• The Journal of the Korean bone and joint tumor society
• /
• v.2 no.1
• /
• pp.88-93
• /
• 1996

Neurilemmomas are the most common benign tumor of the peripheral nerve trunks, and arises from the cells in the sheath of Schwann. Neurilemmomas are well encapsulated and may be separated easily from surrounding tissue and lie completely within a larger nerve trunk, with bundles of neurofibrils spread out over the surface of the tumor. A careful dissection and retraction of the nerve bundles will allow the tumor to be enucleated from the parent nerve without any significant interference with the function of the nerve. Resection of the involved nerve is seldom necessary and should be avoided if at all possible. Our aim in microscopic excision of neurilemmoma of extremities is to reduce any disturbance of the intact neurofibrils of the parent nerve. Thirteen cases of neurilimmomas were treated by microscopic excision at the Department of Orthopaedic Surgery, Korea University Hospital between January 1990 and March 1995. The results was as follows ; 1. The average age at surgical intervention was 40.1 years. Cases in fourth and fifth decades predominated. 2. In their anatomical distribution, 8 cases were in the upper extremity and 5 cases in the lower extremity. 11 cases were on the flexor surface. 3. On the operative field, all the tumors were well encapsulated, however 1 case of 13 was adherent to the periosteum of fibula. 4. In all cases, the tumor were enucleated from the parent nerve without any injury to nerve under high-power magnification, preserving individual fascicles, and sensory and motor function.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.6
• /
• pp.488-496
• /
• 2004

Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

• Archives of Reconstructive Microsurgery
• /
• v.6 no.1
• /
• pp.9-28
• /
• 1997

Adequate vascularization is pivotally essential for a successful nerve graft. Theoretically, the immediate vascularization will inhibit fibroblast infiltration and stimulate nerve cell regeneration. In this study, histomorphological and electrophysiological studies were performed to determine if vascularized grafts are functionally superior. In rat model, a 4cm segment of the sciatic nerve was obtained and placed as a non vascularized graft on one side, and as a vascularized graft connected to the inferior gluteal vessels on the opposite side. To determine the compound action potential of the gastrocnemius muscle, electromyography was done after 2, 3 and 4 months. Histomorphologically, the distribution of myelinated nerve fibers and Schwann cell were evaluated after toluidine blue staining, The following resutls were obtained: 1. The electrophysiological studies showed no difference between the nonvascularized and vascularized grafts. 2. Two and three months after grafting, myelinated nerve fibers were more abundant in the vascularized proximal, middle and distal areas in all nerve fibers of varying diameters. 3. In the post-nonvascularized graft 2-month group, a few myelinated nerve fibers were present in the proximal and middle areas, but none distally. In the post-vascularized graft 2 month group, myelinated nerve fibers ranging $2-8{\mu}m$ were present in all three areas. 4. In the post-nonvascularized graft 3 month group, a few myelinated nerve fibers ranging in $2-6{\mu}m$ were present in all three areas, but in the post-vascularized graft 3 month group, many myelinated nerve fibers ranging in $2-10{\mu}m$ were present in all three areas. 5. In the post-graft 4-month group, more myelinated nerve fibers were present in all three areas of the vascularized grafts. However, nerve fibers of less than $2{\mu}m$ in diameter were more abundant in the non vascularized grafts. 6. Schwann cells were more abundant in the proximal, middle and distal areas of the post-vascularized 2, 3 and 4-month grafts. Based on these findings, the immediate restoration of circulation in vascularized nerve grafts allows for the increased number of surviving Schwann cells, rapid healing of the axon and myelin sheath changes which occur during Wallerian degeneration, and thus is able to stimulate a morphologically optimal regeneration.

• The Journal of Korean Medicine
• /
• v.33 no.3
• /
• pp.133-146
• /
• 2012

Background: Most antitumor agents have the side effect of chemotherapy-induced peripheral neuropathy (CIPN). Cancer patients who take antitumor agents suffer from CIPN, but there is no known treatment for it. Unlike the central nerve system, the peripheral nerve can self-repair, and the Schwann cell takes this mechanism. Objectives: In this study, we researched the effect of YideungJetong-Tang (YJT) extract on taxol-induced sciatic nerve damage, through in vitro and in vivo experiments. Also, we studied the effect of YJT extract on neurite recovery and anti-inflammatory effect after compression injury of sciatic nerve in vivo. Methods: Vehicle, taxol and taxol+YJT were respectively applied on sciatic nerve cells of rat in vitro, then the cells were cultured. The sciatic nerve cells and Schwann cells were then observed using Neurofilament 200, Hoechst, ${\beta}$ -tubulin, S-$100{\beta}$, caspase-3 and phospho-Erk1/2. CIPN was induced by taxol into the sciatic nerve of rat in vivo, then YJT extract was taken orally. The axons, Schwann cells and neurites of the DRG sensory nerve were then observed using Neurofilament 200, ${\beta}$-tubulin, Hoechst, S-$100{\beta}$, phospho-Erk1/2 and caspase-3. YJT was taken orally after sciatic nerve compression injury, and the changes in axon of the sciatic nerve, Schwann cells and TNF-${\alpha}$ concentration were observed. Results: The taxol and YJT treated group showed significant effects on Schwann cell recovery, neurite growth and recovery. In vivo, YJT compared with control group showed Schwann cell structural improvement and axons recovering effect after taxol-induced Schwann cell damage. After sciatic nerve compression injury, recovery of distal axon, changes of Schwann cell distribution, and anti-inflammatory response were observed in the YJT. Conclusions: Through this study, we found that after taxol-induced neurite damage of sciatic nerve in vivo and in vitro, YJT had significant effects on sciatic nerve growth and Schwann cell structural improvement. In vivo, YJT improved recovery of distal axons and Schwann cells and had an anti-inflammatory effect.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.9 no.2
• /
• pp.108-115
• /
• 2009

Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.

• The Korean Journal of Pain
• /
• v.9 no.2
• /
• pp.390-394
• /
• 1996

Background: Occipital neuralgia is characterized by pain, usually deep and aching, in the distribution the second and/or third cervical dorsal root. Two broad groups of patients include primary occipital neuralgia with no apparent etiology and secondary neuralgia with structural pathology. Patients with occipital neuralgia can develop autonomic changes and hyperesthesia. In patients who have not improved with conservative treatment, we have carried out various nerve blocks and evaluated the effectiveness. Methods: In a series of 20 occipital neuralgia patients with no apparent etiolgy, we have carried out great occipital nerve blocks with needle TEAS. In patients who have not improved more than 75% on VAS with great occipital block, we have carried out C2 ganglion blocks and in patients who have not improved more than 75% with C2 ganglion block, C3 root blocks, C2/C3 facet joint blocks have been carried out in due order. Results: In 3 patients out of 10 patients who have not improved with great occipital nerve block, C2 ganglion block led to pain relief. A good response of C3 root block was achived in 2 of 7 patients without response to C2 ganglion block and C2/C3 facet joint block led to improvement in 1 of 5 patients without response to C3 root block. Conclusions: Nerve blocks like great occipital nerve block, C2 ganglion block, C3 root block, or C2/C3 facet joint block were effective in the patients who have not improved with conservative treatment.

• Archives of Reconstructive Microsurgery
• /
• v.21 no.2
• /
• pp.149-152
• /
• 2012

Purpose: The vessels of peripheral nerves have been extensively studied since Breidenbach used vascularizd nerve grafts. Tayor and Pinel studied the course and distribution of the vessels of peripheral nerves. However, the vessels of digital nerves are still not well known. The objective of this study was to prove vessels of digital nerves and to investigate the pathway of that. Materials and Methods: 36 patients and 2 fresh human cadavers were studied under the microscope and histologic sections under the light microscope.. Results: We found that digital nerves had own arterioles and venules as well as peripheral nerves. This small vessels of digital nerves paralleled the digital nerves or run in a spiral. Digital nerves were abundantly vascularized throught their length by a succession of vessels and by their repeated divisions and anastomoses. Conclusion: The clinical implications of this results can be discussed in relation to the dissection of nerves, the possibility of vasculized nerve grafts.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.6
• /
• pp.445-449
• /
• 2006

Objective : The accurate anatomy of the facial nerve is essential for successful surgical outcome. The purpose of the present study is to know such information on the facial nerve from a series of specimens. Methods : This study is based on cadaveric dissection of 41 Korean fetus and stillborn infant and describes anatomical variations of the peripheral branches of the facial nerve that pose a importance in a number of neruosurgical procedure. Results : The branching patterns were classified into six types according to modified Davis classification : the frequencies of occurrence were : type I, 4.9%; type II, 24.4%; type III, 34.1%; type IV, 19.5%; type V, 12.2%; and type VI, 4.9%. Types II, III and IV together accounted for almost 80% of the specimens. Conclusion : Compared to previous adult and western stillborn fetus cadaveric studies, there was no significant difference in the percentage of the types between the subjects in the present study, similar pattern and anatomic distribution.

• Proceedings of the KOSOMBE Conference
• /
• v.1993 no.05
• /
• pp.28-30
• /
• 1993

We have investigated the feasibility study, especially for optimal TR, to obtain 3-D MR neurographic imaging (neurograms or nervography) which shows the distribution of peripheral nerve fibers at the human forearm using 4.7 T magnet. To peform a successful formation of MR neurographic imaging, nerve signal should be separated from the other signal comes from surrounding muscle or fat, because nerves are usually embeded in muscle or fat. Generally, it is well known that nerve has shoter T1 value than that of muscle. Thus, repetition time was optimized to maximize the signal intensity defference between the muscel and nerve. We have also used spin-echo(SE) sequence with long echo time($60{\sim}90\;msec$) to enhance the different signal intensity between muscles and pheriperal nerves base on the fact that muscle tissue has longer T2 relaxation lime than that or nerve.

• The Korean Journal of Zoology
• /
• v.37 no.4
• /
• pp.504-513
• /
• 1994

The present study was carried out 1) to show the ontogenic development of CA-and GnRH-containing nerve fobres in the median eminence, 2) to simultaneously demonstrate the synaptic contact between these two nenre fibres in the rat median eminence at the ultrastructural level using light and electron microscopic doublelabel immunostainlngs. GnRH-and CA-nenre terminals were detectable in the median eminence at embryonic day 19.5. The CA-newe terminals were obsenred in the entire legion of the extern31 lavers, while GnRH-newe terminals only in the lateral portion. At the 14th postnatal daw, both %ropes of nerve terminals showed a very similar distribution to those of adult one. In the median eminence of adult rats, a substantial overlap existed in the distribution of GnRH fibres with CA-containing nerve fibres. This overlap was most intense throughout the external palisade zone. Furthermore, an electron microscopic double label immunostaining showed that there was a close apposition of CA- and GnRH-nenre fobres. These axo-axonic contacts occurred frequently in the internal and palisade zones, i.e. at the level of the fobre preterminals. These morphological results suggest that the CA-mediated GnRH secretion may occur via sxo-axonic interaction in the median eminence.