• Korean Journal of Acupuncture
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• v.24 no.2
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• pp.129-139
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• 2007

목적 : Signal transducers and activators of transcription 6 (Stat 6) 유전자는 면역세포의 발달에 있어서 중요한 유전인자이며, IL-4와 같은 사이토카인에 의해 유전자 발현이 조절된다. 본 연구에서는 Stat 6 유전자 제거 생쥐와 정상 (wild type, W/T) 생쥐에 carrageenan으로 염증을 유도한 후 족삼리에 침치료를 시행하여 시상하부에서의 유전자 발현 양상을 분석하고자 하였다. 방 법 : BALB/c (W/T, n=12) and BALB/c-Stat 6 유전자 제거 생쥐 (n=12)의 발뒤꿈치 표피에 1% carrageenan을 30 ul 주사하여 염증을 유도하였다. 침은 염증 유도 30분 후에 족삼리(ST36)에 시침하였으며, 염증유도에 의한 부종 증가율을 매 시간마다 측정하여 총 5시간동안 측정하였다. 마이크로에러이는 Stat 6 유전자 제거 생쥐를 염증 유발 군과 염증유발 후 침을 처치한 군으로 나누고, 시상하부를 적출하여 RNA를 분리한뒤 마이크로어레이 프로파일을 분석하였다. 결 과 : 염증에 의한 부종증가율을 비교한 결과, Stat 6 유전자 제거 생쥐 그룹의 부종증가율이 W/T 생쥐의 부종 증가율보다 약 50 % 정도 감소하였으며, 각 3, 4, 5시간째에 유의한 차이를 나타내었다. (각 p<0.05). W.T생쥐군과 Stat 6 유전자 제거 생쥐군 모두에서, 침 처치군이 염증 유발 군에 비해, 염증 유발 2시간 후부터 유의한 감소를 나타내었다. 시상하부의 유전자 발현을 관찰한 결과, 39개의 유전자가 3배 이상 감소하였으며, 19개의 유전자는 3배 이상 증가하였다. 결 론 : W/T 생쥐군과 Stat 6 유전자 제거 생쥐 모두에서 침의 진통효과는 나타나며, 이의 기전에는 시상하부에서의 침 치료에 의한 염증관련 유전자들의 감소와, 항염증과 관련된 유전자들이 증가가 관여하는 것으로 보인다., 10, 11), 내측전완피신경(TE5, 6, 7, 8, 9, 10, 11), 후상완피신경(TE12, 13), 상외측상완피신경(TE13), 외측쇄골상신경(TE14, 15),대이개신경(TE16, 17, 18, 19), 소후두신경(TE19, 20), 이개측두신경(TE20, 21, 22), 안면신경측두지(TE22, 23), 관골측두신경(TE23), 중층에 견갑상신경(TE15), 견갑배신경(TE15), 경상설골근신경(TE17), 후이개신경(TE18, 19, 20), 안면신경측두지(TE20, 21, 22), 심층에 후골간신경(TE5, 6, 7), 요골신경심지(TE8, 9, 12, 13), 견갑상신경(TE14), 액와신경가지(TE14), 부신경(TE16), 안면신경과 부신경가지(TE17), 설인신경(TE17), 설하신경(TE17), 경신경고리(TE17), 미주신경(TE17), 안면신경 (TE18). 3) 혈(血) 관(管) : 천층에 척측정맥배측지(TE1, 2), 고유수장지동맥배측지(TE1), 배측중수골동맥배측지(TE2), 배측중수골정맥(TE3), 척측피정맥(TE4, 5, 6, 7, 8, 9, 10, 11), 배측정맥궁(TE4), 부요측피정맥(TE6, 8, 9),요측피정맥(TE10, 11), 후견봉정맥가지(TE13, 14), 후이개동 ${\cdot}$ 정맥(TE16, 17, 18, 19, 20), 전이개동 ${\cdot}$ 정맥(TE20), 천측두동 ${\cdot}$ 정맥(TE22, 23), 중층에 후상완회선동맥(TE14), 견갑배동맥(TE15), 견갑상동맥(TE15),천측두동 ${\cdot}$ 정맥(TE21), 관골측두동 ${\cdot}$ 정맥(TE23), 심층에 배측중수골동맥(TE3), 배측수근동맥궁(TE4), 후골간동맥(TE4, 5, 6, 7, 8, 9), 전골간동맥(TE6, 7, 9)

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.7-11
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• 2001

Purpose : To evaluate the neurologic abnormalities in the donor limb after contralateral C7 transfer in brachial plexus injury. Materials and Methods : From August 1996 to December 1999, five patients with brachial plexus injury were treated with contralateral C7 nerve root transfer. The average follow up was 16 months(range, 5 to 36 months). The clinical findings were assessed using the British Medical Research Council Grading System, and also measured grip power, pinch power of hand and two point discrimination of the fingers. Results : We had no difference in shoulder abduction and elbow flexion after contralateral C7 transfer. The grip and pinch strength were recovered within 4weeks. Sensory loss occurred in all patients and was noted to be more severe on index and middle finger. Four patients recovered within 2 weeks, one continued till one year. Subjective numbness and pain on percussion minimally persisted until last follow-up. Conclusion : The division of the C7 nerve root resulted in minimal and temporary functional deficit in the donor upper limb.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.137-146
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• 1996

There has been no general agreement about optimal time for nerve surgery in the closed brachial plexus injury(BPI). From our early experiences, we knew by chance that spontaneous recovery in BPI patients may begin even later than 8 months after injury. Authors' strategy, which was based on our early experiences, for the treatment of closed fresh injury was 'wait and see' unlit 8 months after injury. From 1985 to 1994, we observed 103 patients with BPI. All of them did not have any operation until 8 months after injury. There were 95 men and 8 women with a mean age of 29 years. Motorcycle injury(31%) and vehicle accident(28%) were main causes of injury. Whole plexus types were observed in 56 patients(54%), upper plexus types in 29(28%), lower plexus types in 3(3%), and infraclavicular types in 15(15%). Electromyography was performed in all patients. This was repeated every three months to detect the recovery. Results were evaluated by authors' criteria, in which AMA system of brachial plexus impairment was modified. Duration of follow up was average 25 months. 47 patients(46%) showed spontaneous improvement, which was initially detected at average 7.8 months(range,3 months-16 months) after trauma by electromyography. The average score of these 47 patients improved from 14.8 points to 39.8 points.31 patients(30%) had nerve surgery such as nerve graft, neurotization or neurolysis. Average duration from injury to nerve surgery, was 10 months. Among 31 patients who had nerve surgery, 16 patients improved from preoperative 21.5 points to postoperative 36.3 points in average. Because spontaneous recovery began in average 7.8 months after injury, we think that it would be better to 'wait and see' for at least one year in patients with closed BPI expecting spontaneous recovery.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.1-7
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• 2012

Purpose: The purpose of this study was to identify the effectiveness of multimodal pain control method in an early phase after arthroscopic rotator cuff repair, under interscalene brachial plexus block, this study was performed. Materials and Methods: The study was progressed with the 80 cases of arthroscopic rotator cuff repair. Interscalene brachial plexus block was used to all of the 80 cases and patients were divided into 2 groups. Group A consisted of patients injected with bupivacaine, through subacromial space catheter after surgery, and group B consisted of patients with additional method of multimodal pain control using oral opioids, acetaminophen-tramadol complex and selective COX2 inhibitor. Subacromial cathter was removed after injection in both groups. The pain during the day time and night time was compared on the operation day, postoperative 1st, 2nd, 3rd day and 2nd weeks, and it was measured with VAS (visual analogue scale) score. Additionally, the number of ketolorac injection and side-effect related to analgesics was compared between the 2 groups. Results : The mean VAS score of night time on the operation day and day/night time pain of the 1st, 2nd, 3rd day and 2nd weeks was 7.4, 7.0/6.8, 4.5/5.2, 4.8/5.0, 2.2/2.7 on group A and 6.5, 4.3/5.4, 3.2/4.3, 3.0/4.1, 2.4/2.5 on group B, respectively. Significant difference was observed in the night pain on the operation day, 1st, 2nd, 3rd day time and 1st night time pain (p<.05). The average number of ketololac injection was 1.1 and 0.5 in each group, and there was no difference in the frequency of side effects. Conclusion: Multimodal pain control method, after arthroscopic rotator cuff repair, showed an effective early pain control and improved patients' satisfaction.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.246-250
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• 2006

Brachial neuritis is a rare disorder of unknown etiology that affects the lower motor neurons of the brachial plexus. The clinical course is characterized by acute onset of severe pain followed by weakness and gradual recovery. Among diagnostic tests, electromyography may be useful. The brachial neuritis has been confused with other painful shoulder conditions. The awareness of this disorder helps prevent unwarranted diagnostic studies & treatment. The authors report a case of brachial neuritis.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.729-732
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• 1997

A case of chest wall malignant peripheral nerve sheath tumor(MPNST) was reported in the U.S.A by Mark and coworkers6)(1991), but none in korea. MPNST accounts for approximately 10% of all soft tissue sarcoma, mostly in patients between 20 and 50 years of age. MPNST arises in association with a major nerve trunk, including the sciatic nerve, brachial plexus, and sacral plexus and the most common anatomical site is the proximal portion of the upper and lower extremity and trunk. Surgical treatment is local excision of mass in low grade sarcoma but unblock resection is necessary in high grade sarcoma. We experienced multiple huge low grade MPNST on left chest wall of a 50 years old man. The tumor and invalved chest wall were removed, and the chest wall defect(15$\times$8 cm) was reconstructed with Teflon. Postoperative course was unevenful.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.1
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• pp.24-31
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• 2014

Objectives The purpose of this study is to know the effect of acupuncture on brachial plexus palsy due to birth injury. Methods We decided to treat one week of Vojta therapy and occupational therapy, but other were combined, and then add three weeks of acupuncture treatment as well. Results Right clavicle fracture at birth brachial plexus injury due to decreased locomotion of the right upper extremity, muscle weakness in children aged 7 months to Vojta therapy, occupational therapy and acupuncture, when performed in conjunction mobility increase of the shoulder joint, elbow support improvement, recovery of motor function of the hand grip, etc. to obtain a significant motor function recovery improvement. Conclusion Acupuncture was a good treatment of choice for the better shoulder, joint and hands movements.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.241-243
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• 2006

Central pain is defined as pain associated with lesions of the central nervous system, and is among the most intractable of chronic pain syndromes. A 47 year-old-female, who had right arm and shoulder pain, was diagnosed with syringomyelia of the Arnold Chiari malformation type I and received foramen magnum decompression and a syringo-subarachnoid shunt. After the operation, the evoked pain was improved, but she complained of a continuous burning pain, coupled with cold and tactile allodynia. This symptom failed to fully subside on administration of oral medicine; therefore, brachial plexus block was performed, which relieved her pain transiently. Through repeated trials, a gradual decrease in the pain intensity and frequency was found. However, the way in which brachial plexus block improves spinal central pain is not completely known.

• 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.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.143-146
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• 2001

Background : Backpack palsy was described in military personnel with shoulder girdle and proximal upper extremity symptoms, predominantly motor in nature related to the use of heavy backpack. Currently, backpack were used for sports, transporting school books and child carriers. We evaluated clinical and electrophysiological feature of backpack palsy. Methods : We included 11 patients with brachial plexopathy as a result of wearing a heavy backpack on long distance marches. All patients were done routine blood sampling, chest X-ray, C-spine X-ray and electrophysiological studies. Results : All patients were right handed person and were not as having a thoracic outlet syndrome. Sensory changes were main initial symptoms and major persistent symptoms were motor weakness. 9 patients(81.8%) were damaged the brachial plexus on non-dominant side, 1 patient was dominant and 1 patient was bilateral involvement. 10 patients(90.9%) were damaged to upper trunk of the brachial plexus by EMG findings. The prognosis was good, 10 patients(90.9%) were complete recovery during 8 weeks, 1 patient was developed reflex sympathetic dystrophy confirmed by 3-phase bone scan. Conclusions : Depression of the clavicle and costoclavicular space probably plays a certain role in pathogenic mechanism. The non-dominant side is more frequently affected, probably due to underdevelopment of the musculature in that side.