• Title/Summary/Keyword: Denervation

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Herniation after deep circumflex iliac artery flap: two cases of rare complication

  • Kim, Hee-Sung;Kim, Jae-Young;Hur, Hyuk;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.10.1-10.5
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    • 2016
  • Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

The end effector of circadian heart rate variation: the sinoatrial node pacemaker cell

  • Yaniv, Yael;Lakatta, Edward G.
    • BMB Reports
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    • v.48 no.12
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    • pp.677-684
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    • 2015
  • Cardiovascular function is regulated by the rhythmicity of circadian, infradian and ultradian clocks. Specific time scales of different cell types drive their functions: circadian gene regulation at hours scale, activation-inactivation cycles of ion channels at millisecond scales, the heart's beating rate at hundreds of millisecond scales, and low frequency autonomic signaling at cycles of tens of seconds. Heart rate and rhythm are modulated by a hierarchical clock system: autonomic signaling from the brain releases neurotransmitters from the vagus and sympathetic nerves to the heart's pacemaker cells and activate receptors on the cell. These receptors activating ultradian clock functions embedded within pacemaker cells include sarcoplasmic reticulum rhythmic spontaneous Ca2+ cycling, rhythmic ion channel current activation and inactivation, and rhythmic oscillatory mitochondria ATP production. Here we summarize the evidence that intrinsic pacemaker cell mechanisms are the end effector of the hierarchical brain-heart circadian clock system.

Orthostatic Intolerance: Postural Tachycardia Syndrome (기립성 못견딤증: 기립성 빈맥 증후군)

  • Park, Ki-Jong
    • Annals of Clinical Neurophysiology
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    • v.11 no.1
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    • pp.1-8
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    • 2009
  • Orthostatic intolerance is defined as the development of various symptoms during standing that are relieved by recumbency. Postural tachycardia syndrome (POTS) is another nomenclature of orthostatic intolerance. POTS characterized by a heart rate increase ${\geq}30$ bpm from supine to standing or >120 bpm at standing without orthostatic hypotension. POTS is a heterogenous in presentation with various pathophysiologic mechanisms. Important mechanisms are hypovolemia, denervation, hyperadrenergic and deconditioning state. There are presented as lightheadness or dizziness, palpitations, presyncope, sense of weakness, tremulousness, shortness of breath. POTS are classified under 3 groups that are neuropathic, hyperadrenergic, and deconditioning POTS. Most patients can be improved from a pathophysiologically based regimen of management.

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Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report- (복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고-)

  • Yoon, Keon-Jung;Kim, Jong-Lul
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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Clinical Experience for a Patient with Long QT Syndrome -A case report- (QT간격연장증후군(Long QT Syndrome) 환자의 치료경험 -증례 보고-)

  • Park, Tae-Kyu;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.115-118
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    • 2000
  • Stellate ganglion block is most commonly used in pain clinic because it is an easy procedure and it has broad indications reported that Angina pectoris, tachyarrhythmia and long QT syndrome (LQTS) are indicated. LQTS is a disorder of the abnormalities of cardiac sympathetic innervation and of myocardial repolarization. LQTS is characterized by marked prolongation of the QT interval, often manifestating as syncope, seizures, or sudden death due to polymorphic ventricular tachyarrhythmia known as torsades de pointes. Treatment of symptomatic patients usually begin with beta blocker. The elective treatment of LQTS patients unresponsive to beta blocker is the left cardiac sympathetic denervation. We report a case of LQTS patient who had received stellate ganglion block.

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The Clinical Usefulness of Laryngeal Electromyography(LEMG) for Differential Diagnosis of Traumatic Unilateral Vocal Cord Palsy -A Case Report- (후두외상으로 발생한 일측 성대 마비의 감별진단으로서 후두근전도검사의 유용성 -증례보고-)

  • 최홍식;김한수;김정홍;장정현
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.188-192
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    • 2002
  • Unilateral vocal cord palsy which is associated with laryngeal trauma is not uncommon event. In a 42-year-old male, a cricoid cartilage fracure had been developed after blunt trauma. The endoscopic findings showed contusion and diffuse swelling around the left arytenoid and false cord. During phonation, the mobility of left side true vocal cord was decreased. There were no level difference and displacement of the left side arytenoid. We used the laryngeal electromyography (LEMG) to make a differential diagnosis between the cricoarytenoid joint dislocation and the injury of recurrent laryngeal nerve. At the right thyroarytenoid muscle and cricothyroid muscle, the findings of LEMG were normal. But the amplitude and frequency during phonation were decreased (partial denervation) at the left thyroarytenoid muscle. LEMG is a very useful method to predict the diagnosis of vocal cord palsy.

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Total Tongue Reconstruction with Reinnervated Rectus Abdominis Musculocutaneous Flap (재신경화된 복직근 근피판을 이용한 혀 전체 재건술)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.161-167
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    • 2006
  • After total glossectomy, recovery of swallowing and speech function can greatly improve quality of life. The reconstructed tongue must be thick enough to contact with the hard palate for articulation. If the free flap is denervation, it may procede to have atrophy postoperatively. Therefor it is difficult to maintain the tongue volume for a long period of time. To resolve this problem, we have used a innervated rectus abdominis musculocutaneous flap and maintaining the volume through a neurorrhaphy. 7 patients underwent immediate reconstruction using a reinnervated rectus abdominis musculocutaneous free flap in which included intercostal nerve was anastomosed to the remaining hypoglossal nerve. The reinnervated rectus abdominis musculocutaneous free flap has provided good tongue contour with sufficient bulk and shown no obvious atrophy in all patients even though postoperative 9 months later. Considering swallowing and articulation, we concluded that reinnervated rectus abdominis musculocutaneous flap is a viable method after total glossectomy

Surface Electromyographic Measure in Patients with Winging Scapula (익상견갑 환자의 표면근전도 검사)

  • Kim, Chul Hyun;Lee, Yang Soo;Lee, Yong Boem;Rho, Jae Hyun;Lee, Zee Ihn
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.124-126
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    • 2005
  • The effect of serratus anterior dysfunction is seen in the scapular winging. We report 2 cases with winging scapula clinically but do not reveal denervation potentials in needle electromyography. Surface myoelectric measurements of median frequency and root mean square values show difference in fatigability and amplitude in affected side.

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Anterior Interosseous Nerve Syndrome with Varient Nerve Innervation: A Case Report (해부학적 변이를 가지는 전방골간신경 증후군: 1예 보고)

  • 이준호;나재범;김재수;유진종;이경규;정성훈
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.147-151
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    • 2002
  • Anterior interosseous nerve syndrome is characterized by weakness of the flexor pollicis longus, the flexor digitorum profundus and the pronator quadratus in the presence of normal sensation. Although MR imaging findings of anterior interosseous nerve syndrome has been reported in a few articles, we report herein a case of anterior interosseous nerve syndrome involving more than usual muscles innervated by anterior interosseous nerve, caused by varient nerve innervation.

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Sympathetic Regulation of Aquaporin Water Channels in Rat Kidney

  • Lee, Jong-Un;Yoo, Kwang-Jay;Oh, Yoon-Wha;Lim, Dong-Yoon
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.3
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    • pp.181-185
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    • 2003
  • Whether there exists a sympathetic neural regulation on the aquaporin (AQP) channels in the kidney was examined. Male Sprague-Dawley rats were used. They were renal nerve denervated by stripping the nervous and connective tissues passing along the renal artery and vein, and painting these vessels with 10% phenol solution through a midline abdominal incision. Three days later, the expression of AQP1-4 proteins in the denervated kidneys was determined. The content of norepinephrine was found significantly decreased following the denervation. Accordingly, the expression of AQP2 proteins was markedly decreased. The expression of AQP3 and AQP4 was also slightly but significantly decreased, while that of AQP1 was not. Neither the basal nor the AVP-stimulated accumulation of cAMP was significantly affected in the denervated kidney. It is suggested that the sympathetic nervous system has a tonic stimulatory effect on AQP channels in the kidney.