nerve has the analgesic effect but both stimulation of contralteral common peroneal nerve and contralateral superficial radial nerve to the pain site where flexion reflex was elicited have no analgesic effect.

• The Korean Journal of Pain
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• 제10권2호
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• pp.196-202
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• 1997

Background: Various pain treatments have been administered to relieve patients suffering from postoperative pain. Among these, epidural or intravenous opiate administration is by far the most widly applied treatment in recent times. However it was our objective to device a more effective and safe means of postoperative analgesia. Methods: We studied 110 healthy pregnant women scheduled for delivery by elective cesarean section. EPI(epidural)-group is administered morphine 1.5 mg and 0.25% bupivacaine 8 ml as bolus dose, then, a mixture of morphine 6 mg and 0.125% bupivacaine 95 ml as continuous dose via epidural route. IV(intravenous)-group is administered nalbuphine 6~7 mg as bolus dose and nalbuphine 60~70 mg with 0.9% normal saline 90 ml as continuous dose via intravenous route, at the rate of 2 ml/hr for 2 days. We compared the analgesic efficacy and side effects of these two groups using VAS pain score and time duration of constant pain level. Results: VAS pain score was similar between the two groups, but pain duration was significantly shorter in EPI-group. Incidence of pruritus was significantly lower with the IV-group, of nausea and vomiting were similar for both groups, no respiratory depression for either groups. Conclusions: Although the EPI-group had better analgesic efficacy, the IV-group had lower incidence of side effects, and simplicity and safety methods of operation. Therefore, We propose further research and consideration of administering the kinds and doses of those medications prescribe to the IV group in conjunction with other drugs for safer and better efficacy of postoperative analgesia.

• 한국식품영양과학회지
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• 제36권2호
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• pp.246-249
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• 2007

Phenylalnine은 enkephalin, endorphine의 분해를 촉진하는 carboxypeptidase, aminopeptidase의 작용을 억제하는 필수아미노산으로 식욕억제, 정서 안정, 통증, 기분조절 관련 아미노산이다. 자연계의 L-phenylalanine과 비교하여 물리화학적 당량반응으로 구조가 보다 안정한 DL-phenylalnine(DLPA)을 소재로 가공적성을 조사하였다. DLPA는 $60^{\circ}C$ 이상의 온도와 농도변화에서 용해 시 98%T 이상의 값을 나타내어 가공 적합성을 보였고, 다양한 pH 범위에서도 99%T 이상의 값을 보여 용해 안정성을 확인하였다.

• Journal of Ginseng Research
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• 제19권3호
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• pp.219-224
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• 1995

The modulatory effects of total ginseng saponin (TGS) on the 1, 6, and opioid receptor binding in morphine tolerance and dependence were examined in this study. The specific [$^{3}H$]DAGO ([D-$Ala^2$, N-$Mephe^4$, $Glyco^4$] enkephalin) binding was significantly increased in chronic morphine (10 mg/kg, i.p.) treated mouse striatum. The specific [$^{3}H$]DPDPE ([D-$Pen^2$, D-$Pen^5$] enkephalin) binding was ignificantly increased following morphine treatment in the mouse striatum and cortex. Also, an apparent decrease in the affinity of [$^{3}H$]DPN (diprenorphine) was observed after chronic morphine treatment in mouse striatum and cortex. 7GS produced a sleight increase of specific [$^{3}H$]DAGO, [$^{3}H$]DPDPE binding and a significant increase of specific [$^{3}H$]DPN binding in the mouse brain striatum. In cortex, TGS produced an inhibition of specific [$^{3}H$]DAGO and [$^{3}H$]DPDPE binding and increase of the specific [$^{3}H$]DPN binding. The prolonged administration of TGS (25, 50, 100, and 150 mg/kg, i.p., 3 wks) produced an inhibition of increased [$^{3}H$]DAGO specific binding following morphine without significant changes in the agonist binding to and receptors in mouse striatum and cortex. These contracted alterations in $\mu$, $\gamma$ and $\kappa$ opiate receptor binding were dependent in TGS dogs and brain sites.

• The Korean Journal of Physiology
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• 제30권1호
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• pp.85-96
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• 1996

Adenosine and its analogues are known to possess analgesic effects and to be involved in the opiate-induced antinociception as well. This study was designed to investigate the effects of three adenosine agonists, 5'- (N-cyclopropyl) -carboxamidoadenosine(CPCA), 5'-N-ethylcarboxamidoadeno-sine (NECA) and $N^6-cyclohexyladenosine$ (CHA) on the signal transmission in the spinal cord and also to elucidate mechanisms of their actions in the anesthetized cat. All the tested adenosine agonists(i.v,) exerted inhibitory effects on the responsiveness of the wide dynamic range (WDR) cells, the inhibitory action of CHA, an adenosine $A_1$ receptor agonist, $(80{\mu}g/Kg)$ being most weak. The intravenous CPCA, an adenosine $A_2$ receptor agonist, $(20{\mu}g\;/Kg)$ and NECA, nonspecific adenosine receptor agonist, $(20{\mu}g\;/Kg)$ inhibited the responses of WDR cells to pinch and C fiber stimulation more strongly than those to brush and A fiber stimulation. CPCA (i.v.) also suppressed the responses of WDR cells to thermal stimulus. And all the CPCA-induced inhibitions were caffeine-reversible. When CPCA was directly applied onto the spinal cord or intravenously administered into the spinal cat, on average, about three quarters of the CPCA-induced inhibitory effect was abolished. On the other hand, in the animal with spinal lesions in the ipsilateral dorsolateral area, the CPCA-induced inhibition was comparable to that observed in the spinal cats. In conclusion, this study shows that adenosine agonists strongly suppress the responses of WDR cells to pinch, C fiber stimulation and thermal stimuli mainly through the supraspinal adenosine $A_2-receptors$.