• Clinical and Experimental Pediatrics
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• 제52권6호
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• pp.705-709
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• 2009

대상포진은 흔한 질환으로 여러 가지 합병증을 동반 할 수 있으나 대상포진에 동반되어 수막염이 생긴 경우는 보고는 많지 않다. 저자들은 15개월에 수두 예방접종을 시행 받았고, 5세 때 수두를 앓은 과거력이 있던 건강한 14세 남자 환아에서 대상포진에 동반되어 급성 무균성 수막염이 발생한 증례에서 뇌척수액에서 중합효소연쇄반응을 통해 VZV DNA를 검출한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.86-91
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• 2012

Purpose: Mass can compress around tissue and cause deviation of normal anatomical structures. Often, mass grows toward neurovascular pedicle and encircles depending on the nature of mature mass. Neglecting neurovascular involvement of the mass is a serious problem not to be overlooked. Authors have performed microscopic approach regarding mass involving the neurovascular pedicle in the hand. Materials and Methods: From January 2007 through February 2012, retrospective analysis for nine cases of mass involving neurovascular pedicles was done. Patients were evaluated preoperatively by ultrasonography or MRI and checked intraoperative finding. Masses were evaluated by site, preoperative evaluation, involved neurovascular pedicle, histopathologic diagnosis, complication, and recurrence. Results: The site of mass involving neurovascular pedicles was 4 cases on the wrist, 2 cases on the palm, 2 cases on the finger, 1 case on the hand dorsum. Involved neurovascular pedicles were 3 radial arteries and nerves, 3 proper digital arteries and nerves, 1 radial artery, 1 superficial branch of radial nerve, 1 common digital artery and nerve. The histopathologic diagnosis of mass were 3 ganglions, 2 giant cell tumors, 2 epidermal cysts, 1 fibroma, and 1 benign spindle tumor. There were 2 cases of recurrence and secondary excisions were performed. Conclusion: Neurovascular pedicle injury can lead to serious complication like sensory and motor disorders, distal part ischemia, and so on. In case of mass suspected neurovascular invasion, accurate preoperative evaluation such as ultrasonography or MRI is necessary. To prevent any neurovascular related complication during mass excision, delicate surgical technique using a microscope becomes essential.

• 대한족부족관절학회지
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• 제11권2호
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• pp.187-191
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• 2007

Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.

• The Korean Journal of Pain
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• 제9권1호
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• pp.57-62
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• 1996

Stellate ganglion block(SGB) improves cutaneous blood flow of the head and neck region and upper extremity. For this reason, SGB has been performed in neural and circulatory disorders. But there is controversy on the cerebral blood flow regulation by sympathetic innervation. We investigated the hypothesis that cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral blood flow could be affected by blocking ipsilateral sympathetic innervation of cerebral vasculature. In 10 volunteers, the blood flow velocity and pulsatility index(PI) of middle cerebral artery(MCA) was measured using Transcranial Doppler Flowmeter, before and 15 minutes after SGB, at block side and opposite side. The blood flow velocity of MCA at block side was increased from $62.60{\pm}7.60$ cm/s to $72.80{\pm}8.01$ cm/s(P<0.01) and the PI at block side decreased from $0.75{\pm}0.12$ to $0.60{\pm}0.11$(P<0.05). But the blood flow velocity and PI at opposite side did not change. This study demonstrated that the cerebral blood flow could be increased by SGB, the preganglionic nerve fibers of which synapse with other cervical sympathetic ganglions.

• The Korean Journal of Pain
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• 제37권4호
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• pp.320-331
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• 2024

Background: MicroRNA (miRNA) plays a crucial role in neuropathic pain (NP) by targeting mRNAs. This study aims to analyze the regulatory function and mechanism of miR-382-5p/dual specificity phosphatase-1 (DUSP1) axis in NP. Methods: We utilized rats with chronic constriction injury (CCI) of the sciatic nerve as the NP model. The levels of miR-382-5p and DUSP1 were reduced by intrathecal injection of lentiviral interference vectors targeting miR-382-5p and DUSP1. The mRNA levels of miR-382-5p and DUSP1 in the dorsal root ganglions (DRGs) were measured by RT-qPCR assay. The pain behavior was evaluated by mechanical nociceptive sensitivity and thermal nociceptive sensitivity. The expression levels of interleukin-6 (IL)-6, IL-1β, and tumor necrosis factor-α in the DRGs were analyzed by ELISA assay. The targeting relationship between miR-382-5p and DUSP1 was verified by DLR assay and RIP assay. Results: Compared to the Sham group, the CCI rats exhibited higher levels of miR-382-5p and lower levels of DUSP1. Overexpression of miR-382-5p significantly decreased DUSP1 levels. Reducing miR-382-5p levels can lower the mechanical nociceptive sensitivity and thermal nociceptive sensitivity of CCI rats and inhibit the over-activation of pro-inflammatory factors. Reduced miR-382-5p levels decreased NP in CCI rats. DUSP1 is the target of miR-382-5p, and down-regulation of DUSP1 reverses the inhibitory effect of reduced miR-382-5p levels on NP. Conclusions: Down-regulation of miR-382-5p inhibits the over-activation of pro-inflammatory factors by targeting and regulating the expression of DUPS1, thereby alleviating NP.

• 한국패류학회지
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• 제16권1_2호
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• pp.1-9
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• 2000

아프리카왕달팽이 Achatina fulica의 내장신경 절과 우체벽신경절은 좌, 우 양반구로 구성된 나비모습을 하고 있으며, 이들 신경절의 피질부와 수질부의 표피부위에는 신경세포가 밀집되어 있는 반면 중앙부위에는 신경섬유가 망상형으로 신경망을 구성하고 있었다. 두 신경절의 피질부 및 수질부에 위치한 신경세포들은 초대형신경세포(200 $\mu\textrm{m}$ 이상)와 대형신경세포(직경 60-70 $\mu\textrm{m}$ 이상), 중형신경세포(직경 30-40 $\mu\textrm{m}$) 그리고 소형신경세포(직경 10-15 $\mu\textrm{m}$) 등 4종류로 구분할 수 있었다. 초대형 및 대형신경세포는 20-22개 정도로 매우 소수가 관찰된 반면, 중형신경세포(약 400-500개)와 소형신경세포(약 700-800개)는 다수가 관찰되었다. AB/AY 이중염색반응에서 초대형 신경세포는 light Yellow cell(LYC)로, 대형 및 중형신경세포는 yellow green cell (YGC)과 dark green cell(DGC) 등 두 종류로 그리고 소형신경세포는 yellow cell(YC)과 blue cell(BC) 등으로 각각 확인되었다. Somatostatin 면역염색반응에서 양성반응을 나타낸 DGC는 성장조절물질 분비의 억제에 관여하는 것으로 확인되었으며, 초대형 및 대형신경세포는 신경분비기능 이외 포식작용을 수행하는 것으로 각각 확인되었다.

• Applied Microscopy
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• 제30권3호
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• pp.265-272
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• 2000

낙지 Octopus minor의 상완 신경절을 광학현미경과 전자현미경을 통해 관찰한 결과 다음과 같은 결론을 얻었다. 낙지의 상완신경절은 각각의 흡반 밑에서 둥근 형태로 관찰되었는데 그들의 크기는 흡반의 크기에 비례하였다. 둥근 형태의 상완신경절은 피질부와 수질부 두 부분으로 구분되었던 바, 피질부에서는 신경세포의 집단이, 수질부에는 신경망이 위치해 있었다. 신경세포의 집단에서는 3종류(소, 중, 대형)의 신경세포들이 관찰되었는데 소신경세포는 직경이 $0.9{\mu}m$정도인 둥근 형태의 작은 세포인데 비해 중신경세포는 직경 $1.6\times1.3{\mu}m$정도인 타원형세포였다. 대신경세포는 직경이 $2.8{\mu}m$정도 크기의 난원형의 큰 세포로 확인되었고 이들 3종류의 세포들은 모두 전자밀도가 낮아서 밝게 관찰되었으며 세포소기관의 발달은 미진하였다. 또한 중신경세포인 경우에는 $0.6\times0.4{\mu}m$정도 크기의 전자밀도가 중등도인 방추형 신경교세포에 의해 둘러싸여 있었다. 수질부의 신경망에서는 다양한 크기의 수상돌기와 축색돌기들이 복잡한 그물형태를 하고 있었다. 이들은 돌기내에서 4종류의 화학연접소포 (chemical synaptic vesicle)들을 소지하고 있었는데, 전자밀도가 매우 높고 직경이 100 nm 정도인 electron-dense synaptic vesicle과 전자밀도가 중등도이며 직경이 90nm 정도인 median electron-dense synaptic vesicle 그리고 중앙에 전자밀도가 높은 둥근 핵을 포함하는 직경 90nm정도의 electron-dense cored synaptic vesicle등이 관찰되었다. 그러나 전자밀도가 투명한 연접소포(electron-lucent synaptic vesicle)는 직경이 50nm정도로 가장 작은 형태를 하고 있었다.

• The Korean Journal of Pain
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• 제9권2호
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• pp.399-402
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• 1996

Endoscopic transthoracic sympathectomy (ETS) has recently become estabilished as a successful treatment for severe palmar and axillary hyperhidrosis. Descriptions have been published of neurolytic, operative and alternative endoscopic procedures involving thermocoagulation, laser coagulation, or or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. All methods have advantage and disadvantages. A 19-year-old male who suffered from severe hyperhidrosis on face, palms and axillary areas, has been initially treated with stellate ganglion block in other pain clinic. He was transfered to our pain clinic for endoscopic thoracic sympathectomy. The patient was intubated left side 34 Fr. double lumen tube and positioned left semi-lateral position for right sympathectomy. Right side pneumothorax was created by clamping the ipsilateral side of the double lumen tube and aspiration of air. 11-mm trocar was introduced through incision at the third intercostal space in anterior axillary line, and then additional two 11-mm and 5-mm trocar was introduced through second and fifth intercostal space in mid axillary line. The lung was gently retracted and the parietal pleura over the heads of the appropriate ribs excised using 5-mm sharp insulated coagulating microprocesss. The T4, T3, and T2 ganglions, as well as accompanying rami communicantes, and other branchs arising from upper thoracic nerves to the brachial plexus and surrounding tissues were carefully dissected, coagulated. During sympathectomy, skin temperature of middle was continuously monitored. Elevation of palmar skin temperature intraoperatively indicated an adequate sympathectomy with a definite therapeutic effect. A No. 28 Fr. thoracotomy tube was introduced through a troca under video guidance, placed under water seal after the lung was reinflated. the controlateral side was performed same procedure. After bilateral sympathectomy, chest tubes were removed, and then, he was discharged 2 days after operation with great satisfaction. The ETS provides a well-tolerated, cost-effective alternative to thoracic sympathectomy for primary hyperhidrosis and sympathetic mediated neuropathic pain disorder. And T2 ganglion is considered the key ganglion for the treatment of primary hyperhidrosis. The low incidence of compensatory sweating may by explained by the limited extent of the sympathectomy.

• 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.