• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.3
• /
• pp.213-217
• /
• 2024

Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.

• International Journal of Oral Biology
• /
• v.38 no.4
• /
• pp.135-140
• /
• 2013

The present study investigated the effects of QX-314 on inflammatory pain of the temporomandibular joint (TMJ). Experiments were carried out on male Sprague-Dawley rats weighing 220-280 g. Under anesthesia, the TMJ of each animal was injected with $50{\mu}L$ of formalin (5%). The number of noxious behavioral responses, including rubbing or scratching of the facial region including the TMJ area, was recorded over 9 sequential 5 min intervals for each animal. Although 2.5% QX-314 did not affect formalin-induced nociceptive behavior, administration of 5% QX-314 with formalin significantly decreased the number of scratches produced by the formalin injection. Co-administration of capsaicin, a TRPV1 agonist, with 2.5% QX-314 produced significant anti-nociceptive effects whereas 2.5% QX-314 alone did not. However, the co-administration of capsaicin did not enhance the anti-nociceptive effects in the 5% QX-314-treated rats. Moreover, the co-administration of capsazepine, a TRPV1 antagonist, did not attenuate anti-nociceptive effects in the 5% QX-314-treated rats. These findings suggest that TRPV1 is effective in the transport of low but not high doses of QX-314. Moreover, a high dose of QX-314, which is not mediated by peripheral TRPV1 activity, may be viable therapeutic strategy for inflammatory pain in the TMJ.

• Journal of Hospice and Palliative Care
• /
• v.17 no.3
• /
• pp.113-121
• /
• 2014

The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.

• The Korean Journal of Pain
• /
• v.5 no.2
• /
• pp.263-268
• /
• 1992

Involvement of the facial nerve(herpes zoster oticus, Ramsay Hunt Syndrome) is a rather common clinical syndrome. It begins with unilateral ear pain, followed shortly by a peripheral facial palsy. Paresis or paralysis may affect the muscles of facial expression, which also close the eyelids. The levator palpebrae which is innervated by the 5th cranial nerve is spared, so the eye may remain open. The rash is usually confined to the tympanic membrane and the external auditory canal. It may spread to involve the outer surface of the lobe of the ear, anterior pillar or the fauces and mastoid. There also may be a loss of taste in the anterior two thirds of tongue. At time, the auditory nerve involvement produces tinnitus, deafness and vertigo. The 5th, 8th and 10th nerves and even the upper cervical spinal nerve can be involved presumedly on the base of spread of the infective process along anastomotic connections between the facial nerve. The facial paralysis is identical to that of Bells palsy. Frequently the recovery of facial nerve function is incomplete, leaving the patient with some residual facial weak ness. We experienced 2 cases of Ramsay Hunt Syndrome. The first patients, 55 year old male, visited our pain clinic on the day when his left facial nerve start to paralyze. We injected 6 ml of 0.25% bupivacaine into his left stellate ganglion 15 times. TENS was also applicated simultaneously. His facial paralysis was recovered completely 3 weeks after treatment without any complications. Another one, 53 year old male, visited us 7 weeks after onset of facial paralysis. He has been treated conventional oriental method(acupuncture, massage, warm application, etc). But the degree of his left facial paralysis didn't improve at all He has been treating with SGB 50 times and TENS for 2 months. Temporal and zygomatic branch of his left facial nerve recovered nearly completely but buccal and mandibular branch did not recover completely. We are willing to insist on the early treatment is the best choice in managing of Ramsay Hunt Syndrome.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.12 no.4
• /
• pp.679-690
• /
• 2017

The purpose of this study was to investigate the relationship between neck posture and range of motion and neck disability index(NDI) in young adults with reduced cervical lordosis. This study selected 34 young adults with cervical lordosis reduced (Cobb's angle less than 35 degrees). The assessor measured neck flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation and forward displacements of all subjects using cervical of range motion instrument, Then, the NDI was evaluated. After all assessments, degree for cervical lordosis was divided into two groups: bottom group(severe cervical lordosis) and top group(mild cervical lordosis). The bottom group was significantly higher in Cobb's angle, extension, left lateral flexion, right lateral flexion, left rotation, right rotation and forward displacement compared to the top group (p<.05). There was no significant difference between the two groups in flexion, NDI(p >.05). In comparison of subscale of NDI, top group was significantly higher in pain, lifting, and headache than bottom group (p <.05). In correlation analysis, Cobb's angle showed significant positive correlation with flexion, extension, left lateral flexion, right lateral flexion, left rotation and right rotation(p<.05), and showed significant negative correlation with forward displacement, NDI(p<.05). Cobb's angle showed a significant negative correlation with pain, lifting, and headache of subscale of NDI(p<.05). The findings of this study potentially suggest that neck posture may affect the cervical range of motion and pain.

• International Journal of Oral Biology
• /
• v.39 no.1
• /
• pp.49-56
• /
• 2014

We investigated the role of central P2X receptors in inflammatory pain transmission in the orofacial area in rats. Experiments were carried out using male Sprague-Dawley rats weighing 230-280g. Complete Freund's adjuvant (CFA, $40{\mu}L$) was applied subcutaneously to the vibrissa pad to produce inflammatory pain. The intracisternal administration of iso-PPADS tetrasodium salt, a non-selective P2X receptor antagonist, A317491 sodium salt hydrate, a $P2X_{2/3}$ receptor antagonist, 5-BDBD, a $P2X_4$ receptor antagonist, or A438079 hydrochloride, a $P2X_7$ receptor antagonist, was performed 5 days after CFA injection. Subcutaneous injections of CFA produced increases in thermal hypersensitivity. Intracisternal injections of iso-PPADS ($25{\mu}g$) or A438079 (25 or $50{\mu}g$) produced significant anti-hyperalgesic effects against thermal stimuli compared to the vehicle group. A317491 or 5-BDBD did not affect the head withdrawal latency times in rats showing an inflammatory response. Subcutaneous injections of CFA resulted in the up-regulation of OX-42, a microglia marker, and GFAP, an astrocyte marker, in the medullary dorsal horn. The intracisternal administration of A438079 reduced the numbers of activated microglia and astrocytes in the medullary dorsal horn. These results suggest that a blockade of the central $P2X_7$ receptor produces antinociceptive effects, mediated by inhibition of glial cell function in the medullary dorsal horn. These data also indicate that central $P2X_7$ receptors are potential targets for future therapeutic approaches to inflammatory pain in the orofacial area.

• The Journal of Korean Physical Therapy
• /
• v.17 no.3
• /
• pp.311-327
• /
• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• Journal of Korean Medicine Rehabilitation
• /
• v.25 no.1
• /
• pp.77-85
• /
• 2015

This study analyzed the MMPI (Minnesota Multiphashic Personality Inventory), VAS (Visual Analogue Scale), cervical and lumbar curvature (Cervical angle, Ishihara Index, Lumbar angle, Ferguson angle) and satisfaction score of patient of traffic accident. About 59 cases of patients admitted to the Korean Medicine hospital, MMPI and pain levels (VAS) cervical and lumbar curvature (Cervical angle, Ishihara Index, lumbar angle, Ferguson angle) and satisfaction score were measured and statistically analyzed. Depending on the type of accident divided into two groups of In car TA and Out car TA. After hospitalization, patient's pain index was improved as a whole. Pain index and evaluation of the cervical and lumbar curvature, according to the accident types, the difference was not statistically significant. In the analysis of the MMPI validity scales, In car TA group was analyzed by 'V-shaped', Out car TA group was analyzed by umbrella- shaped, 'inverted V-shaped'. Clinical scales of out car TA group were analyzed by 3-1 profile compared to the In car TA group. Results of multiple regression analysis showed no association between factors and MMPI scales. In the case of a traffic accident patients, damage to the body, as well as emotional and psychological factors are thought to affect the condition or prognosis of patients. In the future, for the management and treatment of these parts will be needed to complement the academic or institutional.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.22 no.5
• /
• pp.207-220
• /
• 2021

This study aimed to evaluate the impact of education and counselling by nurses on anxiety, uncertainty, and pain in patients with benign uterine tumors. Electronic databases, including PubMed, OVID, CINAHL, Google Scholar, and Korean databases and were searched during January 2020. A total of 401 studies were identified of which 13 were suitable for meta-analysis. Cochrane's risk of bias tool and the R version 3.5.2 (Meta-analysis with R) program were used for analysis. The authors performed a meta-analysis of the 13 trials that met eligibility criteria. The findings in this study indicate that the effect size of nursing education for anxiety was Hedges' g=-0.89 (95% CI:-1.39 to -0.47), as indicated by a "large effect size" and the effect size of pain was Hedges' g=-0.49 (95% CI:-0.95 to -0.02) as indicated by a "moderate effect size". The effect size of uncertainty was Hedges' g=-1.38 (95% CI:-3.98 to 1.23), and it was not statistically significant. In the meta-subgroup analyses by approach intervention type, cognitive-behavioral programs, demonstration intervention, and relaxation therapy had a significant effect. The risk of publication bias was low. It may therefore be concluded that pre-operative education by nurses for patients with benign uterine tumors would affect their levels of anxiety, uncertainty, and pain.

• Korean Journal of Adult Nursing
• /
• v.12 no.3
• /
• pp.431-451
• /
• 2000

In this paper, I will examine the variables influencing the Quality of Life of arthritis patients and present basic materials which help arthritis patients have positive thinking in life and ultimately lead a satisfactory life. The subjects for this study are 231 inpatients and outpatients with arthritis living in J and K city in Chonbug Province. For the analysis of collected data I employed the SAS program. The variables for characteristics and the quality of life were analysed by descriptive statistics, T-test and ANOVA, and the relations among variables were analysed through Pearson Correlation; the Regression method was employed to predict the factors affecting quality of life. For the validity of reliance on measuring equipment Cronbach Alpha was used. The results of the study are as follows : (1) The mean score of quality of life of arthritis patients is 3.09(5 in the maximum). The general characteristics which affect the quality of life are age(F=5.13, p=0.0006), standard of education(F=6.49, p=0.0003), marriage status(F=7.77, p=0.0005), monthly pay(F=4.37, p=0.0020), medical benefits (F=4.85, p=0.0087), and supports(F=4.39, p=0.0050). For the disease-related characteristics, there is a significant difference in the 6 items: pain control method(F=5.92, p= 0.0002), physical therapy(F=3.25, p=0.013), whethere or not patients exercise(F=4.62, p=0.0000), regularity of exercise(F=4.79, p=0.0000), frequency of exercise(F=6.29, p=0.0001), and amount of exercise(F=4.62, p=0.0043). Depending on the type of arthritis, there is also a significant difference in the degree of pain felt. The patients with infectious arthritis suffer from pain the most, followed by those with gout, rheumatism and degenerative arthritis, in that order. Although statistics don't show any convincing evidence, those with gout perceive that they are in best health condition, followed by those with rheumatism, degenerative arthritis, and infectious arthritis, in that order(F=2.23, p=0.0669). (2) The quality of life of arthritis patients is correlated positively with perceived health status(r=0.56, p=0.0001), health promoting behavior(r=0.53, p=0.0001), family support (r=0.46, p=0.0001), amount of exercise (r=0.36, p=0.0001), ADL(r=0.36, p=0.0001), HLOC(r=0.32, p=0.0001), frequency of exercise(r=0.32, p=0.0001)in that order, while correlated negatively with the degree of pain felt(r=-0.32, p=0.0001), the number of pain regions(r=-0.19, p= 0.0041), and the duration of pain(r=-0.14, p=0.0279). (3) Regression analysis reveals that the most powerful predictor of the quality of life is perceived health status, which account for 31.11%. The other predictors of the quality of life, which account for 60.22%, are health promoting behavior(16.51%), family support(3.81%), ADL(2.52%), gender(1.86%), the number of family members(1.36%), level of pain(1.24%), duration of pain (1.08%), and level of education(0.67%). The results of the study show that perceived health status and health promoting behavior are the two most important variables. However, considering that the perceived health condition is difficult to control by nursing intervention, it is suggested that the level of expectation for patients, must be decided first, and the health promoting behavior and the family support influencing the quality of life must be taken into account as targets for nursing intervention. As a way of controlling the quality of life, I think that a more comprehensive approach comprising the above important variables along with demographic and general characteristics is needed. I also suggest that we must continue to explore the variables affecting the quality of life and include those variables in nursing intervention.