• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.25-34
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• 2009

Purpose : The purpose of this study is to investigate that the Effects of Pain, Lumbar Flexibility and Abdominal Obesity of Patient with Low Back Pain and Abdominal Obesity after Lumbar Strengthening Exercise. Methods : The selected subjects of this study were 17 patients who had diagnosis on low back pain and body mass index was more than $25kg/m^2$ and lumbar length was more than 90cm. They divided into a control group with 10 patients doing lumbar stabilization exercise and an experimental group with 7 patients ding simple lumbar strengthening exercise in order to compare degrees of oswestry disability index and lumbar stability, lumbar length was measured before the exercise, in 4 weeks and 8 weeks after exercises respectively. Result : lumbar strengthening exercise on patients with low back pain and abdominal obesity affected improving function of lumbar and decrease of pain with abdominal obesity. Conclusion : Then lumbar stabilization exercise than simple strengthening exercise affected decrease of Visceral fat tissue on abdominal obesity.

• Nutrition Research and Practice
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• 제15권4호
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• pp.411-430
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• 2021

Irritable bowel syndrome (IBS) is a frequently diagnosed gastrointestinal (GI) disorder characterized by recurrent abdominal pain, bloating, and changes in the stool form or frequency without any structural changes and overt inflammation. It is not a life-threatening condition but causes a considerable level of discomfort and distress. Among the many pathophysiologic factors, such as altered GI motility, visceral hypersensitivity, and low-grade mucosal inflammation, as well as other immunologic, psychologic, and genetic factors, gut microbiota imbalance (dysbiosis), which is frequently found in IBS, has been highlighted as an etiology of IBS. Dysbiosis may affect gut mucosal homeostasis, immune function, metabolic regulation, and even visceral motor function. As diet is shown to play a fundamental role in the gut microbiota profile, this review discusses the influence of diet on IBS occurring through the modulation of gut microbiota. Based on previous studies, it appears that dietary modulation of the gut microbiota may be effective for the alleviation of IBS symptoms and, also an effective IBS management strategy based on the underlying mechanism; especially because, IBS currently has no specific treatment owing to its uncertain etiology.

• 한국식품영양학회지
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• 제10권2호
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• pp.186-192
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• 1997

성별, 직업, 성품, 생활양식이 전혀 다른 K43과 C45 환자의 위 내시경적 소견과 치료방법을 논의하였다. K43은 잘못된 식습관과 스트레스에 의한 미란성 위염환자로서 제산제와 함께 H2-수용체 길항제, H+/K+-pump 억제제, prostaglandin 제제, colloidal bismuth, sucralfate prokinetics 등 전통적인 약물에서부터 부작용을 감소시킨 최근에 개발된 약물에 이르기까지 효과가 인정된 약물들을 폭넓게 사용하였으나 증상을 개선치 못하였으며, 임상병리 검사와 상복부 초음파 검사는 정상이었으나, 소화생리기능 검사에서 visceral hypersensitivity를 나타내었다. 그러나 C45는 평소에 두통으로 NSAIDs를 습관적으로 복용한 경험에 의하여 발생되었을 것으로 추정되는 전형적인 위·십이지장 궤양의 환자로서 H. pylori 박멸제와 함께 일반적인 소화성 궤양의 치료제로 활동기에서 치유기로 증상을 크게 완화시켰다. 특히 K43은 amitryptyline을 투여하였으나 난치성 환자로 남아 있다. 이러한 원인불명의 비궤양 환자는 미국에서 해마다 15%씩 증가하는 추세에 있고 적절한 치료법도 없으며, 우리 나라에서는 통계치도 없는 실정인 점을 지적하고 싶다.

• Journal of Ginseng Research
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• 제45권6호
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• pp.706-716
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• 2021

Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.

• The Korean Journal of Pain
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• 제33권2호
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• pp.108-120
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• 2020

From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

• 기본간호학회지
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• 제15권2호
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• pp.161-170
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• 2008

Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

• The Korean Journal of Pain
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• 제12권2호
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• pp.238-241
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• 1999

Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

• The Korean Journal of Pain
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• 제28권1호
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• pp.22-31
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• 2015

Background: The celiac plexus and splanchnic nerves are targets for neurolytic blocks for pain relief from pain caused by upper gastrointestinal tumors. Therefore, we investigated the analgesic effect of a celiac plexus block versus a splanchnic nerve block and the effects of these blocks on the quality of life six months post-intervention for patients with upper GIT tumors. Methods: Seventy-nine patients with inoperable upper GIT tumors and with severe uncontrolled visceral pain were randomized into two groups. These were Group I, for whom a celiac plexus block was used with a bilateral needle retrocrural technique, and Group II, for whom a splanchnic nerve block with a bilateral needle technique was used. The visual analogue scale for pain (0 to 100), the quality of life via the QLQ-C30 questionnaire, and survival rates were assessed. Results: Pain scores were comparable in both groups in the first week after the block. Significantly more patients retained good analgesia with tramadol in the splanchnic group from 16 weeks onwards (P = 0.005, 0.001, 0.005, 0.001, 0.01). Social and cognitive scales improved significantly from the second week onwards in the splanchnic group. Survival of both groups was comparable. Conclusions: The results of this study demonstrate that the efficacy of the splanchnic nerve block technique appears to be clinically comparable to a celiac block. All statistically significant differences are of little clinical value.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.456-462
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• 2001

Objective : Although cingulotomy has been applied to patients with affective disorders more frequently, there are numerous reports of its use for the control of severe pain. The goal of this study was to investigate the role of stereotactic bilateral anterior cingulotomy for intractable cancer pain. Method : Between January and June, 2000, we underwent stereotactic bilateral anterior cingulotomy in 6 patients for intractable cancer pain with poor response to opioids. The patients were suffering from widespread musculoskeletal or visceral pain. We made four lesions along the two tracks on either side of the cingulate cortex. Result : In all patients, pain reliefs after cingulotomy were dramatic and immediate. Five out of six patients did not require any opioids and one patient could reduce dose of opioids. There were no deaths or serious complications related to the procedure. Conclusion : These results suggested that a bilateral anterior cingulotomy might be useful method to control intractable cancer pain associated with the widespread metastatic disease. To provide rationale of bilateral anterior cingulotomy in intractable cancer pain, the theoretical mechanisms and role of bilateral anterior cingulotomy are discussed, along with our surgical techniques and the course of our patients.

• The Korean Journal of Physiology and Pharmacology
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• 제10권6호
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• pp.323-327
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• 2006

Despite the wealth of data concerning the roles of ${\alpha}-CGRP$ in nociceptive behaviors, ${\alpha}-CGRP-null$ mice showed no obvious phenotypic differences in nociceptive behaviors from wild type. The present studies specifically demonstrate that ${\alpha}-CGRP$ null mice showed no CGRP immunoreactivity from the spinal cord, implying that CGRPs in the mice spinal cord are mainly a-isoforms. However, the nociceptive behaviors of the null mice are not significantly different from the wild type mice in thermal nociceptive behaviors on hotplate, chemical nociception tests to intraplantar capsaicin or formalin injection, and visceral pain behaviors to intraperitoneal acetic acid or magnesium sulfate injections. These data suggest that ${\alpha}-CGRP$ is dispensable for nociceptive behaviors or that compensatory mechanisms may exist to overcome the absence of this peptide.