• Title/Summary/Keyword: persistent pain

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Roles of Reactive Oxygen Species on Neuronal Excitability in Rat Substantia Gelatinosa Neurons (척수 아교질 신경세포의 흥분성에 대한 활성산소종의 역할)

  • Choi, Jeong-Hee;Kim, Jae-Hyo;Lim, Sung-Jun;Park, Byung-Rim;Kwon, Kang-Beom
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.432-437
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    • 2007
  • Reactive oxygen species (ROS) are toxic agents that may be involved in various neurodegenerative diseases. Recent studies indicate that ROS are also involved in persistent pain through a spinal mechanism. In the present study, whole cell patch clamp recordings were carried out on substantia gelatinosa (SG) neurons in spinal cord slice of neonatal rats to investigate the effects of ROS on neuronal excitability and excitatory synaptic transmission. In current clamp condition, tert-buthyl hydroperoxide (t-BuOOH), an ROS donor, induced a electrical hyperexcitability during t-BuOOH wash-out followed by a brief inhibition of excitability in SG neurons. Application of t-BuOOH depolarized membrane potential of SG neurons and increased the neuronal firing frequencies evoked by depolarizing current pulses. Phenyl-N-tert-buthylnitrone (PBN), an ROS scavenger, antagonized t-BuOOH induced hyperexcitability. IN voltage clamp conditions, t-BuOOH increased the frequency and amplitude of spontaneous excitatory postsynaptic currents (sEPSCs). In order to determine the site of action of t-BuOOH, miniature excitatory postsynaptic currents (mEPSCs) were recorded. t-BuOOH increased the frequency and amplitude of mEPSCs, indicating that it may modulate the excitability of the SG neurons via pre- and postsynaptic actions. These data suggest that ROS generated by peripheral nerve injury can induce central sensitization in spinal cord.

Treatment of Shepherd's Crook Deformity with Huckstep's nail in Fibrous Dysplasia - A Case Report - (섬유성 골이형성증에서 Huckstep 정을 이용한 Shepherd's Crook 변형의 치료 - 증례 보고 -)

  • Whang, Kuhn-Sung;Kim, Tae-Seung;Kim, Byoung-Hoon;Lee, Jong-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.27-31
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    • 2002
  • Clinical symptoms of fibrous dysplasia in proximal femur include pain, limping, and leglength discrepancy. Occasionally varus deformity, which may range from mild coxa vara to a marked shepherd's crook deformity was developed. Surgical intervention generally is considered advisable in the presence of persistent pain unresponsive to conservative treatment or significant or progressive deformity. Depending on the lesion size, lesion site, and deformity, several treatment methods have been used. This is a report on one case of bilateral shepherd's crook deformity in fibrous dysplasia, which was treated with corrective osteotomy by Huckstep nail.

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Differential effect of electroacupuncture analgesia depending on the point selection in a rat model of CFA-induced arthritis (CFA로 유도한 관절염에서 선혈(選穴)에 따른 전침(電鍼)의 진통효과 차이)

  • Yang, Bum-Sik;Koo, Sung-Tae;Kim, Kyoung-Sik;Sohn, In-Cheul
    • Korean Journal of Acupuncture
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    • v.22 no.1
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    • pp.95-108
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    • 2005
  • Objective : In the present study, the effect of electroacupuncture (EA) applied to several acupoints and non-acupoint in CFA-induced knee arthritis was examined. Methods : A common source of persistent pain in humans is arthritis. Arthritis was induced by injection of CFA $125\;{\mu}l$ into knee joint cavity under enflurane anesthesia. The rat subsequently showed swelling of the ankle and a reduced stepping force of the affected limb for the next several days. The reduced stepping force of the limb was presumably due to a painful knee. EA was applied to either of $LR_2,\;LI_4$, or non-acupoint on the contralateral forelimb for 30 min under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next 4 h. Results : EA applied to $LR_2$ point produced a significant improvement of stepping force of the affected foot lasting for at least 2 h. However, neigher $LI_4$ point nor non-point produced any significant increase of weight bearing force. The improvement of stepping pressure was interpreted as an analgesic effect. The analgesic effect was specific to the acupuncture point since the analgesic effect on CFA-induced knee arthritic pain model could not be mimicked by EA applied to a point, $LI_4$ or non-acupoint. In addition, both NO production and iNOS protein expression increased by arthritis were suppressed by EA applied to $LR_2$ point. Conclusion : These data suggest that EA produces a potent analgesic effect in the rat model of CFA-induced knee arthritis. This analgesic effect is produced by applying EA to an acupoint at opposite side from the painful area in a stimulus point-specific way.

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Revision Rotator Cuff Repair (회전근 개 봉합술 후 재수술)

  • Kim, Young-Kyu;Kim, Dong-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.119-125
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    • 2009
  • The primary purposes of revision repair for a failed rotator cuff repair are a relief of pain and functional improvement. Therefore, revision repair is most proper in patients with the functional deficit accompanied with the shoulder weakness as well as the persistent pain. The important factor that is considered in revision repair is a quality of torn cuff. Especially, Care must be taken to ensure that the revision repair is possible, considering the size of tendon defect, atrophy of the muscle, fatty infiltration and extent of the retraction of tendon. Revision repair of a failed rotator cuff repair is more difficult, and the functional results are less satisfactory than those of primary repair, because excessive bursal scarring and tendon retraction may be exhibited, a large or massive tear is often detected, tear has usually been present for a long time, and a quality of muscle-tendon may be poor. So, we discuss our experiences related to revision repair after a failed cuff repair that has been recently introduced through the articles.

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Symptomatic Temporomandibular Joint Herniation through the Foramen of Huschke: A Case Report

  • Song, Hee-Jeong;Lee, Yuni;Choi, Hang-Moon;Kim, Young-Jun;Kim, Cheul;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • v.46 no.4
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    • pp.161-164
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    • 2021
  • The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient's symptom level and the patient's general health status. If the clinical symptoms are not severe, no treatment is required.

Improvement Effect of Soyeom Pharmacopuncture on Gout via NLRP3 Inflammasome Regulation

  • Sung Wook Kim;Jun Ho Lee;Hyeonjin Kim;Seong Hoon Lee;Dajeong Jeong;Hyuk Soon Kim;Cheol-Jung Lee;Dae Yong Kim;Tae Han Yook;Gabsik Yang
    • Journal of Pharmacopuncture
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    • v.25 no.4
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    • pp.396-403
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    • 2022
  • Objectives: Gout is an inflammatory arthritis of the joints and soft tissues occurring due to deposition of monosodium urate (MSU) crystals, which are caused by persistent hyperuricemia. Soyeom pharmacopuncture is one treatment method that has been traditionally used for pain management in Oriental medicine. However, studies on its effect in reducing gout pain have been insufficient. Therefore, we selected Soyeom pharmacopuncture among natural products used in Korea as the new target of our study. Methods: The effects of Soyeom pharmacopuncture were examined in mouse models of acute gout induced by injection of MSU crystals into footpads. IL-1β, IL-6, and TNF-α production were examined by immunoblotting and enzyme-linked immunosorbent assay as hallmarks of NLRP3 inflammasome and cytokine activation. Results: Soyeom pharmacopuncture reduced foot edema in gout-induced mice, as well as IL-1β, nitrite, IL-6, and TNF-α production. Moreover, Soyeom pharmacopuncture also reduced MSU-induced gout inflammatory gene expressions, specifically those in the NF-kB pathway. Conclusion: Pharmacopuncture may serve as a new solution for other inflammatory diseases as well. Through active follow-up studies, we could thoroughly understand the clinical value of Soyeom pharmacopuncture.

Effectiveness of thaumaturgic distraction in alleviation of anxiety in 4-6-year-old children during inferior alveolar nerve block administration: a randomized controlled trial

  • Payal Kothari;Aditi Mathur;Rashmi Singh Chauhan;Meenakshi Nankar;Sunnypriyatham Tirupathi;Ashrita Suvarna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.3
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    • pp.143-151
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    • 2023
  • Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion: Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

Korean Medicine Review and Treatment Suggestions for the Main Symptoms of Long COVID (Long COVID의 주요 증상에 대한 한의학적 고찰과 치료 제안)

  • Yosun, Hwang;Euna, Lee;Hyungwoo, Kim
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.5
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    • pp.155-162
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    • 2022
  • Even after testing negative for COVID-19, some patients continue to struggle with a variety of symptoms such as fatigue, shortness of breath, gastrointestinal problems and neurological problems. The World Health Organization (WHO) defined long COVID (Post COVID-19 conditions) as "A disease occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months, that cannot be explained by an alternative diagnosis." As a possible pathological mechanism of long COVID, three hypotheses are proposed: the persistence of the infectious state due to the residual virus, the persistent inflammatory response, and the autoimmune response. The main symptoms of long COVID are shortness of breath (dyspnea), abdominal pain and dyspepsia, fatigue, cognitive problems (brain fog), anosmia and dysgeusia, and chest pain, palpitations and tachycardia. In the Chinese guidelines, COVID-19 patients were divided into mild, moderate, severe, and recovery, and prescriptions with effective therapeutic effects were summarized to encourage combined treatment of chinese and western medicine. Globally, only symptomatic therapy is recommended for long COVID, but a specific treatment has not yet been proposed. Recently, morbidity code for post COVID-19 conditions was created, and it is planned to announce guidelines for long COVID treatment and management in the first half of 2023. In line with this trend, the Korean medical community needs to make efforts to prepare treatment guidelines for patients with long COVID.

Revisional Rotator Cuff Repair (회전근 개 재파열 후 봉합술)

  • Kim, Kyungil;Jeong, Jinyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.91-99
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    • 2019
  • Most patients experience pain relief and functional improvement after arthroscopic rotator cuff repair. In some patients, however, symptoms still remain after surgery. Failed rotator cuff repair is a complex outcome of biological, technical, and traumatic factors. Moreover, re-tears might or might not be the main cause for patients with persistent pain after rotator cuff repair. Therefore, a thorough understanding of the patient's history, physical examination, and appropriate imaging studies will be needed to evaluate and manage these patients. The patient's age, functional requirement, quality of the rotator cuff, preoperative range of motion, quality of the deltoid, and glenohumeral arthritis are factors to consider before performing revisional rotator cuff repair. Preoperative patient education is as important as the surgical technique for successful revisional rotator cuff repair.

Surgical Outcome of Achilles Reconstruction Using Allotendon and a Calcaneal Tunneling Technique in Patients with Chronic Achilles Rupture (동종건과 종골 터널을 이용한 만성 아킬레스건 파열 환자의 아킬레스건 재건술의 수술적 결과)

  • Gab-Lae Kim;Sung-Yup Hong;Jung Hyun Cho;Tong Young Yoon
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.15-20
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    • 2024
  • Purpose: Achilles tendon rupture is a frequently encountered ankle pathology associated with a substantial burden of intense pain and functional deficits. Chronic Achilles tendon ruptures with considerable defects pose intricate repair challenges that are often marred by complications such as re-rupture and persistent pain. Various treatment methods, including allograft transplantation, have been proposed, but the literature on this technique is limited. In this study, we propose a surgical approach utilizing allotendon transplantation and a calcaneal tunneling technique and provide clinical evaluation details. Materials and Methods: Fifteen patients with chronic Achilles tendon ruptures treated with allotendon between 2020 and 2022 were included in the study. Patients were evaluated at 1, 3, and 6 months postoperatively using Visual Analog Scale (VAS) scores and Achilles Tendon Total Rupture Scores (ATRSs). Complications were assessed postoperatively. Results: The average VAS score was 7 before surgery, 7.3 immediately after surgery, and 4.3 at 1 month, 2.5 at 3 months, and 1.3 at 6 months after surgery. Because the sample was limited to 15 individuals and distributions were non-normal, the analysis was conducted using the non-parametric Wilcoxon's signed-rank test, and statistical significance was accepted for p-values<0.05. Results showed a significant improvement in ATRS and VAS scores versus preoperative and immediate postoperative values. VAS scores showed a decreasing trend after surgery, whereas average ATRS scores increased from 14 before surgery, 33.8 at 1 month, 82.7 at 3 months, and 93.9 at 6 months. Conclusion: This study suggests that allograft transplantation using the described calcaneal tunnel technique provides an effective treatment for chronic Achilles tendon ruptures. However, extensive research and long-term clinical trials are required to validate and better understand the technique's efficacy.