• Title/Summary/Keyword: Nerve

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An anatomic study of the facial nerve (임상가를 위한 특집 3 - 얼굴신경의 해부학)

  • Kwak, Hyun-Ho;Park, Bong-Su;Kim, Hee-Jin
    • The Journal of the Korean dental association
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    • v.50 no.10
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    • pp.624-629
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    • 2012
  • This study examined the anatomical relationships along with the variability of the facial nerve trunk and its branches with an emphasis on the intraparotid connections between the divisions. And histomorphometric observations of the facial nerve branches and fascicles were performed on 40 Korean half-heads. The facial nerve trunk was bifurcated into two main divisions(35/40, 87.5%) and the other five cases were divided into a trifurcation pattern. According to the origin of the buccal branch, the branching patterns of the facia l nerve were classified into four categories. Communications between the facial and auriculotemporal nerve branches were observed in 37 out of 40 cases(92.5%). In the histological observation, the buccal branch had the greatest number of branches(3.47), however the zygomatic branch had the largest diameters(0.93mm). This detailed description of the facial nerve anatomy wi ll provide useful information for surgical procedures such as a tumor resection. a facial nerve reconstruction, autonerve graft. and facelift.

Ulnar Nerve Injury Caused by the Incomplete Insertion of a Screw Head after Internal Fixation with Dual Locking Plates in AO/OTA Type C2 Distal Humerus Fractures

  • Shin, Jae-Hyuk;Kwon, Whan-Jin;Hyun, Yoon-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.236-239
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    • 2017
  • After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

Cholinergic contraction to the perivascular nerve stimulation on the isolated coronary artery of pig (돼지 적출 심관상동맥에 있어서 perivascular nerve stimulation에 의한 cholinergic 수축 작용)

  • Shim, Cheol-soo;Park, Sang-eun;Jeon, Seok-cheol;Han, Bang-keun;Kim, Joo-heon
    • Korean Journal of Veterinary Research
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    • v.35 no.2
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    • pp.237-243
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    • 1995
  • The effects of various autonomic blocking agents to perivascular nerve stimulation were investigated on isolated coronary artery of pig. 1. The magnitude of contractile response to perivascular nerve stimulation increased with increasing frequency(280Hz) of stimulation. 2. The contractions to perivascular nerve stimulation(40V, 40Hz, 0.5msec, 1min) were increased by pretreatment of the cholinestrase inhibitor, physostigmine. 3. The contraction to perivascular nerve stimulation(40V, 40Hz, 0.5msec, 1min) was antagonised by the muscarinic antagonist, atropine. 4. The contraction to perivascular nerve stimulation(40V, 40Hz, 0.5msec, 1min) was blocked by the neural blocker, tetrodotoxin. 5. The contractions to perivascular nerve stimulation(40V, 40Hz, 0.5msec, 1min) were not significantly affected by the ${\alpha}$-adrenergic antagonist, phentolamine or ${\beta}$-adrenergic antagonist, propranolol. 6. The contractile response by the acetylcholine was increased by the pretreatment of cholinestrase inhibitor, physostigmine. This findings suggest that the powerful excitatory action by the perivascular nerve stimulation may be linked to muscarinic receptor by cholinergic nerve excitation in coronary artery of pig.

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Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons?

  • Crowe, Christopher S;Liao, Joseph C;Curtin, Catherine M
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.626-629
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    • 2015
  • Peripheral nerve injuries remain a challenge for reconstructive surgeons with many patients obtaining suboptimal results. Understanding the level of injury is imperative for successful repair. Current methods for distinguishing healthy from damaged nerve are time consuming and possess limited efficacy. Confocal laser endomicroscopy (CLE) is an emerging optical biopsy technology that enables dynamic, high resolution, sub-surface imaging of live tissue. Porcine sciatic nerve was either left undamaged or briefly clamped to simulate injury. Diluted fluorescein was applied topically to the nerve. CLE imaging was performed by direct contact of the probe with nerve tissue. Images representative of both damaged and undamaged nerve fibers were collected and compared to routine H&E histology. Optical biopsy of undamaged nerve revealed bands of longitudinal nerve fibers, distinct from surrounding adipose and connective tissue. When damaged, these bands appear truncated and terminate in blebs of opacity. H&E staining revealed similar features in damaged nerve fibers. These results prompt development of a protocol for imaging peripheral nerves intraoperatively. To this end, improving surgeons' ability to understand the level of injury through real-time imaging will allow for faster and more informed operative decisions than the current standard permits.

Neural Ablation and Regeneration in Pain Practice

  • Choi, Eun Ji;Choi, Yun Mi;Jang, Eun Jung;Kim, Ju Yeon;Kim, Tae Kyun;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.3-11
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    • 2016
  • A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration.

Experimental Study for Nerve Regeneration Using Tubes Filled with Autogenous Skeletal Muscle in a Gap of Rabbit Sciatic Nerves (백색 가토 좌골 신경의 신경 결손부위에서 자가 골격근 충진 도관을 이용한 신경재생 연구)

  • Lee, Jun-Mo;Shin, Sung-Jin;Seo, Jeong-Hwan;Song, Chang-Ho
    • Archives of Reconstructive Microsurgery
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    • v.12 no.1
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    • pp.1-12
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    • 2003
  • The bridging of nerve gaps is still one of the major problems in peripheral nerve surgery. To evaluate the role of silicon tube in nerve regeneration, gaps were made by resection of tibial components of sciatic nerves of twenty-five New Zealand rabbits. The gaps were divided into five groups. In group I, the tibial components of sciatic nerves were isolated and the incision immediately closed. In group II, 1-cm segments of the nerve were removed and the silicon tubes filled with autogenous skeletal muscle were sutured in place. In group III, 1-cm segments of the nerve were removed and the silicon tubes filled without muscle were sutured in place. In group IV, 2-cm segments of the nerve were removed and the silicon tubes filled with autogenous skeletal muscle were sutured in place. In group V, 2-cm segments of the nerve were removed and the silicon tubes filled without muscle were sutured in place. At 16th week, the eletromyography, the light and transmission electron microscopy were performed. Nerve conduction study stimulating sciatic nerve proximal to the lesion and recording at gastrocnemius muscle showed that the compound muscle action potentials of the group II with 1 cm nerve defect filled with muscle were higher amplitudes than the group III without muscle. Compound muscle action potentials of the group IV with 2 cm defect filled with muscle showed similar results in comparison with the group V. The light and transmission electron microscpy showed that a good morphological pattern of nerve regeneration in 1 cm gap than 2 cm and in gap with muscle than gap without muscle.

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Implantable Nerve Cuff Electrode with Conductive Polymer for Improving Recording Signal Quality at Peripheral Nerve (말초 신경 신호 기록의 효율성 개선을 위한 전도성 폴리머가 적용된 생체삽입형 커프형 신경전극)

  • Park, Sung Jin;Lee, Yi Jae;Yun, Kwang-Seok;Kang, Ji Yoon;Lee, Soo Hyun
    • Journal of Sensor Science and Technology
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    • v.24 no.1
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    • pp.22-28
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    • 2015
  • This study demonstrates a polyimide nerve cuff electrode with a conductive polymer for improving recording signal quality at peripheral nerve. The nerve cuff electrodes with platinum (Pt), iridium oxide (IrOx), and poly(3,4-ethylenedioxythiophene): p-toluene sulfonate (PEDOT:pTS) were fabricated and investigated their electrical characteristics for improving recorded nerve signal quality. The fabricated nerve cuff electrodes with Pt, IrOx, and PEDOT:pTS were characterized their impedance and CDC by using electrochemical impedance spectroscopy (EIS) and cyclic voltammetry. The impedance of PEDOT:pTS measured at 1 kHz was $257{\Omega}$, which was extremely lower than the value of the nerve cuff electrodes with IrOx ($15897{\Omega}$) and Pt ($952{\Omega}$), respectively. Furthermore, the charge delivery capacity (CDC) of the nerve cuff electrode with PEDOT:pTS was dramatically increased to 62 times than the nerve cuff electrode with IrOx. In ex-vivo test using extracted sciatic nerve of spaque-dawley rat (SD rat), the PEDOT:pTS group exhibited higher signal-to-interference ratio than IrOx group. These results indicated that the nerve cuff electrode with PEDOT:pTS is promising for effective implantable nerve signal recording.

Anatomical Study on the Heart Meridian Muscle in Human

  • Park Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.26 no.1 s.61
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    • pp.11-17
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    • 2005
  • This study was carried out to identify the components of the human heart meridian muscle, the regional muscle group being divided into outer, middle, and inner layers. The inner parts of the body surface were opened widely to demonstrate muscles, nerves, blood vessels and to expose the inner structure of the heart meridian muscle in the order of layers. We obtained the following results; $\cdot$ The heart meridian muscle is composed of muscles, nerves and blood vessels. $\cdot$ In human anatomy, the difference between terms is present (that is, between nerves or blood vessels which control the meridian muscle and those which pass near by). $\cdot$ The inner composition of the heart meridian muscle in the human arm is as follows: 1) Muscle H-l: latissimus dorsi muscle tendon, teres major muscle, coracobrachialis muscle H-2: biceps brachialis muscle, triceps brachialis muscle, brachialis muscle H-3: pronator teres muscle and brachialis muscle H-4: palmar carpal ligament and flexor ulnaris tendon H-5: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficialis tendon, flexor digitorum profundus tendon H-6: palmar carpal ligament & flexor retinaculum, flexor carpi ulnaris tendon H-7: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficial is tendon, flexor digitorum profundus tendon H-8: palmar aponeurosis, 4th lumbrical muscle, dorsal & palmar interrosseous muscle H-9: dorsal fascia, radiad of extensor digiti minimi tendon & extensor digitorum tendon 2) Blood vessel H-1: axillary artery, posterior circumflex humeral artery H-2: basilic vein, brachial artery H-3: basilic vein, inferior ulnar collateral artery, brachial artery H-4: ulnar artery H-5: ulnar artery H-6: ulnar artery H-7: ulnar artery H-8: palmar digital artery H-9: dorsal digital vein, the dorsal branch of palmar digital artery 3) Nerve H-1: medial antebrachial cutaneous nerve, median n., ulnar n., radial n., musculocutaneous n., axillary nerve H-2: median nerve, ulnar n., medial antebrachial cutaneous n., the branch of muscular cutaneous nerve H-3: median nerve, medial antebrachial cutaneous nerve H-4: medial antebrachial cutaneous nerve, ulnar nerve H-5: ulnar nerve H-6: ulnar nerve H-7: ulnar nerve H-8: superficial branch of ulnar nerve H-9: dorsal digital branch of ulnar nerve.

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Effects on Response of Nervous Tissue to Samuljetong-tang after Damaged by Taxol Treatment or Sciatic Nerve Injury (사물제통탕(四物除痛湯)이 Taxol 처리 및 좌골신경 압좌 손상 후 신경조직 변화에 미치는 영향)

  • Youn, Sung-Sik;Kim, Chul-Jung;Cho, Chung-Sik
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.126-144
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    • 2012
  • Background : Peripheral nerves more rapidly recover than central nerves. However, it has been known that the degree of reaction of axons of peripheral nerves is affected by distinctive characteristics of axons and environmental factors near the axons. Taxol is a widely used medicine as for ovarian, breast, lung and gastric cancer. However it causes patients difficulties under treatment due to its toxic and side effects, which include persistent pain. Objectives : This study reviewed how SJT extract in vitro and in vivo affects nerve tissues of a sciatic nerve damaged by Taxol. It also studied how SJT extract in vivo affects axons of the sciatic nerve after the sciatic nerve was damaged by pressing. Methods : After vehicle, Taxol, and Taxol plus SJT were treated respectively for tissue of the sciatic nerve in vitro and then tissues were observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and anti-cdc2. SJT was also oral medicated by injecting Taxol into the sciatic nerve of in vivo rats. Tissues of the sciatic nerve and axons of DRG sensory nerves were then observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and p-Erk1/2. After inflicting pressing damage to the sciatic nerve of in vivo rats, tissues of the sciatic nerve and DRG sensory nerve were observed using Neurofilament 200, Hoechst, $S100{\beta}$, caspase-3, anti-cdc2, phospho-vimentin, ${\beta}1$-integrin, Dil reverse tracking and p-Erk1/2. Results : The group of in vitro Taxol plus SJT treatment had meaningful effects after sciatic nerve tissue was damaged by Taxol. The group of in vivo SJT treatment had effects of regenerating Schwann cells and axons which were damaged by Taxol treatment. The group of in vivo SJT had effects of regenerating axons in damaged areas after the sciatic nerve was damaged by pressing, and also had variations of distribution in Schwann cells at DRG sensory nerves and axons. Conclusions : This study confirmed that SJT treatment is effective for growth of axons in the sciatic nerve tissues and improvement of Schwann cells after axons of the sciatic nerve tissues was damaged. After tissues of sciatic nerve was damaged by pressing in vivo, SJT treatment had effects on promoting regeneration of axon in the damaged area and reactional capabilities in axons of DRG sensory nerves.

Functional Outcomes of Multiple Sural Nerve Grafts for Facial Nerve Defects after Tumor-Ablative Surgery

  • Lee, Myung Chul;Kim, Dae Hee;Jeon, Yeo Reum;Rah, Dong Kyun;Lew, Dae Hyun;Choi, Eun Chang;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.461-468
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    • 2015
  • Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.