Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
Journal of the Korean Society of Radiology
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v.85
no.1
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pp.3-23
/
2024
Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.
This experiment was designed to explore the specific functional interrelations between the vestibular semicircular canals and the extraocular muscles which may disclose the neural organization, connecting the vestibular canals and each ocular motor nuclei in the brain system, for vestibuloocular reflex mechanism. In urethane anesthetized rabbits, a fine wire insulated except the cut cross section of its tip was inserted into the canals closely to the ampullary receptor organs through the minute holes provided on the osseous canal wall for monopolar stimulation of each canal nerve. All extraocular muscles of both eyes were ligated and cut at their insertio, and the isometric tension and EMG responses of the extraocular muscles to the vestibular canal nerve stimulation were recorded by means of a physiographic recorder. Upon stimulation of the semicircular canal nerve, direction if the eye movement was also observed. The experimental results were as follows. 1) Single canal nerve stimulation with high frequency square waves (240 cps, 0. 1 msec) caused excitation of three extraocular muscles and inhibition of remaining three muscles in the bilateral eyes; stimulation of any canal nerve of a unilateral labyrinth caused excitation (contraction) of the superior rectus, superior oblique and medial rectus muscles and inhibition (relaxation) of the inferior rectus, inferior oblique and lateral rectos muscles in the ipsilateral eye, and it caused the opposite events in the contralateral eye. 2) By the overlapped stimulation of triple canal nerves of a unilateral labyrinth, unidirectional (excitatory or inhibitory) summation of the individual canal effects on a given extraocular muscles was demonstrated, and this indicates that three different canals of a unilateral vestibular system exert similar effect on a given extraocular muscles. 3) Based on the above experimental evidences, a simple rule by which one can define the vestibular excitatory and inhibitory input sources to all the extraocular muscles is proposed; the superior rectus, superior oblique and medial rectus muscles receive excitatory impulses from the ipsilateral vestibular canals, and the inferior rectus, inferior oblique and lateral rectus muscles from the contralateral canals; the opposite relationship applies for vestibular inhibitory impulses to the extraocular muscles. 4) According to the specific direction of the eye movements induced by the individual canal nerve stimulation, an extraocutar muscle exerting major role (a muscle of primary contraction) and two muscles of synergistic contraction could be differentiated in both eyes. 5) When these experimental results were compared to the well known observations of Cohen et al. (1964) made in the cats, extraocular muscles of primary contraction were the same but those of synergistic contraction were partially different. Moreover, the oblique muscle responses to each canal nerve excitation appeared to be all identical. However, the responnes of horizontal (medial and lateral) and vertical (superior and inferior) rectus muscles showed considerable differences. By critical analysis of these data, the author was able to locate theoretical contradictions in the observations of Cohen et al. but not in the author's results. 6) An attempt was also made to compare the functional observation of this experiment to the morphological findings of Carpenter and his associates obtained by degeneration experiments in the monkeys, and it was able to find some significant coincidence between there two works of different approach. In summary, the author has demonstrated that the well known observations of Cohen et al. on the vestibulo-ocular interrelation contain important experimental errors which can he proved by theoretical evaluation and substantiated by a series of experiments. Based on such experimental evidences, a new rule is proposed to define the interrelation between the vestibular canals and the extraocular muscles.
Objectives : This study was performed to evaluate the effects of Hwangryunhaedok-tang(Huanglianjiedu-tang HHT) water extract on locomotor dysfunction induced by spinal cord injury(SCI) in rats. Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rats. HHT was orally given once a day for 14 days after SCI. Neurological behavior was examined with the Basso-Beattie-Bresnahan locomotor rating scale. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue staining. Using immunohistochemisty, cellular damage to neurons and nerve fibers were examined against Bax and MAP-2. As inflammatory response markers, iNOS and COX-2 expressions were also examined. Results : 1. HHT ameliorated the locomotor dysfunction of the SCI-induced rats. 2. HHT attenuated the reduction of motor neurons in the ventral horn of the SCI-induced rat spinal cord. 3. HHT significantly reduced the number of Bax positive cells in the peri-lesion of the SCI-induced rat spinal cord. 4. HHT attenuated the reduction of MAP-2 positive cells in the peri-lesion of the SCI-induced rat spinal cord. 5. HHT significantly reduced the number of iNOS and COX-2 positive cells in the peri-lesion of the SCI-induced rat spinal cord. Conclusions : These results suggest that HHT improves the locomotor dysfunction of SCI by protecting motor neurons from cell death through anti-inflammatory effect.
Background Pedicled transverse rectus abdominis musculocutaneous flaps typically sacrifice the entire muscle. In our experience, the lateral strip of the rectus abdominis muscle can be spared in an attempt to maintain function and reduce morbidity. When the intercostal nerves are injured, muscle atrophy appears with time. The severed intercostal nerve was reinserted into the remnant lateral strip of the rectus abdominis muscle to reduce muscle atrophy. Methods The authors retrospectively reviewed 9 neurotized cases and 10 non-neurotized cases. Abdominal computed tomography was performed to determine the area of the rectus muscles. Electromyography (EMG) was performed to check contractile function of the remnant muscle. A single investigator measured the mean areas of randomly selected locations (second lumbar spine) using ImageJ software in a series of 10 cross-sectional slices. We compared the Hounsfield unit (HU) pre- and postoperatively to evaluate regeneration quality. Results In the neurotization group, 7 of 9 cases maintained the mass of remnant muscle. However, in the non-neurotization group, 8 of 10 lost their mass. The number of totally atrophied muscles in each of the two groups was significantly different (P=0.027). All of the remnant muscles showed contractile function on EMG. The 9 remaining remnant rectus abdominis muscles showed declined the HU value after surgery but also within a normal range of muscle. Conclusions Neurotization was found to be effective in maintaining the mass of remnant muscle. Neurotized remnant muscle had contractile function on EMG and no fatty degeneration by HU value.
Nam, Soo Hyun;Hong, Young Bin;Hyun, Young Se;Nam, Da Eun;Kwak, Geon;Hwang, Sun Hee;Choi, Byung-Ok;Chung, Ki Wha
Molecules and Cells
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v.39
no.5
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pp.382-388
/
2016
Inherited peripheral neuropathies (IPN), which are a group of clinically and genetically heterogeneous peripheral nerve disorders including Charcot-Marie-Tooth disease (CMT), exhibit progressive degeneration of muscles in the extremities and loss of sensory function. Over 70 genes have been reported as genetic causatives and the number is still growing. We prepared a targeted gene panel for IPN diagnosis based on next generation sequencing (NGS). The gene panel was designed to detect mutations in 73 genes reported to be genetic causes of IPN or related peripheral neuropathies, and to detect duplication of the chromosome 17p12 region, the major genetic cause of CMT1A. We applied the gene panel to 115 samples from 63 non-CMT1A families, and isolated 15 pathogenic or likelypathogenic mutations in eight genes from 25 patients (17 families). Of them, eight mutations were unreported variants. Of particular interest, this study revealed several very rare mutations in the SPTLC2, DCTN1, and MARS genes. In addition, the effectiveness of the detection of CMT1A was confirmed by comparing five 17p12-nonduplicated controls and 15 CMT1A cases. In conclusion, we developed a gene panel for one step genetic diagnosis of IPN. It seems that its time- and cost-effectiveness are superior to previous tiered-genetic diagnosis algorithms, and it could be applied as a genetic diagnostic system for inherited peripheral neuropathies.
Son Byung Chul;Cho Kyu Do;Jo Min Seop;Wang Young Pil;Cho Deog Gon
Journal of Chest Surgery
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v.38
no.3
s.248
/
pp.249-252
/
2005
Neurogenic tumors of the brachial plexus region are relatively rare. We report a recent experience of schwannoma of the right brachial plexus in the inferior trunk, which was successfully treated by microsurgical resection. A 38-year- old man presented a dysesthetic pain in the supraclavicular area and the right forearm of C6, 7 dermatome. Rubbery hard mass was palpated in the right supraclavicular area and magnetic resonance imaging showed a well circumscribed, well enhanced ovoid mass with cystic degeneration on the right brachial plexus portion. The patient underwent complete removal of the mass through the anterior cervicothoracic (modified Dartevelle) approach. At the postoperative 3 months, there is no neurologic deficit.
Objective: The purpose of this study is to indicate further research direction in dementia by examining recent Korean-medicine journals. Method: We have reviewed eleven different journals that have been published from 1997 to 2006. Result 1.In philological study paper, cerebrovascular dementia is most common type of dementia and age, sex, past history have influence on the attack of disease. Introduced medical treatment to dementia of Korean medicine are Removing wind(祛風), Be in the peace(安神), Refreshing lung and raising blood(淸肺養血) etc. 2.According to the research paper, a prognosis of dementia which Is mixed(Alzheimer type and cerebrovascular type) is bad. Sinmac(申脈)-BL.62), Jeohae(照海)-Kl.06), waegwan(外關)-TE.05), naegwan(內關)-PC.6) among the palmacgyohoeheol(八脈交會穴) have good effect in medical treatment. Medical treatment which is based on chaejil(體質)) shows up to be more effective. Also many medicines have good effect, especially chongmyung-tang(聰明湯)) and chongmyung-tang-gamibang(聰明湯加味方)) have good effect on decreasing memory caused by nerve cell degeneration. Conclusion: The Korean medical treatments have many advantage in taking the dementia so the researches about this are more needed.
Kim, Gi-Do;Kim, Eun-Jung;Choi, Ki-Bok;Yoo, Young-Dae;Kim, Gye-Yeop
The Journal of Korean Physical Therapy
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v.18
no.3
/
pp.59-70
/
2006
Purpose: This study is intended to examine the aquatic exercise on the improvement of muscle atrophy and motor function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: We used 60 Sprague-Dawely rats which were divided into 4 groups; the subjects were divided into group of 5 rats. Group I was a group of high dose aquatic exercise after inducing ischemic stroke; Group II was a group of low dose aquatic exercise after inducing ischemic stroke; Group III was a control group, Group IV was a sham group without ischemic stroke. Results: Muscle weight of gastrocnemius muscle was significantly difference in Group II compared to Group III on 8 weeks(p<0.05). For the changes in relative muscle weight of gastrocnemius muscle, there was significant increase in Group II compared to Group III on 8 weeks(p<0.05). For neurologic exercise behavior test, Group II generally had the highest score, compared to other groups. The results of behavior test that Group II improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group III. Conclusion: Based on these results, aquatic exercise may improve muscle atrophy and contribute to the improvement of motor function.
This study was conducted to elucidate the pathogenesis of Aujeszky's disease virus(ADV) by histopathologic examination. The first Korean ADV Isolate, which was isolated from piglets with clinical signs of Aujeszky's disease in Yangsan(YS) county, Kyungnam province, was inoculated into 32 days old piglets with a dose of $10^{5.9}$$TCID_{50}/ml$ through intranasal or intramuscular route. These piglets were sacrificed at intervals of every 24hrs for 8 days. The virulence of YS strain was determined by the observation of clinical signs, gross findings, and histopathologic changes in tissues. The virus recovery test was performed from brain, spleen, lung and tonsil in cell culture. The pathogenesis of YS strain was determined by the observation of histopathologlc lesions in CNS and neuronal tracts. The major clinical signs were fever, anorexia, dyspnea, constipation, tremor, ataxia, circling movement, hindleg paralysis and salivation. The clinical signs were more severe in piglets of the group inoculated intranasally than those of the intramuscularly inoculated gorup. Lymphocytopenia was detected on day 5 to day 6 postinoculation (PI). The ADV was recovered from the tissue homogenates of tonsil, lung, spleen and cerebrum in cell culture. The highest virus titer was detected from tonsil between day 6 and day 7 PI. Reddish sublobar consolidation foci were scattered in the apical and cardiac lobes of lung. Although yellowish necrotic foci were detected in tonsil and liver, hemorrhagic lesions were mainly observed in heart, kidney and lymph nodes. Histopathologically, degeneration and necrosis of nerve cells, nonsuppurative meningoe-ncephalitis, nodular gliosis and perivascular cuffings were observed in CNS. Multifocal fibronecrotic foci were observed in lung, liver, lymph nodes and spleen. The major pathologic changes were detected in the midbrain, pons and medulla oblongata. Eosinophilic intranuclear inclusion bodies were mainly observed in epithelia and /or macrophages of tonsil, liver, lung, spleen and submandibular lymph nodes, and neurons of brain, respectively. Observation of viral particles at various stages of replication were possible from the endothelial cells of the alveolar capillaries and tonsillar crypt epithelia by transmission electron microscope.
An abattoir study on the abdominal fat necrosis in adult cattle was performed pathologically. Grossly, masses of fat necrosis were leekgreen in colour, lobulated on the cut surface, and saponificated in the texture. These necrotic adipose tissues infiltrated usually into neighboring parenchymal organs including intestines and pancreas, leading to fibrosis or atrophy of them. Histopathologically, necrotic fat cells contained acidophilic, opaque, amorphous substance or basophilic fibrillar or granular minerals in their cytoplasms. The lesions of fat necrosis were divided by fibroconnective tissue. With increase of the severity, necrotic fat cells fused each other and then formed fat cysts. In this severe lesion, necrotic fat cells were partialy or completely replaced by macrophages. Multinucleated giant cells were scattered in this lesion. Interestingly, small artery in the lesion of fat necrosis revealed severe thickening of internal elastic membrane. Severe fibrosis was observed in or between the outer longitudinal and inner circular muscular externas causing segregation, degeneration and necrosis of muscle fibers. The nerve cells of Auerbach's and Meissner's plexuses surrounded by fibrosis were degenerated or necrotic. In addition, necrotic fat cells infiltrated into the pancreas, resulting in pancreas atrophy. From these results, it is speculated that fat necrosis might compromise intestinal movement due to necrosis of muscular externa and ganglion cells of Auerbach's and Meissner's plexuses.
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