• Title/Summary/Keyword: 신경절단

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The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis (수장부 다한증환자의 흉부 교감신경절단술후 교감신경 피부반응)

  • 김오곤;홍종면;이석재;홍장수;이광래;김상규
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.579-583
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    • 1999
  • Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

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Change of both Palmar Temperature During Thoracoscopic Sympathicotomy for Palmar Hyperhidrosis (다한증환자의 흉부교감신경절단술시 양측 손바닥의 온도변화)

  • Lee, Hyeon-Jae;Kim, Dae-Sik;Moon, Seung-Cheol;Koo, Won-Mo;Yang, Jin-Young;Lee, Gun;Lim, Chang-Young;Park, Chung-Hyun
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.461-464
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    • 1999
  • Background: Thoracoscopic T2 sympathicotomy is an effective method for the treatment of palmar hyperhidrosis. Not only are the symptoms of hyperhidrosis abolished but also the temperature of the ipsilateral palm is elevated due to the sympatholytic vasodilation after the completion of the sympathicotomy on the first side. However little is known about the temperature changes in the contralateral palm. This study was performed to evaluate the changes in both palmar temperatures during the thoracoscopic T2 sympathicotomy for palmar hyperhidrosis. Material and Method: Thoracoscopic T2 sympathicotomy was performed in 15 patients with primary palmar hyperhidrosis. Surface temperatures of both palms were monitored continuously and were recorded simultaneously during the 7 different stages of the operation. Result: When T2 sympathicotomy was performed on the first(left) side, an ipsilateral increase with a contralateral decrease of temperature was observed. The difference in the temperature of both palms was greatest just before the sympathicotomy on the contralateral(right) side(Lt. 34.6$\pm$0.9$^{\circ}C$ vs. Rt. 31.6$\pm$1.3$^{\circ}C$, P<0.0001). After the sympathicotomy on the second(right) side, temperature of the right palm was elevated. The difference in the temperature of both palms was abolished at the end of the operation(Lt.34.7$\pm$0.9$^{\circ}C$ vs. Rt.34.4$\pm$1.$0^{\circ}C$, P=0.415). Conclusion: When T2 sympathicotomy was performed on the first side, an ipsilateral palmar temperature increased due to the sympatholytic vasodilation. However contralateral palmar temperature decreased due to a vasoconstriction. Although the mechanism of vasoconstriction is still unknown, it is postulated that there may be a cross- inhibitory effect by the post-ganglionic neurons innervating blood vessels of the palm.

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Effects on Osteoclast in Periodontal Ligament Space by Denerveation of Inferior Alveolar Nerve in Young and Adult Rats (하치조 신경 절단이 치주인대공간에서 파골세포에 미치는 영향)

  • Park, Kyung-Duk;Sung, Jae-Hyun;Bae, Yong-Chul;Kyung, Hee-Moon
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.506-513
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    • 2004
  • Osteoclast action is necessary for alveolar bone remodeling in orthodontic tooth movement. The nervous system has also been reported to be associated with bone remodeling. This study was aimed to investigate the changes of osteoclasts in the periodontal ligament (PDL) space after surgical resection of the inferior alveolar nerve (IAN). Experimental rats were divided into young and adult groups. A surgical resection procedure of the IAN was carried out in the left side of the mandible and a sham operation in the right side of the mandible. The number of osteoclasts on the bundle bone surface and the resorption activity of the osteoclasts were histomorphometrically measured. The changes in distribution of substance P (SP) immunoreactive (IR) nerve fiber were evaluated in the PDL and pulp. SP-IR nerve fiber was depleted in both the PDL and pulp of the IAN resection side in both groups, which confirmed the resection of IAN to be successfully conducted. The number of osteoclasts in the IAN resection side was significantly reduced in both the young and adult groups (p<0.01 and p<0.05), whereas the resorption activity of osteoclasts did not show any significant difference between the IAN resection side and the sham operation side in both groups (p>0.05 and p<0.05). The adult group showed that the number of osteoclasts reduced significantly (p<0.01) and the resorption activity didn't change in comparison with the young group (p>0.05). These results suggest that surgical resection of the IAN and aging reduce the population of the recruited osteoclasts within the PDL, but don't affect on the osteoclastic resorption activity.

The Tendency of Compensatory Hyperhidrosis after Sympathicotomy in Essential Hyperhidrosis (다한증의 교감신경 차단술후 보상성 다한증의 경향)

  • 이재훈;박기성;박창권;유영선;이광숙;최세영
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.223-226
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    • 2002
  • Background: Thoracoscopic sympathicotomy is an effective treatment in essential hyperhidrosis. However, many patients suffer from compensatory hyperhidrosis. Compensatory hyperhidrosis is a very uncomfortable problem, but the mechanisms underlying compensatory hyperhidrosis are not completely understood. Material and Method: From May 1999 to June 2001, 25 cases of thoracoscopic sympathicotomy at the 2nd rib for facial hyperhidrosis and 116 cases of thoracoscopic sympathicotomy at the 3rd rib for palmar hyperhidrosis were performed in 141 patients. All of the patients were divided into noncompensatory sweating(NCS) and compensatory sweating(CS) group. Each group was investigated according to age, sex, body surface area(BSA), level of sympathicotomy and occupation. Result: The global rate of compensatory hyperhidorsis were 64.5%(91/141). There was no difference between the two groups for BSA, level of sympathicotomy and occupation. Mean age showed 23.2 years old in NCS group and 26.4 years old in CS group(p=0.09). In CS group, 46 cases were male(50.5%) and 45 cases were female(49.5%) and in NCS group, 19 cases were male(38.0%) and 31 cases were female(62.0%) (p=0.16). Conclusion: There were no available statistical data, but there was the fact that old age and male patients had the tendency for compensatory hyperhidrosis. If we have more patient group and consider the patient's family history or psychiatric problems, we will have more valuable data for compensatory hyperhidrosis.

Effects of Deer Antler on the Regeneration of Peripheral Nerves; About Sprout Formation of Experimentally Transected Sciatic Nerves in Rat (말초신경의 재생에 대한 녹용의 효과; 랫드에서 실험적 절단 좌골신경의 Sprout 형성에 관해)

  • Chang, Byung-Joon;Cho, Ik-Hyun;Choi, Hye-Young;Won, Hui-Young;Park, Chang-Hyun;Bae, Chun-Sik;Choe, Nong-Hoon
    • Applied Microscopy
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    • v.32 no.1
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    • pp.67-80
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    • 2002
  • This study was carried out to investigate the effects of deer antler extract on the regeneration of peripheral nerves. Sprague-Dawley male rats weighing about 300 gm were fed deer antler extract for 1, 2, and 3 weeks per oral (1.5 ml/100 gm B.W.), respectively, once a day and transected both sides of sciatic nerve of each leg. After keeping for 6 hours, sciatic nerves taken from proximal part of transected region were treated with conventional transmission electron microscopical method and then observed with electron microscope. The results obtained were summarized as follows; 1. Sciatic nerves of normal control group were not showing any sprouts and electron dense axolemmal projections were frequently observed. 2. Sciatic nerves of saline treated groups were showing axonal sprouts at the nodes of Ranvier. The length of them was usually short, and numerous vesicles, vacuoles and organelles including neurofilament were contained. The number of nodes of Ranvier containing sprouts from 100 longitudinal sectioned nerve fibers was 29 (29%) in 1 week treated group, 32 (32%) in 2 weeks treated group, and 30 (30%) in 3 weeks treated group, respectively. 3. Sciatic nerves of deer antler treated groups were showing axonal sprouts at the node of Ranvier as well. Although most of the sprouts were short, some sprouts of 2 weeks and 3 weeks treated groups were quite long. Sprouts usually contained numerous vesicles, vacuoles and cell organelles such as neurofilaments and mitochondria. The number of nodes of Ranvier containing sprouts from 100 longitudinal sectioned nerve fibers was 38 (38%) in 1 week treated group, 46 (46%) in 2 weeks treated group, and 48 (48%) in 3 weeks treated group respectively. The results described above explain pretreatment of deer antler extract improves the sprout formation of transected sciatic nerves, and then it suggests deer antler may be effective for the regeneration of peripheral nerves.

족부질환과 운동

  • Jo, Yun-U
    • The Monthly Diabetes
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    • s.213
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    • pp.21-23
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    • 2007
  • 당뇨병성 족부질환은 크게 당뇨병성 족부 혈관병증, 당뇨병성 족부 신경병증, 당뇨병성 족부궤양 등으로 나누어지며, 당뇨병환자에서 하지에 궤양 및 괴사가 발생 위험도는 정상인에 비하여 15~17배나 높다. 이러한 당뇨병성 족부질환을 제대로 치료하지 않으면 발의 일부나 전부를 절단하게 되며, 외상에 의한 절단을 제외하면 하지 절단의 가장 주요한 원인이 된다. 당뇨병성 족부질환으로 인해 불가피하게 절단이 되었다 하더라도 수술 직후부터 적극적인 약물치료 및 재활치료는 정상인과 거의 동일하게 일상생활 수행 및 독립보행이 가능하며, 스포츠를 포함한 여가활동까지 가능하다.

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Evidence for the Drp1-dependent Mitochondrial Fission in the Axon of the Rat Cerebral Cortex Neurons (흰쥐 대뇌 피질 신경세포의 축삭에서 Drp1 의존적 미토콘드리아의 분열)

  • Cho, Bong-Ki;Lee, Seung-Bok;Sun, Woong;Kim, Young-Hwa
    • Applied Microscopy
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    • v.41 no.4
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    • pp.249-255
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    • 2011
  • Neurons utilize a large quantity of energy for their survival and function, and thereby require active mitochondrial function. Mitochondrial morphology shows dynamic changes, depending on the cellular condition, and mitochondrial dynamics are required for neuronal development and function. In this study, we found that the length of mitochondria in the distal axon is significantly shorter than that of mitochondria in dendrites or proximal axons of cerebral cortical neurons, and the reason for this difference is the local fission within the axon. We also found that suppression of Drp1, a key regulator of mitochondrial fission, resulted in significant elongation of mitochondria in axons. Collectively, these results suggest that local mitochondrial fission within the axon contributes to region-dependent mitochondrial length differences in the axons of cortical neurons.

The Effect of Thoracoscopic Sympathicotomy at the 4th Rib (R4) for Treating Palmar Hyperhidrosis (수부 다한증에서 제4번 늑골 위 교감신경절단술(R4)의 효과)

  • Noh, Dong-Sub;Park, Chang-Kwon;Kum, Dong-Yoon;Kim, Jae-Bum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.343-346
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    • 2008
  • Background: Thoracoscpic sympathicotomy is an effective treatment for essential hyperhidrosis. Patients are generally satisfied with the surgery at the early post operative period, but they suffer from recurrence and compensatory sweating at the late post operative period. There are many sympathicotomy methods for minimizing recurrence and the compensatory sweating. We compared the outcome from between the R3 and R4 sympathicotomy methods for the symptoms, atisfaction, recurrence and compensatory sweating. Material and Method: From January 1999 to July 2007, 39 cases of thoracoscopic sympathicotomy at the 3rd rib (R3) and 72 cases of thoracoscopic sympathicotomy at the 4th rib (R4) for treating palmar hyperhidrosis were compared for the early and late satisfaction, the compensatory sweating and recurrence. Result: There is no difference of gender and age for the 2 groups. Early satisfaction was reported by 94.9% of the R3 patients and by 98.7% of the R4 patients. 84.6% of the R3 patients reported late satisfaction and 87.5% of the R4 patients reported late satisfaction. There were no significant differences between the groups for the early and late satisfaction. But there was a difference between the groups for compensatory sweating (23.1% in the R3 group and 9.7% in the R4 group (p=0.020)). The reoperation rate due to recurrence was 5.1% in the R3 group and 4.2% in the R4 group. There was no significant difference between the groups for recurrence. Conclusion: R4 sympathicotomy has excellent therapeutic results for compensatory sweating as compared to R3 sympathicotomy for treating palmar hyperhidrosis.

Shape, Volume Prediction Modeling and Identical Weights Cutting for Frozen Fishes (동결생선의 외형과 부피 예측 모델링 및 정중량 절단)

  • Hyun, Soo-Hwan;Lee, Sung-Choon;Kim, Kyung-Hwan;Seo, Ki-Sung
    • Journal of the Korean Institute of Intelligent Systems
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    • v.22 no.3
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    • pp.294-299
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    • 2012
  • This paper suggests a modeling technique for shape and volume prediction of fishes to cut them with identical weights for group meals. The measurement and prediction of frozen fishes for group meals are very difficult because they have a bending deformation occurring at frozen stage and a hollow by eliminating the internals. Besides there exist twinkles problem of surface caused by freeze and variable weights by moisture conditions. Therefore a complex estimation algorithm is necessary to predict the shape and volume prediction of fishes exactly. Hollow prediction, pattern classification and modeling for tails using neural network, integration based volume prediction algorithm are suggested and combined to solve those problems. In order to validate the proposed method, the experiments of 3-dimensional measurement, volume prediction and fish cutting for spanish mackerel, saury, and mackerel are executed. The cutting experiments for real fish are executed.