• Title/Summary/Keyword: Nerve ligation

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Repetitive Electroacupuncture Alleviate Neuropathic Pain in Association with Suppressing Activation of Spinal Glial Cells (반복적인 전침 처치의 척수 교세포 활성 억제를 통한 신경병증성 통증 억제 효과)

  • Lee, Heun Joo;Jeong, Bo Eun;Song, Da Eun;Park, Min Young;Koo, Sungtae
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.56-63
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    • 2013
  • Objectives : Effects of repetitive electroacupuncture(EA) on the pain behavior and activation of spinal glial cells were examined in the rat model of neuropathic pain. Methods : Twenty one adult male Sprague-Dawley rats were randomly assigned into 3 groups(control group, SP6 group, ST36+GB34 group). Neuropathic pain was induced by tight ligation of L5 spinal nerve. Mechanical and thermal hypersensitivity of hind paw were tested. Immunohistochemistry was performed in spinal cord L5/6 of all groups. EA was treated once in a day from the $5^{th}$ day after surgery. Results : EA treatments applied to ST36 and GB34 reduced significantly both of mechanical and thermal hypersensitivity after 3 times of treatment throughout the experiments. In the SP6 group, the analgesic effect was also shown after 7 times of treatment. Immunohistochemistry demonstrated inhibition of microglia and astrocyte activation in the spinal cord L5/6 dorsal horn in the ST36+GB34 group. Conclusions : The present results suggest that repetitive EA exert strong analgesic effect on neuropathic pain. These analgesic effects in neuropathic pain are associated with suppressing the activation of microglia and astrocyte.

Effects of Electro and Laser Acupuncture Treatment with $GB_{39}$ and $GB_{34}$ on Neuropathic Pain in Rats Induced by Tibial and Sural Nerve Ligation (현종(懸鍾)($GB_{39}$).양릉천(陽陵泉)($GB_{34}$)의 전침(電鍼) 및 레이저침이 백서(白鼠)의 신경병리성(神經病理性) 동통(疼痛)에 미치는 영향)

  • Kim, Yong Se;Lee, Ju Hee;Lee, Sang Hyun;Na, Chang Su;Cho, Myoung Rae
    • Journal of Acupuncture Research
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    • v.30 no.3
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    • pp.125-134
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    • 2013
  • Objectives : We studied the effects of electro and laser acupuncture treatment with $GB_{39}$ and $GB_{34}$ on neuropathic pain in rats induced by tibial and sural nerve ligation. Methods : To produce the model of neuropathic pain, the tibial and sural nerves of rats were ligated by a 6-0 silk thread. Three days after the neuropathic surgery, only electro acupuncture(EA), electro acupuncture and 830 nm laser acupuncture(EA-LA-1), and electro acupuncture and 904 nm laser acupuncture(EA-LA-2) were treated with $GB_{39}$ and $GB_{34}$ twice a week for 8 weeks. We observed the withdrawal response of neuropathic rats' legs by von Frey filament and acetone stimulation. We also observed c-fos and nocieptin on the central gray area in the midbrain of neuropathic rats. Results : As we observed the effect of mechanical allodynia, the EA and EA-LA-1 groups in 5 and 6 weeks and the EA-LA-2 group in 6 weeks increased significantly compared with the control group. As for the effect of c-fos activity in the central gray region, the EA, EA-LA-1, and EA-LA-2 groups decreased significantly compared with the control group. The EA-LA-2 group increased significantly compared with the control group as regards the effect of nociceptin activity in the central gray region. Conclusions : We noticed the synergic effect of electro and laser acupuncture treatment because the EA-LA-1 and EA-LA-2 groups had more controllable effect compared with the control group. This study can be used in clinical therapy for neuropathic pain.

Endovenous Laser Treatment (EVLT) with High Ligation of an Incompetent Small Saphenous Vein (소복재정맥 역류에서 고위결찰술을 동반한 정맥내 레이저 치료)

  • Jeong, Jae-Han;Kim, Kun-Il;Lee, Won-Yong;Kim, Hyoung-Soo;Cho, Sung-Woo;Lee, Hee-Sung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.150-155
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    • 2010
  • Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.

Studies of Alterations in Spleno-Hepatic Reflex in Portal Hypertensive Cats (간문맥 고혈압 고양이에서 비-간 교감신경성 반사의 변동에 대한 연구)

  • Song, Hwan-Kyu;Rhim, Byung-Yong;Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.23 no.1
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    • pp.15-23
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    • 1987
  • To elucidate the mechanism of splanchnic hyperemia associated with chronic portal hypertension, we have investigated the alteration in visceral reflexes in conjuction with circulatory hemodynamics in portal ligated portal hypertension in cats. When capsaicin, bradykinin and vasopressin were injected via splenic artery of sham cat, respectively, they caused not only reflex excitation of systemic arterial pressure, but also elevation of splenic venous pressure with unchanged heart rates. Simultaneously, they evoked the sympathetic efferent excitation of liver (spleno-hepatic reflex) as well as of spleen (spleno-splenic reflex). Similarly, capsaicin upon pledging on the liver surface evoked a significant increase in the pressor reflex with hepatic nerve excitation (hepato-hepatic reflex). After portal ligation, the splenic venous pressure was gradually elevated in association with decrease in systemic arterial pressure. However, the excitation of pressor reflex was enhanced on the and day, thereafter, being returned to the control, and the reflexly induced spleno-splenic, spleno-hepatic and hepato-hepatic sympathetic excitations were significantly diminished on the 8th day following portal vein ligation. In conclusion, it is suggested that sympathetic reflexes to spleen and liver are specifically intervened by the same central pathways and furthermore, the diminution of these viscero-visceral reflex excitations after portal ligation may be related to the intestinal hyperemia.

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The Effect of Urinary Trypsin Inhibitor Against Neuropathic Pain in Rat Models

  • Jung, Ki Tae;Lee, Hyun Young;Yoon, Myung Ha;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.356-360
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    • 2013
  • Background: Nerve injury sometimes leads to chronic neuropathic pain associated with neuroinflammation in the nervous system. In the case of chronic neuropathic pain, the inflammatory and algesic mediators become predominant and result in pain hypersensitivity following nervous system damage. It is well known that urinary trypsin inhibitor (ulinastatin, UTI) has an anti-inflammatory activity. Recently, the neuroprotective action of UTI on the nervous system after ischemic injury has been reported. Thus, we evaluated the neuroprotective effect of ulinastatin in a rat model of neuropathic pain. Methods: Neuropathic pain was induced with L5 spinal nerve ligation (SNL) in male Sprague-Dawley rats weighing 100-120 g. The rats were divided into 3 groups, with n = 8 in each group. The rats in the control group (group 1) were administered normal saline and those in group 2 were administered UTI (50,000 U/kg) intravenously through the tail vein for 3 days from the day of SNL. Rats in group 3 were administered UTI (50,000 U/kg) intravenously from the $5^{th}$ day after SNL. The paw withdrawal threshold was measured using the von Frey test for 3 days starting from the $5^{th}$ day after SNL. Results: The paw withdrawal thresholds were significantly increased in the rats of group 2 compared to the other groups (P < 0.05). Conclusions: Ulinastatin, which was administered for 3 days after SNL, increased the paw withdrawal threshold and it could have a neuroprotective effect in the rat model of neuropathic pain.

Involvement of the spinal γ-aminobutyric acid receptor in the analgesic effects of intrathecally injected hypertonic saline in spinal nerve-ligated rats

  • Myong-Hwan Karm;Hyun-Jung Kwon;Euiyong Shin;Honggyoon Bae;Young Ki Kim;Seong-Soo Choi
    • The Korean Journal of Pain
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    • v.36 no.4
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    • pp.441-449
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    • 2023
  • Background: Hypertonic saline is used for treating chronic pain; however, clinical studies that aid in optimizing therapeutic protocols are lacking. We aimed to determine the concentration of intrathecally injected hypertonic saline at which the effect reaches its peak as well as the underlying γ-aminobutyric acid (GABA) receptor-related antinociceptive mechanism. Methods: Spinal nerve ligation (SNL; left L5 and L6) was performed to induce neuropathic pain in rats weighing 250-300 g. Experiment 1: one week after implanting the intrathecal catheter, 60 rats were assigned randomly to intrathecal injection with 0.45%, 0.9%, 2.5%, 5%, 10%, and 20% NaCl, followed by behavioral testing at baseline and after 30 minutes, 2 hours, 1 day, and 1 week to determine the minimal concentration which produced maximal analgesia. Experiment 2: after determining the optimal intrathecal hypertonic saline concentration, 60 rats were randomly divided into four groups: Sham, hypertonic saline without pretreatment, and hypertonic saline after pretreatment with one of two GABA receptor antagonists (GABAA [bicuculline], or GABAB [phaclofen]). Behavioral tests were performed at weeks 1 and 3 following each treatment. Results: Hypertonic saline at concentrations greater than 5% alleviated SNL-induced mechanical allodynia and had a significant therapeutic effect, while showing a partial time- and dose-dependent antinociceptive effect on thermal and cold hyperalgesia. However, pretreatment with GABA receptor antagonists inhibited the antinociceptive effect of 5% NaCl. Conclusions: This study indicates that the optimal concentration of hypertonic saline for controlling mechanical allodynia in neuropathic pain is 5%, and that its analgesic effect is related to GABAA and GABAB receptors.

Study on Change of Poly ADP Ribose Polymerase in the Rat with Thrombotic Stroke by Full Wave Cockroft Walton method's Transcranial Magnetic Stimulation

  • Kim, Whi-Young;Kim, Jun-Hyoung
    • Journal of Magnetics
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    • v.19 no.1
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    • pp.20-27
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    • 2014
  • This study examined the relationships between protein expression and Poly ADP ribose polymerase in brain cell death in brains damaged by thrombotic stroke and treated with the Full Wave- Cockroft Walton (FWCW) method of Transcranial Magnetic Stimulation (TMS). The two-way switching element for TMS drove a half-bridge inverter of the current resonance of direct current voltage (+) and direct current voltage (-), and the experiment was conducted by stimulating the mice with thrombotic stroke through a range of pulses. Thrombotic stroke was caused of ligation of the common carotid artery of male SD mice, and blood reperfusion was conducted five minutes later. Protein expression was examined in immune reaction cells, which reacted to an antibody to Poly ADP ribose polymerase in the cerebrum cells, and western blotting. Observations of the PARP changes after thrombotic stroke showed that the number of Poly ADP ribose polymerase reactions were significantly lower (p < 0.05) in the group treated with TMS of the FWCW than the group with thrombotic stroke 24 hours after its onset. The application of FWCW-TMS helped prevent the necrosis of nerve cells and might prevent the brain damage that occurs as a result of thrombotic stroke, and improve the function recovery and disorder of brain cells.

Surgical Repair of Left Ventricular Aneurysm and Postinfarction Ventricular Septal Defect with Myocardial Revascularization (A report of 6 cases] (심근경색후 발생한 좌심실류 및 심실중격결손의 외과적 치료 (6례 보고))

  • 조범구
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.996-1002
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    • 1988
  • A clinical analysis was performed on 115 cases of -patent ductus arteriosus treated surgically during the period of 11 years from Aug. 1977 to Jul. 1988. at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Among 115 cases, male was 38 and female was 77 and ages ranged 12 days to 27 years old with the average of 8 7/12 years. The major clinical symptoms on admission were frequent URI attack[77.4%], dyspnea on exertion[32.2%] and palpitation[13%]. On auscultation, continuous machinery murmurs were detected in 97 cases[84.3%] and loud systolic murmurs were detected in 18 cases[15.7%]. Preoperative electrocardiographic findings were as follows: LVH 59[51.3%], RVH 12[10.4%], BVH 16[13.9%] and WNL 28[24.3%]. Radiologically, there were increased pulmonary vascularity in 104[90.4%] and cardiomegaly 62[53.9%]. Cardiac catheterization were performed in 101 cases and mean systolic pulmonary arterial pressure was 49.84*29.7mmHg and mean Qp/Qs was 2.95k1.8. Methods of operation were multiple ligation in 96, division in 11 and transpulmonary arterial repair using cardiopulmonary bypass in 8. Complication were recannalization in 2, temporary hoarseness due to left recurrent laryngeal nerve paralysis in 3 and respiratory distress in 1 and overall mortality rate was 1.7%[2 cases].

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Penetrating Neck Trauma by Gunshot Injury: 1 Case Report (총상에 의한 경부 관통상 -치험 1례-)

  • Hong, Yoon Joo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.95-99
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    • 2005
  • Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

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Pharmacological interactions between intrathecal pregabalin plus tianeptine or clopidogrel in a rat model of neuropathic pain

  • Lee, Hyung Gon;Kim, Yeo Ok;Choi, Jeong Il;Han, Xue Hao;Shin, Yang Un;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.59-65
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    • 2022
  • Background: There is still unmet need in treating neuropathic pain and increasing awareness regarding the use of drug combinations to increase the effectiveness of treatment and reduce adverse effects in patients with neuropathic pain. Methods: This study was performed to determine the individual and combined effects of pregabalin, tianeptine, and clopidogrel in a rat model of neuropathic pain. The model was created by ligation of the L5-L6 spinal nerve in male Sprague-Dawley rats; mechanical allodynia was confirmed using von Frey filaments. Drugs were administered to the intrathecal space and mechanical allodynia was assessed; drug interactions were estimated by isobolographic or fixed-dose analyses. Results: Intrathecal pregabalin and tianeptine increased the mechanical withdrawal threshold in a dose-dependent manner, but intrathecal clopidogrel had little effect on the mechanical withdrawal threshold. An additive effect was noted between pregabalin and tianeptine, but not between pregabalin and clopidogrel. Conclusions: These findings suggest that intrathecal coadministration of pregabalin and tianeptine effectively attenuated mechanical allodynia in the rat model of neuropathic pain. Thus, pregabalin plus tianeptine may be a valid option to enhance the efficacy of neuropathic pain treatment.