1.Management of Chronic Pain.
Journal of the Korean Medical Association 2001;44(12):1293-1298
Chronic pain defined as pain that persists beyond the period of healing, in the absence of ongoing pathology, usually means pain over 3 to 6 months after the cure of the original disease. In this situation, the pain itself loses its protective function only to fall into a disease entity. There have been many efforts to treat chronic pain, with analgesics being the most commonly used modality, which include non-steroidal anti-inflammatory drug, opioids, antidepressant, and anxiolytic agents. Pain clinicians especially use nerve blocks for the control of intractable pain. Although the effect of nerve block or trigger point injection with local anesthetics is temporary, its effect of breaking the vicious cycle of pain patheway gives a long-term effect of analgesia. There are many diseases managed at pain clinics, including headache, trigeminal neuralgia, neck and shoulder pain, low back pain, complex regional pain syndrome, herpes zoster and postherpetic neuralgia, fantom pain, peripheral neuralgia, and vascular disease. The main nerve indicated for pain control may be any kind of somatic and sympathetic nerves and ganglions responsible for the pain.
Analgesia
;
Analgesics
;
Analgesics, Opioid
;
Anesthetics, Local
;
Anti-Anxiety Agents
;
Chronic Pain*
;
Ganglion Cysts
;
Headache
;
Herpes Zoster
;
Low Back Pain
;
Neck
;
Nerve Block
;
Neuralgia
;
Neuralgia, Postherpetic
;
Pain Clinics
;
Pain, Intractable
;
Pathology
;
Shoulder Pain
;
Trigeminal Neuralgia
;
Trigger Points
;
Vascular Diseases
2.The Effect of Isoflurane and Propofol upon Focal Cerebral Ischemia.
Korean Journal of Anesthesiology 1991;24(6):1083-1089
The effect of isoflurane and propofol anesthesia upon the infarct size after middle cerebral artery occlusion was studied using 18 male Sprague-Dawley rat. The infarct area was calculated using Quantimet autoradiography and compared between conscious control and anesthe-tized rats. The results were as follows; 1) Slightly increased volume of infarction was noted in anesthetized rat with no significancy compare to conscious control rats, but the caudate nucleus revealed statistically significant increased vloume of infarction in isoflurane anesthesia rats. 2) The protective effect for cerebral ischaemia of isoflurane or propofol seems insignificant, but we can use them in the neuroanesthetic field without difficulty because they do not increase the infarcted volume. 3) Durging iaoflurane anesthesia the elevated brain glucose and glucose-6-phosphate may increase neurological damage after ischaemia. Furthermore the change of CBF/Metabolism relationship may affect to the infarction.
Anesthesia
;
Animals
;
Autoradiography
;
Brain
;
Brain Ischemia*
;
Caudate Nucleus
;
Glucose
;
Glucose-6-Phosphate
;
Humans
;
Infarction
;
Infarction, Middle Cerebral Artery
;
Isoflurane*
;
Male
;
Propofol*
;
Rats
;
Rats, Sprague-Dawley
3.The Effect of Isoflurane and Propofol upon Focal Cerebral Ischemia.
Korean Journal of Anesthesiology 1991;24(6):1083-1089
The effect of isoflurane and propofol anesthesia upon the infarct size after middle cerebral artery occlusion was studied using 18 male Sprague-Dawley rat. The infarct area was calculated using Quantimet autoradiography and compared between conscious control and anesthe-tized rats. The results were as follows; 1) Slightly increased volume of infarction was noted in anesthetized rat with no significancy compare to conscious control rats, but the caudate nucleus revealed statistically significant increased vloume of infarction in isoflurane anesthesia rats. 2) The protective effect for cerebral ischaemia of isoflurane or propofol seems insignificant, but we can use them in the neuroanesthetic field without difficulty because they do not increase the infarcted volume. 3) Durging iaoflurane anesthesia the elevated brain glucose and glucose-6-phosphate may increase neurological damage after ischaemia. Furthermore the change of CBF/Metabolism relationship may affect to the infarction.
Anesthesia
;
Animals
;
Autoradiography
;
Brain
;
Brain Ischemia*
;
Caudate Nucleus
;
Glucose
;
Glucose-6-Phosphate
;
Humans
;
Infarction
;
Infarction, Middle Cerebral Artery
;
Isoflurane*
;
Male
;
Propofol*
;
Rats
;
Rats, Sprague-Dawley
4.Regulation of cellular immunity in cryptococcosis III. induction ofcryptococcus neoformans-specific T cells and hybridoma.
Tai You HA ; Young Min PARK ; Yoon Kyu PARK ; Hern Ku LEE ; Chong Wook PARK
Korean Journal of Immunology 1992;14(1):15-23
No abstract available.
Cryptococcosis*
;
Hybridomas*
;
Immunity, Cellular*
;
T-Lymphocytes*
5.Regulation of cellular immunity in cryptococcosis III. induction ofcryptococcus neoformans-specific T cells and hybridoma.
Tai You HA ; Young Min PARK ; Yoon Kyu PARK ; Hern Ku LEE ; Chong Wook PARK
Korean Journal of Immunology 1992;14(1):15-23
No abstract available.
Cryptococcosis*
;
Hybridomas*
;
Immunity, Cellular*
;
T-Lymphocytes*
6.Effects of Propofol Anesthesia on Local Cerebral Glucose Utilization and Cerebral Blood Flow in Rat.
Korean Journal of Anesthesiology 1989;22(4):497-505
The influence of Propofol on regional cerebral function and CBF were studied using 24 male Spragus-Dawley rat by quantitative autoradiographic technique for glucose ( (14C)deoxyglucose) and (14C) Iodoantipyrine. Rats had both femoral artery and vein cannulated and were placed on lead weight. Propofol was infused intravenously at a rate of 0.35 mg/kg/min. for induction and 0.3 mg/kg/min for maintenance untill loss of corneal reflex with stable vital signs. Local cerebral glucose utilization and CBF were checked from conscious control rats and propofol anesthetized rats. The results were as follows; 1) There was no physiologically significant effect of propofol on body temperature, MAP, PaCO, and pH. 2) Regional cerebral glucose utilization was markedly decreased in many, but not all, cerebral structures. 3) The order of decreased glucose utilization was Diencephalone>Telencephalone>Mesence-phalone>Mylencephalone. which means the forebrain was more affected than hindbrain. 4) The most affected area of glucose utilization were cerebral association area, visual system and sensory motor cortex, but the auditory system was not so much affected. 5) During combined use of N,O and propofol, there was no significant stimulation effect of N,O to propofol in glucose utilization. 6) Regional CBF were markedly decreased in many brain regions which means low local cerebral glucose utilization with low CBF. 7) Propofol has specific effect of lowering cerebral metabolic rate, CBF, and intracranial pressure but no signigicant effect on cardiovascular system, pulmonary system, or temperature.
Anesthesia*
;
Animals
;
Body Temperature
;
Brain
;
Cardiovascular System
;
Femoral Artery
;
Glucose*
;
Humans
;
Hydrogen-Ion Concentration
;
Intracranial Pressure
;
Male
;
Motor Cortex
;
Propofol*
;
Prosencephalon
;
Rats*
;
Reflex
;
Rhombencephalon
;
Veins
;
Vital Signs
7.The Inhibition of Stress-Induced c-fos Expression by Superior Cervical Ganglion Block in Rat Brain.
Hyun Ju JUNG ; Chong Min PARK ; Dong Suk CHUNG ; Myung Ja AHN ; Hyung Jin BYUN
Korean Journal of Anesthesiology 1997;33(6):1029-1036
BACKGROUND: Using c-fos expression one of the immediate early gene, as a marker of altered neuronal response, we investigated the effect of superior cervical ganglion block (SCGB) exhibiting the same effect of SGB of human on the activity of several brain regions which are considered as located on autonomic neural pathway and neuroendocrine axis in rat. METHOD: The 48 Sprague-Dawley strain rats were divided into 4 groups, as saline/stress (control) group, SCGB/stress (tested) group, saline group, SCGB group. Superior cervical ganglion block was conducted in the SCGB/stress group and SCGB group while saline/stress and saline group were sham operated. After then restraint stress was imposed on the animals of SCGB/stress group and saline/stress group. And 2 hour after injection (saline, SCGB group) or restraint stress (saline/stress, SCGB/stress group), c-fos protein (Fos) was localized by immunocytochemistry. RESULTS: Much stronger Fos immunoreactivity was induced in the several brain region of control group rats compared to other three groups and the numbers of Fos positive cell count of tested group were significantly decreased in paraventricular hypothalamic nucleus (p<0.01), A5 (p<0.01), raphe pallidus (p<0.05), nucleus tractus solitaius (p<0.01) compared to control group. CONCLUSION: This study demonstrate that superior cervical ganglion block attenuates stress induced neuronal activities of paraventricular hypothalamic nucleus, A5, raphe pallidus, nucleus tractus solitarius.
Animals
;
Axis, Cervical Vertebra
;
Brain*
;
Cell Count
;
Genes, vif
;
Humans
;
Immunohistochemistry
;
Neural Pathways
;
Neurons
;
Paraventricular Hypothalamic Nucleus
;
Rats*
;
Rats, Sprague-Dawley
;
Solitary Nucleus
;
Superior Cervical Ganglion*
8.The Effect of Atropine and Neostigmine on the Memory of Rats.
Korean Journal of Anesthesiology 1994;27(3):214-219
The effect of anticholinergics on memory was studied using 32 male Sprague-Dawley rats. In the control group the trained rats were tested the first performance time of T-maze and the second performance time checked 4-6 hours after injection of 1.0-1.5 mL of normal saline via penile vein. For the experimental groups, after checking the first performance time, 0.1 mg/kg of atropine sulfate in group B, and 1.0 mg/kg in group C was injected via penile vein.And 30 mg/kg injected into intraperitoneal cavity in group D. But for the group E, the mixture of 1.0 mg/kg of atropine and 0.01 mg/kg of neostigmine was injected into the penile vein. 4-6 hours after injection the second performance time was checked and continued these sets of experiment once a day for 6 days. To compare the number of errors (the qualitative effect) the accuracy rate (Number of right trials/Number of total trials x 100) was checked. To eompare the running time (the quantitative effect) the mean performance ratio (II/I x 100) (i.e., I is the score in the first performance time and II is the score in the second performance time) was compared between control and experimental groups. The results were as follows ; 1) The percentage of correct performance was 84.2% in control group, but 86.1% in group B, 91.0% in C, 96.0% in D and 89.6% in E was noted. 2) The performance ratio of control group A was 100.2 but 82.4 in B, 94.7 in C, 83.2 in D and 89.4 in E was recorded. 3) These results suggest that posttraining exposure to atropine sulfate facilitates the accuracy of performance and shortens the running time and no different effect was observed by additional injection of neostigmine in rats.
Animals
;
Atropine*
;
Cholinergic Antagonists
;
Humans
;
Male
;
Memory*
;
Neostigmine*
;
Rats*
;
Rats, Sprague-Dawley
;
Running
;
Veins
9.The Effects of Inhalational Anesthetics on Memory and Cognitive Function.
Korean Journal of Anesthesiology 1994;27(10):1292-1299
Many investigators have studied the effects of commonly used general anesthetic agents on CNS and found that a variety of congintive functions including psychomotor activity, assciative learning and short-term tasks were affected by anesthetice, and the ability of inhalstional anesthetics to depress or ebhance neuronal excitibility depends on the anesthetics, the anesthetic conectration, and particular brain region examined. To study the effects of inhalational snesthetics on meomory and congnitive function in human, we selected 123 patients scheduled for elective surgery, in ASA Phyaical Status Class I or II, for experimental group. But the patients undergoing a major surgery and with previous neuropsychiatrie history were excluded. As control group, 92 healthy volunteers were selected. Three tests Bender Gestalt Test, Trail Making B Test and Cognitive Cspacity Screening Examination-were performed on the properative day and the 4-5th postoperative day in experimental group. In control group these tests were performed tow times at the aame intervals. The mean performance ratos (II/ IX100) (i.e I is the score in the first examination and 3 id the score in the second examination)in experimental group were compared with those in control group. Results were as follows; 1. Bender Gestalt Test The mean performance ratios of control group 104.2+/-8.8 in man, 104.7+/-9.8 in woman and 104.5+/-9.4 in total control group. In experimental group they were 102.6+/-9.2 in man, 105.3+/-9.5 in woman and 104.9+/-9.2 in total experimental group. 2. Trail Making B Test The mean performance ratios of control group were 99.8+/-8.3 in ma, 97.6+/-10.0 in woman and 98.8+/-10.0 in total control group. In experimental group they were 99.2+/-13.5 in man, 97.9+/-14.0 in woman and 98.5+/-14.7 in total experimental group. 3. Cognitive Capacity Screening Examination The mean performance ratios of control group were 100.9+/-3.9 in man, 100.2+/-3.4 in woman snd 100.5+/-3.3 in total control group. In experimental group they were 99.4+/-2.1 in man, 101.6+/-3.7 in woman and 101.2+/-3.6 in total experimental The performance ratios of Congitive Capacity Sereening Examination in woman were signifi- cantly increased in experimental group, compared with control group. (p<0.05), but no differences were observed in total experimental group. The performance ratios of Bender Gestalt Test and Trail Making B Test in experimental group were increased more thatn those in control group but no statistical singificance was observed. According to these results we could confirm that inhalational anesthetics hsve no significant effects on memory and congnitive function.
Anesthetics*
;
Bender-Gestalt Test
;
Brain
;
Female
;
Healthy Volunteers
;
Humans
;
Learning
;
Mass Screening
;
Memory*
;
Neurons
;
Research Personnel
10.The Effects of Inhalation Anesthetics on the Memory of Rats.
Korean Journal of Anesthesiology 1994;27(1):8-13
The effect of inhalation anesthetics on memory was studied using 26 male Sprague-Dawley rats. In the control group the trained rats were tested the first performance time of T-maze and left them to anesthetic chamber for 120min. and checked second performance time 24hours later (Group A). For the experimental group the first performance time was tested and animals were exposed to the anesthetics (1% Halothane with N20:02=2:1) for 120min. and checked second performance time 24hours after cessation of exposure to evaluate retrograde amnesia (Group B). For the test of anterograde amnesia (Group C) rats were anesthetized before test the first performance time and checked second performance time 24hours later. The mean perfor- mance ratio (II/I) (i.e., I is the score in the first performance time and II is the score in the second performance time) was compared between anesthetized and non-anesthetized control group. In the group A the ratio was 102.8+/-19 but in group B it was 96.4+/-13 during anesthesia, 79.+/-19 after anesthesia and 92.3+/-11 in overaU anesthetized group, and was 100.2+/-17 in group C. All data of group B were significantly different with group A (p<0.01). But no statistical difference between group C and A was observed (p=0.174). These results suggest that post- training exposure to volatile anesthetics facilitates memory and no anterograde amnesia observed by pretraining exposure. These may be volatile anesthetics facilitate memory by enhancement of memory consolidation and/or retention or interference reduction.
Amnesia, Anterograde
;
Amnesia, Retrograde
;
Anesthesia
;
Anesthetics
;
Anesthetics, Inhalation*
;
Animals
;
Halothane
;
Humans
;
Inhalation*
;
Male
;
Memory*
;
Rats*
;
Rats, Sprague-Dawley