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Lee WJ, Choi SH, Jang JH, Moon JY, Kim YC, Noh E, Shin JE, Shin H, Kang DH. Different patterns in mental rotation of facial expressions in complex regional pain syndrome patients. Medicine (Baltimore) 2017; 96:e7990. [PMID: 28953620 PMCID: PMC5626263 DOI: 10.1097/md.0000000000007990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Although facial pain expressions are considered to be the most visible pain behaviors, it is known that the association between pain intensity and facial pain expression is weak for chronic pain. The authors hypothesized that the facial pain expressiveness was altered in chronic pain and investigated it with a mental rotation task using various facial expression, which seems to be associated with actual facial movements. As a task stimulus, 4 types of facial expression stimuli consisted of upper (tightening of eye and furrowed brows) and lower (raising upper lip) pain-specific facial expressions, and upper (eyeball deviation) and lower (tongue protrusion) facial movements not using facial muscles were used. Participants were asked to judge whether a stimulus presented at various rotation angles was left- or right-sided. The authors tested 40 patients with complex regional pain syndrome (CRPS) (12 women, age range 21-60) and 35 healthy controls (15 women, age range 26-64). In an analysis of reaction time (RT) using a linear mixed model, patients were slower to react to all types of stimuli (P = .001) and a significant interaction between group (patient or control) and type of facial expression was observed (P = .01). In the post hoc analysis only patients showed longer RTs to raising upper lip than other types of facial expressions. This reflects a deficit in mental rotation tasks especially for lower facial region pain expressions in CRPS, which may be related to the psychosocial aspects of pain. However, comprehensive intra- and interpersonal influences should be further investigated.
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Kim JH, Choi SH, Jang JH, Lee DH, Lee KJ, Lee WJ, Moon JY, Kim YC, Kang DH. Impaired insula functional connectivity associated with persistent pain perception in patients with complex regional pain syndrome. PLoS One 2017; 12:e0180479. [PMID: 28692702 PMCID: PMC5503260 DOI: 10.1371/journal.pone.0180479] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/15/2017] [Indexed: 11/18/2022] Open
Abstract
Given that the insula plays a contributory role in the perception of chronic pain, we examined the resting-state functional connectivity between the insular cortex and other brain regions to investigate neural underpinnings of persisting perception of background pain in patients with complex regional pain syndrome (CRPS). A total of 25 patients with CRPS and 25 matched healthy controls underwent functional magnetic resonance imaging at rest. With the anterior and posterior insular cortices as seed regions, we compared the strength of the resting-state functional connectivity between the two groups. Functional connectivity between the anterior and posterior insular cortices and the postcentral and inferior frontal gyri, cingulate cortices was reduced in patients with CRPS compared with controls. Additionally, greater reductions in functional connectivity between the anterior insula and right postcentral gyrus were associated with more severe sensory pain in patients with CRPS (short-form McGill Pain Questionnaire sensory subscores, r = -.517, P = .023). The present results imply a possible role of the insula in aberrant processing of pain information in patients with CRPS. The findings suggest that a functional derangement of the connection between one of the somatosensory cortical functions of perception and one of the insular functions of awareness can play a significant role in the persistent experience of regional pain that is not confined to a specific nerve territory.
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Park MS, Kim SK, Park HJ, Seok H, Kang SW, Lee SH, Kim YG, Moon JY, Kim TH, Kim YH, Kang SW, Chung JH, Jeong KH. Association Studies of Bone Morphogenetic Protein 2 Gene Polymorphisms With Acute Rejection in Kidney Transplantation Recipients. Transplant Proc 2017; 49:1012-1017. [PMID: 28583517 DOI: 10.1016/j.transproceed.2017.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans. METHODS Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5' near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region). RESULTS Among the six SNPs tested, the rs235767, rs1005464, and rs3178250 SNPs were significantly associated with AR (P < .05). The rs1049007 and rs235768 SNPs also showed an association with GD (P < .05). CONCLUSIONS In conclusion, these results suggest that the BMP2 gene polymorphism may be related to the development of AR and GD in kidney transplant recipients.
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Choi EJ, Yoo YJ, Lee PB, Kim YC, Lee SC, Moon JY. A Retrospective Study to Evaluate the Effect of Concentration of Hypertonic Saline on Efficacy and Safety of Epidural Adhesiolysis. Anesth Analg 2017; 124:2021-2029. [DOI: 10.1213/ane.0000000000001925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Moon JY, Yun EJ, Yoon DY, Choi CS, Seo YL, Cho YK, Lim KJ, Baek S, Hong SJ, Yoon SJ. The 100 Most-Cited Articles Focused on Ultrasound Imaging: A Bibliometric Analysis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2017; 38:311-317. [PMID: 28511228 DOI: 10.1055/s-0042-120259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose The number of citations that an article has received reflects its impact on a particular research area. The aim of this study was to identify the 100 most-cited articles focused on ultrasound (US) imaging and to analyze the characteristics of these articles. Methods We determined the 100 most-cited articles on US imaging via the Web of Science database, using the search term. The following parameters were used to analyze the characteristics of the 100 most-cited articles: publication year, journal, journal impact factor, number of citations and annual citations, authors, department, institution, country, type of article, and topic. Results The number of citations for the 100 most-cited articles ranged from 1849 to 341 (median: 442.0) and the number of annual citations ranged from 108.0 to 8.1 (median: 22.1). The majority of articles were published in 1990 - 1999 (39 %), published in radiology journals (20 %), originated in the United States (45 %), were clinical observation studies (67 %), and dealt with the vessels (35 %). The Department of Internal Medicine at the University of California and the Research Institute of Public Health at the University of Kuopio (n = 4 each) were the leading institutions and Salonen JT and Salonen R (n = 4 each) were the most prolific authors. Conclusion Our study presents a detailed list and analysis of the 100 most-cited US articles, which provides a unique insight into the historical development in this field.
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Lee SC, Jin HS, Joo Y, Kim YC, Moon JY. The minimal effective dose of cis-9-cetylmyristoleate (CMO) in persons presenting with knee joint pain: A double-blind, randomized, placebo-controlled trial. Medicine (Baltimore) 2017; 96:e6149. [PMID: 28248869 PMCID: PMC5340442 DOI: 10.1097/md.0000000000006149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Nutraceuticals containing cis-9-cetylmyristoleate (CMO) are used to improve knee pain despite the lack of placebo-controlled studies in humans. The aim of the study was to explore the minimal effective dose of CMO for relieving knee joint pain. METHODS Twenty-eight subjects with mild degree arthritic knee joint pain were randomized into 4 groups; groups A, B, and C that contained 100%, 80%, and 62.4% of fatty acid component with 12.5% of CMO, and control group D (starch 100%). The pain intensity, functional disability, and the Patient Global Impression of Change (PGIC) were assessed for a 12-week ingestion period. RESULTS Compared to group D (n = 6), there were significant differences in pain score in group A (n = 7, P = 0.005) and group C (n = 7, P = 0.012), but not significant in group B (n = 6, P = 0.180). Western Ontario and McMaster Universities Arthritis (WOMAC) score decreased significantly in groups A and C. The PGIC was positive in the majority (>50%) in groups A, B, and C, whereas negative in 83.3% in group D (control). CONCLUSION CMO is effective in alleviating knee pain in persons with mild degree arthritis of the knee joint, at an effective dose of 62.4%.
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Lee HJ, Kim TH, Kang SW, Kim YH, Kim SK, Chung JH, Kim YG, Moon JY, Lee SH, Ihm CG, Lee TW, Jeong KH. Association Interleukin-4 and Interleukin-4 Receptor Gene Polymorphism and Acute Rejection and Graft Dysfunction After Kidney Transplantation. Transplant Proc 2017; 48:813-9. [PMID: 27234743 DOI: 10.1016/j.transproceed.2015.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 11/25/2015] [Accepted: 12/30/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cytokine genotypes have previously been studied in patients undergoing solid organ transplantation; certain polymorphisms have been implicated in the development of acute rejection (AR) and graft dysfunction (GD). Allograft outcomes determined, in part, by alloimmune responses is mainly mediated by T-cell responses, activated and driven by cytokines. Interleukin-4 (IL-4) is one such cytokine, which exerts its biological effects through binding to the IL-4 receptor (IL-4R) complex on target cells. In the present study, we investigated whether polymorphisms of the IL-4 and/or IL-4R gene were associated with susceptibility to acute AR and GD after kidney transplantation. METHODS We analyzed 2 single nucleotide polymorphism (SNPs) of IL-4 (rs2243250 and rs2070874) and 3 SNPs of IL-4R (rs1801275, rs2107356, and rs1805010) in 344 kidney transplant recipients. These patients included 62 of whom had developed AR and 215 of whom had GD in 1 year after kidney transplantation. RESULTS The AR group included 62 patients (45 men and 17 women). There was a statistically significant difference in the male-to-female ratio and the use of tacrolimus in the AR group. The GD group included 215 patients. Patients who developed GD were more likely to be older and have an underlying cause of end-stage renal disease that was unknown compared with patients who did not have GD, the cause of which was typically known. Among the SNPs examined, 1 of the SNPs in the IL-4R gene (ie, rs1801275) showed a statistical association with AR (co-dominant model, P = .061; dominant model, P = .019; and log-addictive model, P = .029). In addition, 1 of the IL-4R SNPs (ie, rs2107356) was statistically associated with GD (dominant model, P = .034). No significant difference in the IL-4 genotype was observed between the AR/GD and non-AR/non-GD subjects. CONCLUSIONS One IL-4R gene polymorphism (rs1801275) was associated with AR. In addition, a separate IL-4R SNP (rs2107356) was statistically associated with GD after kidney transplantation.
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Moon JY, Choi JK, Shin JY, Chon SW, Dev S. A brief report on a technical description of ultrasound-guided lumbar sympathetic block. Korean J Pain 2016; 30:66-70. [PMID: 28119774 PMCID: PMC5256261 DOI: 10.3344/kjp.2017.30.1.66] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 11/09/2022] Open
Abstract
The lumbar sympathetic ganglion block (LSGB) is widely used for diagnosing and treating sympathetically maintained pain disorders. The LSGB has been conventionally carried out under fluoroscopy or computed tomography guidance. However, as ultrasound technology improved, ultrasound-guided interventions have been expanding their territory to deeper structures. Ultrasound guidance provides many benefits including protecting vascular injection, shortening procedure time in some cases, and reducing the emission of radiation. In this report, we describe a successful case of a US-guided LSGB without major complications. We expect that US-guided LSGBs can be implemented and furnished in the daily outpatient clinical setting by highly trained pain physicians.
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Sung JK, Choi JH, Jeong J, Kim WJ, Lee DJ, Lee SC, Kim YC, Moon JY. Korean Version of the painDETECT Questionnaire: A Study for Cultural Adaptation and Validation. Pain Pract 2016; 17:494-504. [DOI: 10.1111/papr.12472] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/24/2016] [Accepted: 05/10/2016] [Indexed: 12/26/2022]
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Kim WJ, Shin HY, Kim YC, Moon JY. Clinical Association Between Brain MRI Findings With Epidural Blood Patch in Spontaneous Intracranial Hypotension. J Neurosurg Anesthesiol 2016; 28:147-52. [DOI: 10.1097/ana.0000000000000259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moon JY, Choi SS, Lee SY, Lee MK, Kim JE, Lee JE, Lee SH. The Effect of Nefopam on Postoperative Fentanyl Consumption: A Randomized, Double-blind Study. Korean J Pain 2016; 29:110-8. [PMID: 27103966 PMCID: PMC4837116 DOI: 10.3344/kjp.2016.29.2.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/22/2016] [Accepted: 03/22/2016] [Indexed: 01/23/2023] Open
Abstract
Background Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient
controlled analgesia (PCA). Methods Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl 1,000 µg; Group B, fentanyl 500 µg + nefopam 200 mg; and Group C, fentanyl 500 µg + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. Results Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. Conclusions The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.
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Kwon SG, Roh DH, Yoon SY, Choi SR, Choi HS, Moon JY, Kang SY, Kim HW, Han HJ, Beitz AJ, Oh SB, Lee JH. Role of peripheral sigma-1 receptors in ischaemic pain: Potential interactions with ASIC and P2X receptors. Eur J Pain 2016; 20:594-606. [PMID: 26358747 DOI: 10.1002/ejp.774] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND The role of peripheral sigma-1 receptors (Sig-1Rs) in normal nociception and in pathologically induced pain conditions has not been thoroughly investigated. Since there is mounting evidence that Sig-1Rs modulate ischaemia-induced pathological conditions, we investigated the role of Sig-1Rs in ischaemia-induced mechanical allodynia (MA) and addressed their possible interaction with acid-sensing ion channels (ASICs) and P2X receptors at the ischaemic site. METHODS We used a rodent model of hindlimb thrombus-induced ischaemic pain (TIIP) to investigate their role. Western blot was performed to observe changes in Sig-1R expression in peripheral nervous tissues. MA was measured after intraplantar (i.pl.) injections of antagonists for the Sig-1, ASIC and P2X receptors in TIIP rats or agonists of each receptor in naïve rats. RESULTS Sig-1R expression significantly increased in skin, sciatic nerve and dorsal root ganglia at 3 days post-TIIP surgery. I.pl. injections of the Sig-1R antagonist, BD-1047 on post-operative days 0-3 significantly attenuated the development of MA during the induction phase, but had no effect on MA when given during the maintenance phase (days 3-6 post-surgery). BD-1047 synergistically increased amiloride (an ASICs blocker)- and TNP-ATP (a P2X antagonist)-induced analgesic effects in TIIP rats. In naïve rats, i.pl. injection of Sig-1R agonist PRE-084 alone did not produce MA; but it did induce MA when co-administered with either an acidic pH solution or a sub-effective dose of αβmeATP. CONCLUSION Peripheral Sig-1Rs contribute to the induction of ischaemia-induced MA via facilitation of ASICs and P2X receptors. Thus, peripheral Sig-1Rs represent a novel therapeutic target for the treatment of ischaemic pain.
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Kim EJ, Moon JY, Kim YC, Park KS, Yoo YJ. Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea. Yonsei Med J 2016; 57:475-81. [PMID: 26847303 PMCID: PMC4740543 DOI: 10.3349/ymj.2016.57.2.475] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/30/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Intrathecal morphine pump (ITMP) infusion therapy is efficient in managing malignant and nonmalignant chronic pain refractory to standard treatment. However, the high cost of an ITMP is the greatest barrier for starting a patient on ITMP infusion therapy. Using the revised Korean reimbursement guidelines, we investigated the cost effectiveness of ITMP infusion therapy and conducted a patient survey. MATERIALS AND METHODS A retrospective chart review of 12 patients who underwent ITMP implantation was performed. Morphine dose escalation rates were calculated, and numeric rating scale (NRS) scores were compared before and after ITMP implantation. We surveyed patients who were already using an ITMP as well as those who were candidates for an ITMP. All survey data were collected through in-person interviews over 3 months. Data on the cost of medical treatment were collected and projected over time. RESULTS The NRS score decreased during the follow-up period. The median morphine dose increased by 36.9% over the first year, and the median time required to reach a financial break-even point was 24.2 months. Patients were more satisfied with the efficacy of ITMP infusion therapy than with conventional therapy. The expected cost of ITMP implantation was KRW 4000000-5000000 in more than half of ITMP candidates scheduled to undergo implantation. CONCLUSION The high cost of initiating ITMP infusion therapy is challenging; however, the present results may encourage more patients to consider ITMP therapy.
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Moon JY, Kwon IS, Lee JW, Park SI, Chon GR, Lee JY, Ahn JY, Chang YJ, Kwon SJ. Validation of acute physiology and chronic health evaluation (APACHE) IV score in a korea provincial icus by comparing korean simplified acute physiology score (SAPS) III. Intensive Care Med Exp 2015. [PMCID: PMC4798174 DOI: 10.1186/2197-425x-3-s1-a335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Chang Y, Moon JY, Cho YJ, Lee SM, Jeon K, Kim SC, Kim YS, Chong YP, Kim YS, Hong SB. The current pathogens and treatment of hospital-acquired pneumonia/ventilator-associated pneumonia in medical intensive care units. Intensive Care Med Exp 2015. [PMCID: PMC4798512 DOI: 10.1186/2197-425x-3-s1-a707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lee YS, Lee JW, Lee J, Min NE, Park JE, Jung JW, Park DI, Kim KD, Ahn HJ, Choi JW, Park YH, Ryu S, Jeong WJ, Moon JY. The usefulness of modified national early warning score with the age level in critically ill medical patients. Intensive Care Med Exp 2015. [PMCID: PMC4797895 DOI: 10.1186/2197-425x-3-s1-a834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Moon JY. Predictive Factors Associated with Success and
Failure for Radiofrequency Thermocoagulation
in Patients with Trigeminal Neuralgia. Pain Physician 2015. [DOI: 10.36076/ppj.2015/18/537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Radiofrequency thermocoagulation (RFT) has been widely used to manage
trigeminal neuralgia (TN) refractory to oral medication. Careful selection of patients for
managing TN with RFT can decrease morbidity and improve treatment efficacy.
Objectives: The goal of this study was to determine clinical variables related to the treatment
outcome in patients with TN undergoing RFT.
Study Design: Retrospective analysis.
Setting: University hospital in Korea.
Methods: Demographic and clinical data were garnered by billing records for patients with
TN who received RFT by one pain physician between January 2005 and August 2014. A
successful outcome was pre-defined as at least 50% pain relief on a 0 – 10 NRS pain score
for longer than 6 months after RFT. Variables evaluated for their association with outcome
included age, gender, baseline pain score, etiology, type of pain, co-existing psychopathology,
and history of previous intervention.
Results: Among 90 patients who underwent RFT for managing TN, 75 patients (83.3%)
reported a successful outcome (> 50% pain relief at 6 months after RFT procedure). Pain
characteristics was the most significant predictor associated with successful outcomes of RFT
in both univariate and multivariate logistic analysis; odds ratio of provoked paroxysmal pain
was 131.516 and mixed type of pain was 20.602 in multivariate analysis.
Limitations: Prospective studies are recommended to confirm our findings and ascertain
which additional variables can be taken into account to improve the likelihood of a successful
outcome for RFT in patients with TN.
Conclusion: A provoked paroxysmal pain or mixed pain condition was associated with a
positive outcome for RFT in patients with TN. In addition, bilateral TN, high baseline NRS pain
score, or co-morbid psychiatric condition was related with negative outcomes in univariate
analysis. Pain clinicians should consider these findings when selecting patients for managing
TN to increase the efficacy of RFT.
Key words: Facial pain, outcome assessment, predictive value, radiofrequency
thermocoagulation, trigeminal neuralgia
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Jin HS, Shin JY, Kim YC, Lee SC, Choi EJ, Lee PB, Moon JY. Predictive Factors Associated with Success and Failure for Radiofrequency Thermocoagulation in Patients with Trigeminal Neuralgia. Pain Physician 2015; 18:537-545. [PMID: 26606005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Radiofrequency thermocoagulation (RFT) has been widely used to manage trigeminal neuralgia (TN) refractory to oral medication. Careful selection of patients for managing TN with RFT can decrease morbidity and improve treatment efficacy. OBJECTIVES The goal of this study was to determine clinical variables related to the treatment outcome in patients with TN undergoing RFT. STUDY DESIGN Retrospective analysis. SETTING University hospital in Korea. METHODS Demographic and clinical data were garnered by billing records for patients with TN who received RFT by one pain physician between January 2005 and August 2014. A successful outcome was pre-defined as at least 50% pain relief on a 0-10 NRS pain score for longer than 6 months after RFT. Variables evaluated for their association with outcome included age, gender, baseline pain score, etiology, type of pain, co-existing psychopathology, and history of previous intervention. RESULTS Among 90 patients who underwent RFT for managing TN, 75 patients (83.3%) reported a successful outcome (> 50% pain relief at 6 months after RFT procedure). Pain characteristics was the most significant predictor associated with successful outcomes of RFT in both univariate and multivariate logistic analysis; odds ratio of provoked paroxysmal pain was 131.516 and mixed type of pain was 20.602 in multivariate analysis. LIMITATIONS Prospective studies are recommended to confirm our findings and ascertain which additional variables can be taken into account to improve the likelihood of a successful outcome for RFT in patients with TN. CONCLUSION A provoked paroxysmal pain or mixed pain condition was associated with a positive outcome for RFT in patients with TN. In addition, bilateral TN, high baseline NRS pain score, or co-morbid psychiatric condition was related with negative outcomes in univariate analysis. Pain clinicians should consider these findings when selecting patients for managing TN to increase the efficacy of RFT. CLINICAL TRIAL REGISTRATION IRB No. 1403-118-569.
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Kim MK, Moon JY, Choi HY, Oh SH, Lee N, Choi YJ. Investigation of the magnetic properties in double perovskite R2CoMnO6 single crystals (R = rare earth: La to Lu). JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2015; 27:426002. [PMID: 26442994 DOI: 10.1088/0953-8984/27/42/426002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We have successfully synthesized the series of the double-perovskite R2CoMnO6 (R = rare earth: La to Lu) single crystals and have investigated their magnetic properties. The ferromagnetic order of Co(2+)/Mn(4+) spins emerges mainly along the c axis. Upon decreasing the size of rare earth ion, the magnetic transition temperature decreases linearly from 204 K for La2CoMnO6 to 48 K for Lu2CoMnO6, along with the enhancement of monoclinic distortion. The temperature and magnetic-field dependences of magnetization reveal the various magnetic characteristics such as the metamagnetic transition in R = Eu, the isotropic nature of rare earth moment in R = Gd, and the reversal of magnetic anisotropy in R = Tb and Dy. Our results offer comprehensive information for understanding the roles of mixed-valent magnetic ions and rare earth magnetic moments on the magnetic properties.
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Song KD, Lee MW, Park HJ, Cha DI, Kang TW, Lee J, Moon JY, Rhim H. Hepatic radiofrequency ablation: in vivo and ex vivo comparisons of 15-gauge (G) and 17-G internally cooled electrodes. Br J Radiol 2015; 88:20140497. [PMID: 25882688 DOI: 10.1259/bjr.20140497] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To compare the performance of the 15-G internally cooled electrode with that of the conventional 17-G internally cooled electrode. METHODS A total of 40 (20 for each electrode) and 20 ablation zones (10 for each electrode) were made in extracted bovine livers and in in vivo porcine livers, respectively. Technical parameters, three dimensions [long-axis diameter (Dl), vertical-axis diameter (Dv) and short-axis diameter (Ds)], volume and the circularity (Ds/Dl) of the ablation zone were compared. RESULTS The total delivered energy was higher in the 15-G group than in the 17-G group in both ex vivo and in vivo studies (8.78 ± 1.06 vs 7.70 ± 0.98 kcal, p = 0.033; 11.20 ± 1.13 vs 8.49 ± 0.35 kcal, p = 0.001, respectively). The three dimensions of the ablation zone had a tendency to be larger in the 15-G group than in the 17-G group in both studies. The ablation volume was larger in the 15-G group than in the 17-G group in both ex vivo and in vivo studies (29.61 ± 7.10 vs 23.86 ± 3.82 cm(3), p = 0.015; 10.26 ± 2.28 vs 7.79 ± 1.68 cm(3), p = 0.028, respectively). The circularity of ablation zone was not significantly different in both the studies. CONCLUSION The size of ablation zone was larger in the 15-G internally cooled electrode than in the 17-G electrode in both ex vivo and in vivo studies. ADVANCES IN KNOWLEDGE Radiofrequency ablation of hepatic tumours using 15-G electrode is useful to create larger ablation zones.
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Moon JY, Roh DH, Yoon SY, Choi SR, Kwon SG, Choi HS, Kang SY, Han HJ, Beitz AJ, Oh SB, Lee JH. σ1 receptors activate astrocytes via p38 MAPK phosphorylation leading to the development of mechanical allodynia in a mouse model of neuropathic pain. Br J Pharmacol 2014; 171:5881-97. [PMID: 25158784 PMCID: PMC4290724 DOI: 10.1111/bph.12893] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/12/2014] [Accepted: 08/21/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND PURPOSE Spinal astrocytes have emerged as important mechanistic contributors to the genesis of mechanical allodynia (MA) in neuropathic pain. We recently demonstrated that the spinal sigma non-opioid intracellular receptor 1 (σ1 receptor) modulates p38 MAPK phosphorylation (p-p38), which plays a critical role in the induction of MA in neuropathic rats. However, the histological and physiological relationships among σ1, p-p38 and astrocyte activation is unclear. EXPERIMENTAL APPROACH We investigated: (i) the precise location of σ1 receptors and p-p38 in spinal dorsal horn; (ii) whether the inhibition of σ1 receptors or p38 modulates chronic constriction injury (CCI)-induced astrocyte activation; and (iii) whether this modulation of astrocyte activity is associated with MA development in CCI mice. KEY RESULTS The expression of σ1 receptors was significantly increased in astrocytes on day 3 following CCI surgery. Sustained intrathecal treatment with the σ1 antagonist, BD-1047, attenuated CCI-induced increase in GFAP-immunoreactive astrocytes, and the treatment combined with fluorocitrate, an astrocyte metabolic inhibitor, synergistically reduced the development of MA, but not thermal hyperalgesia. The number of p-p38-ir astrocytes and neurons, but not microglia was significantly increased. Interestingly, intrathecal BD-1047 attenuated the expression of p-p38 selectively in astrocytes but not in neurons. Moreover, intrathecal treatment with a p38 inhibitor attenuated the GFAP expression, and this treatment combined with fluorocitrate synergistically blocked the induction of MA. CONCLUSIONS AND IMPLICATIONS Spinal σ1 receptors are localized in astrocytes and blockade of σ1 receptors inhibits the pathological activation of astrocytes via modulation of p-p38, which ultimately prevents the development of MA in neuropathic mice.
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Lee I, Budiawan H, Moon JY, Cheon GJ, Kim YC, Paeng JC, Kang KW, Chung JK, Lee DS. The value of SPECT/CT in localizing pain site and prediction of treatment response in patients with chronic low back pain. J Korean Med Sci 2014; 29:1711-6. [PMID: 25469075 PMCID: PMC4248596 DOI: 10.3346/jkms.2014.29.12.1711] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/12/2014] [Indexed: 12/20/2022] Open
Abstract
In many circumstances, causing sites of low back pain (LBP) cannot be determined only by anatomical imaging. Combined functional and morphological imaging such as bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) may be helpful in identifying active lesions. The purpose of this study was to evaluate the usefulness of bone SPECT/CT in localizing the pain site and the treatment of chronic LBP. One hundred seventy-five patients suffering from chronic LBP who underwent SPECT/CT were included, retrospectively. All of the patients received multiple general treatments according to the symptoms, and some of them underwent additional target-specific treatment based on SPECT/CT. Numerical rating scale (NRS) pain score was used to assess the pain intensity. Of 175 patients, 127 showed good response to the given therapies, while the rest did not. Overall, 79.4% of patients with definite active lesions showed good response. Patients with mild active or no lesions on SPECT/CT had relatively lower response rate of 63.0%. Good response was observed by the treatment with the guidance of active lesions identified on SPECT/CT. SPECT/CT could be useful in identifying active lesions in patients with chronic LBP and guiding the clinicians to use adequate treatment.
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Moon JY. A Pressure Comparison Between Midline
and Paramedian Approaches to the Cervical
Epidural Space. Pain Physician 2014. [DOI: 10.36076/ppj.2014/17/155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: In the cervical spine, the ligamentum flavum (LF) is often incompletely fused
at the midline. Therefore, accessing the epidural space (ES) using the loss of resistance (LOR)
technique via the midline approach could be less reliable than the paramedian approach. Since
the tactile sensation of LOR is due to abrupt loss of pressure upon entering the ES, we have
compared pressure changes between the 2 different cervical epidural techniques.
Objectives: The aim of this study was to compare pressure changes during the pathway to
the cervical ES between the 2 approaches.
Study Design: A prospective, open-labeled, randomized, comparative study.
Setting: An interventional pain management practice in a hospital, Republic of Korea.
Methods: The 74 patients were randomly assigned to either a midline or paramedian group.
The pressure changes were monitored and classified into 4 grades according to the following
criteria:
Grade I. The pressure waveform sequence consisted of 3 components in chronological order:
1) a high positive pressure just prior to entering the ES; 2) an abrupt pressure decrease at the
moment of entering the ES; and 3) a negative peak pressure before cervical epidural pressure
equilibration. Grade II. A high positive pressure followed by a precipitous pressure drop,
without negative peak pressure upon entering the ES. Grade III. High positive pressure before
entering the ES, followed by continuous pressure decrease without negative pressure. Grade
IV. No pressure changes before or after entering the cervical ES.
Results: An abrupt pressure decrease at the moment of exiting the LF or entering the ES was
more frequently observed when using the paramedian approach (P < 0.05) with the odds ratio
of 4.96 (95% CI, 1.63 – 15.12) as compared with the midline approach.
Limitations: A correlation between the abrupt pressure decrease and LOR tactile sensation
has been assumed.
Conclusion: Under the assumption that the LOR sensation is due to an abrupt decrease in
pressure the moment the needle enters the ES or exits the LF, this study claims that the accuracy
of accessing the cervical ES can be improved significantly using the paramedian approach.
Clinical trial: NCT01009385. Institutional Review Board (IRB): H-1208-107-422
Key words: Cervical epidural injection, loss of resistance technique, ligamentum flavum,
midline approach, paramedian approach, epidural space
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Joo Y, Moon JY, Kim YC, Lee SC, Kim HY, Park SY. A pressure comparison between midline and paramedian approaches to the cervical epidural space. Pain Physician 2014; 17:155-162. [PMID: 24658476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In the cervical spine, the ligamentum flavum (LF) is often incompletely fused at the midline. Therefore, accessing the epidural space (ES) using the loss of resistance (LOR) technique via the midline approach could be less reliable than the paramedian approach. Since the tactile sensation of LOR is due to abrupt loss of pressure upon entering the ES, we have compared pressure changes between the 2 different cervical epidural techniques. OBJECTIVES The aim of this study was to compare pressure changes during the pathway to the cervical ES between the 2 approaches. STUDY DESIGN A prospective, open-labeled, randomized, comparative study. SETTING An interventional pain management practice in a hospital, Republic of Korea. METHODS The 74 patients were randomly assigned to either a midline or paramedian group. The pressure changes were monitored and classified into 4 grades according to the following criteria: Grade I. The pressure waveform sequence consisted of 3 components in chronological order: 1) a high positive pressure just prior to entering the ES; 2) an abrupt pressure decrease at the moment of entering the ES; and 3) a negative peak pressure before cervical epidural pressure equilibration. Grade II. A high positive pressure followed by a precipitous pressure drop, without negative peak pressure upon entering the ES. Grade III. High positive pressure before entering the ES, followed by continuous pressure decrease without negative pressure. Grade IV. No pressure changes before or after entering the cervical ES. RESULTS An abrupt pressure decrease at the moment of exiting the LF or entering the ES was more frequently observed when using the paramedian approach (P < 0.05) with the odds ratio of 4.96 (95% CI, 1.63 - 15.12) as compared with the midline approach. LIMITATIONS A correlation between the abrupt pressure decrease and LOR tactile sensation has been assumed. CONCLUSION Under the assumption that the LOR sensation is due to an abrupt decrease in pressure the moment the needle enters the ES or exits the LF, this study claims that the accuracy of accessing the cervical ES can be improved significantly using the paramedian approach. CLINICAL TRIAL NCT01009385. Institutional Review Board (IRB): H-1208-107-422.
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Kim EJ, Moon JY, Park KS, Yoo DH, Kim YC, Sim WS, Lee CJ, Shin HY, Kim JH, Kim YD, Lee SJ. Epidural steroid injection in korean pain physicians: a national survey. Korean J Pain 2013; 27:35-42. [PMID: 24478899 PMCID: PMC3903799 DOI: 10.3344/kjp.2014.27.1.35] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 12/05/2013] [Accepted: 12/10/2013] [Indexed: 11/13/2022] Open
Abstract
Background Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.
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Rhee CK, Yoo KH, Lee JH, Park MJ, Kim WJ, Park YB, Hwang YI, Kim YS, Jung JY, Moon JY, Rhee YK, Park HK, Lim JH, Park HY, Lee SW, Kim YH, Lee SH, Yoon HK, Kim JW, Kim JS, Kim YK, Oh YM, Lee SD, Kim HJ. Clinical characteristics of patients with tuberculosis-destroyed lung. Int J Tuberc Lung Dis 2013; 17:67-75. [PMID: 23232006 DOI: 10.5588/ijtld.12.0351] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Multicentre study. OBJECTIVE To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB. DESIGN We reviewed patients with TB-destroyed lung between May 2005 and June 2011. RESULTS A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1). CONCLUSION Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.
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Park HS, Sin WK, Kim HY, Moon JY, Park SY, Kim YC, Lee SC. Scrambler therapy for patients with cancer pain - case series -. Korean J Pain 2013; 26:65-71. [PMID: 23342211 PMCID: PMC3546214 DOI: 10.3344/kjp.2013.26.1.65] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 11/14/2012] [Accepted: 11/15/2012] [Indexed: 12/13/2022] Open
Abstract
More than 80% of cancer patients experience cancer pain. Among them, more than 50% experience moderate to severe pain. To control cancer pain, a variety of methods have been used, including medications and nerve blocks. In some patients, however, it is impossible to perform nerve blocks due to caner metastasis into the epidural space, while in other patients, opioid dose escalation is impossible due to opioid side effects; thus, cancer pain management is difficult. Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. Scrambler therapy synthesizes 16 different types of nerve action potentials that provide "non-pain" information via cutaneous nerves. The advantages of this treatment are that it is non-invasive and safe and has no significant side effects. In this case series, we report the treatment results of using scrambler therapy in three cancer patients with intractable pain.
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Kim HY, Park JW, Park SY, Moon JY, Shin JH, Park SH. Psoas compartment blockade in a laterally herniated disc compressing the psoas muscle -a case report-. Korean J Pain 2012; 25:116-20. [PMID: 22514781 PMCID: PMC3324737 DOI: 10.3344/kjp.2012.25.2.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 12/14/2011] [Accepted: 12/26/2011] [Indexed: 11/05/2022] Open
Abstract
A psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and analgesia for post-operative pain. Currently, this block is advocated for relieving pain in the lower extremity and pelvic area resulting from various origins. We report a case of a 69-year-old male patient who had gait abnormality with posterior pelvic and hip pain, which were both aggravated by hip extension. From the magnetic resonance image, the patient was found to have a laterally herniated intervertebral disc at the L2/3 level, which compressed the right psoas muscle. This was thought to be the origin of the pain, so a psoas compartment block was performed using 0.25% chirocaine with triamcinolone 5mg, and the pain in both the pelvis and hip were relieved.
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Lee DG, Kim GH, Park DY, Jeong JH, Moon JY, Lee BE, Hosuk I, Song GA. Endoscopic submucosal resection of esophageal subepithelial lesions using band ligation. Endoscopy 2011; 43:822-5. [PMID: 21818736 DOI: 10.1055/s-0030-1256615] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Subepithelial lesions (SELs) are occasionally found in the esophagus during upper endoscopy. Sometimes endoscopic resection is needed for accurate diagnosis or in the rare cases of malignant transformation of SELs. In this case series, we evaluated the usefulness of endoscopic submucosal resection with a ligation device (ESMR-L) in esophageal SELs. Twenty-three patients with 25 esophageal SELs that were no larger than 13 mm and were localized within the muscularis mucosae or submucosa were enrolled. ESMR-L was successfully performed in all 25 SELs. The en bloc resection rate was 100% (25/25), and histologically complete resection was achieved in 24 lesions (24/25, 96%). After resection of the lesion by snare, minor immediate bleeding occurred in four cases, but there was no delayed bleeding or perforation.
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Yoo HS, Nahm FS, Yim KH, Moon JY, Kim YS, Lee PB. Pregnancy in woman with spinal cord stimulator for complex regional pain syndrome: a case report and review of the literature. Korean J Pain 2010; 23:266-9. [PMID: 21217892 PMCID: PMC3000625 DOI: 10.3344/kjp.2010.23.4.266] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 11/08/2010] [Accepted: 11/09/2010] [Indexed: 12/26/2022] Open
Abstract
Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity. During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.
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Lee KJ, Moon JY, Choi HK, Kim HO, Hur GY, Jung KH, Lee SY, Kim JH, Shin C, Shim JJ, In KH, Yoo SH, Kang KH, Lee SY. Immune regulatory effects of simvastatin on regulatory T cell-mediated tumour immune tolerance. Clin Exp Immunol 2010; 161:298-305. [PMID: 20491794 DOI: 10.1111/j.1365-2249.2010.04170.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Statins are potent inhibitors of hydroxyl-3-methylglutaryl co-enzyme A (HMG-CoA) reductase, and have emerged as potential anti-cancer agents based on preclinical evidence. In particular, compelling evidence suggests that statins have a wide range of immunomodulatory properties. However, little is known about the role of statins in tumour immune tolerance. Tumour immune tolerance involves the production of immunosuppressive molecules, such as interleukin (IL)-10, transforming growth factor (TGF)-beta and indoleamine-2,3-dioxygenase (IDO) by tumours, which induce a regulatory T cell (T(reg)) response. In this study, we investigated the effect of simvastatin on the production of IL-10, TGF-beta and IDO production and the proliferation of T(regs) using several cancer cell lines, and Lewis lung cancer (3LL) cells-inoculated mouse tumour model. Simvastatin treatment resulted in a decrease in the number of cancer cells (3LL, A549 and NCI-H292). The production of the immune regulatory markers IL-10, TGF-beta in 3LL and NCI-H292 cells increased after treatment with simvastatin. The expression of IDO and forkhead box P3 (FoxP3) transcription factor was also increased in the presence of simvastatin. In a murine 3LL model, there were no significant differences in tumour growth rate between untreated and simvastatin-treated mice groups. Therefore, while simvastatin had an anti-proliferative effect, it also exhibited immune tolerance-promoting properties during tumour development. Thus, due to these opposing actions, simvastatin had no net effect on tumour growth.
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Kim TH, Lee PB, Son HM, Choi JB, Moon JY. Spontaneous lead breakage in implanted spinal cord stimulation systems. Korean J Pain 2010; 23:78-81. [PMID: 20552080 PMCID: PMC2884218 DOI: 10.3344/kjp.2010.23.1.78] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 12/03/2009] [Accepted: 12/11/2009] [Indexed: 11/29/2022] Open
Abstract
Spinal cord stimulation (SCS) has become an established clinical option for treatment of refractory chronic pain. Current hardware and implantation techniques for SCS are already highly developed and continuously improving; however, equipment failures over the course of long-term treatment are still encountered in a relatively high proportion of the cases treated with it. Percutaneous SCS leads seem to be particularly prone to dislocation and insulation failures. We describe our experience of lead breakage in the inserted spinal cord stimulator to a complex regional pain syndrome patient who obtained satisfactory pain relief after the revision of SCS.
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Yoon WJ, Moon JY, Song G, Lee YK, Han MS, Lee JS, Ihm BS, Lee WJ, Lee NH, Hyun CG. Artemisia fukudo essential oil attenuates LPS-induced inflammation by suppressing NF-kappaB and MAPK activation in RAW 264.7 macrophages. Food Chem Toxicol 2010; 48:1222-9. [PMID: 20156520 DOI: 10.1016/j.fct.2010.02.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 02/06/2010] [Accepted: 02/08/2010] [Indexed: 01/21/2023]
Abstract
In the present study, the chemical constituents of Artemisia fukudo essential oil (AFE) were investigated using GC-MS. The major constituents were alpha-thujone (48.28%), beta-thujone (12.69%), camphor (6.95%) and caryophyllene (6.01%). We also examined the effects of AFE on the production of nitric oxide (NO), prostaglandin E(2) (PGE(2)), tumour necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6, in lipopolysaccharide (LPS)-activated RAW 264.7 macrophages. Western blotting and RT-PCR tests indicated that AFE has potent dose-dependent inhibitory effects on pro-inflammatory cytokines and mediators. We investigated the mechanism by which AFE inhibits NO and PGE(2) by examining the level of nuclear factor-kappaB (NF-kappaB) activation within the mitogen-activated protein kinase (MAPK) pathway, which is an inflammation-induced signal pathway in RAW 264.7 cells. AFE inhibited LPS-induced ERK, JNK, and p38 phosphorylation. Furthermore, AFE inhibited the LPS-induced phosphorylation and degradation of Ikappa-B-alpha, which is required for the nuclear translocations of the p50 and p65 NF-kappaB subunits in RAW 264.7 cells. Our results suggest that AFE might exert an anti-inflammatory effect by inhibiting the expression of pro-inflammatory cytokines. Such an effect is mediated by a blocking of NF-kappaB activation which consequently inhibits the generation of inflammatory mediators in RAW264.7 cells. AFE may be useful for treating inflammatory diseases.
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Moon JY, Kim YC, Park MJ, Lee PB, Lee SC, Kang DH, Shin MS, Kwon TM. Cognitive Assessment in Complex Regional Pain Syndrome Patients. Korean J Pain 2009. [DOI: 10.3344/kjp.2009.22.1.28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Park CD, Kim JW, Choi JB, Lee MJ, Moon JY, Lee PB. Neuralgic Amyotrophy Considered as Cervical Radiculopathy -A case report-. Korean J Pain 2009. [DOI: 10.3344/kjp.2009.22.2.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Moon JY, Choi JB, Lee PB, Son HM, Nam FS, Kim YC, Lee SC, Lee SJ. An Open-Label Trial of the 5% Lidocaine Patches for the Treatment of Chronic Pain. Korean J Pain 2009. [DOI: 10.3344/kjp.2009.22.3.216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Park HC, Bae YU, Cho SD, Kim SA, Moon JY, Ha KC, Kim DW, Lee K, Jeong YK, Kwack DO, Heo JS, Lee YG, Joo WH. Toluene-induced accumulation of trehalose by Pseudomonas sp. BCNU 106 through the expression of otsA and otsB homologues. Lett Appl Microbiol 2007; 44:50-5. [PMID: 17209814 DOI: 10.1111/j.1472-765x.2006.02036.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The objective of this study was to investigate toluene-induced accumulation mechanism of trehalose in a toluene-tolerant bacterium Pseudomonas sp. BCNU 106. METHODS AND RESULTS The accumulation of trehalose by a toluene-tolerant bacterium Pseudomonas sp. BCNU 106 was examined at various cultivation time by measuring the total intracellular trehalose content, trehalase activity and mRNA levels of the trehalose-biosynthetic genes. The pattern of trehalose accumulation corresponded to the mRNA expression pattern of the trehalose-biosynthetic genes with the maximum level at 12 h or 4 h of cultivation with 10% (v/v) toluene, respectively. The trehalose-biosynthetic genes were also cloned and sequenced. Furthermore, the effects of toluene addition on the intracellular osmotic pressure and pH were investigated. It was shown that homeostasis was maintained in the bacterial cells. CONCLUSIONS In a toluene-tolerant bacterium Pseudomonas sp. BCNU 106, a significant amount of trehalose was accumulated through the toluene-induced expression of the trehalose-biosynthetic genes after the exposure to toluene. SIGNIFICANCE AND IMPACT OF THE STUDY The accumulation of the high level of intracellular trehalose was preceded by the expression of otsA/B genes in toluene-tolerant bacteria, contributing to the elucidation of the tolerance mechanism.
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Moon JY, Joh JY, Kim YH, Lee EH, Lee CJ, Lee SC, Kim CS. Pulsed Radiofrequency Treatment in Glossopharyngeal Neuralgia: A report of 2 cases. Korean J Anesthesiol 2006. [DOI: 10.4097/kjae.2006.50.1.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hwang SG, Lee HC, Lee DW, Kim YS, Joo WH, Cho YK, Moon JY. Induction of apoptotic cell death by a p53-independent pathway in neuronal SK-N-MC cells after treatment with 2,2',5,5'-tetrachlorobiphenyl. Toxicology 2001; 165:179-88. [PMID: 11522376 DOI: 10.1016/s0300-483x(01)00432-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Apoptotic cell death is an active process, which is a critical feature of the regulated development of multicellular organisms. Polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants, some of which may be neurotoxic. This study investigates the 2,2', 5,5'-tetrachlorobiphenyl (PCB 52) induced apoptosis in human neuronal SK-N-MC cells, and the role of p53 in this response. Upon treatments with PCB 52, time- and concentration-dependent inhibition of the cell viability was observed. PCB 52 also caused apoptosis, as measured by cell morphology and DNA fragmentation. The capability of PCB 52 to induce apoptosis was associated with the proteolytic cleavage of specific target proteins, such as poly(ADP-ribose) polymerase (PARP) and beta-catenin proteins, suggesting the possible involvement of caspases. In general, DNA-damaging agents induce accumulation of the tumor suppressor protein p53, leading cells to either growth arrest in G1, or apoptosis. However, our data showed that both p53 and Bcl-2 protein levels were decreased in a time-dependent manner during apoptosis after exposure to PCB 52. These results suggest that PCB 52 induced a p53-independent apoptosis in these cells.
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Suh YG, Kim YH, Park MH, Choi YH, Lee HK, Moon JY, Min KH, Shin DY, Jung JK, Park OH, Jeon RO, Park HS, Kang SA. Pimarane cyclooxygenase 2 (COX-2) inhibitor and its structure-activity relationship. Bioorg Med Chem Lett 2001; 11:559-62. [PMID: 11229771 DOI: 10.1016/s0960-894x(01)00004-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The structure-activity relationship and molecular modelings of a novel pimarane COX-2 inhibitor are reported. Particularly, a series of linker extended analogues designed on the basis of these studies exhibited significantly enhanced COX-2 inhibitory activities and selectivities.
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Moon JY, Lee DW, Park KH. Inhibition of 7-ethoxycoumarin O-deethylase activity in rat liver microsomes by naturally occurring flavonoids: structure-activity relationships. Xenobiotica 1998; 28:117-26. [PMID: 9522437 DOI: 10.1080/004982598239623] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
1. The inhibitory effects of several naturally occurring flavonoids and related compounds on cytochrome P450-dependent 7-ethoxycoumarin O-deethylase (ECOD) and the structure-activity relationships were studied in liver microsomes from rats treated with 3-methylcholanthrene (MC). 2. All the flavonoids (flavone, apigenin, chrysin, flavonol, fisetin, kaempferol, morin, myrisetin, quercetin, flavanone, hesperetin and naringenin) studied inhibited microsomal ECOD activity in the following order: flavones > flavonols > flavanones, were mixed type inhibitors and had Ki in the range of 0.17-4.5 microM. (+/-)-Catechin had no effect. 3. The double bond between C2 and C3 of the C ring, the keto group and hydroxyl group of this ring in the flavonoids seem to play major roles in inhibiting the ECOD activity. 4. The hydroxyl groups in the C5 and C7 positions of A ring in the flavone and the hydroxyl group in the C3 position of C ring in the flavonol classes, respectively, were important factors for the inhibition of the enzyme. 5. In a series of 3, 5, 7-trihydroxyflavones, the hydroxyl group at the C4 in the B ring was also an important factor for the inhibition of ECOD activity, but hydroxyl groups in other positions of the B ring had little effect on the inhibition. 6. We conclude that all the flavonoids studied inhibit ECOD activity by interfering with the binding of substrate to the active site and other site(s) of the enzyme and that their structural differences lead to different binding affinities at the active site and possibly to binding at other site(s) of the enzyme for the flavonoids.
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Park C, Moon JY, Cokic P, Webster DA. Na(+)-translocating cytochrome bo terminal oxidase from Vitreoscilla: some parameters of its Na+ pumping and orientation in synthetic vesicles. Biochemistry 1996; 35:11895-900. [PMID: 8794772 DOI: 10.1021/bi9530503] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Vitreoscilla cytochrome bo ubiquinol oxidase is similar in some properties to the Escherichia coli enzyme, but unlike the latter, the Vitreoscilla oxidase functions as a primary Na+ pump. When purified Vitreoscilla cytochrome bo is incorporated into liposomes made from Vitreoscilla phospholipids and energized with a quinol substrate, it translocates Na+, not H+, across the vesicle membrane. Since protonophores CCCP (carbonyl cyanide m-chlorophenylhydrazone) and DTHB (3,5-di-tert-butyl-4-hydroxybenzaldehyde) stimulated the Na+ pumping, it is unlikely that it is a secondary effect due to the presence of Na+/H+ antiporter activity in the preparations. The efficiency of the Na+ pumping was 3.93 Na+ pumped per O2 consumed when ascorbate/TMPD was used as the substrate. The cytochrome has a K(m) and Kcat for Na+ of 2.9 mM and 277 s-1, respectively. When ferricytochrome c was entrapped within liposomes prepared from Vitreoscilla phospholipids, it was reduced by Q1H2 (ubiquinol-1) but not by ascorbate/TMPD (N,N,N',N'-tetramethyl-1,4-phenylenediamine). Although Q1H2 was oxidized by cytochrome bo in solution at a rate approximately 14 times that of the latter substrate, the rate of accumulation of Na+ within cytochrome bo vesicles driven by the membrane impermeable ascorbate/TMPD was 1.23 times that of the membrane permeable ubiquinol. These data allowed a calculation that in these synthetic proteoliposomes the cytochrome bo molecules are only 51% directed inward; a value of 61% inward-directed was estimated by measuring the ascorbate/TMPD oxidase activity of the proteoliposomes before and after disrupting them with Triton X-100. A random orientation of the E. coli cytochrome bo oxidase in proteoliposomes has also been reported.
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