• Archives of Reconstructive Microsurgery
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• 제1권1호
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• pp.39-44
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• 1992

Benign peripheral nerve tumors, although infrequent, must be considered as a possible cause of pain and disability in the extremities. There are three varieties of these tumors that are of clinical importance: neurilemmomas, neurofibromas, and post-traumatic neuroma. Neurilemmomas are the most common primary solitary tumor of the peripheral nerve trunks, and are almost always benign, Neurofibromas may occur as a solitary nerve tumor, but can present as multiple lesions as in von Recklinghausen's disease. Clinically, this tumor may presents as a solitary mass in the subcutaneous tissue which is centrally located with the nerve fibers travelling through the tumor mass. Traumatic neuroma is the proliferation of nerve elements with connective tissue during the process of regeneration from severed nerves undergoing Wallerian degeration, and is therefore not a true neoplasm. A neuroma-in-countinuity is the result of partial severance of a nerve, or of a crushing or traction injury in which all or part of the epineurium and perineurium is intact. We experienced each of the three varieties. With magnification, the neurilemmoma was removed by meticulous dissection from the parent nerve preserving the normal fascicles to which it was attached. The neurofibroma was excised and the nerve was reconstructed with interposed vein graft and the neuroma-in-continuity was excised and reconstructed with sural nerve graft. We report histologic characteristics of each tumors and the methods to repair the nerve defects after tumor excision with brief discussion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.61.1-61.8
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• 2019

Background: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. Methods: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. Results: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. Conclusion: Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.81-84
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• 2011

Purpose: Nerve injury is one of the complication which can develop after brow lift. Peripheral nerve ending which is stretched from supraorbital nerve and supratrochlear nerve can be injured and symptoms such as pain, dysesthesia may appear. Usually, developed pain disappeared spontaneously and does not go on chronic way. We experienced a case that a patient complained chronic pain after brow lift which was not controlled by conservative management such as medications, local nerve block and report a successful surgical treatment of chronic pain after brow lift. Methods: A 24-year-old male who received brow lift with hairline incision at local hospital was admitted for chronic pain at the right forehead. The pain was continued for 3 months even though fixed thread was removed. Local nerve block at trigger point with mixed 1 mL 2% lidocaine and 1 mL Triamcinolone acetonide was done and oral medications, Gabapentine and carbamazepine, were also applied but there was no difference in the degree of pain. Therefore the operation was performed so that careful dissection was carried out at right supraorbital neurovascular bundle and adhered supraorbital nerve was released from surrounding tissues and covered with silastic sheet to prevent adhesion. Results: The pain was gradually relieved for a week. The patient was discharged without complications. No evidence of recurrence has been observed for 2 years. Conclusion: The pain developed after brow lift was engaged with nerve injury and sometimes remains chronically. Many kinds of conservative management to treat this complication such as medications, local nerve block have been reported and usually been used. But there are some chronic cases that conservative treatment do not work. In sum, we report 1 case of successful surgical treatment for relief of intractable pain developed after brow lift surgery.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.306-312
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• 2018

안면 신경의 측두지는 그 해부학적 위치로 인하여 외상성 손상에 취약하며, 이로 인해 환자는 종종 상당한 미용적, 기능적 손실을 경험한다. 나아가 결손이 있는 만성 손상은 신경 이식 등의 추가적인 시술이 필요한 경우가 많기에 급성 손상에 비하여 그 치료가 까다롭다. 본 연구에서는 안면 신경의 측두지 손상 발생으로부터 1개월 후에 지연된 신경 이식을 한 남성 환자의 증례를 다루었다. 우리는 성공적으로 비복 신경을 분할 이식하였으며 환자는 양호한 미용적, 기능적 회복을 보였다.

• Annals of Clinical Neurophysiology
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• 제22권1호
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• pp.19-23
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• 2020

Background: Peripheral nerve injury rarely occurs in patients with rhabdomyolysis. Based on our experience and previous reports, we consider prolonged immobilization a risk factor for the development of peripheral neuropathy in rhabdomyolysis patients. Methods: This study analyzed 28 patients with rhabdomyolysis due to prolonged immobilization. We analyzed their demographic and laboratory data, clinical and imaging findings, and outcomes, and compared these factors between patients with and without neuropathy. Results: Seven of the 28 patients had peripheral neuropathy, including sciatic neuropathy or lumbosacral plexopathy. Compared to those without neuropathy, the patients with neuropathy were younger (p = 0.02), had higher peak creatine kinase (CK) levels (p = 0.02), had higher muscle uptake in bone scans (p = 0.03), and more frequently exhibited abnormal muscle findings in computed tomography (CT) (p = 0.004). Conclusions: Patients with prolonged immobilization-induced rhabdomyolysis and neuropathy had higher CK levels, increased uptake on bone scans, and more-frequent abnormal muscles on CT than those without neuropathy. These findings indicate that peripheral neuropathy is more likely to develop in patients with severe muscle injury.

• 혜화의학회지
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• 제14권1호
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• pp.201-211
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• 2005

Cdc2 kinase is a prototypical cyclin-dependent kinase critical for G2 to M phase cell cycle transition. Yet, its function in the nervous system is largely unknown. Here, we investigated possible role of Cdc2 in axonal regeneration using sciatic nerve system in rat. Cdc2 protein levels and activity were increased in the injured sciatic nerves 3 and 7 days after crush injury and then decreased to basal level 14 days later. Administration of Cdc2 kinase inhibitor roscovitine in vivo at the time of crush injury significantly inhibited axonal regeneration when regrowing axons were analyzed using retrograde tracers. Cdc2 protein levels in cultured Schwann cells which were prepared from sciatic nerves 7 days after crush injury were much higher compared with those from uninjured sciatic nerves, suggesting that Cdc2 protein expression was primarily induced in the Schwann cells. To further investigate Cdc2 function in Schwann cell, we examined changes in cultured Schwann cell proliferation and migration in culture system. Both the number of proliferating Schwann cells and the extent of neurite outgrowth from co-cultured DRG neurons were significantly decreased by Cdc2 inhibitor roscovitine treatment in DRG culture which was prepared from animals with sciatic nerve injury for 7 days. Also, Schwann cell migration in the injured sciatic nerve explant was significantly inhibited by roscovitine treatment. Taken together, the present data suggest that Cdc2 may be involved in peripheral nerve regeneration via Schwann cell proliferation and migration.

• The Journal of Korean Physical Therapy
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• 제19권4호
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• pp.33-41
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• 2007

Purpose: To investigate environmental enrichment and nerve stimulation follows in application times with the change of BDNF & Trk-B receptor in the motor cortex and spinal cord. Methods: Experimental groups were divided into the five groups. Group I: normal control group, Group II: experiment control group, Group III: sciatic never electrical stimulation after MCAO, Group IV: application of only environmental enrichment after MCAO, Group V: never electrical stimulation with environmental enrichment after MCAO. Histologic observation and coronal sections were processed individually in goat polyclonal antibody phosphorylated BDNF and rabbit polyclonal antibody Trk-B receptor. Results: In immunohistochemistric response of BDNF and Trk-B, group II were showed that lower response effect at postischemic 1 days, 3 days, and 7 days. Group V were showed that increase response effect at postischemic 3 days, 7 days and 14 days. Specially showed that the most response effect at postischemic 14 days. In neurobehavioral assessment, group V were significantly difference from other groups on between-subject effects. Conclusion: The above results suggest that combined environmental enrichment with peripheral nerve electrical stimulation in focal ischemic brain injury were more improved that the change of BDNF & Trk-B receptor expression than non treatment.

• 대한물리의학회지
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• 제15권1호
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• pp.43-54
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• 2020

PURPOSE: This study examined the effects of mild-intensity exercise (MIE) and high-intensity interval exercise (HIIE) on the recovery of the motor function over time in sciatic nerve crush injury rats. METHODS: The MIE group ran on a treadmill at a speed of 8.3 m/min to perform low-intensity training with maximum oxygen uptakes ranging from 40 to 50%. The HIIE group ran on the treadmill at a speed of 25 m/min to perform high-intensity training with a maximum oxygen uptake of 80%. The interval training was performed based on a 1:1 work-to-rest ratio. The effects of each form of exercise on the rats' walking abilities following their recovery from the peripheral nerve injuries were evaluated based on the results of behavior tests performed at one and 14 days. RESULTS: According to the test results, the MIE group showed significant improvements in the rats' ankle angle in the initial stance phase, and in the ankle and knee angles in the toe-off phase (p<.05). The HIIE group exhibited significant improvements in the ankle and knee angles in the initial stance phase, SFI(p<.05). CONCLUSION: The state of such patients can be improved by applying the results of this study in that MIE and HIIE on a treadmill can contribute to the recovery of the peripheral nerve and motor skill. In particular, MIE is used as a walking functional training in the toe-off stance phase, while HIIE is suitable in the initial stance stage.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.74-91
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• 2002

This studies to investigate the effects of ultrasound and swimming on the changes of the serum creatine kinase, latate dehydrogenase, aspatate aminotransferase, alanine aminotransferase, alkaline phosphatase, in peripheral nerve and muscle injury rats. The forty Sprague-Dawley adult male rats were assigned to the 4 groups: the experimental groups(3), and the peripheral nerve and muscle injury control group(1). There was made artificial injured by ischial nerve and muscle of each rats the each experimental ultrasound group and swimming group were treated from 3 days after being injuried for the 5 minutes and 10 minutes every day during the 10 days and 16 days respectively. The results were as follows: 1. The activities of creatine kinase, lactate dehydrogenase were significantly decreased on of the ultrasound and swimming groups for 10 days. All experimental group were significantly decreased for 16 days. there were significantly decreased the swimming group and ultrasound group were to the 10 days group. 2. The activities of asparatate aminotransferase, alalnine aminotransferase on the ultrasound group were significantly increased to the injured control group, there were significantly decreased the ultrasound group for 16 days group were to the 10 days group and there were significantly increased the swimming group for 16 days group were to the 10 days group. 3. The activities of alkaline phosphatase changes were no difference all experimental groups, there were significantly increased for 16 days group to the 10 days group. From these results it may be concluded that the effects of the ultrasound and swimming, the changes of the serum activities creatine kinase , lactate dehydrogenase of (; the objective indicates) to the muscle regeneration process of the nerve and muscle injured rats.

• 대한한방내과학회지
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• 제33권2호
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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.