• 대한족부족관절학회지
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• 제15권4호
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• pp.223-231
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• 2011

Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

• The Korean Journal of Pain
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• 제18권2호
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• pp.263-266
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• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

• The Korean Journal of Pain
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• 제14권1호
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• pp.37-40
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• 2001

Background: It had been reported by authors that linear polarized infrared light radiation (Superizer: SL) near the stellate ganglion had a similar effect on the change of skin temperature of hand compared with the stellate ganglion block (SGB). We hypothesized that this was due to dilatation of vessels and an increased blood flow. The aim of this study was to measure the velocity of blood flow in peripheral vessels after linear polarized infrared light radiation near the stellate ganglion and to compare the effect of SL with that of SGB using local anesthetics. Methods: Forty patients whose clinical criteria were matched for the symptoms of SGB were selected for study. We radiated the stellate ganglion by linear polarized infrared light radiation and measured the blood flow of radial artery using Ultrasound Doppler blood flow meter before and after 10, 20 and 30 minutes post-radiation. After 3 days, SGB was performed using 8 ml of 1% mepivacaine to the same patient, and the radial artery blood flow was measured in the same manner. Results: The blood flow velocity was increased by 40% and 27% at 10 min and 20 min after SL and by 42% and 41% at 10 min and 20 min after SGB. However, there was no statistically significant difference in blood flow velocity between SGL and SGB. Conclusions: We could conclude that linear polarized radiation is a clinically simple and useful noninvasive therapeutic tool in clinical area.

• Applied Microscopy
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• 제26권3호
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• pp.349-367
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• 1996

The development of small granule-containing cell in the superior cervical ganglion was studied by electron microscopic method in human fetuses ranging from 40 mm to 260 mm crown rump length (10 to 30 weeks of gestational age). At 40 mm fetus, the superior cervical ganglion was composed of clusters of undifferentiated cells, primitive neuroblasts, and unmyelinated nerve fibers together with blood vessels. At 90 mm fetus, the superior cervical ganglion consisted of neuroblasts, satellite cell, small granule-containing cells, and unmyelinated nerve fibers. Two morphological types of the small granule-containing cells in the superior cervical ganglion were first indentified at 90 mm fetus, but were rare. Type I granule-containing cell occurred in solitary and had long processes, whereas type II cells tend to appeared in clusters near the blood capillaries. The granule-containing cells were characterized by the presence of dense-cored vesicles ranging from $150{\sim}300nm$ in diameter in both the cell bodies and processes. Other organelles included abundant mitochondria, rough endoplasmic reticulum, neurotubules, and widely distributed ribosomes. The granule-containing cells had long processes similar to those found in principal ganglionic cells. They could be identified by their content in dense-cored vesicles. The small granule-containing cells increased somewhat in size and number with increase of fetal age. Synaptic contacts were first found on the solitary granule-containing cell at 150 mm fetus. Synaptic contacts between the soma and processes of type I granule-containing cells and preganglionic axon terminals were observed. In addition, synaptic junctions between the processes of granule-containing cells and presumed dendrite of postganglionic neuron were also observed from 150 mm onward. On the basis of these features type I granule-containing cells could be considered as interneurons. The clusters of type II granule-containing cells were located in the interstitial or subcapsular portions of the ganglion, and had short processes which ended in close relation to fenestrated capillaries. Therefore it may be infer that clusters of type II granule-containing cells have an endocrine function.

• The Korean Journal of Pain
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• 제23권1호
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• pp.11-17
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• 2010

Background: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. Methods: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. Results: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was $30.5{\pm}0.4^{\circ}$ and entry point was $7.7{\pm}0.2\;cm$ and $6.7{\pm}0.1\;cm$ lateral from midline in males and females respectively. Conclusions: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.

• 생명과학회지
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• 제17권8호통권88호
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• pp.1068-1074
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• 2007

파브알부민(pa π albumin)은 망막의 다양한 세포타입에서 분포하고 있다. 본 연구팀은 이전연구에서 박쥐 망막의 내핵층에서의 파브알부민의 분포를 보고하였다. 현재 연구에서 본 연구팀은 한국관박쥐 (Rhinolophus ferrumequinum) 망막의 신경절세포층에 존재하는 파브알부민을 함유하는 신경세포를 규명하였고, 이들 세포의 분포양상을 조사하였다. 실험 결과,파브알부민의 면역반응성은 신경절세포층의 다수 세포에서 발견되었으며, 이들 세포는 주로 중간형 이상 크기의 세포체를 가지고 있었다. 조사된 세포체의 직경은 12.35 - 19.12 ${\mu}m$ 의 범위를 가지며 (n=166), 신경섬유층의 섬유 역시 염색되는 것으로 보아, 파브알부민을 함유하는 신경절세포는 대부분이 중간형이상 크기의 신경절세포임을 뒷받침하고 있다. NND (nearest neighbor distance) 분석을 통해서 본, 평균 NND는 59.57 에서 62.45 ${\mu}m$ 로 나타났으며, 평균 RI (regularity index) 는 2.95 ${\pm}$ 0.3 (mean${\pm}$s.d., n=4) 으로 계산되었다. 이를 종합해보면, 파브알부민은 한국관박쥐 망막의 신경절세포층에서 중간형이상 크기의 신경절세포에서 주로 발현하고 있으며, 이들은 규칙적인 배열을 가진 채 잘 조직화된 분포양상을 보여주고 있음을 알 수 있었다. 이러한 결과들은, 아직까지 명확하게 규명되어 있지 못한 박쥐의 시각에 대한 이해에 중요하게 적용될 수 있을 것이라고 사료된다.

• 한국의학물리학회지:의학물리
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• 제15권4호
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• pp.228-236
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• 2004

망막의 신경절세포는 눈에 가해진 시각 정보를 흥분파의 형태로 변환하여 시신경을 통하여 대뇌의 시각피질까지 전달한다. 과거에 사용하여 왔던 방법은 단일 전극을 단일 뉴론의 세포내, 외에 삽입함으로써 특정 시간대에 특정 뉴론만을 기록하는 방법이었으므로 신경망 전체를 통하여 처리되어 나오는 정보를 알아보기에는 적합하지 않다. 다행히 최근에 다채널 전극을 사용하여 여러 신경세포에서 나오는 신호를 동시에 기록할 수 있는 다채널기록법(multichannel recording) 이 개발되었으므로 본 연구에서는 8행 ${\times}$ 8열의 다채널전극을 사용한 다채널기록법을 이용하여 망막신경절세포 군집의 흥분파를 기록, 분석함으로써 단일 신경세포가 아닌 망막 신경망을 거쳐 최종적으로 나오는 신호에 대해서 연구하였다. 전극에 부착된 망막 절편에 2초 동안 빛을 가하고 5초 동안 빛이 차단되는 자극을 반복적으로 인가한 후, PSTH 분석방법으로 망막 신경절세포를 ON 세포, OFF세포, ON/OFF세포의 세가지 유형으로 분류할 수 있었으며, ON 세포: 35.0$\pm$4.4%, OFF 세포： 30.4$\pm$1.9%, ON/OFF 세포： 34.6$\pm$5.3% (전체 망막절편수=8)로 분포되어 있음을 확인하였다. 또한 상호상관(Cross-Correlation) 분석방법을 통해서 인접한 세포들끼리 매우 짧은 시간대에(<1 ms) 동기화된 흥분을 발사함을 확인할 수 있었고, 동기화된 흥분은 6～8개의 세포로 구성된 세포 클러스터에서 일어남을 확인하였다. 즉 개개의 신경절세포들이 빛 자극을 처리함에 있어 독립적으로 작용한다는 기존의 가정과는 달리 인접한 세포끼리는 동기화된 흥분을 보이는 것을 확인하였으며, 이러한 방식은 시세포 수와 신경절세포 수의 불균형으로 인해 초래되는 병목현상을 완화할 수 있는 효과적인 기전으로 생각된다.

• The Korean Journal of Pain
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• 제10권1호
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• pp.124-126
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• 1997

Stellate ganglion block is the most widely practiced procedure in the pain clinics due to its wide range of indications. We experienced a rare case who exhibited severe hematoma in neck following stellate ganglion block. A 58-year-old female patient injured by a traffic accident was admitted to the department of negro surgery for the treatment of cerebral contusion, cervical and lumbar sprain and left arm paresis. Because left sensory neural hearing loss occurred, the patient was referred to the pain clinic for treatment with stellate ganglion block due to her left sensory neural hearing loss. The next day stellate ganglion block was done with a negative aspiration for blood. Three hours later, hematoma in neck was found and the patient complained of pain in the neck and dyspnea. The symptoms and signs of respiratory difficulty were progressively aggravated. The hematoma was removed and ruptured muscular branch of vertebral artery was ligated under surgical exploration. In this case, the needle was apparently in the branch of vertebral artery during or after injection in spite of the negative aspiration for blood. Authors recommend that compression of the injected site over 5 minutes should be necessary to prevent a hematoma formation despite of a negative aspiration for blood.

• The Korean Journal of Pain
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• 제10권1호
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• pp.11-15
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• 1997

Background : There are several treatment of trigeminal neuralgia including Gasserian Ganglion Block. This paper retrospectively analyze the efficacy of Gasserian Ganglion Block as main treatment of trigeminal neuralgia. Methods : We studied 55 patients for followings; sex, age, duration from onset to visit, consulted mediator, causes, characteristics of pain, affected area, types of block, kinds and volume of used neurolytic agents, duration from first block to repeat block, types of repeat block, complications, if surgery was necessary after block. Results : Characteristic items of trigeminal neuralgia are similar with other studies. Mean duration of pain relief was 23 months. The duration was shortened in the repeat block. There were no significant complication. Conclusion : Considering Gasserian Ganglion Block as main treatment of trigeminal neuralgia is an effective and safe method. Therefore we would like to recommend the need to increase public awareness of trigeminal neuralgia and its possible treatment in pain clinics through mass commanication.

• 대한골관절종양학회지
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• 제19권2호
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• pp.83-86
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• 2013

말초 신경에 발생하는 결절종은 일부 보고된 바는 있으나, 발생 빈도는 드문 것으로 되어있으며 발생 부위는 비골 신경이 가장 흔한 것으로 보고되고 있다. 이외에도 요골 신경, 척골 신경, 정중 신경, 좌골 신경, 경골 신경 및 후 골간신경에 발생한 경우도 보고되고 있다. 저자들은 내측 족저 신경에 발생한 신경 내 결절종 1예와 총 비골 신경에 발생한 신경 내 결절종 1예를 신경학적 후유증 없이 치료하여 이를 보고하고자 한다.