• The Korean Journal of Physiology
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• v.30 no.2
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• pp.289-297
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• 1996

Excitatory amino acids (EAA) are thought to play an important role in producing cell death associated with ischemic and traumatic spinal cord injury. The present study was carried out to determine if the response characteristics of spinal sensory neurons in segments adjacent to degeneration sites induced by EAA are altered following these morphological changes. Intraspinal injections of quisqualic acid (QA) produced neuronal degeneration and spinal cavitation of gray matter. The severity of lesions was significantly attenuated by pretreatment with a non-NMDA antagonist NBQX. In extracellular single unit recordings, dorsal horn neurons in QA injected animal showed the increased mechanosensitivity, which included a shift to the left in the stimulus-response relationship, an increased background activity and an increase in the duration of after-discharge responses. Neuronal responses, especially the C-fiber response, to suprathreshold electrical stimulation of sciatic nerve also increased in most cases. These results suggest that altered functional states of neurons may be responsible for sensory abnormalities, e.g. allodynia and hyperalgesia, associated with syringomyolia and spinal cord injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.53-60
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• 2002

Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.188-192
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• 2002

Unilateral vocal cord palsy which is associated with laryngeal trauma is not uncommon event. In a 42-year-old male, a cricoid cartilage fracure had been developed after blunt trauma. The endoscopic findings showed contusion and diffuse swelling around the left arytenoid and false cord. During phonation, the mobility of left side true vocal cord was decreased. There were no level difference and displacement of the left side arytenoid. We used the laryngeal electromyography (LEMG) to make a differential diagnosis between the cricoarytenoid joint dislocation and the injury of recurrent laryngeal nerve. At the right thyroarytenoid muscle and cricothyroid muscle, the findings of LEMG were normal. But the amplitude and frequency during phonation were decreased (partial denervation) at the left thyroarytenoid muscle. LEMG is a very useful method to predict the diagnosis of vocal cord palsy.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.277-280
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• 2009

Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin (acetylsalicylic acid). In addition, partial evacuation and waiting for the resorption of the hematoma may help to prevent damage to the 7th and 8th cranial nerves.

• Proceedings of the PSK Conference
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• 2003.10b
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• pp.188.2-188.2
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• 2003

Large-conductance $Ca^{2+}$ activated potassium channels $(BK_{ca})$ are widely distributed and play key roles in various cell functions. In nerve cells, B $K_{ca}$ channels shorten the duration of action potentials and block $Ca^{2+}$ entry thereby repolarizing excitable cells after excitation. $(BK_{ca})$ channel opening has been postulated to confer neuroprotection during stroke and has attracted attention as a means for therapeutic intervention in asthma, hypertension, convulsion, and traumatic brain injury. (omitted)

• Physical Therapy Korea
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• v.29 no.3
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• pp.241-248
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• 2022

Background: The PyeongChang 2018 Winter Paralympic Games (WPG) being one of the most successful Paralympic Games (PG) in modern athletic world history, hosted the largest number of elite athletes representing 49 National Paralympic Committees (NPCs). Objects: The present investigation highlighted the demographic and clinical characteristics of injured athletes and non-athletes and the physiotherapy services provided during the PyeongChang 2018 WPG. Methods: Prospective descriptive epidemiology study, in which the study group comprised of 201 participants (51 athletes and 150 non-athletes) who were admitted to and utilized the polyclinic physiotherapy service of 2018 PyeongChang WPG in Physiotherapy Department of Paralympic Village from March 1, 2018 to March 20, 2018. Results: Qualitative frequency analysis of injury type demonstrated highest number of chronic injuries (51%, n = 100) in athletes and non-athletes. Anatomical injury site analysis revealed that the spine and shoulder areas were affected with equal frequency for athletes (54.9%, n = 14), whereas for non-athletes, the frequencies of spine and shoulder area injuries were 36.7% (n = 55) and 26% (n = 39), respectively. The Pyeongchang WPG showed a high rate of athletes visiting the physiotherapy service during the pre-competition period (33.3%, n = 50), which may have led to smaller incidence rate of traumatic injury. The physiotherapy treatment service analysis demonstrated that manual therapy (35.4%, n = 230) was most commonly utilized, followed by transcutaneous electrical nerve stimulation/interference current therapy (TENS/ICT), therapeutic massage and therapeutic exercise. Conclusion: We established the importance of prophylactic and preventive physiotherapy services to reduce the risk of sports injuries during WPG.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.145-157
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• 2017

Purpose: We accessed epidemioloy of 908 acute burns (7 years) in the military, of injuries and propose proper educational programs to suit community. Methods: We surveyed burn demographics, circumstances of injuries, size, result of treatment. Results: The mean age was 20.6 years. The flame burns (FB) (325, 35.8%) were most common, followed scald (SB) (305, 33.6%), contact (CB) (219, 24.1%), electric (EB) (45, 5.0%) and chemical burns (ChB) (14, 1.5%). The more occurred during winter (29.7%). SB had mean 3.9% total body surface area (TBSA). The 251 (82.3%) had superficial burns by spillage of hot water/food on lower limbs (45.6%), feet (33.8%) in summer (34.8%), treated with simple dressing (92.8%). Morbidity rate was 5.6%; post traumatic stress disease (PTSD) (0.7%). FB had large wound (9.3% TBSA). The 209 (64.3%) had superficial burns by ignition to flammable oils (31.7%) and bomb powders (29.2%) on head/neck (60.3%), hands (58.6%) in summer (31.7%), autumn (30.2%). They underwent simple dressing (83.4%) and skin graft (16.0%). Morbidity rate was 18.8%; PTSD (10.5%), inhalation injuries (4.0%), corneal injury (3.7%), amputations (0.9%), and mortality rate (1.2%). CB had small (1.1% TBSA), deep burns (78.5%) by hotpack (80.4%) on lower limbs (80.4%). The more (59.8%) underwent skin graft. EB had 6.8% TBSA. The 29 (64.4%) had superficial burns by touching to high tension cable (71.1%) on hand (71.1%), upper limbs (24.4%) in autumn (46.8%). They underwent simple dressing (71.1%) and skin graft (24.4%). They showed high morbidity rate (40.0%); loss of consciousness (13.3%), nerve injuries (11.1%), neuropathy (8.9%), amputations (2.2%), and mortality rate (2.2%). Conclusions: The cook should wear apron over the boots during work. The lighter or smoking should be strictly prohibited during work with flammable liquids or bomb powders. Don't directly apply hotpack to skin for a long time. Use insulating glove during electric work. Keep to the basic can prevent severe injury and proper education is important.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1094-1102
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• 2001

Objective : During the trans-condylar or trans-jugular approach for the lesion of cranio-cervical junction(CCJ), its necessary to identify the accurate locations of vertebral artery(VA), internal jugular vein(IJV) and its related lower cranial nerves. These neurovascular structures can also be damaged during the operation for vascular tumor or traumatic aneurysm around extra-jugular foramen, because of their changed locations. To reduce the neurovascular injury at the operation for CCJ, morphometric relationship of its surrounding neurovascular structures based on the tip of the transverse process of atlas(C1 TP), were studied. Materials & Methods : Using 10 adult formalin fixed cadavers, tip of mastoid process(MT) and TPs of atlas and axis were exposed bilaterally after removal of occipital and posterior neck muscles. Using standard caliper, the distances were measured from the C1 TP to the following structures : 1) exit point of VA from C1 transverse foramen, 2) branching point of muscular artery from VA, 3) entry point of VA into posterior atlanto-occipital membrane(AOM), 4) branching point of C-1 nerve. In addition, the distances were measured from the mid-portion of the posterior arch of atlas to the entry point of the VA into AOM and to the exit point of the VA from C1 transverse foramen. After removal of the ventrolateral neck muscles, neurovascular structures were exposed in the extra-jugular foraminal region. Distances were then measured from the C1 TP to the following structures : 1) just extra-jugular foraminal IJV and lower cranial nerves, 2) MT and branching point of facial nerve in parotid gland. In addition, distance between MT and branching point of facial nerve was measured. Results : The VA was located at the mean distance of 12mm(range, 10.5-14mm) from the C1 transverse foramen and entered into the AOM at the mean distance of 24mm(range, 22.8-24.4mm) from the C1 TP. The mean distance from the mid portion of the C1 posterior arch was 20.6mm(range, 19.1-22.3mm) to the entry point of the VA into AOM and 38.4mm(range, 34-42.4mm) to the exit point of the VA from C1 transverse foramen. Muscular artery branched away from the posterior aspect of the transverse portion of VA below the occipital condyle at the mean distance of 22.3mm(range, 15.3-27.5mm) from the C1 TP. The C-1 nerve was identified in all specimens and ran downward through the ventroinferior surface of the transverse segment of VA and branched at the mean distance of 20mm(range, 17.7-20.3mm) from the C1 TP. The IJV was located at the mean distance of 6.7mm(range, 1-13.4mm) ventromedially from the lateral surface of the C1 TP. The XI cranial nerve ran downward on the lateral surface of the IJV at the mean distance of 5mm(range, 3-7.5mm) from the C1 TP. Both IX and X cranial nerves were located in the soft tissue between the medial aspect of the internal carotid artery(ICA) and the medial aspect of the IJV at the mean distance of 15.3mm(range, 13-24mm) and 13.7mm(range, 11-15.4mm) from the C1 TP, respectively. The IX cranial nerve ran downward ventroinferiorly crossing the lateral aspect of the ICA. The X cranial nerve ran downward posteroinferior to the IX cranial nerve and descended posterior to the ICA. The XII cranial nerve was located between the posteroinferior aspect of the IX cranial nerve and the posterior aspect of the ICA at the mean distance of 13.3mm(range, 9-15mm) ventromedially from the C1 TP. The distance between MT and C1 TP was 17.4mm(range, 12.5-23.9mm). The VII cranial nerve branched at the mean distance of 10.2mm(range, 6.8-15.3mm) ventromedially from the MT and at the mean distance of 17.3mm(range, 13-21mm) anterosuperiorly from the C1 TP. Conclusion : This study facilitates an understanding of the microsurgical anatomy of CCJ and may help to reduce the neurovascular injury at the surgery around CCJ.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.16-22
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• 1995

We analyzed 11 children who underwent epiphyseal transplantation to the forearm for manage growing deformity ranged from 2 years 6 months to years(average 5 years 10 months) follow-up period. Etiologies of the functional impairment of the eleven were five traumatic, three congenital and three tumorous conditions. Lesions of epiphysis were distal radius in eight patients and distal ulna in three patients. Operation was performed with removal of non-functioning or deformed epiphysis followed by transplantation of free vascularized proximal fibular epiphysis with microvascular anastomesis. Evaluation was performed radiologically and functionally. The 9(81.8%) patients showed growth of transplanted epiphysis by radiological examination during follow up. At the last follow up, average growth rate was 0.86cm per year excepts 2 cases of no growth. Active wrist motion near normal to contralateral joint was achieved in 7 patients. In other 2 patients, active joint motion was improved but weaker than contralateral joint. Complications on donor site were two transient peroneal nerve palsy which have been resolved after 2 and 5 months post operation and one valgus ankle deformity. The ankle deformity was corrected with $Langenski\"{o}ld$ operation of the dital tibiofibular fusion. At recipient site, there was one superficial infection and it was easily controlled by systemic antibiotics. Many subsequent reports have described successful nonvascularized epiphyseal transplante, but overall results have been inconsistent and unsatisfactory. Other experimental and clinical studies in the transfer of vascularized epiphyses has encourage its clinical application. We also could gel successful growth in several cases with free vascularized epiphyseal transplantation.