• Title/Summary/Keyword: 신경 차단

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The Heart Rate and ECG Changes after Endoscopic Thoracic Sympathectomy in Patients with Primary Hyperhidrosis (원발성 다한증 환자에서 흉부 교감 신경 차단술 후의 심박동수 및 심전도 변화)

  • Kim, Jae-Jun;Kim, Young-Du;Park, Chan-Beom;Moon, Seok-Whan;Cho, Deog-Gon;Sa, Young-Jo;Seo, Jong-Hee;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.214-219
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    • 2009
  • Background: Primary focal hyperhidrosis is characterized by overactivity of the sympathetic nervous function, and this has been effectively treated with endoscopic thoracic sympathetic denervation (ESD). The imbalance of sympathetic and parasympathetic nervous system that's created by ESD may affect the heart, lung and other thoracic organs. We analyzed the heart rate and ECG changes after performing ESD at our hospital, and this is the first such study that has been conducted on this. Material and Method: Of the 263 patients who underwent ESD between October 1996 and October 2006, 130 had ECG before and after ESD, and they were classified into 3 groups according to the level of ESD: Group I (n=40) patients underwent ESD at the 2nd rib (T2ESD), Group II (n=80) at the 3rd rib (T3ESD) and Group III (n=10) at the 4th rib (T4ESD). Result: There was no mortality or major morbidity. Heart rate (HR) was significantly decreased from $71.6{\pm}10.6/min\;to\;66.8{\pm}10.2/min$ after ESD (p<0.01); however, the PR (from $148.6{\pm}21.2$ msec to $152.8{\pm}20.5$ msec) and QTc (from $399.2{\pm}15.4$ msec to $404.0{\pm}15.1$ msec) intervals were significantly increased after ESD in the patients who suffered with primary hyperhidrosis (p<0.01). According to the level of ESD, there were significant changes in the HR and QTc interval in group I (T2ESD), the HR and PR interval in group II and the QTc interval in Group III. Conclusion: There were significant changes in the heart rate and ECG findings after ESD. The thoracic sympathetic denervation of T2, T3 and T4 affected the electrical activity of the heart at the resting state.

국부마취제

  • Jin, Jeong-Il
    • The Science & Technology
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    • v.31 no.5 s.348
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    • pp.71-71
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    • 1998
  • 코카인은 인체신경의 신호전달을 막아 진통을 차단한다. 코카인용액을 눈에 넣으면 마취효과 뿐만 아니라 동공확대 능력을 지니고 있어 눈수술에 활용했고 그 후에는 치과수술에도 사용하게 되었다. 그러나 아직도 이상적인 국부마취제는 만들지 못하고 있다. 우리나라 어느 화학연구소에서는 최근 몇년간 무중독증 마취약 개발을 한창 진행하고 있어 크게 기대되고 있다.

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Resveratrol Induces Cell Death through ROS-dependent MAPK Activation in A172 Human Glioma Cells (사람의 신경교모세포종 기원 세포에서 레스베라트롤에 의한 활성산소종 생성 증가와 MAPK 활성화를 통한 세포 사멸 효과)

  • Jung, Jung Suk;Woo, Jae Suk
    • Journal of Life Science
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    • v.26 no.2
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    • pp.212-219
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    • 2016
  • Glioblastoma multiforme is the most common and most aggressive type of primary brain tumor in humans. Despite intensive treatment, including surgery, radiation, and chemotherapy, most patients die of the disease. Although the anti-cancer activity of resveratrol has been demonstrated in various cancer cell types, its underlying mechanism in glioma cells is not fully elucidated. The present study was undertaken to investigate the effect of resveratrol on cell viability and to determine the molecular mechanism in A172 human glioma cells. Resveratrol caused the generation of reactive oxygen species (ROS), and resveratrol-induced cell death was prevented by antioxidants (N-acetylcysteine and catalase), suggesting that an oxidative mechanism is responsible for resveratrol-induced cell death. Resveratrol-induced phosphorylation of extracellular signal-regulated kinase (ERK), p38 kinase, and c-Jun N-terminal kinase (JNK), and resveratrol-induced cell death were prevented by inhibitors of these kinases. Resveratrol-induced activation of caspase-3 and cell death were prevented by the caspase inhibitors. ERK activation and caspase-3 activation induced by resveratrol was blocked by N-acetylcysteine. Taken together, these results suggest that resveratrol causes a caspase-dependent cell death via activation of ERK, p38, and JNK, mediated by ROS generation, in human glioma cells.

Molecular Mechanism of Action of Local Anesthetics: A Review

  • Yun, Il;Kang, Jung-Sook
    • Journal of Life Science
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    • v.2 no.2
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    • pp.97-107
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    • 1992
  • Strichartz and Richie have suggested that the mechanism of sodium donductance block of local anesthetics involves their interaction with a specific binding site within the sodium channel. However, there is evidence that local anesthetics can interact electrostatically with membrane proteins as well as membrane lipids. Whether or not all actions of local anesthetics are mediated by common site remains unclear. Thus, it can not be ruled out that local anesthetics concurrently interact with neuronal membrane lipids since sodium channels were found to be tightly associated with membrane lipids through covalent or noncovalent bonds. In summary, it is strongly postulated that local anesthetics, in addition to their direct interaction with sodium channels, concurrently interact with membrane lipids, fluidize the membrane, and thus induce conformational changes of sodium channels, which are known to be tightly associated with membrane lipids.

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Ultrasound-Guided Shoulder Injections (초음파 유도하 견관절 주사요법)

  • Moon, Young Lae;Jun, Yong Cheol;Sun, Jae Myeong
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.393-401
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    • 2019
  • The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.823-830
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    • 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.

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Long Term Outcome of Endoscopically Clipping the Upper Part of R4 Sympathetic Block and R4 Sympathetic Block for the Treatment of Palmar Hyperhidrosis (수장부 다한증에서 Clipping에 의한 흉부4번 교감신경절 상부 차단술과 흉부4번 교감신경절 완전 차단술에 대한 장기성적 비교)

  • Choi, Bong-Chun;Kim, Yong-Han;Sa, Young-Jo;Park, Jae-Kil;Lee, Sun-Hee;Sim, Sung-Bo
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.752-758
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    • 2007
  • Background: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. Material and Method: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). Result: For group 1, 41.9% experienced no sweating and 48.4% re-plied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions, 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. Conclusion: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.

Effects of Various Nootropic Candidates on the Impaired Acquisition of Ethanol-treated Rats in Step-through Test (에탄올 급성 투여로 유발된 학습획득 손상에 미치는 수종 뇌기능개선 후보 물질의 작용)

  • Lee Soon-Chul;Kim Eun-Joo;You Kwan-Hee;Kang Jong-Seong;Moon Yang-Sun
    • Journal of Ginseng Research
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    • v.23 no.2 s.54
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    • pp.115-121
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    • 1999
  • Effects of single and repeated administration of various nootropic candidates were examined on impaired acquisition by single oral administration of 3 g/kg ethanol (EtOH) in step through test. The inhibitory effect of EtOH on acquisition was significantly reduced by single picrotoxin, but not affected by diazepam, acetyl-L-carnitine and apomorphine. Single or repeated red ginseng total saponin and deprenyl, single piracetam, repeated N-methyl-D-glucamine, but not single or repeated protopanaxadiol, protopanaxatriol and centrophenoxine significantly ameliorated the impairment of acquisition by EtOH. On the other hand, the inhibitory effect of repeated red ginseng total saponin but not that of repeated N-methyl-D-Glucamine, was significantly blocked by pretreatment of $\alpha$-methyl-$\rho$-tyrosine, a inhibitor of catecholamine synthesis. Whereas, the inhibitory effect of repeated deprenyl on EtOH amnesia was exaggerated by $\alpha$-methyl-$\rho$-tyrosine. These results suggest that the amelioration processes of drugs on ethanol amnesia involve complex mechanism between the central GABAergic and dopaminergic neuronal activity in memory and learning, although the effects of repeated drugs administration are not yet clear.

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Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.