• The Korean Journal of Pain
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• v.7 no.2
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• pp.162-169
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• 1994

Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.139-143
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• 1995

Hyperhidrosis is the state of abnormal sweating on the palm, sole and axillary region. The main treatment of hyperhidrosis are surgical sympathectomy and a thoracic sympathetic ganglion block with neurolytics. Among them, a thoracic sympathetic ganglion block is used in pain clinic for the treatment of hyperhidrosis. I have successfully performed a thoracic sympathetic ganglion block on a 21 year old female patients with pure alcohol. I concluded that the thoracic sympathetic ganglion block was one of the most effective treatment of hyperhidrosis.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.239-244
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• 2001

Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.128-131
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• 1999

Stellate ganglion block is a well established method for the management of certain pain syndromes (e.g., chronic regional pain syndrome, facial pain) in the cervicothoracic region and upper extremity. The stellate ganglion resides between the C7 transverse process and the head of the first rib. Anesthetic injections for the stellate ganglion block are typically made at the level of the transverse process of either the C6 or C7 vertebrae to avoid the pleura, vessels, and nerve roots. Method of positioning the needle tip directly at the ganglion has been described, but are problematic because of the risk of injury to or injection into adjacent structures. It is necessary to know the exact anatomic position of the stellate ganglion when permanent blockade is required by means of radiofrequency thermocoagulation. Whereas fluroscopy shows only bony feature, computerized tomography also images nerves, vessels, and lung, allowing accruate needle placement. We report a case of the percutaneous radiofrequency thermocoagulation of the stellate ganglion after computerized tomography-guided localization.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.312-318
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• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.7-22
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• 1998

The development of the superior cervical ganglion was studied by electron microscopic method in human fetuses ranging from 40 mm to 260 mm of crown-rump length(10 to 30 weeks of gestational age). At 40 mm fetus, the superior cervical ganglion was composed of clusters of undifferentiated cell, primitive neuroblast, primitive supporting cell, and unmyelinated fibers. At 70 mm fetus, the neuroblasts and their processes were ensheated by the bodies or processes of satellite cells. The cytoplasm of the neuroblast contained rough endoplasmic reticulum, mitochondria, Golgi complex, Nissl bodies and dense-cored vesicles. As the neuroblasts grew and differentiated dense-cored vesicles moved away from perikaryal cytoplasm into developing processes. Synaptic contacts between the cholinergic axon and dendrites of postganglionic neuron and a few axosomatic synapses were first observed at 70 mm fetus. At 90 mm fetus the superior cervical ganglion consisted of neuroblasts, satellite cells, granule-containing cells, and unmyelinated nerve fibers. The ganglion cells increased somewhat in numbers and size by 150 mm fetus. Further differentiation resulted in the formation of young ganglion cells, whose cytoplasm was densely filled with cell organelles. During next prenatal stage up to 260 mm fetus, the cytoplasm of the ganglion cells contained except for large pigment granules, all intracytoplasmic structures which were also found in mature superior cervical ganglion. A great number of synaptic contact zones between the cholinergic preganglionic axon and the dendrites of the postganglionic neuron were observed and a few axosomatic synapses were also observed. Two morphological types of the granule-containing cells in the superior cervical ganglion were first identified at 90 mm fetus. Type I granule-containing cell occurred in solitary, whereas type II tended to appeared in clusters near the blood capillaries. Synaptic contacts were first found on the solitary granule-containing cell at 150 mm fetus. Synaptic contacts between the soma of type I granule-containing cells and preganglionic axon termials were observed. In addition, synaptic junctions between the processes of the granule-containing cells and dendrites of postganglionic neuron were also observed from 150 mm fetus onward. In conclusion, superior cervical ganglion cells and granule-containing cells arise from a common undifferentiated cell precursor of neural crest. The granule-containg cells exhibit a local modulatory feedback system in the superior cervical ganglion and may serve as interneurons between the preganglionic and postganglionic cells.

• Journal of Photoscience
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• v.9 no.2
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• pp.21-24
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• 2002

Pineal organs of poikilotherm vertebrates transform the environmental light information into a humoral message and a neuronal activity. The former is melatonin, and the latter is modulation of the impulse in ganglion cells. The ganglion cells are physiologically classified into luminosity (achromatic) type and chromatic one, as the neural activity is modulated in two ways. We attempted to classify the pineal ganglion cells with morphological characteristics by means of the three- dimensional reconstruction method. In the pineal ganglion cells of river lamprey, there are two different features, oval and spherical. For comparison of their projection region in the brain, the tracing investigation was also carried out. The application of the neural tracer near mesencephalic tegmentum showed that only oval-shaped ganglion cells were labeled in the pineal organ. These results suggest that the oval-shaped ganglion cell is functionally different from the spherical one.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.167-172
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• 2010

Objectives : This observation was to report the clinical effects of acupotomy in treating wrist ganglion. Methods : From 7th April, 2010 to 12th May, 2010, 1 female patient who had a wrist ganglion was treated with ultra sound-guided acupotomy therapy and self moxibustion & massage. Results : The patient's wrist ganglion was disappeared on the surface of the skin after just one time acupotomy therapy. Hypoechoic lesion was turned into hyperechoic lesion on a ultrasonographic. After 1 month, a wrist ganglion was recurred, but the size of wrist ganglion was reduced. Conclusions : Acuputomy therapy has an effect of reducing the wrist ganglion size, but patient self management is important in preventing recurrence. The ganglion not visible on the surface of the skin must be considered as a treatment target.

• Journal of Acupuncture Research
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• v.17 no.4
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• pp.113-119
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• 2000

Objectives : Wrist ganglion is one of the most common diseases on the wrist joint. So far acupuncture, medication, drainage and local anesthetic excision therapy have been used for this disease, but the development of more effective treatment method is being expected because of frequent recurrence and side effect. Considered that most ganglion is polycystic, on the basis of classic centro-square acupuncture, newly transformed centro-square acupuncture was applied to this report. Methods : All the patients with wrist ganglion was divided into two groups. Newly transformed centro-square acupuncture was app(ied to one group composed of 11 patients and classic centro-square acupuncture to the other group with 19 patients. Classic centro-square acupuncture is made up of slanting and straight insertion. the former is a method that tips of 4 needles are inserted from the outersurface of wrist ganglion oriented to the center of the ganglion, the latter is that tip of one needle is inserted on the center of the ganglion straightly. In the newly transformed centro-square acupuncture, straight insertion of dry needle was taken place of by syringe needle in order to drain phlegm. In this report, classic and newly transformed centro-square acupuncture were used somewhat differently from original ones. Moxibustion was applied after removing all the needles. In newly transformed centro-square acupuncture, moxibustion was also applied after drainage of phlegm and slanting insertion. Results : 1. Wrist ganglion was frequently developed around the acupoint of Tae-Yeon(Tai Yuan, LU9) and Yang-Ji(Yang Chi, TE4) and the difference between occurrence of development on the left and right hand had no significancy. 2. The mean number of treatment for recovery : The newly transformed centro-square acupuncture had fewer treatment than classic one. 3. The newly transformed centro-square acupuncture was more effective than classic one. 4. As a result of following up 6 to 72 months after wrist ganglion had been eliminated, there was no recurrence. Conclusion : In the treatment of wrist ganglion, newly transformed centro-square acupuncture can be regarded as more useful method in the clinical practice, because it has comparatiely shorter duration of treatment and is more effective.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.56-59
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• 2009

The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.