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

One of hypothesis is that sleep loss related to a decrease in serotonergic activity plays a significant role in attempted suicide. A growing evidence suggests that central serotonergic activity plays a key role in the etiology of suicide. It has been reported that the cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5-HIAA), the main metabolite of serotonin, were reduced in suicide attempters. In addition, there is evidence that tryptophan hydroxylase is associated with suicide. The association between sleep and suicide was also suggested by some researchers. Several recent studies have showed the association between sleep disturbance and suicide rates in patients with mental disorders and in a general population. In addition, it has been suggested that serotonin plays a role in maintaining arousal and regulating muscle tone and in regulating some of the phasic events of REM sleep. Especially, it is well-known that 5-HT2 receptors are related to slow wave sleep. In conclusion, it is clear that sleep, serotonin activity, and suicide are linked, although the direction of causation needs clarification. In future, large population-based cohort studies are needed to demonstrate the direction of causation in the relationships between sleep, serotonin activity, and suicide.
Arousal ; Cohort Studies ; Humans ; Mental Disorders ; Muscles ; Serotonin ; Sleep, REM ; Suicide ; Suicide, Attempted ; Tryptophan Hydroxylase

No abstract available.
Adolescent* ; Humans ; Pain Threshold* ; Self-Injurious Behavior*

No abstract available.
Adolescent* ; Humans ; Pain Threshold* ; Self-Injurious Behavior*

No abstract available.
Child* ; Drug Therapy* ; Humans

No abstract available.
Child* ; Drug Therapy* ; Humans

No abstract available.

Sleep-related eating disorder (SRED) is a newly recognized parasomnia that describes a clinical condition of compulsive eating under an altered level of consciousness during sleep. Recently, it is increasingly recognized in clinical practice. The exact etiology of SRED is unclear, but it is assumed that SRED might share features of both sleepwalking and eating disorder. There have been also accumulating reports of SRED related to the administration of various psychotropic drugs, such as zolpidem, triazolam, olanzapine, and combinations of psychotropics. Especially, zolpidem in patients with underlying sleep disorders that cause frequent arousals, may cause or augment sleep related eating behavior. A thorough sleep history is essential to recognition and diagnosis of SRED. The timing, frequency, and description of food ingested during eating episodes should be elicited, and a history of concurrent psychiatric, medical, sleep disorders must also be sought and evaluated. Interestingly, dopaminergic agents as monotherapy were effective in some trials. Success with combinations of dopaminergic and opioid drugs, with the addition of sedatives, has also been reported in some case reports.
Arousal ; Benzodiazepines ; Consciousness Disorders ; Dopamine Agents ; Eating ; Feeding and Eating Disorders ; Feeding Behavior ; Humans ; Hypnotics and Sedatives ; Parasomnias ; Psychotropic Drugs ; Pyridines ; Sleep Wake Disorders ; Somnambulism ; Triazolam

This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnaire. Out of 161 burn patients 111(69.8%) were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over) males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion(20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.
Adult ; Baths ; Burns* ; Child ; Child, Preschool ; Daegu* ; Emergencies* ; Emergency Medical Services* ; Female ; Gases ; Hospitals, General ; Hospitals, University ; Humans ; Male ; Occupational Health ; Protective Devices ; Surveys and Questionnaires ; Water

Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.