• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.966-974
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• 2021

Objective : To explore the clinical efficacy and safety of microvascular decompression (MVD) combined with internal neurolysis (IN) in the treatment of recurrent trigeminal neuralgia (TN) after MVD. Methods : Sixty-four patients with recurrent TN admitted to the hospital from January 2014 to December 2017 were divided into two groups according to the surgical method. Twenty-nine patients, admitted from January 2014 to December 2015, were treated with MVD alone, whereas 35 admitted from January 2016 to December 2017 were treated with MVD+IN. The postoperative efficacy, complications, and pain recurrence rate of the two groups were analyzed. Results : The efficacy of the MVD+IN and MVD groups were 88.6% and 86.2%, and the cure rates were 77.1% and 65.5% respectively. There was no statistically significant difference between the two groups (p>0.05). The cure rate (83.3%) of patients in the MVD+IN group, who were only found thickened arachnoid adhesions during the operation that could not be fully released, was significantly higher than that of the MVD group (30.0%) (p<0.05), while the efficacy (91.7% vs. 70%) of the two groups was not statistically different (p>0.05). For patients whose arachnoid adhesions were completely released, there had no significant difference (p>0.05) in the efficacy (87% vs. 94.7%) and recurrence rate (5.0% vs. 11.1%). The incidence of postoperative facial numbness (88.6%) in the MVD+IN group was higher than that in the MVD group (10.3%) (p<0.01). The long-term incidence of facial numbness was not statistically significant (p>0.05). In the 18-36 months follow-up, the recurrence rate of patients in the MVD+IN group (9.7%) and in the MVD group (16%) were not statistically different (p>0.05). Conclusion : A retrospective comparison of patients with recurrent TN showed that both MVD and MVD combined with IN can effectively treat recurrent TN. Compared with MVD alone, MVD combined with IN can effectively improve the pain cure rate of patients with recurrent TN who have only severe arachnoid adhesions. The combination does not increase the incidence of long-term facial numbness and other complications.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3219-3222
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• 2012

A comparative study between 17 Japanese and 19 Indian patients with oral squamous cell carcinomas (OSCCs) revealed that the tumour prognostic indicator mean vessel density (MVD) count for angiogenesis was relatively high at 57.1 in Indian as compared to 39.3 in Japanese (P=0.001) cases, whereas the lymph-vessel density (LVD) count for lymphangiogenesis was lower (12.8 vs 48.0, P=0.002). Both male and female Indians had higher MVD counts, but LVD counts were only slightly lower in females. MVD count was relatively high among the cases below 65 years old in both the countries (P=0.4). Japanese cases with Tongue cancer had higher MVD count, but the Indian cases had lower LVD counts. Size-wise, T2 and T3 had higher counts of MVD both in Indian and Japanese cases. MVD and LVD count was higher in grades II and III both in Japanese and Indian cases. There was insignificant difference of the MVD counts among smokers, but the tobacco chewers in Indian cases had higher counts of MVD and LVD (P value by Bartlett test 0.35, 0.57 respectively). The hot-spots of tumour sites had variable rates of lymphocyte infiltration showed higher MVD counts in all the cases. Although the clinical characteristics and demographic variables usually relate to MVD and LVD counts, the tendency of higher values, especially among tobacco chewers, identified as the highest risk group for occurrence of oral cancer needs to be investigated further.

• The Plant Pathology Journal
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• v.22 no.4
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• pp.334-338
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• 2006

Chrysanthemum chlorotic mottle viroid(CChMVd) isolates have been identified from chrysanthemum showing yellow spots or infected without symptom. They were 399-400 nucleotides length of RNA. CChMVd-SSHA6(GenBank accession no. DQ450682) revealed a GAAA to DUUC substitution in positions 82-85 of CChMVd-MSIN34(GenBank accession no. DQ402041). In vitro RNA transcripts with the complete CChMVd sequence were infectious and induced the typical CChMVd infection symptom of yellow spots in chrysanthemum cv. Sharotte. CChMVd caused reduction in growth in some cultivars, whereas some cultivars were not affected. This is the first report on the occurrence of CChMVd in chrysanthemum in Korea.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.6
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• pp.403-408
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• 2020

Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.183-189
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• 2005

Objectives: Angiogenesis is the process of new blood vessel development from preexisting vessel. The growth of tumor is dependent on angiogenesis. This study was aimed to determine the role of the VEGF expression and MVD(microvessel density) in salivary gland tumors and to analyze the correlation between the expression of VEGF/MVD, and clinical manifestation. Material and Methods: We analyzed the expression of VEGF and average MVD and neo-MVD in the 57 cases of salivary gland tumors by immunohistochemistry. Results: VEGF expression was higher in malignant tumors than in benign tumors. Average and neo-MVD were not different in benign tumor and malignant tumor. There was a tendency of positive correlation between VEGF expression and MVD but it was not statistically significant. Stage, T stage and recurrance rate were not correlated with VEGF expression, average-MVD and neo-MVD. Expression of VEGF, average-MVD and neo-MVD were significantly increased in Warthin's tumor compared with pleomorphic adenoma. Conclusion: Overexpression of VEGF has an important role in malignant salivary gland tumors.

• Korean Journal of Community Nutrition
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• v.12 no.4
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• pp.396-404
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• 2007

Increased oxidative stress contributes to the progression of atherosclerosis. We measured serum antioxidant mineral concentrations, capacities of serum antioxidant enzymes and fasting lipid profile in 97 male patients with coronary artery disease (CAD) and 21 male controls. Nutrient intake was assessed by the semi-quantitative food frequency method. CAD patients were divided into single-vessel disease (SVD, n=66) and multi-vessel disease (MVD, n = 31) groups on the coronary angiography. The ratio of serum LDL- to HDL-cholesterol elevated with an increasing number of diseased vessels compared to the control (control < SVD < MVD, p < 0.05). Patients with SVD and MVD had higher levels of serum lipoprotein (a) than the control (p < 0.05). The mean intake of carbohydrate, protein and cholesterol was higher in MVD patients and the intakes of vitamins C and E were lower in MVD and SVD patients than in the control (p < 0.05). Serum copper (Cu) and zinc (Zn) levels were higher in MVD and SVD patients than in the control (Cu: control $75.8{\pm}5.07$, SVD $99.2{\pm}2.90$, MVD $100.1{\pm}2.32{\mu}g/dL$, p<0.01; Zn: $76.8{\pm}5.36$, $119.0{\pm}5.95$, $129.1{\pm}2.70{\mu}g/dL$, p < 0.01). And the ratio of Zn to Cu was higher in SVD and MVD patients than in the control (control $0.78{\pm}0.06$, SVD $0.88{\pm}0.05$, MVD $0.99{\pm}0.04$, P < 0.05). The activity of glutathione peroxidase (GSH-Px) was lower in MVD than in SVD and the control (control $35.13{\pm}1.34$, SVD $35.30{\pm}1.01$, MVD $31.00{\pm}1.04 U/mg$ protein, p < 0.05). The ratio of the activities of superoxide dismutase (SOD) to GSH-Px was higher in MVD than in control and SVD (p < 0.05). In groups with CAD, serum Cu and Zn concentrations and their ratio were changed compared to the control. GSH-Px activity was decreased and the ratio of SOD to GSH-Px was increased in the patients with MVD. The balances between the activities of SOD and GSH-Px should also be considered a risk factor in CAD patients.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.357-363
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• 2005

Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.288-292
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• 2012

Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve (VI, VII, and VIII) palsy following MVD and its clinical courses. Methods : Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss. Results : DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve. Conclusion : Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9921-9926
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• 2014

To investigate the value of expression of annexin A2, microvessel density (MVD) and CD105 in pancreatic ductal adenocarcinoma (PDAC) tissues and adjacent normal tissues, immunohistochemical staining was used. The positive expression rate of Annexin A2 and the MVD in pancreatic ductal adenocarcinoma tissues was higher than that in in adjacent normal tissues (p<0.005). Expression of Annexin A2 and MVD correlated with histological grade (p<0.05). MVD of cancers in TNM stage IIb was higher than that in TNM stageI~IIa (p<0.026). Cancerous tissues with Annexin A2 staining grade 3+ had lower MVD than the tissues with the other Annexin A2 staining grade (p<0.05). Patients with high MVD had worse prognosis. However, our study did not confirm Annexin A2 was an independent risk factor for patients with PDAC. We confirmed MVD labeled by CD105 was an independent risk factor for patients with PDAC and had moderate predictive value of prognosis.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.738-748
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• 2017

Objective : We present our experience of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) and evaluate the postoperative outcomes in accordance with four different operative techniques during MVD. Methods : In total, 30 patients with intractable primary typical GPN who underwent MVD without rhizotomy and were followed for more than 2 years were included in the analysis. Each MVD was performed using one of four different surgical techniques : interposition of Teflon pieces, transposition of offending vessels using Teflon pieces, transposition of offending vessels using a fibrin-glue-coated Teflon sling, and removal of offending veins. Results : The posterior inferior cerebellar artery was responsible for neurovascular compression in 27 of 30 (90%) patients, either by itself or in combination with other vessels. The location of compression on the glossopharyngeal nerve varied; the root entry zone (REZ) only (63.3%) was most common, followed by both the REZ and distal portion (26.7%) and the distal portion alone (10.0%). In terms of detailed surgical techniques during MVD, the offending vessels were transposed in 24 (80%) patients, either using additional insulation, offered by Teflon pieces (15 patients), or using a fibrin glue-coated Teflon sling (9 patients). Simple insertion of Teflon pieces and removal of a small vein were also performed in five and one patient, respectively. During the 2 years following MVD, 29 of 30 (96.7%) patients were asymptomatic or experienced only occasional pain that did not require medication. Temporary hemodynamic instability occurred in two patients during MVD, and seven patients experienced transient postoperative complications. Neither persistent morbidity nor mortality was reported. Conclusion : This study demonstrates that MVD without rhizotomy is a safe and effective treatment option for GPN.