• Title/Summary/Keyword: 말초신경손상

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Long-Term Follow-Up after the Sural Nerve Graft on the Injured Temporal Branch of the Facial Nerve: A Case Report (안면신경의 측두지 손상에서 비복 신경을 이용한 지연 신경 이식술 후 장기 추적 예후: 증례보고)

  • Cheon, Jeong-Hyun;Chung, Jae-Ho;Yoon, Eul-Sik;Lee, Byung-Il;Park, Seung-Ha
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.306-312
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    • 2018
  • The temporal branch of the facial nerve is particularly vulnerable to traumatic injuries due to its anatomic location, which often causes severe aesthetic and functional loss in the patient. Moreover, a chronic injury with nerve defect is more difficult to treat compared to acute injury, because it usually needs an additional procedure such as a nerve graft surgical procedure. This case shows a male patient who had a divided temporal branch of the facial nerve one month after an injury. We successfully grafted the split sural nerve and showed a good aesthetic, functional recovery for the patient.

The expression of c-fos and HSP70 by the Capsaicin injection in the spinal cord(dorsal horn) (Capsaicin 적용 후 손상된 흰쥐 척수내 c-fos와 HSP70의 발현)

  • Kim, Dong-Hyun;Kim, Souk-Boum;Baek, Su-Jeong;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.131-137
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    • 2002
  • C-fos는 원종양유전자(proto-oncogene)인 v-fos의 세포 동족체로써, 성장인자나 신경전달 물질에 의해 수분 내에 다양한 형태의 세포에서 활성화된다. Fos단백질은 스트레스와 통증 과정의 신호전달기전에서 세포활동을 조절하는 3차전령으로 활동한다. 열충격 단백질(Heat shock protein : 이하 HSP)은 계통발생학적으로 초기 척추 동물에서부터 발현되며 생체방어체계의 중요한 인자로 세포가 고열, 외상, 허혈 등의 스트레스에 직면했을 때 발현이 증가하는 단백질로 알려져 있다. 본 연구에서는 캡사이신(capsaicin)으로 말초 신경병변을 유발시킨 후 통각신경활성의 지표로 이용되는 원종양 유전자인 c-fos의 발현과 열 또는 스트레스로 야기되는 손상에 대한 조직의 방어작용으로 발현되는 HSP 70의 발현을 동시에 관찰함으로서, 급성으로 유발된 말초 신경병변의 확인과 동시에 실험동물 체내에서 방어적인 역할을 밝히는 일환으로 이 실험을 실시하였다. 본 실험의 결과는 다음과 같다; 1. 척수 등쪽뿔 천층(Laminae I and II)에서 각각 c-fos와 HSP70을 항원으로 하는 면역조직화학적 방법으로 염색한 표본에서 0.9% NaCI 투여 2시간 후 c-fos와 HSP70의 양성을 나타내는 세포는 전혀 없음을 알 수 있었다. 2. 척수 등쪽뿔 천층에서 c-fos 단백질을 항원으로 하는 면역조직화학적 방법으로 염색한 표본에서 Capsaicin 투여 2시간 후 c-fos 단백질에 양성을 나타내는 세포가 많이 발현됨을 육안적 관찰로서 알 수 있었다. 3. 척수 등쪽뿔 천층에서 HSP70을 항원으로 하는 면역조직화확적 방법으로 염색한 표본에서 Capsaicin 투여 2시간 후 HSP7O의 양성을 나타내는 세포가 보통수준으로 발현됨을 육안적 관찰로서 알 수 있었다. 이 실험의 결과로 볼 때, 화학적인 신경병변 유발물질에 의한 손상을 방어하기 위해서 체내에는 내인성 물질이 형성될 것이라는 추측과 c-fos 가 다른 유전자의 발현을 유도한다는 점을 함께 고려 하였을때, Capsaicin에 의한 말초 신경병변에서 c-fos 발현이 많이 나타나는 것은 손상을 방어하는 물질의 생성에 관여하기 때문이며, 방어물질 중 이 실험에서 본 HSP70도 증가한 내인성 방어물질의 하나라고 할 수 있을 것이다.

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The Effect of Transplantation of Schwann Cell and SIS Sponge on the Injured Peripheral Nerve Regeneration (슈반세포와 SIS 스폰지의 이식이 손상된 말초 신경 재생에 미치는 영향)

  • Kim, Cho-Min;Kim, Soon-Hee;Kim, Su-Mi;Park, Sang-Wook;Lee, Il-Woo;Kim, Moon-Suk;Rhee, John-M.;Khang, Gil-Son;Lee, Hai-Bang
    • Polymer(Korea)
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    • v.32 no.1
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    • pp.49-55
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    • 2008
  • It is recognized that Schwann cells (SC) are essential for peripheral nerve development and regeneration. SIS (small intestinal submucosa) consists of some growth factors which can stimulate cell activity without immune rejection responges. SCs were harvested from the femurs and tibias of female Fischer rat and then suspended with $2{\times}10^6$ cell/sponge in SIS sponge. Fischer rat received an implant consisting of the SCs and the SIS sponge at the place of a 5 mm gap created by the sciatic nerve resection. Thin sections were stained with H &E staining and immunostaining of S-100, GFAP and NF after 1, 2, and 4 weeks. It was observed that the effects of the SIS sponge with SCs on neuroinduction(Group II, with scaffold & cell) are strong as much as uninjured model(Control I), and significantly stronger than SIS sponge model (Group 1, with scaffold only) and blank model (Control II). In conclusion, these results suggest that SIS sponge filled with SCs may have an important role for peripheral nerve regeneration of tissue engineering.

특집 : 미세혈관 합병증 - 당뇨병은 혈관병 - 당뇨병은 혈관에 어떤 영향을 미칠까?

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.259
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    • pp.14-16
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    • 2011
  • 당뇨병을 장기간 앓게 되면 혈관이 분포한 모드 조직 또는 기관을 침범하는 임상 증후군이 발생하는데 이를 당뇨병의 만성 합병증이라고 부른다. 당뇨병 만성 합병증의 기본적인 병리생리는 혈관 질환이며 침범하는 장기와 혈관의 크기에 따라 다음과 같이 분류된다. 눈에 생기는 망막증, 신장에 생기는 신장병증, 신경 특히 말초신경에 발생하는 신경병증들은 미세혈관의 손상에 따라 발생하므로 미세혈관 합병증이라고 부르며 심장에 생기는 협심증, 뇌혈관 경색으로 대표되는 뇌졸중, 하지 동맥폐색증은 대혈관 합병증이라고 부른다.

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A peripheral tremor associated with intractable pain after traffic accident : case report

  • Hong, Joo-Chul;Kim, Seong-Ho
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.74-77
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    • 2009
  • There are debates about whether peripherally induced movement disorders exist. We report a case of upper limb tremor induced by peripheral nerve injury. A 20-year-old male patient presented with pain and tremor of the left upper extremity, 2 days after a car accident. Magnetic resonance images of the brain and cervical spine were normal. His past medical history was unremarkable and there were no family members with symptoms of movement disorders. He suffered from an aggravating tremor for about 10 minutes, four to six times a day. We treated the patient with medication, epidural infusion, cervical nerve root block and trigger point injection of the trapezius muscle. The pain subsided 50% and the incidence of tremor attacks was reduced to once or twice a day. The role of peripheral trauma in the genesis of movement disorders has not been generally accepted. It is unclear whether peripheral trauma can induce dystonia and other movement disorders. It has been proposed that peripheral trauma can alter sensory input and induce cortical and subcortical reorganization that generates a movement disorder. Some studies provide evidence for central reorganization following peripheral injury.

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Effect of Red Ginseng Total Saponin on Sciatic Nerve Regeneration (홍삼사포닌이 좌골신경 재생에 미치는 영향)

  • Han, Hye-Jeong;Lee, Hae-June;Kang, Seong-Soo;Lee, Soo-Han;Cho, Ick-Hyun;Lee, Jong-Hwan;Nah, Seung-Yeol;Park, Chang-Hyun;Uhm, Chang-Sub;Bae, Chun-Sik
    • Journal of Ginseng Research
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    • v.27 no.3
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    • pp.103-109
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    • 2003
  • We investigated the effect of ginseng total saponin (GTS) on the regeneration process of experimentally crush injured rat sciatic nerves. The bilateral sciatic nerves of fifty adult male Sprague-Dawley rats were compressed surgically with a straight hemostat for 30 seconds with 1 mm width. Twenty rats were divided into four groups to test the dose-dependent effect of GTS (0, 50, 100, or 150 mg/kg, i.p.). Saline for vehicle control group or GTS dissolved in saline was administerd for three weeks. After that period of time, the numbers of total myelinated axon and degenerated myelin in the sciatic nerves of bilateral legs were examined and analyzed using image analysis system to confirm a morphological effect of GTS. We found that the most effective concentration of GTS for the regeneration of damaged sciatic nerve was 150 mg/kg. In another set of experiment, thirty rats were divided into two groups as saline-treated vehicle group and GTS-treated group (150 mg/kg, i.p.) for three weeks. Every week we examined the numbers of total myelinated axon and degenerated myelin in the sciatic nerves of bilateral legs using image analysis system to evaluate the effect of GTS on injured nerves. We found that the regeneration of damaged sciatic nerves was facilitated in GTS-treated group compared to saline-treated group until two weeks. However, after that period of time we could not observe the significant difference between saline-treated group and GTS-treated group. These results suggest that GTS is a useful adjuvant therapy for the regeneration of the peripheral nerve injury in short period of treatment.

Peripheral Nerve Injuries Associated with Rotator Cuff Tears (견관절 회전근 개 파열과 동반된 말초 신경 손상)

  • Lee, Kwang-Won;Lee, Ho;Na, Kyu-Hyun;Choy, Won-Sik
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.117-122
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    • 2006
  • Purpose: The purpose of this study is to investigate the relationship between rotator cuff tear and nerve injury, and prevalence of nerve injury using electromyographic study. Materials and Methods: From May 2004 to Feb. 2005, 19 cases, who underwent surgery for full-thickness rotator cuff tear, were evaluated for nerve injury using electomyogram instruments preoperatively. Rotator cuff tears caused by acute high energy trauma were excluded in this study. Mean age was 59 (range, 45-87) years and mean duration of symptoms was 45 (range, 1-360) month. Results: There were six nerve injuries (31.6%). All of them were incomplete brachial plexus injuries, and mainly postganglionic lesions. Four cases among them had minor trauma history. There were no significant differences in terms of cuff tear size, range of motion, pain score and functional score between groups with and without nerve injury. Conclusion: This study showed high prevalence (31.6%) of nerve injury in full-thickness rotator cuff tear. So careful physical examination and evaluation for nerve injury are needed in rotator cuff tear.

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Influence of Transcutaneous Electrical Nerve Stimulation and Electroacupuncture on C-fos Expression in Spinal Cord and Functional Recovery After Rat Sciatic Nerve Crush Injury (경피신경전기자극과 전침자극이 흰쥐 좌골신경 압좌손상 후 척수내 c-fos 발현과 기능회복에 미치는 영향)

  • Lee, Hyun-Min
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.187-195
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    • 2009
  • The purpose of this study was to identify the effect of transcutaneous electrical nerve stimulation(TENS) and electroacupuncture(EA) after sciatic nerve crush injury in rats. Subjects were classified TENS group with TENS application, EA group with EA application and Control group which is not applicated electrical stimulation. TENS and EA stimulations were applied post-injury day(PD) 1 to 14 after sciatic nerve injury. This study observed c-fos expression in rat lumbar spinal cord. In addition, the paw withdrawal latency(PWL) and sciatic function index(SFI) were measured. The results were as follows: At PD 1, control group had higher c-fos immunoreactivity than experimental groups. At PD 7 and 14, control group had higher c-fos immunoreactivity than experimental groups. The PWL of experimental groups were significantly lower than control group. The SFI had not significant difference in all groups. But the average of experimental groups were higher than control group. These results suggest that TENS and EA applications increasing sensory and motor nerve recovery while decreasing c-fos immunoreactivity after sciatic nerve crush injury.

The Polyneuropathy in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자들의 다발성 말초신경병변에 대한 연구)

  • Baek, Jong-Cheul;Myung, Jae-Il;Kang, Heon-Seok;Kim, Yeong-Rock;Youm, Houng-Roul;Ryeu, Hyung-Seun;Lee, Soong;Kim, Wan;Noh, Jean-Yee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.806-814
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    • 1997
  • The incidence, type and distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneuropathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy(13 patients, 30%) more commonly occurs than clinical polyneuropathy(9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.

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A Testing System Development for Unilateral Neglect Patient (편측무시 환자를 위한 평가시스템 개발)

  • Lee, Hyeon-Gi;Hong, Ji-Heon;Yang, SUng-Min;Lee, Hyun
    • Proceedings of the Korea Information Processing Society Conference
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    • 2014.04a
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    • pp.226-229
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    • 2014
  • 편측무시는 뇌졸중 환자에게서 나타나는 지각 손상중의 하나로 말초 운동 및 감각 신경의 손상과 상관없이 손상된 대뇌반구의 반대편의 공간과 신체의 지각이 감소된 상태로 양방향에서 동시에 주어지는 자극에 대해서 한쪽 자극만을 지각하며 뇌손상 반대편의 신체 움직임의 인식 부족과, 무시된 공간쪽으로의 적은 눈 움직임을 보인다. 이와 같은 편측무시를 측정하는 기존 방법으로는 Albert Test, Line bisection Test, Star Cancellation Test 등이 있다. 하지만, 기존 편측무시 평가 방식에는 여러 가지 단점들이 발생한다. 항상 새로운 평가용지가 필요, 검사시간이 오래 소모되고, 모든 작업을 수작업으로 진행, 종이로 데이터를 관리, 수작업이므로 인력낭비 발생한다. 따라서 본 논문에서는 이러한 아날로그 방식에서 나오는 문제점들을 누구나 사용하고 있는 스마트 디바이스를 이용해 디지털방식으로 전환하여 기존의 비효율적이던 방식을 개선시키고자 평가시스템을 개발하고자 한다.