• Title/Summary/Keyword: pain affect

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Clinical Pharmacogenomics of Drug Metabolizing Enzymes and its Clinical Application (약물대사효소의 유전적 다형성 및 임상적 응용)

  • Kim, Kyung-Im;Kim, Seung-Hee;Park, Ji-Eun;Chae, Han-Jung;Choi, Ji-Sun;Shin, Wan-Gyun;Son, In-Ja;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.155-164
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    • 2006
  • Great inter-variability in drug response and adverse drug reactions is related to inter-variability of drug bioavailability, drug interaction and patient's disease and physyological state that cause change in absorption, distribution, metabolism and excretion of drugs. However, these alone do not sufficiently predict and explain inter-variability in drug response. In recent studies, it is reported that inter-variability in drug response and adverse drug reactions may largely resulted from genetically determined differences in drug absoption, distribution, metabolism and drug target proteins. Especially, the major human drug-metabolizing enzymes such as CYP450, N-acetyl tranferase, thiopurine S-methyl transferase, glutathione S-transferase are identified as the major gene variants that cause inter-individual variability in drug's response and adverse drug reactions. These variations may have most significant implications for those drugs that have narrow therapeutic index and serious adverse drug reactions. Therefore, the genetic variation such as polymorphisms in drug metabolizing enzymes can affect the response of individuals to drugs that are used in the treatment of depression, psychosis, cancer, cardiovascular disorders, ulcer and gastrointestinal disorders, pain and epilepsy, among others. This review describes the pharmacogenomics of the drug metabolizing enzymes associated with the drug response and its clinical applications.

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Dental treatment of a patient with long QT syndrome under moderate sedation with target-controlled infusion of propofol

  • Kim, Kyung Jin;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Shin, Teo Jeon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.161-165
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    • 2015
  • Long QT syndrome (LQTs) is a rare congenital disorder of the heart's electrical activity. Patients with LQTs are at increased risk of developing fatal ventricular arrhythmias. Elevated levels of sympathetic stimulation can exacerbate this risk. Successful behavior management is indispensable in the treatment of patients with LQTs. However, many drugs involved in pharmacologic behavior management are known to adversely affect the QT interval. Therefore, careful selection of a sedative drug is essential in avoiding such incidences. A 10-year-old boy with a known diagnosis of LQTs required restorative treatment due to dental caries at the permanent molar. He required sedation since treatment was painful and dental phobia can trigger sympathetic stimulation, creating a dangerous situation for patients with LQTs. Therefore, the treatment was performed over two sessions under moderate sedation involving propofol combined with nitrous oxide. Restorative treatment was successful without any complications under sedation with a target-controlled infusion (TCI) of propofol. There was no significant QT prolongation during pulpal treatment. Propofol TCI may be a good candidate for sedation in patients with LQTs.

Recent Developments in the Use of Intralesional Injections Keloid Treatment

  • Perdanasari, Aurelia Trisliana;Lazzeri, Davide;Su, Weijie;Xi, Wenjing;Zheng, Zhang;Ke, Li;Min, Peiru;Feng, Shaoqing;Zhang, Yixin;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.620-629
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    • 2014
  • Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.

Dorsal Neck Muscle Fatigue Affects Cervical Range of Motion and Proprioception in Adults with the Forward Head Posture

  • Yeo, Sang-Seok;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • v.32 no.5
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    • pp.319-324
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    • 2020
  • Purpose: This study was to investigate the effect of dorsal neck muscle fatigue on the cervical range of motion (CROM) and proprioception in adults with the forward head posture (FHP). Methods: Thirty pain-free subjects were enrolled in this study. All subjects were measured the forward head angle by taking the capture of the sagittal plane of their upper body to determine the FHP. Subjects were distributed into two groups: the FHP group (n=14) and Control group (n=16). All subjects were measured the CROM and the Head repositioning accuracy (HRA) for joint proprioception before and after inducing muscle fatigue of the dorsal neck. The CROM and HRA were measured in neck flexion, extension, right-left lateral flexion, and right-left rotation. Sorenson's test was used to induce muscle fatigue of the dorsal neck. Results: Total CROMs were significantly decreased after dorsal neck muscle fatigue in both groups (p<0.05). Total HRAs were significantly increased after dorsal neck muscle fatigue in the FHP group (p<0.05), but there were no significant differences in the control group (p>0.05). Total CROM changes were not significant differences between groups (p>0.05), but total HRA changes were significant differences between groups (p<0.05) except for right and left lateral flexion (p>0.05). Conclusion: Immediate CROM and proprioception reduction after the dorsal neck muscle fatigue were observed in adults with the FHP. Therefore, FHP can significantly affect the CROM and positioning consistency of cervical proprioception.

Delayed Improvement after Endoscopic Carpal Tunnel Release

  • Kim, Dong-Ho;Cho, Byung-Moon;Oh, Sae-Moon;Park, Dong-Sik;Park, Se-Hyuck
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.390-394
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    • 2014
  • Objective : In most patients with carpal tunnel syndrome (CTS), pain and/or paresthesia disappeared or decreased in a month after endoscopic carpal tunnel release (ECTR). However, subpopulation of patients showed delayed improvement following ECTR. We analyzed the delayed improvement hands to investigate the characteristics of those patients and to determine the predictable factors of delayed improvement. Methods : Single-portal ECTRs were performed in 1194 hands of 793 CTS patients from 2002 to 2011. Five-hundred seventy hands with minimal 1-year postoperative follow-up were included. We divided the 545 satisfied hands into early (group A) and delayed (group B) groups according to improvement period of 1 month. Demographic data, clinical severity and electrodiagnostic abnormality were compared between groups. Results : Group A included 510 hands and group B included 35 hands. In group B, 11 hands improved in 2 months, 15 hands in 3 months and 9 hands in 6 months, respectively. In group A/B, according to clinical severity, 60/1 hands were graded to I, 345/24 hands to II, 105/10 hands to III. In group A/B, based on electrodiagnostic abnormality, 57/3 hands were classified to mild, 221/11 hands to moderate and 222/21 hands to severe group. Statistical analysis between groups did not reach significance but electrodiagnostic or clinical severity had a tendency to affect the delayed response. Conclusion : It is difficult to predict the factors contributing to postoperatively-delayed response in subpopulation of CTS patients. However, we recommend that postoperative observation for at least 6 months is necessary in patients without symptomatic improvement.

Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth

  • Han, Tae Hwan;Lee, Jin;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.259-268
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    • 2016
  • Purpose: Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods: Hair mineral analyses were performed in 56 children (age, 1-15 years) presenting with malnutrition, poor growth, poor appetite, anorexia, with/without other GI symptoms (diarrhea, abdominal pain, constipation) from August 2012 to March 2015. Biochemical studies for macronutrients and major micronutrients were also conducted. Results: Hair zinc deficiency was diagnosed in 88%, and serum zinc deficiency was diagnosed in 55% of the children. There was no statistical correlation between serum and tissue zinc level. Hair zinc levels were highly correlated with serum vitamin D (r=-0.479, p=0.001), which also showed correlation with hair levels of magnesium and calcium. (r=0.564, 0.339, p=0.001, 0.011). Hair calcium level was correlated with serum pre-albumin (r=0.423, p=0.001). These correlations may explain the phenomenon that the major clinical manifestation of zinc deficiency is poor body growth. Clinical symptoms were resolved in most children after zinc supplementation. Conclusion: Hair zinc and mineral analyses are useful as a therapeutic guide in the clinical investigation of children with malnutrition and poor growth.

Effects of Sayeok-tang on Papain-Induced Osteoarthritis in Mice (Papain으로 유도된 골관절염 생쥐 모델에서 사역탕(四逆湯)의 항골관절염 효능에 관한 연구)

  • Kung, Shyang En;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.2
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    • pp.212-224
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    • 2013
  • This study intends to clarify how Sayeok-tang(here in after reffered to SYT) affect C57BL/10 mice whose osteoarthritis was induced by papain. Osteoarthritis was induced by injecting papain in the knee joint of 3 groups(n=6) of mice. Normal group was non-treatment group and was not injected papain, whereas control mice were orally administered with $200{\mu}{\ell}$ of physiological saline. Positive comparison group was medicated with 100 mg/kg of Joins$^{(R)}$ mixed with $200{\mu}{\ell}$ of physiological saline. Experimental group was medicated with 400 mg/kg of SYT mixed with $200{\mu}{\ell}$ of physiological saline. Both Positive and experimental comparison groups were orally medicated once per day for 4 weeks. After the experiment, the functions of liver and kidney, inflammation cytokine values within serum, degree of revelation for inflammation cytokine genes, immune cells within blood, metabolism of arachidonic acid and amount of cartilage were measured and histopathological changes in the knee joint structures were observed. As results, SYT had no significant effect on the liver and kidney functions. Interleukin-$1{\beta}$(IL-$1{\beta}$), interleukin-6(IL-6), monocyte chemo attractant protein-1(MCP-1) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) were significantly decreased. Inflammation cytokines in joints were all significantly decreased. Prostaglandin $E_2(PGE_2)$, thromboxane $B_2(TXB_2)$ were significantly decreased. Destruction of cartilage on micro computed tomography(CT)-arthrography was meaningfully decreased. In terms of histopathology, infiltration of inflammation, proliferation of synovial membrane, subsidence of cartilage and bone due to penetration of excessive formation of synovial cell and destruction of cartilage were small. Based on all results mentioned above, Sayeok-tang(SYT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments because of its anti-inflammatory effects and alleviation of pain with histopathological effective efficacy.

A Literature Review of Management on Radiodermatitis (방사선 피부염 치료법에 대한 문헌고찰)

  • Kwon, Mi Hye;Yoon, Jee-Hyun;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.25 no.1
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    • pp.11-24
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    • 2020
  • Objective : Radiodermatitis is a common sequelae in 95% of patients receiving radiation therapy, which is important to be well managed as it can affect the patient's quality of life as well as the cancer treatment schedule. The aim of this study is to review and summarize the interventions available for the treatment of acute radiodermatitis, including traditional Korean medicine, and to propose treatment algorithms for clinicians. Methods : To collect studies about managements for radiodermatitis, domestic and foreign database were used such as Korean journal of traditional knowledge portal (KTKP), Korean studies information service system (KISS), national discovery or science leaders (NDSL), and oriental medicine advance searching integrated system (OASIS), Pubmed, Google scholar and Scopus. Results : Thirty-two studies were selected. There were nine studies on usual care and dressing, eleven studies on chemical agents, two studies on biological preparations, and ten studies on herbal medicines. Conclusion : Hygienic options and dressings have proved to be useful in the management of radiodermatitis. Chemical agents such as corticosteroid, statin, and topical antibiotic agent have proved to alleviate symptoms and severity, regenerate damaged skin, and prevent secondary infection. In biological preparations, EGF (epidermal growth factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) could be used to protect skin and prevent radiodermatitis. For herbal medicines, Calendula, catechin, β-sitosterol, and Jaungo (紫雲膏) may be effective for symptoms including pain, itching, and burning sensation induced by radiation therapy. Because of some research with conflicting results, further studies are needed to propose an algorithm for more optimal treatments.

Higher Expression of TRPM7 Channels in Murine Mature B Lymphocytes than Immature Cells

  • Kim, Jin-Kyoung;Ko, Jae-Hong;Nam, Joo-Hyun;Woo, Ji-Eun;Min, Kyeong-Min;Earm, Yung-E;Kim, Sung-Joon
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.2
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    • pp.69-75
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    • 2005
  • TRPM7, a cation channel protein permeable to various metal ions such as $Mg^{2+}$, is ubiquitously expressed in variety of cells including lymphocytes. The activity of TRPM7 is tightly regulated by intracellular $Mg^{2+}$, thus named $Mg^{2+}$-inhibited cation (MIC) current, and its expression is known to be critical for the viability and proliferation of B lymphocytes. In this study, the level of MIC current was compared between immature (WEHI-231) and mature (Bal-17) B lymphocytes. In both cell types, an intracellular dialysis with $Mg^{2+}$-free solution (140 mM CsCl) induced an outwardly-rectifying MIC current. The peak amplitude of MIC current and the permeability to divalent cation ($Mn^{2+}$) were several fold higher in Bal-17 than WEHI-231. Also, the level of mRNAs for TRPM7, a molecular correspondence of the MIC channel, was significantly higher in Bal-17 cells. The amplitude of MIC was further increased, and the relation between current and voltage became linear under divalent cation-free conditions, demonstrating typical properties of the TRPM7. The stimulation of B cell receptors (BCR) by ligation with antibodies did not change the amplitude of MIC current. Also, increase of extracellular $[Mg^{2+}]_c$ to enhance the $Mg^{2+}$ influx did not affect the BCR ligation-induced death of WEHI-231 cells. Although the level of TRPM7 was not directly related with the cell death of immature B cells, the remarkable difference of TRPM7 might indicate a fundamental change in the permeability to divalent cations during the development of B cells.

Azoospermia Following Mumps Orchitis:2 Case (볼거리 고환염에 따른 무정자증: 2례)

  • Sim, Hyun-Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.11
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    • pp.767-775
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    • 2016
  • Mumps is an acute viral disease that affects the entire body, including inflammation of the salivary glands. Mumps is accompanied by unilateral or bilateral parotid gland swelling and pain. Mumps virus is spread to others by air, saliva, direct contact, and urine, and occurs in high-density population places such as schools, army, etc. Bilateral testicular involvement is seen in 10-60% of cases. If mumps orchitis affect post-pubertal men, approximately 50% of the infected people are said to experience severe testicular atrophy within 1-2 months as a complication. Mumps orchitis can alter the count, morphology, and motility of sperm and result in oligozoospermia and infertility caused by a rare azoospermia. When suspected of mumps orchitis, active initial symptomatic treatment can prevent infertility due to azoospermia in future adults. A case of mumps orchitis report two cases with references to the ultrasonnography and semen.