• The Korean Journal of Pain
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• v.12 no.1
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• pp.21-26
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• 1999

Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of central nervous system (CNS) and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative low dose epidural bupivacaine and morphine could affect postoperative pain, changes plasma cortisol, and serum glucose. Methods: Thirty patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. General anesthesia was induced in all patients and after that, epidural blocks were done except the control group (n=10) patients. Preoperative block group (n=10) received 0.5% bupivacaine 50 mg and morphine 2 mg epidurally as a bolus before operation and followed by 0.1% bupivacaine $5\;mghr^{-1}$ and morphine $0.2\;mghr^{-1}$ for 10 hours. Postoperative block group (n=10) received the same doses of bupivacaine and morphine under the same method postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative pain by visual analogue scores (VAS), analgesic requirement (first requirement time, total amounts used), side effects, plasma cortisol level and serum glucose level were compared. Results: Until postoperative 6 hrs, VAS of control group was higher than those of the epidural groups. No difference was observed in VAS between the two epidural groups. First analgesics requirement time and total amounts of used analgesics were not different between the two epidural groups, but first analgesic requirement time of preoperative block group was significantly prolonged compared with control group. Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Low dose preoperative epidural bupivacaine and morphine could not reduce postoperative pain, plasma cortisol level and serum glucose level compared with postoperative block group.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.72-83
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• 2023

Background: Globally, spinal cord injury (SCI) results in a big burden, including 90% suffering permanent disability, and 60%-69% experiencing neuropathic pain. The main causes are oxidative stress, inflammation, and degeneration. The efficacy of the stem cell secretome is promising, but the role of human neural stem cell (HNSC)-secretome in neuropathic pain is unclear. This study evaluated how the mechanism of HNSC-secretome improves neuropathic pain and locomotor function in SCI rat models through antioxidant, anti-inflammatory, anti-matrix degradation, and neurotrophic activities. Methods: A proper experimental study investigated 15 Rattus norvegicus divided into normal, control, and treatment groups (30 µL HNSC-secretome, intrathecal in the level of T10, three days post-traumatic SCI). Twenty-eight days post-injury, specimens were collected, and matrix metalloproteinase (MMP)-9, F2-Isoprostanes, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, and brain derived neurotrophic factor (BDNF) were analyzed. Locomotor recovery was evaluated via Basso, Beattie, and Bresnahan scores. Neuropathic pain was evaluated using the Rat Grimace Scale. Results: The HNSC-secretome could improve locomotor recovery and neuropathic pain, decrease F2-Isoprostane (antioxidant), decrease MMP-9 and TNF-α (anti-inflammatory), as well as modulate TGF-β and BDNF (neurotrophic factor). Moreover, HNSC-secretomes maintain the extracellular matrix of SCI by reducing the matrix degradation effect of MMP-9 and increasing the collagen formation effect of TGF-β as a resistor of glial scar formation. Conclusions: The present study demonstrated the mechanism of HNSC-secretome in improving neuropathic pain and locomotor function in SCI through antioxidant, anti-inflammatory, anti-matrix degradation, and neurotrophic activities.

• Women's Health Nursing
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• v.17 no.5
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• pp.484-490
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• 2011

Purpose: This study was aimed to investigate the impact of job stress on low back symptoms among Clinical nurses (CNs) in university hospital. Methods: A total of 322 CNs employed in a hospital in Seoul were interviewed by a well-trained interviewer using the structured questionnaire. Data collected for this study includes demographics, social and work characteristics, low back symptoms, and job stress. To test the impact of job stress on low back symptoms, we used multiple logistic regression analysis. Results: The prevalence of low back symptoms was 25.8% in this study. Low back symptoms differed significantly by factors, such as physical work burden, past history of injury and work duration. Also low back symptoms differed significantly by organizational system among independent variables of job stress. In a multiple logistic regression analysis, the odds ratio of organizational system to low back symptoms was 2.07 after an adjustment. Conclusion: This study showed that organizational system among job stress was a significant variable in explaining low back symptoms. We suggest the improvement of organizational system category as a preventive strategy for low back pain in CNs working in hospital.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.2
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• pp.1-12
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• 2009

Objectives : The purpose of this study was to investigate the relationship between pain and psychological state in female office workers with neck pain. Methods : Experimental group of 31 healthy subjects complained of neck and arm discomfort related to computer use which lasted more than 3 months in the past year and was present in the past 7 days as well as on the day of test. Outcomes were assessed by meridian-electromyography(MEMG), Neck Disability Index(NDI), Visual Analog Scale(VAS), Beck Depression Inventory(BDI), Stress Reaction Inventory(SRI), Holmes & Rahe Social Readjustment Rating Scale(SRRS). Results : The NDI score and BDI score had a correlationship(r=0.48), and the NDI score and SRI score also had a correlationship(r=0.48), significantly. The NDI score and contraction power of upper trapezius by MEMG had a correlationship significantly, but with the other muscles the NDI score didn't have correlationships. The NDI score and the SRI score were significantly higher in depression group(BDI score ${\circ}{\surd}$14). The contraction power of trapezius by MEMG was significantly lower in depression group. Conclusions : The results suggest that mental stress can be a major risk factor of neck pain in female office workers.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.80-83
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• 2008

Local infiltration in surgical wounds can reduce postoperative pain with very few side effects. We experienced two cases of chronic pain after forehead lift surgery. A 41-year-old male patient was suffering from a headache at the crown of the head and pain from the posterior neck. A 54-year-old female patient had pain around the forehead, worsened by psychological stress. They underwent forehead lift surgery 10 years and 8 months ago, respectively. Conservative treatments such as medication and physical therapy were not effective. After wound infiltration with 1% lidocaine more than ten times, pain significantly resolved in both patients.

• Women's Health Nursing
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• v.7 no.2
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• pp.188-202
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• 2001

This study was designed to investigate the effect of one-to-one labor support on labor pain, labor stress response, childbirth experience and neonatal status for primipara by a quasi experiment (nonequivalent control group pretest-posttest design), from April 30, 1999 to February 20, 2000. The subjects of this experiment consisted of eighty two primipara with single gestation, full term, uncomplicated pregnancies. Forty one were in the experimental group and forty one in the control group. Their mean age was 25.95 years, their mean gestation period was 39.9 weeks. A caring package of one-to-one labor support had three components. Physical support consisted of massage, back pressure, touch. Emotional support was provided by a continuous nurse's presence, acceptance and encouragement. Informational support involved teaching breathing skills, relaxation skills and knowledge about the labor process. Data assessed labor pain, pulse rate and blood pressure to measure labor stress response. Also, in measuring the value of labor stress response, plasma epinephrine, plasma norepinephrine and serum cortisol were measured. In the 24 hours after birth, the data for the postpartum mother's childbirth experiences was collected. Umbilical cord arterial blood pH, one minute and five minute Apgar score were measured after birth. Data was analyzed by t-test, $x^2$-test, repeated measures ANOVA, ANCOVA with SAS Program. The results were as follows; 1. Labor pain was significantly low in the experimental group(P=.016). 2. No significant group effects were found, but significant time effects were found for plasma epinephrine, norepinephrine, serum cortisol, pulse rate and blood pressure. 3. The childbirth experience of the experimental group was significantly more positive than the control group (P = .005). 4. The umbilical cord arterial blood pH of the experimental group was significantly higher than the control group(P=.014). There was no significant difference between the two groups in neonatal one minute and five minute Apgar scores. In conclusion, these findings indicate that one-to-one labor support could be effective in decreasing labor pain, and increasing positive childbirth experiences, also increasing the neonatal umbilical cord arterial blood pH for primipara. So, one-to-one labor support could be applied as an effective nursing treatment for primipara.

• Journal of Oral Medicine and Pain
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• v.47 no.4
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• pp.174-182
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• 2022

In chronic temporomandibular disorders (TMDs), constituent tissues such as muscles are sensitive to pain and psychological stress, which negatively affect the quality of life. In addition, since chronic TMDs is often accompanied by diseases such as psychological disorders and other chronic pain disorders, the diagnosis of those diseases and patient referrals are mandatory. The management of chronic pain in TMDs requires a multidisciplinary and holistic approach. Pharmacological therapy using cyclobenzaprine, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, progressive relaxation, and psychological approaches using cognitive behavioral therapy such as shifting negative thoughts about pain are all valid treatment options.

• Journal of Korean Physical Therapy Science
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• v.9 no.1
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• pp.153-158
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• 2002

Pain, which is the most significant issue for the physical therapist, is the cause of various diseases until it disappears, and results in a lot of obstructions to treatment. Pain is very complicated. It is a subjective symptom that informs of a pathologic condition in the body, and one of the unpleasant experiences that people have. It is accompanied with anxiety and fear. Many researchers including Krause(1987) have identified the pain mechanism based on pain perception for many centuries and they have suggested many theories as they believed that pain management was possible. Reviewing the contents of psychoanalysis, uncontrollable pain that can't be explained is described as a defense mechanism to an unconscious psychological conflict. That is, mental pain is transferred to the body and the pain becomes unbearable. What is important is, like Keefe(1992) said, that the pain experience itself is primary stress and one should cope with it, whatever the cause of the pain. This paper investigates the background of the psychological theory of pain. Based on the efforts of previous studies, the next research generation will understand the treatment process for pain more dearly and will contribute to the prevention and protection from pain that humans undergo.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.51-60
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• 1999

This study was designed to evaluate anxiety & depression symptoms and pressure pain threshold in patients with posttraumatic stress disorder(n=23) and to find out the relationship between the affective symptoms and the pressure pain threshold scores. And this was compared with healthy control subjects(n=18). The scores of pressure pain threshold were checked with algometer. The results were as follows : PTSD patients showed higher scores of anxiety & depression symptoms than that of the control group. In contrast with our hypothesis, pressure pain threshold in PTSD patients presented statistically significant higher scores than that of the control group. These results may be derived from following factors. First, chronic depression has influenced the pain perception of patients with PTSD rather than anxiety symptoms, second, abnormal state of the opiate system in PTSD patients, third, the sick role of the PTSD patients, fourth, the socio-environmental factor of the PTSD patients. In conclusion, affective symptoms, especially depression, were related to the chronic pain in patients with PTSD, however, the causality of elevated pressure pain threshold was uncertain in this study. To understand more clearly the relation between affective symptoms and chronic pain, it will be necessary to control the other specific factors.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.203-212
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• 2013

Objectives This study was to investigate the correlation of low back pain, stress by event, and fear-avoidance beliefs caused by traffic accident. Methods We investigated 103 cases of out-patient with traffic accident. The patients answered that Visual Analogue Scale (VAS), Impact of Event Scale Revised Korean Version (IES-R-K), and Fear-Avoidance Beliefs Questionnaire (FABQ) on the first medical examination. We calculated statistical significance with this data. Results VAS, IES-R-K, and FABQ scores of the female patients with the traffic accident were higher than the male patients. VAS, IES-R-K, and FABQ scores showed low significant positive correlation and showed partial correlation between IES-R-K and FABQ, controlled by VAS, had no statistical significance in this research. Conclusions More considerations on pain, stress by event, and fear avoidance belief should be needed in treatment of the traffic accident patients.