• The Korean Journal of Pain
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• 제35권1호
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• pp.66-77
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• 2022

Background: Thrombospondin-4 (TSP4) upregulates in the spinal cord following peripheral nerve injury and contributes to the development of neuropathic pain (NP). We investigated the effects of cyanocobalamin alone or in combination with morphine on pain and the relationship between these effects and spinal TSP4 expression in neuropathic rats. Methods: NP was induced by chronic constriction injury (CCI) of the sciatic nerve. Cyanocobalamin (5 and 10 mg/kg/day) was administered 15 days before CCI and then for 4 and 14 postoperative days. Morphine (2.5 and 5 mg/kg/day) was administered only post-CCI. Combination treatment included cyanocobalamin and morphine, 10 and 5 mg/kg/day, respectively. All drugs were administered intraperitoneally. Nociceptive thresholds were detected by esthesiometer, analgesia meter, and plantar test, and TSP4 expression was assessed by western blotting and fluorescence immunohistochemistry. Results: CCI decreased nociceptive thresholds in all tests and induced TSP4 expression on the 4th postoperative day. The decrease in nociceptive thresholds persisted except for the plantar test, and the increased TSP4 expression reversed on the 14th postoperative day. Cyanocobalamin and low-dose morphine alone did not produce any antinociceptive effects. High-dose morphine improved the decreased nociceptive thresholds in the esthesiometer when administered alone but combined with cyanocobalamin in all tests. Cyanocobalamin and morphine significantly induced TSP4 expression when administered alone in both doses for 4 or 14 days. However, this increase was less when the two drugs are combined. Conclusions: The combination of cyanocobalamin and morphine is more effective in antinociception and partially decreased the induced TSP4 expression compared to the use of either drug alone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.375-395
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• 2006

Purpose: Lingual nerve (LN) damage may be caused by either tumor resection or injury such as wisdom tooth extraction, Although autologous nerve graft is sometimes used to repair the damaged nerve, it has the disadvantage of necessity of another operation for nerve harvesting. Moreover, the results of nerve grafting is not satisfactory. The nerve growth factor (NGF) is well-known to play a critical role in peripheral nerve regeneration and its local delivery to the injured nerve has been continuously tried to enhance nerve regeneration. However, its application has limitations like repeated administration due to short half life of 30 minutes and an in vivo delivery model must allow for direct and local delivery. The aim of this study was to construct a well-functioning $rhNGF-{\beta}$ adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with enhanced and extended secretion of hNGF from the injured nerve by injecting $rhNGF-{\beta}$ gene directly into crush-injured LN in rat model. Materials and Methods: $hNGF-{\beta}$ gene was prepared from fetal brain cDNA library and cloned into E1/E3 deleted adenoviral vector which contains green fluorescence protein (GFP) gene as a reporter. After large scale production and purification of $rhNGF-{\beta}$ adenovirus, transfection efficiency and its expression at various cells (primary cultured Schwann cells, HEK293 cells, Schwann cell lines, NIH3T3 and CRH cells) were evaluated by fluorescent microscopy, RT-PCR, ELISA, immunocytochemistry. Furthermore, the function of rhNGF-beta, which was secreted from various cells infected with $rhNGF-{\beta}$ adenovirus, was evaluated using neuritogenesis of PC-12 cells. For in vivo evaluation of efficacy of $rhNGF-{\beta}$ adenovirus, the LNs of 8-week old rats were exposed and crush-injured with a small hemostat for 10 seconds. After the injury, $rhNGF-{\beta}$ adenovirus($2{\mu}l,\;1.5{\times}10^{11}pfu$) or saline was administered into the crushed site in the experimental (n=24) and the control group (n=24), respectively. Sham operation of another group of rats (n=9) was performed without administration of either saline or adenovirus. The taste recovery and the change of fungiform papilla were studied at 1, 2, 3 and 4 weeks. Each of the 6 animals was tested with different solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) by two-bottle test paradigm and the number of papilla was counted using SEM picture of tongue dorsum. LN was explored at the same interval as taste study and evaluated electro-physiologically (peak voltage and nerve conduction velocity) and histomorphometrically (axon count, myelin thickness). Results: The recombinant adenovirus vector carrying $rhNGF-{\beta}$ was constructed and confirmed by restriction endonuclease analysis and DNA sequence analysis. GFP expression was observed in 90% of $rhNGF-{\beta}$ adenovirus infected cells compared with uninfected cells. Total mRNA isolated from $rhNGF-{\beta}$ adenovirus infected cells showed strong RT-PCR band, however uninfected or LacZ recombinant adenovirus infected cells did not. NGF quantification by ELISA showed a maximal release of $18865.4{\pm}310.9pg/ml$ NGF at the 4th day and stably continued till 14 days by $rhNGF-{\beta}$ adenovirus infected Schwann cells. PC-12 cells exposed to media with $rhNGF-{\beta}$ adenovirus infected Schwann cell revealed at the same level of neurite-extension as the commercial NGF did. $rhNGF-{\beta}$ adenovirus injected experimental groups in comparison to the control group exhibited different taste preference ratio. Salty, sweet and sour taste preference ratio were significantly different after 2 weeks from the beginning of the experiment, which were similar to the sham group, but not to the control group.

• 혜화의학회지
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• 제15권2호
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• pp.181-186
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• 2006

Peripheral axons in vertebrate animals can regenerate after nerve injury and accomplish its functional recovery. Numerous studies have revealed that diverse molecular factors are induced during axonal regeneration and their potential roles in axonal regeneration have been studied. Examples is N-CAM, L1, P0, nerve growth factors, GAP-43 and so forth. However, most of the studies on axonal regeneration have been primarily focused on axon fiber regrowth and elucidating molecular factors, and relatively less is known about functional recovery. Also, specific drugs or drug components used in the oriental medicine in relation to nerve fiber regeneration have not been known. And thus, in the present, a study on the effect of Yukmijihwang-tang components and Yukmijihwang-tang extracts to regeneration of peripheral axon fiber is underway by immunofluorescence staining. Therefore, this prior application of Yukmijihwang-tang with documents consideration is reported with a plea for further investigation.

• The Korean Journal of Pain
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• 제4권2호
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• pp.186-190
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• 1991

Causalgia is an extremely incapacitating disease often associated with a major peripheral nerve injury, which is characterized by sustained diffuse burning pain, allodynia and hyperpathia. The condition follows traumatic nerve lesions, often combined with vasomotor and sudomotor disturbances and later trophic changes. While sympathectomy has been the classical treatment of causalgia, others nonsurgical therapies such as regional sympathetic block, IV regional sympathetic block, oral adrenolytic drugs, transcutaneous electrical nerve simulation, physical theraphy, cryotheraphy and psychotheraphy have been used. Causalgia is rare in children and early treatment is controversial because of the possibility of many different complications following aggressive treatment. This is a report of a 6-year-old girl with causalgia suffered after a right posterior tibial nerve injury following an intragluteal injection of an antipyretics. We successfully treated this syndrome with continuous epidural block using 0.5% lidocaine and no specific complication was encountered.

• Annals of Clinical Neurophysiology
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• 제5권2호
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• pp.192-196
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• 2003

The Lateral dorsal cutaneous branch of sural nerve (LDCB) is a terminal sensory branch of lower extremities. It can be injured frequently in peripheral nerves. However, the normal data of each component of nerve conduction study (NCS) of were not studied at this time. The Nerve Conduction Study of LDCB adults were assessed for amplitude, area, duration and nerve conduction velocity (NCV) in normal fifty. We also evaluated how age, sex and dexterity affect the various components of NCS. The Mean amplitude of LDCB was $9.45{\pm}1.93{\mu}V$, area was $4.05{\pm}0.55{\mu}V/s$, duration was $1.50{\pm}0.13s$, and NCV was $37.9{\pm}3.09m/s$, respectively. The amplitude of right was $10.1{\mu}V$ in men, $8.65{\mu}V$ in women. The area of right was $3.83{\mu}V/s$ in less than 40 years and $4.24{\mu}V/s$ in older than 40 years. The areas of left was $3.86{\mu}V/s$ in less than 40 years and $4.30{\mu}V/s$ in older than 40 years. The NCV was 39.0 m/s in less than 40 years and 36.7 m/s in older than 40 years. All of above differences were statistically significant. There were no statistically significant differences between right and left NCS. Normal data of LDCB could be applicable in peripheral neuropathy or nerve injury.

• Annals of Clinical Neurophysiology
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• 제24권2호
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• pp.35-45
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• 2022

Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권1호
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• pp.1-16
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• 2004

The use of artificial nerve conduit containing viable Schwann cells is one of the most promising strategies to repair the peripheral nerve injury. To fabricate an effective nerve conduit whose microstructure and internal environment are more favorable in the nerve regeneration than existing ones, a new three-dimensional Schwann cell culture technique using $Matrigel^{(R)}$. and dorsal root ganglion (DRG) was developed. Nerve conduit of three-dimensionally arranged Schwann cells was fabricated using direct seeding of freshly harvested DRG into a $Matrigel^{(R)}$ filled silicone tube (I.D. 1.98 mm, 14 mm length) and in vitro rafting culture for 2 weeks. The nerve regeneration efficacy of three-dimensionally cultured Schwann cell conduit (3D conduit group, n=6) was assessed using SD rat sciatic nerve defect of 10 mm, and compared with that of silicone conduit filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method (2D conduit group, n=6). After 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were examined using image analyzer and electromicroscopic methods. The SFI and ankle stance angle (ASA) in the functional evaluation were $-60.1{\pm}13.9$, $37.9^{\circ}{\pm}5.4^{\circ}$ in 3D conduit group (n=5) and $-87.0{\pm}12.9$, $32.2^{\circ}{\pm}4.8^{\circ}$ in 2D conduit group (n=4), respectively. And the myelinated axon was $44.91%{\pm}0.13%$ in 3D conduit group and $13.05%{\pm}1.95%$ in 2D conduit group to the sham group. In the TEM study, 3D conduit group showed more abundant myelinated nerve fibers with well organized and thickened extracellular collagen than 2D conduit group, and gastrocnemius muscle and biceps femoris tendon in 3D conduit group were less atrophied and showed decreased fibrosis with less fatty infiltration than 2D conduit group. In conclusion, new three-dimensional Schwann cell culture technique was established, and nerve conduit fabricated using this technique showed much improved nerve regeneration capacity than the silicone tube filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method.

• 대한간호학회지
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• 제39권5호
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• pp.632-640
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• 2009

Purpose: The purpose of this study was to examine the effect of DHEA (Dehydroepiandrosterone) on muscle weight and Type I and II fiber cross-sectional area of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The DHEA group (n=10) had DHEA injections daily for 14 days, and the Vehicle group (n=10) had vehicle injections daily for 14 days. Withdrawal threshold, body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected from the both hindlimbs. Body weight, food intake, activity, muscle weight and Type I, II fiber cross-sectional area of the dissected muscles were measured. Results: The DHEA group showed significant increases (p<.05), as compared to the vehicle group for muscle weight of the unaffected plantaris, and in Type II fiber cross-sectional area of the gastrocnemius muscle. The DHEA group demonstrated a higher pain threshold than the vehicle group whereas total diet intake and activity score were not significantly different between the two groups. Conclusion: DHEA administration for 14 days attenuates unaffected plantaris and gastrocnemius muscle atrophy.

• 대한간호학회지
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• 제40권5호
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• pp.611-619
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• 2010

The purpose of this study was to examine the effects of exercise on muscle weight and Type I and II fiber cross-sectional area of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The Pain+Exercise (PE) group (n=21) and the Sham+Exercise (SE) group (n=20). All rats had 28 sessions of treadmill exercise at grade 10 for 30 minutes, twice/day at 10 m/min for 14 days. Body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected. Muscle weight and Type I, II fiber cross-sectional area of the dissected muscles were measured. Results: The PE group showed significant increases (p<.05), as compared to the SE group for body weight and total diet intake, muscle weight of the unaffected soleus and plantaris, and in Type I and II fiber cross-sectional area of unaffected three muscles and affected plantaris. Conclusion: Exercise for 14 days attenuates unaffected soleus, plantaris and gastrocnemius muscle atrophy in neuropathic pain model.

• The Korean Journal of Pain
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• 제31권1호
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• pp.54-57
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• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.