Lee, Sooho;Cho, Hyung Rae;Yoo, Jun Sung;Kim, Young Uk
The Korean Journal of Pain
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v.33
no.1
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pp.54-59
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2020
Background: The median nerve cross-sectional area (MNCSA) is a useful morphological parameter for the evaluation of carpal tunnel syndrome (CTS). However, there have been limited studies investigating the anatomical basis of median nerve flattening. Thus, to evaluate the connection between median nerve flattening and CTS, we carried out a measurement of the median nerve thickness (MNT). Methods: Both MNCSA and MNT measurement tools were collected from 20 patients with CTS, and from 20 control individuals who underwent carpal tunnel magnetic resonance imaging (CTMRI). We measured the MNCSA and MNT at the level of the hook of hamate on CTMRI. The MNCSA was measured on the transverse angled sections through the whole area. The MNT was measured based on the most compressed MNT. Results: The mean MNCSA was 9.01 ± 1.94 ㎟ in the control group and 6.58 ± 1.75 ㎟ in the CTS group. The mean MNT was 2.18 ± 0.39 mm in the control group and 1.43 ± 0.28 mm in the CTS group. Receiver operating characteristics curve analysis demonstrated that the optimal cut-off value for the MNCSA was 7.72 ㎟, with 75.0% sensitivity, 75.0% specificity, and an area under the curve (AUC) of 0.82 (95% confidence interval [CI], 0.69-0.95). The best cut off-threshold of the MNT was 1.76 mm, with 85% sensitivity, 85% specificity, and an AUC of 0.94 (95% CI, 0.87-1.00). Conclusions: Even though both MNCSA and MNT were significantly associated with CTS, MNT was identified as a more suitable measurement parameter.
Purpose: This study systematically analyzed the impact of aromatherapy on pain in individuals with diabetes. Methods: A search was performed in seven electronic databases based on the PICO-SD (Population, Intervention, Comparison, Outcome, Study Design) framework. The population (P) of interest was individuals with diabetes, and the intervention (I) included aromatherapy targeting pain reduction. The comparison (C) consisted of control groups that received no intervention, another intervention, or usual care. The outcome (O) measured was pain. The quality of the selected literature was assessed using the Joanna Briggs Institute checklist. In MIX 2.0 Pro, the pooled overall effect of pain was calculated using Hedge's g and a random-effects model, and heterogeneity was calculated using the Q statistic and Higgin's I2 values. Meta-regression and exclusion sensitivity analyses were performed. Results: Five articles and seven studies were included, showing a significant pooled overall effect of aromatherapy on diabetes-related pain (Hedge's g = -1.83, 95% CI: -2.76 to -0.91). Meta-regression demonstrated that effectiveness in reducing pain was associated with studies conducted in West Asia, those with IRB approval, and those receiving funding. Additionally, interventions involving subjects under 60, lavender oil (vs. turpentine oil or blended oils), massage therapy (vs. topical application), fewer hours per session, and more repeated measurements (vs. pre/post measurements) were associated with pain reduction. Conclusion: Aromatherapy, especially with lavender oil, effectively manages diabetes-related pain. Short-duration massage application is also effective. A personalized selection of oil type and application method could optimize therapeutic outcomes for individuals with diabetes.
Nahm, Sahngun Francis;Koo, Mi Suk;Kim, Yang Hyun;Suh, Jeong Hun;Shin, Hwa Yong;Choi, Yong Min;Kim, Yong Chul;Lee, Sang Chul;Lee, Pyung Bok
The Korean Journal of Pain
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v.20
no.2
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pp.163-168
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2007
Background: Temporomandibular joint disorder (TMD) is a group of musculoskeletal conditions characterized by pain in the pre-auricular area, limitation of jaw movement and palpable muscle tenderness. Thermography is a nonionizing, noninvasive diagnostic alternative for the evaluation of TMD. This study was conducted to evaluate the usefulness of thermography in the assessment of TMD. Methods: Thermography was conducted on the 61 patients who had been diagnosed with TMD, and on the 34 normal symptom-free volunteers. The temperature differences between opposite sides of the temporomandibular joint (${\Delta}T_{TMJ}$) and the masseter muscle (${\Delta}T_{MST}$) were calculated. The sensitivity and specificity of thermography was calculated at the cut off values of 0.2, 0.3, and $0.4^{\circ}C$. Results: In the patient group, the ${\Delta}T_{TMJ}$ was $0.42{\pm}0.38^{\circ}C$ and the ${\Delta}T_{MST}$ was $0.38{\pm}0.33^{\circ}C$, whereas in the control group the ${\Delta}T_{TMJ}$ was $0.10{\pm}0.07^{\circ}C$ and the ${\Delta}T_{MST}\;0.15{\pm}0.10^{\circ}C$. In addition, the patient group demonstrated a significantly lower level of thermal symmetry than the control group (P < 0.001) in both the temporomandibular joints and the masseter muscles. The sensitivity of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 67.2, 49.2, and 42.6% in the temporomandibular joint (TMJ) and 60.7, 49.2 and 37.7% in the masseter muscle, respectively. The specificity of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 88.2, 100, and 100% in the TMJ and 61.8, 91.2 and 100% in the masseter muscles, respectively. The accuracy of thermography at the cut off values of 0.2, 0.3 and $0.4^{\circ}C$ was 74.7, 67.4, and 63.2% in TMJ and 61.1, 64.2 and 60.0% in the masseter muscles, respectively. Conclusions: Temperature differences exist between the opposite sides of the TMD and masseter muscles in patients with TMD. Although the sensitivity of thermography in the diagnosis of TMD is low, it has high specificity in the evaluation of TMD, and is therefore applicable to patients with TMD.
The main purpose of this study was to clarify the validity with patient's general background of Korean Pain Measurement tool. The subjects of this study were 195 patient from the 8 Med-Surgical wards in H. University Hospital in Seoul. The study was conducted over a 40 day period from Oct. 5, 1985 to Nov. 15, 1985. All patients had pain. Korean Pain Measurement tool and simple discriptive pain scale as Graphic Rating Scale were used to measure the pain, The Pearson Correlation Coefficient test was exercised to measure the correlation between the two kinds of pain tools. To clarify the Sensitivity of Korean Pain tool was used frequency with patient's response. To compare the difference in Pain levels with patient's general background, ANOVA and t-test was employed. To compare the difference in pain levels existed due to pain area of the body used mean numbers. The outcome of the study was as follows : 1. A positive correlation did exist between two pain measurement tools. (r=.2028∼.7768, p <0.002) 2. The sensitive subclass in Korean Pain Measurement tools was 7 subclass. The 7 subclass are inflammatory repeated pain, simple stimulating, traction pressure, dull pain, cavity pain, digestion related pain, suffering. related pain. 3. The existence of levels of pain in accordance with patient's general background, the department of hospital, pain area of the body and school age was supported. Age, sex, religion, marrital status, economic status, acute or chronic status was not supported. 4. The existence of higher pain levels of the body area was anus, chest, and lower pain levels of the body area was eye, ear, nose and throat. Based on the above results, it was found that sensitive subclasses of the Korean Pain Measurement tool was 7 subclass among all of 20 subclass. Thus it can be concluded that Korean Pain Mea-surement tool when partialy used and supplemented, can be an effective tool of pain measurement for the patient in Korea.
Pain is a subjective and multidemensional concept. Therefore the patient's expression of pain have been referedl to the best believable indicator of pain condition but the support data obtained from the patient considered cultural difference is a deficient condition in determinded on the precise nursing diagnosis. The purpose of this reasearch was to understand multiple pain reponses in cultural difference and sensitivity, to encourage communication between medical teams, and to provide the foundation data of on data of precise nursing assessment for the patient in pain. The research problem was to grasp pain express pattern of Korean peptic ulcer patients. The subjects were 20 peptic ulcer patients in medical unit or OPD of twp university hospitals in Seoul. Data were collected from September 7th to 22nd, 1990 by intensive interviews. Interviews were done by the researcher and all were tape - recorded. The Data analysis was done by Phenomenological method from Van Kaam. Validity assured by confirmation of the internal consistency of the statements and catigory by nursing collegue in educational and clinicions in medical care. From the emic data, 96 descriptive statements were organized in 18 theme cluster. The results of study were summerized as follows. 1. Pain Express Pattern cluster of Peptic Ulcer Patients were “Pain as clogging”, “shallow pain”, “pain as pressing”, “nauseating pain”, “pain as smarting”, “pain as pulling”, “pain as pricking”, “pain as bursting”, “wrenching pain”, “excising pain”, “uncontrollable pain for mind and body”, “awakening pain”, “pain as hollowing” and the other cluster. As above mentioned, Pain Express Pattern of Peptic Ulcer Patient appeared diversely in verbal and they were propered to Korean culture. Therefore they will provide for the foundation data of precise nursing assessment.
Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.
Aims : The purpose of this study was to investigate whether there are any changes in taste sensitivity with advancing age and to see if smoking or oral hygiene can affect the taste sensitivity. Method : Nine hundred and thirty four subjects(458 male and 476 females) were included for the study and they were categorized into 4 age groups( under 20, 20 to 39, 40 to 59, and over 60 age group ). The electrical taste thresholds were measured using an electrogustometer for the 4 different sites in the oral cavity, I.e., tongue tip, tougue alteral, circumvallate papilla, and soft palate. Results : The elctrical taste thresholds were significantly incresed with advancing age in both gender, but the pattern of change is moere abrupt in female after 40. There were not significant differences in electrical taste threshold between smoking and non-smoking people. Taste thresholds were significantly lower in the groups with higher frequency of daily toothbrushing than the groups with lower frequency Conclusion : The electrical taste threshold is increased with aging. It is not influenced by smoking but by toothbrushing.
In this study we fed control diet and tryptophan supplemented diets containing 0.35% tryptophan to ICR mice for 2 weeks. The concentrations of serotonin and 5-HIAA were changed by injection of the serotonin synthesis inhibitor, p-CPA and the serotonin precursor, serotoninP and the change of brain serotonin concentration negatively correlated with that of pain sensitivity, and p-CPA and serotoninP also changed the analgesic effect of morphine. The injection of naloxone, the opiate antagonist, resulted in an increase in the writhing frequency, but its antagonistic effect was not significant. The concentration of 5-HIAA elevated in mice brain at least 3hr after administration of morphine hydroxide indicates that the changes in brain serotonin metabolism may be associated with the acute effects of morphine analgesia. In short, these results not only suggest that tryptophan supplemented diet suppress pain sensitivity in mice, but also indicate that at least in part analgesic mechanism of serotonin may be associated with morphine analgesia.
Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.
Park, Jin-Ho;Kim, Hye-Kyoung;Kim, Ki-Suk;Kim, Mee-Eun
Journal of Oral Medicine and Pain
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v.40
no.2
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pp.47-54
/
2015
Purpose: Besides depression and anxiety, recently pain catastrophizing has been emphasized for an important psychological factor explaining pain response in various pain conditions including temporomandibular disorders (TMDs). The aims of this study were to evaluate pain catastrophizing of TMD patients and to investigate how the level of pain catastrophizing related with clinical variables and psychometric morbidity. Methods: Inclusion criterion was all new TMD patients ${\geq}18$ years old attending the Department of Orofacial Pain and Oral Medicine of Dankook University Dental Hospital (Cheonan, Korea) over three-month period in 2014, who completed questionnaires. The questionnaires included the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Symptom Check List- 90-Revised (SCL-90-R). All of them were examined clinically and diagnosed. Results: One hundred fifty five patients diagnosed as TMDs were participated in this study (mean age of $38.7{\pm}15.2$ years, male:female=1:2.5). Mean PCS score of the patients was 17.3 with standard deviation of 12.6. By the median of the PCS score (i.e., 15), the subjects were categorized into the high (${\geq}15$) and low catastrophizers (<15). Increased pain severity and interference and increased score of psychological features of SCL-90-R were found in the TMD patients with higher level of catastrophizing (p<0.001) and there was weak to moderate correlation between those factors (p<0.05). Difference in catastrophizing level was not found for other variables such as age, gender, duration of pain, education level and types of TMDs. Conclusions: Conclusively, pain catastrophizing of TMD patients relates positively to pain severity and pain interference. In addition to depression and anxiety, pain catastrophizing is positively correlated with variable other psychological morbidity such as somatization, obsessive- compulsive, interpersonal sensitivity, paranoid ideation and psychoticism. Types of TMD diagnosis do not seem to affect catastrophizing level. The results of this study suggest that pain catastrophizing should be emphasized and assessed in the TMD patients.
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