• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.324-331
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• 2023

Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.414-419
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• 2023

Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs. Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery. Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients. Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.220-224
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• 2015

A patient presented with loss of consciousness and conversion. During an exercise test, catecholaminergic polymorphic ventricular tachycardia (CPVT) resulted in cardiac arrest. He started taking medication (a beta-blocker and flecainide) and an implantable cardioverter defibrillator (ICD) was inserted, but the ventricular tachycardia did not resolve. Left cardiac sympathetic denervation (LCSD) was then performed under general anesthesia, and the patient was discharged on the second postoperative day without complications. One month after the operation, no shock had been administered by the ICD, and an exercise stress test did not induce ventricular tachycardia. Although beta- blockers are the gold standard of therapy in patients with CPVT, thoracoscopic LCSD is safe and can be an effective alternative treatment option for patients with intractable CPVT.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.424-425
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• 2018

• Biomolecules & Therapeutics
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• v.8 no.2
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• pp.125-131
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• 2000

Idazoxan, $\alpha$$_2$-adrenergic antagonist, produced antidiuretic action by administration into the vein and diuretic action only in ipsilateral kidney by injection into a renal artery in dog. These studies were performed for investigation of mechanism on the renal action induced by idazoxan. Antiduretic action by idazoxan given into vein and diuretic action only in ipsilateral kidney by idazoxan injected into a renal artery were blocked entirely by renal denervation. Antidiuretic action of idazoxan given into the vein was weakened by UK 14,304, $\alpha$$_2$-adrenergic agonist, pretreated into the vein. Above results suggest that antidiuretic action of idazoxan given into the vein is caused by blocking of $\alpha$$_2$-adrenergic receptor, diuretic action only in ipsilateral kidney of idazoxan injected into a renal artery by blocking of $\alpha$$_2$-adrenergic receptor in the kidney.

• Biomolecules & Therapeutics
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• v.6 no.3
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• pp.225-231
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• 1998

This studies were performed for investigation of mechanism on central antidiuretic action of L$_{G}$-Nitro-L-arginine (L-NOARG), nitic oxide systhase inhibitor, in dog. Antidiuretic action of L-NOARG infused into the carotid artery was not affected by renal denervation but inhibited by pretreatment with arginine, NO Precusor. Furthermore, L-NOARG inhibited the diuretic action of dopamine induced by hemodynamic development. Above results suggest that antidiuretic actions of L-NOARG mediated by endogenous substances not associated with renal nerve. Therefore, it is demonstrated that those endogenous substances might be associated with NO which mediate the diuretic action of dopamine.e.

• Physical Therapy Korea
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• v.7 no.3
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• pp.34-48
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• 2000

The purpose of this study was to determine the effects of mild-intensity exercise training on the denervated muscle atrophy in the sciatic nerve injured rat. Thirty-six male Sprague-Dawley rats (250~300 g) were randomly assigned into three groups; sham-denervated group (n=8), denervated group (n=8), and denervated-exercised group (n=20). Exercise consisted of treadmill running at 20 m/min speed with 0% grade for 30 min/day. The animals were decapitated at the second and sixth weeks postcrush. Soleus and medial gastrocnemius were immediately excised to be weighed. Type I and II fibers of the muscles were differentiated by m-ATPase (pH 9.4) stain, and fiber diameters were evaluated. The results were as follows: 1) The weight of the soleus and medial gastrocnemius muscles showed a tendency to increase in both the denervation-exercised groups compared to the denervated group. 2) In the 2-week denervation-exercised group, type II fiber diameter of soleus and type I fiber diameter of medial gastrocnemius were increased significantly compared to the denervated control group. 3) In the 6-week denervated-exercised group, type I fiber diameter of soleus and type II fiber diameter of medial gastrocnemius were hypertrophied significantly compared to sham-denervated group. The results of this study suggested that treadmill exercise partially prevented denervation atrophy in the soleus and medial gastrocnemius of the rat.

• The Korean Journal of Pain
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• v.29 no.1
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• pp.3-11
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• 2016

A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.338-343
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• 2014

Objective : The aim of this study is to evaluate the clinical results of endoscopic radiofrequency ablation of medial branch in patients with chronic low back pain originating from facet joints. Methods : Between October 2010 and December 2013, 52 consecutive patients had suffering from chronic low back pain had undergone endoscopic radiofrequency denervation of medial branch of dorsal ramus. The clinical outcomes of these 52 patients were reviewed retrospectively. Preoperative and postoperative Visual Analogue Scale (VAS) and Korean version of Oswestry Disability Index (K-ODI), and patients' satisfaction with the procedure were assessed. Results : The pain scores on the VAS for back pain had improved significantly from a preoperative mean of 7.1 to a postoperative mean of 2 at the last follow-up (p<0.001). The clinical outcomes based on the K-ODI had also improved significantly from a preoperative mean of 26.5% to postoperative mean of 7.7% at the last follow-up (p<0.001). 80% of patients were satisfied with the procedure. There were no complications associated with the procedure. Conclusion : Our preliminary results demonstrate that endoscopic radiofrequency denervation of medial branch could be an effective alternative treatment modality for chronic back pain originating from facet joints that provides long-term pain relief.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.10
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• pp.122-128
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• 2009

The aim of this study was to investigate, through a longitudinal tracking, whether gender influences morphological characteristics on trabeucular bone of tibia during unloading. 12 male and 15 female ICR mice at 6 week of age were used and randomly allocated into two groups in each gender; unloading and normal group, respectively Mice in unloading group were operated on denervation (sciatic neurectomy). The tibiae were scanned by using in vivo micro-computed tomography (micro-CT) at 0 day (before denervation) and after 14 days. Structural parameters and BMD on tibia were measured. In female, BV/TV (65%), Tb. Th (5%), Tb.N (61%) and BMD (62%) were significantly decreased and BS/BV (17%), Tb.Sp (54%), SMI (19%) and Tb.Pf (75%) were significantly increased after unloading (p<0.05). In male, BV/TV (1%) and Tb.N (10%) were significantly decreased and SMI (5%) was significantly increased after unloading (p<0.05). In addition, trabeuclar bone loss of female was significantly bigger than that of male (p<0.05). These results indicated that effects of unloading on trabecular bone in growing mice might have difference between female and male, although unloading result in loss of quantity and quality on trabecular bone both female and male.