• The Korean Journal of Pain
• /
• v.2 no.1
• /
• pp.49-56
• /
• 1989

Bell's palsy is not a serious disease and recovery is spontaneous in more half of the patients, but this recovery is long delayed in many instances and the cosmetic effect of an altered facial appearance is psychologically distressing. The etiology is unknown, but Kettle's ischemic hypothesis has been widely accepted. The aim of treatment is to reduce edema and improve circulation to the facial nerve. Stellate ganglion block (SGB) resulted in abolishing cerebral vascular spasm and in increasing cerebral blood flow. Thus, stellate ganglion block is effective in treatment of Bell's palsy. From 1978 to Oct. 1988, we have treated 222 patients (20 patients were recurred cases) with facial palsy by SGB and analysed the effect of SGB. We noticed that SGB was very effective in early repetitive treatment (90% recovery). This study is reported and the literature is reviewed.

• Journal of Life Science
• /
• v.28 no.1
• /
• pp.116-129
• /
• 2018

Living creatures possess long-conserved mechanisms to maintain homeostasis in response to various stresses. However, chronic and continuous exposure to stress can result in the excessive production of stress hormones, including catecholamines, which have harmful effects on health. Studies on the relationship between the sympathetic nervous system (SNS) and cancer have been conducted based on the traditional hypothesis that stress can promote cancer progression. Many preclinical and epidemiological studies have suggested that the regulation of ${\beta}$-adrenergic signaling, which mediates SNS activity, can suppress the progression of solid tumors. SNS activation has highly pleiotropic effects on tumor biology, as it stimulates oncogenes, survival pathways, the epithelial - mesenchymal transition, and invasion. Moreover, it inhibits DNA repair and programmed cell death and regulates the tumor microenvironment, including immune cells, endothelial cells, the extracellular matrix, mesenchymal cells, and adipocytes. Although targeted therapies on the molecular basis of tumor proliferation are currently receiving increased attention, they have clinical limitations, such as the compensatory activation of other signaling pathways, emergence of drug resistance, and various side effects, which raise the need for pleiotropic cancer regulation. This review summarizes the effects of the SNS on the development and progression of cancer and discusses the clinical perspectives of ${\beta}$-blockade as a novel therapeutic strategy for this disease.

• The Korean Journal of Pharmacology
• /
• v.26 no.2
• /
• pp.101-111
• /
• 1990

The effect of physostigmine (PS), which has been shown to act on the muscarinic receptors in the brains of the rat, dog and cat, on the arterial blood pressure (BP) was investigated in urethane-anesthetized rabbits. Intravenous (iv) PS, $25{\sim}300\;{\mu}g/kg$, caused little change in BP. However, after treatment of rabbits with either of chlorisondamine (CS), hexamethonium, intracerebroventricular (icv) clonidine, icv xylazine and icy reserpine iv PS produced a pressor response. Spinalization of the rabbit also caused iv PS to increase BP. The pressor effect of iv PS in CS-treated rabbits was markedly reduced after prazosin or pirenzepine. Iv PS inhibited the pressor response to McN-A-343 in CS-treated and in spinal rabbits; alternately during the infusion of McN-A-343 iv PS failed to produce the pressor response. The pressor response to DMPP was not affected by iv PS. Icv PS, $12{\sim}200\;{\mu}g/kg$, produced a pressor response which was accentuated after CS-treatment. This pressor effect was inhibited, though not complete, by prazosin or by pirenzepine. A simultaneous treatment of rabbits with both $[Sar^{1},\;Ala^{8}]-angiotensin$ II, an angiotensin II antagonist, and prazosin or pirenzepine almost completely abolished the pressor effect of icv PS, whereas the angiotensin II antagonist did not enhance the inhibitory effect of pirenzepine and prazosin on the pressor response to iv PS . Icv pirenzepine blocked the pressor response to icv PS without affecting that to iv PS. The present results show that the pressor response to iv PS in CS-treated and in spinal rabbits arises from stimulation of the muscarinic receptors in the sympathetic ganglia, whereas the pressor response by icv PS via activation of the muscarinic receptors in the brain which causes an enhancement in the outflow of sympathetic discharge and angiotensin. The results also suggest that iv PS is unable to produce a pressor response in the rabbit unless the sensitivity of the gangionic muscarinic receptors is altered by ganglionic nicotinic blockade, by the decrease of central sympathetic outflow on the sympathetic ganglia or by spinalization.

• The Korean Journal of Pharmacology
• /
• v.28 no.2
• /
• pp.171-179
• /
• 1992

Effects of a $M_1$ receptor antagonist, pirenzepine, a $M_2$ receptor antagonist, AF-DX116, and a nicotinic receptor antagonist, mecamylamine on the pressor responses to preganglionic sympathetic nerve stimulation (PNS) and McN-A-343 and DMPP in spinal (pithed) rabbits were investigated, in order to elucidate a functional role of $M_1$, $M_2$ and nicotinic receptors in ganglionic transmission. Pirenzepine and AF-DX116 selectively inhibited the McN-A-343-induced pressor response in chlorisondamine-treated rabbit and the BCh-induced bradycardia, respectively. Electrical stimulations of preganglionic sympathetic outflow at T8 level produced increases in blood pressure. Pirenzepine $(3\;{\mu}g/kg)$ significantly inhibited the PNS-induced pressor response and the degree of inhibition was not changed by increasing the doses to $100\;{\mu}g/kg$. AF-DX116 $(100\;{\mu}g/kg)$ had no effect on the PNS-induced pressor response. Mecamylamine inhibited the PNS-induced pressor response in a dose-dependent manner. The inhibitory action of mecamylamine was significantly augmented by combined-treatment with pirenzepine $(30\;{\mu}g/kg)$ but AF-DX116 $(100\;{\mu}g/kg)$ did not affect the inhibitory action of mecamylamine. McN-A-343 and DMPP elicited pressor response in the spinal rabbit. Pirenzepine and AF-DX116 dose-dependently inhibited the McN-A-343-induced pressor response but they did not affect DMPP-induced pressor response. Mecamylamine inhibited both pressor responses induced by McN-A-343 and DMPP. These results suggest that not only nicotinic receptors but also $M_1$ receptors play a facilitatory role in ganglionic transmission but $M_2$ receptors do not contribute the transmission in spinal (pithed) rabbits.

• Journal of Chest Surgery
• /
• v.34 no.11
• /
• pp.823-830
• /
• 2001

Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.208-209
• /
• 2005

Interstitial cystitis is an extremely painful and distressing condition, characterized by severe suprapubic pain, which increases with bladder filling and is relieved by voiding. The daily frequency of micturition may approach 100 times, but no incontinence is observed. The symptoms persist throughout the night, which consequently affects sleep. The etiology of this condition is still unknown, but includes infection, autoimmune response, allergic reaction, neurogenic inflammation, epithelial dysfunction and inherited susceptibility. Herein, a case of interstitial cystitis, with severe symptoms, which was successfully treated with lumbar sympathetic block, is reported.

• The Korean Journal of Pain
• /
• v.5 no.1
• /
• pp.103-107
• /
• 1992

Thoracic sympathetic ganglion block was not applied routinely because of high incidence of complication such as pneumothorax. We successfully managed a patient with sternal pain and a patient with scapular pain by thoracic sympathetic ganglion block. We concluded that thoracic sympathetic ganglion block was an effective treatment for intractable cancer pain. However precise anatomical knowledgement is essential.

• The Korean Journal of Pain
• /
• v.3 no.1
• /
• pp.55-58
• /
• 1990

A case of severe complications following intrathecal administration of 45 ml of hypertonic saline solution for the treatment of postherpetic neuralgia was presented. Transient immediate complications included were tachycardia, hypertension, neck stiffness and muscle twitch. Pulmonary edema, paralytic intestinal obstruction, and the cauda equina syndrome including sphincter disorder with atonic urinary bladder developed shortly after the injection. Tenesmus and sensory abnormality around perineum and soles were the longlasting complications.

• Journal of Chest Surgery
• /
• v.33 no.3
• /
• pp.273-275
• /
• 2000

Endoscopic sympathicotomy is the choice of the treatment for hyperhidrosis. There are some recognized risks such as Honer's syndrome and Hemopneumothorax; however, Chylothorax has very rarely been reported after thoracic sympathicotomy. We recently encountered a case of chylothorax. Early diagnosis and prompt treatment is noteworthy.

• The Korean Journal of Pain
• /
• v.19 no.2
• /
• pp.237-240
• /
• 2006

This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.