• Title/Summary/Keyword: visceral pain

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Fungiform Papillae and its Correlation with Rome III Classification and Spleen Qi Deficiency in Functional Dyspepsia (기능성 소화불량증 환자에서 로마기준 III 아형분류 및 脾氣虛證과 심상유두 수의 상관성 분석)

  • Choi, Jane;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.308-322
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    • 2015
  • Objectives: Whether there exists a distinct pathogenesis in subgroups of functional dyspepsia (FD), the classification of epigastric pain syndrome (EPS), and postprandial distress syndrome (PDS) remains controversial. We aimed to investigate the number of fungiform papillae (FP) in the subgroups of FD and its correlation with the severity of dyspepsia symptoms and spleen qi deficiency. Methods: Patients with FD were enrolled from August to November 2014. All patients were evaluated using a questionnaire and divided into 2 groups according to the Rome III criteria for FD. The severity of dyspepsia symptoms and spleen qi deficiency were separately assessed by Nepean Dyspepsia Index-Korean (NDI-K) version and Spleen qi deficiency questionnaire (SQDQ). The number of FP was measured on the anterior part of tongue, within an area of 9 mm 2, using a digital cam Results: The NDI-K score, SQDQ score, and number of FP in the EPS group were significantly greater than those in the PDS group. Also, the EPS group had more patients diagnosed with spleen qi deficiency. The number of FP showed a significant positive correlation with epigastric pain and burning. Furthermore, the number of FP was significantly associated with the score of some items in NDI-K and SQDQ, even though not with the total score. Conclusions: Thus, measurement of the number of FP could be a new evaluation indicator for allocation into FD subtypes and to investigate the severity of dyspepsia symptoms and spleen Qi deficiency reflecting visceral hypersensitivity.

Understanding Neurogastroenterology From Neuroimaging Perspective: A Comprehensive Review of Functional and Structural Brain Imaging in Functional Gastrointestinal Disorders

  • Kano, Michiko;Dupont, Patrick;Aziz, Qasim;Fukudo, Shin
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.512-527
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    • 2018
  • This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

Surgical Resection of Solitary Fibrous Tumor in the Parietal Pleura -Report of One Case- (흉막에 발생한 고립성 섬유종의 외과적 치험)

  • 이종호;심성보
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.798-801
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    • 1996
  • Solitary fibrous tumors of the pleura are rare, slow-growing benign neoplasm, originating from submesothelial Hbroblasts. Approximately 80% of solitary fibrous tumors of the pleura originate in . the visceral pleura and 20% in the parietal pleura. Many of these tumors are pedunculated, attached to the visceral pleura via a well-vasculariEed stalk, and in size from 1 to 36cm with a mean of 6cm. This case report is of a 48 year old woman who presented with dyspnea and right flank pain. Preoperative chest x-ray showed increased hazy density at right lower lung field, and CT scan showed huge heterogeneous mass which was located in right mid and lower thorax. She underwent surgical resec- tion and a lOX15X loom(2200gm weigh) sized large mass was excised. Final histologic diagnosis was solitary fibrous tumor of the plara. The patient was discharged without any complications postoperately.

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Anti-nociceptive Effect of Curcuma longa Extract on Acetic Acid induced Pain Model (강황 에탄올 추출물 및 그 분획물의 초산 유발에 의한 통증억제 효과)

  • Yoon, Won Ho;Lee, Keyong Ho
    • Korean Journal of Pharmacognosy
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    • v.46 no.3
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    • pp.229-233
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    • 2015
  • The anti-nociceptive effect of an ethanol extract and its various solvent fractions from Curcuma longa Linne ethanol extract was studied using the writhing test in mice. Different fractions by various solvent extraction from Curcuma longa Linne ethanol extract were administered orally 1 hr or time-course (0.5, 1, 2 and 5 hr) before intraperitoneal injection of acetic acid. After treatment with 30% ethanol extract and n-butanol fraction, CB-1, at a dose of 250 mg/kg, the significant writhing responses were 87.5 ± 13.4 (inhibition rate 31%, p<0.01) and 75.1 ± 11.1 (inhibition rate 41%, p<0.01) lower than the control group. At the dose of CB-1 50 mg/kg and 250 mg/kg, CB-1 showed a similar activity comparing to diclofenac of 10 mg/kg. A time-course experiment was performed, which involved oral administration of CB-1 (250 mg/kg) at 0, 0.5, 1, 2, and 5 hr before acetic acid intraperitoneal injection. The most effective time of CB-1 was 30 min before treatment and persisting until 2 hr. This study showed that Curcuma longa Linne has anti-nociceptive properties comparable with those of diclofenac, which suggests promise for the treatment of intractable visceral pain in humans. Major components of the active fraction are identified as curcumin, cyclocurcumin and demethoxycurcumin.

Effects of Herbal Bath on Acetic Acid-induced Somato-visceral Pain in Mice (현호색, 창출, 천수근 약욕이 체성내장통에 미치는 영향)

  • Kim, Ick-Hwan;Lee, Taeck-Hyun;Kim, Chang-Ju;Lee, Choong-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.3
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    • pp.642-650
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    • 2006
  • As an effective non-pharmacological method of pain relief, hydrotherapy was widely used. And bath additive has been used for enhancing the efficacy of hydrotherapy, In the present study, as a bath additive, the analgesic activity of HAC, which composed of Corydalis turtschaninovii, Atractylodes japonica, and Harpagophytum procumbens(HAC), was investigated in the ventrolateral periaqueductal gray (VIPAG), lateral PAG (IPAG), central nuclei of amygdala (CeA), and the paraventricular nucleus of the hypothalamus (PVN) in mice, using writhing test and immunohistochemistry for c-Fos. Male C57BU6 mice weighing $25{\;}{\pm}{\;}2g$ (8 weeks of age) were used for this experiment. The animals were divided into five groups: the control group, the acetic acid treatment group, the acetic acid treatment and 0.01 g/L HAC-immersed group, the acetic acid treatment and 0.1 g/L HAC-immersed group, and the acetic acid treatment and 1.0 g/L HAC-immersed group. To induce somato-visceral pain in the experimental animals, a single intraperitoneal (i.p.) injection of acetic acid was administrated to each animal, and the animals of the control group received injections of equivalent doses of normal saline. The animals of the HAC-immersed groups were immersed the water with HAC powder at the respective doses deep enough to cover the mice body, and those of the control group and the acetic acid treatment group immersed the water without HAC powder at 10 min immediately after the acetic acid injection. Our present study has shown that the HAC reduced the acetic acid-induced abdominal constrictions and the acetic acid-Induced increase of numbers of c-Fos-positive cells in the VIPAG, IPAG, PVN, and CeA. The most potent analgesic effect appeared with the treatment of 1.0 g/L KB-immersed group. Based on our present results, it is very possible that HAC can be a potent therapeutic bath additive for alleviating pain without the fear of addiction to the drugs and side-effects associated with the prescription of multiple analgesic drugs.

Posture and Low Back Pain (일반적인 자세가 요통에 미치는 영향에 대한 고찰)

  • Jung, Mun-Boung;Lee, Geoun-Sung;Kang, Eun-Mi;Oh, Kyeong-Seok
    • Journal of Korean Physical Therapy Science
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    • v.3 no.4
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    • pp.207-214
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    • 1996
  • Main cause of low back pain is a poor posture. Most low back pains are due to a poor posture. The poor posture induces muscle tension and finaliy low back pain. The poor posture arehabitually trained from the childhood by the environmetal factors. In general, maintaining good posture during working and sleeping hours are the first line of defence against back pam. (1) Supine posture is the easiest posture that relaxes and fixes muscles. Supine posture is thus a starting position for on exercise. Lying down releases the weight pressures of head and shoulder and thus body can be relaxed and extended which are helpful for treating back pain. However, supine posture can increase the pressure in ribcage posture aspect and disphragram due to visceral oragans. (2) Sitting in one position for a long time results in fatigue and relaxation of spinal muscies. Finally, body strength is weakened and sitting posture will become poor. If this poor posture continues for a longer time, pain will be accompanied due to overelongation of muscle ligaments. The habitual poor posture could induce intervertebral disc distortion. If the intervertebral disc is damaged, sitting in one position or movement causes pain. (3) Abnormal lumbar curve induces the tention of abdominal muscle and paravertebral muscle groups as well as tention of lower limb muscle group connected to pelvis. For a person with weak body strength, muscle relaxation increases curvature in lumbar, chest and cervical regions. This will induce a pelvic anterior tilting of the imaginary line between A. S. I. S. and P. S. I. S. Hip joint extensor muscle acts on releasing the pelvic anterior tilting. Contrections of hamstring muscle and femoral muscle recover the imaginary line between A.S.LS. and P.S.I.S. from pelvic anterior tilting. thus, contraction of rectus abdominis muscle are required to maintain the normal lumbar curve.

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Alternative Method of Retrocrural Approach during Celiac Plexus Block Using a Bent Tip Needle

  • An, Ji Won;Choi, Eun Kyeong;Park, Chol Hee;Choi, Jong Bum;Ko, Dong-Kyun;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.109-115
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    • 2015
  • Background: This study sought to determine safe ranges of oblique angle, skin entry point and needle length by reviewing computed tomography (CT) scans and to evaluate the usefulness of a bent tip needle during celiac plexus block (CPB). Methods: CT scans of 60 CPB patients were reviewed. Image of the uppermost margin of L2 vertebral body was used to measure the minimal and maximal oblique angles and the distances from the midline to skin puncture point. The imaginary needle trajectory distance was calculated by three-dimensional measurement. When the procedure was performed by using a $10^{\circ}$ bent tip needle under a $20^{\circ}$ oblique X-ray fluoroscopic view, the distance (GF/G'F) from the midline to the actual puncture site was measured. Results: The imaginary safe oblique angle range was $26.4-34.2^{\circ}$ and $27.7-36.0^{\circ}$ on the right and left, respectively. The distance from the midline to skin puncture point was 6.1-7.6 cm on the right and 6.3-7.6 cm on the left. The needle trajectory distance at minimal angle was 9.6-11.6 cm on the right and 9.5-11.5 cm on the left. The distance of GF/G'F was 5.1-6.5 cm and 5.0-6.4 cm on the right and left, respectively. All imaginary parameters were correlated with BMI except for GF/G'F. All complications were mild and transient. Conclusions: We identified safe values of angles and distances using a straight needle. Furthermore, using a bent tip needle under a $20^{\circ}$ oblique fluoroscopic view, we could safely perform CPB with smaller parameter values.

Literature Review and Network Analysis on the Pain Disease Approach of Saam Acupuncture Method (사암도인침법의 통증 질환 접근법에 대한 고찰)

  • Park, Ji-Yeun;Lee, Soon-Ho;Kim, Song-Yi;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.34 no.2
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    • pp.88-99
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    • 2017
  • Objectives : Saam acupuncture initiated by Saamdoin in $17^{th}$ century is one of the most widely adopted acupuncture techniques used by Korean medical doctors in clinic. Our study aimed to analyze the application of the Saam acupuncture method to pain diseases based on the literature data. Methods : Based on the contents described in "(Do Hae Kyo Kam) Saam's acupuncture method", the texts related to pain condition were analyzed. The frequency of prescription of Saam acupuncture method was analyzed, and then the relationships between each acupoint were visualized by network analysis and hierarchical cluster analysis for the quantitative aspect. Results and conclusions: In our study, Lung tonifying and Liver tonifying acupuncture were the most frequently used method for the treatment of pain disease. As the acupoints, BL66 and SI5 were used the most frequently. It was found that visceral pattern identification was considered as the most important factor in the selection of the Saam acupuncture method. Network analysis and hierarchical clustering analysis showed that each acupoint was closely related to other acupoints, and most of them were connected more closely according to the method of Saam acupuncture operation. The experiential prescriptions of Saam acupuncture were classified as an independent group. In the future, fundamental research on the principle of Saam acupuncture method is needed for the various diseases, and research for the clinical efficacy and the mechanism of Saam acupuncture method should be preceded.

Update on Irritable Bowel Syndrome Program of Research

  • Heitkemper, Margaret;Jarrett, Monica;Jun, Sang-Eun
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.579-586
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    • 2013
  • Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

A Study of Mathematical Human Modeling of Sitting Crew during Whole-body Vibration (해상 근무 승무원의 수학적 전신진동 해석 모델에 관한 연구)

  • Kim, Hee-Seok;Kim, Hong-Tae;Park, Jin-Hyoung
    • Journal of the Ergonomics Society of Korea
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    • v.22 no.1
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    • pp.1-15
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    • 2003
  • The resonance behaviour needs be understood to identify the mechanisms responsible for the dynamic characteristics of human body, to allow for the non-linearity when predicting the influence of seating dynamics, and to predict the adverse effects caused by various magnitudes of vibration. However, there are currently no known studies on the effect of vibration magnitude on the transmissibility to thoracic or lumbar spine of the seated person, despite low back pain(LBP) being the most common ailment associated with whole-body vibration. The objective of this paper is to develop a proper mathematical human model for LBP and musculoskeletal injury of the crew in a maritime vehicle. In this study, 7 degree-of-freedom including 2 non-rigid mass representing wobbling visceral and intestine mass, is proposed. Also, when compared with previously published experimental results, the model response was found to be well-matching. When exposed to various of vertical vibration, the human model shows appreciable non-linearity in its biodynamic responses. The relationships of resonance for LBP and musculoskeletal injury during whole-body vibration are also explained.