• The Korean Journal of Physiology and Pharmacology
• /
• v.22 no.5
• /
• pp.539-546
• /
• 2018

Botulinum toxin type A (BoNT/A) has been used therapeutically for various conditions including dystonia, cerebral palsy, wrinkle, hyperhidrosis and pain control. The substantia gelatinosa (SG) neurons of the trigeminal subnucleus caudalis (Vc) receive orofacial nociceptive information from primary afferents and transmit the information to higher brain center. Although many studies have shown the analgesic effects of BoNT/A, the effects of BoNT/A at the central nervous system and the action mechanism are not well understood. Therefore, the effects of BoNT/A on the spontaneous postsynaptic currents (sPSCs) in the SG neurons were investigated. In whole cell voltage clamp mode, the frequency of sPSCs was increased in 18 (37.5%) neurons, decreased in 5 (10.4%) neurons and not affected in 25 (52.1%) of 48 neurons tested by BoNT/A (3 nM). Similar proportions of frequency variation of sPSCs were observed in 1 and 10 nM BoNT/A and no significant differences were observed in the relative mean frequencies of sPSCs among 1-10 nM BoNT/A. BoNT/A-induced frequency increase of sPSCs was not affected by pretreated tetrodotoxin ($0.5{\mu}M$). In addition, the frequency of sIPSCs in the presence of CNQX ($10{\mu}M$) and AP5 ($20{\mu}M$) was increased in 10 (53%) neurons, decreased in 1 (5%) neuron and not affected in 8 (42%) of 19 neurons tested by BoNT/A (3 nM). These results demonstrate that BoNT/A increases the frequency of sIPSCs on SG neurons of the Vc at least partly and can provide an evidence for rapid action of BoNT/A at the central nervous system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.6
• /
• pp.263-268
• /
• 2013

Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

• Journal of Haehwa Medicine
• /
• v.10 no.1
• /
• pp.269-286
• /
• 2001

Objectives : This Investigation was aimed to find out the Classification of Cause and the Effect of Acupuncture and Moxibustion Treatment for Dentalgia Methods : We surveyed the oriental medical books from $\ll$HungTiNeiChing$\gg$ to recent published books concerning the Acupuncture therapy for Dentalgia Results : 1. Since the time of $\ll$HungTiNeiChing$\gg$ there was called "yateng", "yatong", "chiyaqutong", "kouchitong", "nichi", "chichong", "fengchi", "chongshitong", "chongshiyachi", "chifengzhongtong", "chiyinzhong", "yachuangzhongtong" 2. The Oriental Medical cause of Dentalgia are fire, wind, cold, blood stasis, stomach-heat, phlegm, difficiency of kidney, late snack, insect and wound, and then the Western Medical cause are cacodontia, periodontal disease, trigeminal nerve pain, stress 3. The meridians used for the treatment are large intestine, stomach, triple warmer, gallbladder and small intestine 4. The most frequently used acupuncture point for the treatment are Hapkok(LI3), Naejong(S44), Hyopko(S6), Igan(LI2), Sohae(H3), Yanggok(SI5), Hagan(S7), Taeyong(S5), Samgan(LI3), Kokehi(LI11) 5. The most frequently used moxibustion for the treatment are Sungjang(CV24), Yolgyol(L7), Kyonu(LI15), Taeyon(L9), Hapkok(LI3) 6. In the superior dental pain there commonly used the acupuncture point of stomach meridian, triple warmer meridian, gallbladder meridian in the inferior dental pain there commonly used the acupuncture point of large intestine meridian. 7. The most frequently used acupuncture point for the superior dental pain are Naejong(ST44), Yanggok(SI5), Chongnyong(G17), Kakson(TE20), In the inferior detal pain there are Taeyong(S5), Hapkok(LI3), Igan(LI2), Sangyang(LI1), Samgan(LI3) 8. In the treatment of dental pain The Acupuncture therapy utilized the division of region are the Erzhen therapy(耳針療法), the Touzhen therapy(頭鍼療法), the Shouzhen therapy(手鍼療法), the Zuzhen therapy(足鍼療法), the Bizhen therapy(鼻針療法), the Wanhuaizhen therapy 9. In dental pain the other therapy are the Taozhen therapy(陶鍼療法), the Pifuzhen therapy(皮膚針療法), the Dianzhen therapy(電鍼療法), the Yaozhen therapy(藥針療法).

• Restorative Dentistry and Endodontics
• /
• v.25 no.3
• /
• pp.407-420
• /
• 2000

삼차신경절의 뉴런이 구강악안면영역에서의 촉각, 입각, 온도각 및 통각 등 다양한 감각을 중추신경계로 전달하는 역할을 하는 것은 주지의 사실이다. 이러한 신경전달에 있어서 이온통로는 감각정보를 전달하는데 핵심적인 역할을 수행하며 특히 소디움 통로는 활동전위의 발생에 중요하다. 소디움 통로는 tetrodotoxin-sensitive(TTX-s) 및 tetrodotoxin-resistant(TTX-r) 통로로 나누어지는 데 이 중 TTX-r 통로에 발생되는 tetrodotoxin-resistant sodium current(TTX-r $I_{Na}$)는 capsaicin에 민감한 일차구심신경세포에서 유해자극에 의해 통각신호를 발생시키고 전달하는데 중요하다. 또한 칼슘 통로는 시냅스 전도에 있어서 필수적인 역할을 수행하고 있다 한편 치과영역에서 치수의 진정 목적으로 eugenol이 흔히 사용되고 있다. 그러나 eugenol의 그 작용 기전에 대해서 현재까지 이온 통로에 대한 상세한 결과가 없는 실정이며 최근의 보고에 의하면 eugenol이 capsaicin 수용기를 통하여 감각신경에 대한 억제작용을 나타낸다고 한다. 따라서 본 실험은 eugenol과 capsaicin이 흰쥐의 삼차신경절의 TTX-r $I_{Na}$와 칼슘통로에 어떠한 영향을 미치는지를 알아보고 eugenol이 capsaicin 수용기를 통하여 작용하는지를 검증하고자 시행되었다. 삼차신경절 뉴런은 100~150g의 흰쥐의 삼차신경절로부터 외과적으로 절제하여 통법의 화학적 및 기계적 처리를 통해 단일세포로 분리하였고 이를 whole-cell patch clamp 방법을 이용하여 시행한 바 다음과 같은 결론을 얻었다. 1. 1mM의 dugenol은 흰쥐 삼차신경절 뉴런의 TTX-r $I_{Na}$와 HVA $I_{Ca}$를 억제하였다. 2. $1{\mu}m$의 capsaicin은 흰쥐 삼차신경절 뉴런의 TTX-r $I_{Na}$와 HVA $I_{Ca}$를 억제하였다. 3. Capsazepine은 capsaicin의 HVA $I_{Ca}$에 대한 억제작용을 차단하였다. 4. Capsazepine은 capsaicin의 HVA $I_{Ca}$에 대한 억제작용을 차단하지 못하였다. 결론적으로 eugenol과 capsaicin은 tetrodotoxin-resistant sodium current(TTX-r $I_{Na}$)와 high voltage-activated calcium current(HVA $I_{Ca}$)를 모두 억제하는 것으로 나타났으며, 이러한 작용이 통각의 발생과 시냅스 전달과정을 차단하여 치수 진정 목적으로 많이 사용하는 eugenol의 작용기전으로 판단된다. 한편 capsaicin의 길항제인 capsazepine을 전처치하였을 때에도 eugenol의 HVA $I_{Ca}$에 대한 억제효과는 변화가 없었다. 이와같은 결과로 보아 HVA $I_{Ca}$에 관한 한 eugenol은 capsaicin 수용기를 통하여 나타나지 않는 것으로 사료된다.

• Journal of Acupuncture Research
• /
• v.18 no.2
• /
• pp.51-66
• /
• 2001

The purpose of this morphological studies was to investigate the central neural pathway projecting to the acupoints $B_{62}$ and $K_6$ using the neuroanatomical method following injection of transsynaptic neurotropic virus, pseudorabies virus(PRV-Ba and PRV-Ga) into the $B_{62}$ and $K_6$. After survival times of 96 hours following injection into the twenty rats with PRV-Ba(Bartha strain) and PRV-Ga(Bartha strain, ${\beta}$-galacidodase insertion). They were perfused, and their spinal cord and brain were frozen sectioned($30{\mu}m$). These sections were stained by X-gal histochemical and PRV immunohistochemical staining method, and observed with light microscope. The results were as follows : 1. In spinal cord, overlaped PRV-Ba and PRV-Ga labeled neurons projecting to the $B_{62}$ and $K_6$ were founded in thoracic, lumbar and sacral spinal segments. In thoracic spinal segments, Densely labeled areas were founded in lamina IV, V, VII(intermediolateral nucleus) and X areas. In lumbar segemnts, labeled areas were founded in lamina II, IV, V and X areas. In sacral spinal segments, labeled areas were founded in lamina IV, V and VI areas. 2. In brain, overlaped PRV-Ba and PRV-Ga labeled neurons projecting to the $B_{62}$ and $K_6$ were founded in the $A_1$ noradrenalin cells/$C_1$ adrenalin cells/caudoventrolateral reticular nucleus, rostroventrolateral reticular nuclens, nucleus tractus solitarius, area postrema, raphe obscurus nucleus, raphe paltidus nucleus, raphe magnus nucleus, lateral paragigantoceltular nucleus, lateral rcticular nucleus, gigantocellular nucleus, locus coeruleus, subcoeruleus nucleus, motor trigeminal nucleus, Kolliker-Fuse nucleus, $A_5$ cell group, central gray matter, oculomotor nerve, paraventricular hypothalamic nucleus, median eminence, amygdaloid nucleus, frontal cortex, forelimb area, hindlimb area, 1, 2 areas of parietal cortex and granular and agranular cortex. This results were suggest that overlaped PRV-Ba and PRV-Ga labeled areas projecting to the $B_{62}$ and $K_6$ may be related to the emotional relay pathway in the central autonomic center.

• International Journal of Oral Biology
• /
• v.34 no.1
• /
• pp.1-6
• /
• 2009

The purpose of the present study was to examine the role of peripheral nitric oxide (NO) pathways in the onset of interleukin (IL)-1$\beta$-induced mechanical allodynia in the orofacial area. Experiments were carried out on male Sprague-Dawley rats weighing 230-280 gm and surgical procedures were performed under pentobarbital sodium (40 mg/kg, i.p.). Under anesthesia, a polyethylene tube (PE10) was implanted into the subcutaneous area of one vibrissa pad, which enabled the injection of IL-1$\beta$ or other chemicals. We subcutaneously injected 50 ${\mu}L$ of IL-1$\beta$ into a vibrissa pad through the implanted polyethylene tube with a 100 ${\mu}L$ Hamilton syringe. After the administration of 0.01, 0.1, 1, or 10 pg of IL-1$\beta$, withdrawal behavioral responses were examined. The subcutaneous injection of saline had no effects on the air-puff thresholds. Following the subcutaneous injection of 0.01, 0.1, 1, or 10 pg of IL-1$\beta$, the threshold of air puffs decreased significantly to 12 $\pm$ 3, 7 $\pm$ 2, 5 $\pm$ 1, or 5 $\pm$ 1 psi, respectively, in a dose dependent manner. Pretreatment with L-NAME, a nitric oxide synthase (NOS) inhibitor, blocked IL-1$\beta$-induced mechanical allodynia. However, neither D-NAME, an inactive isomer of L-NAME, nor vehicle affected the IL-1$\beta$-induced mechanical allodynia. Subcutaneous injection of IL-1$\beta$ increased the number of c-fos-like immunoreactive neurons, whereas pretreatment with L-NAME decreased this number, in the trigeminal caudal nucleus. These results suggest that pro-inflammatory cytokines and NO are important contributors to the pathogenesis of persistent and exaggerated IL-1$\beta$-induced pain states. Based on these observations, peripheral application of NOS inhibitors may be of therapeutic value in treating pain disorders in the clinic.

• Journal of Microbiology
• /
• v.43 no.5
• /
• pp.430-436
• /
• 2005

In this study, the prevalence and quantity of a latent pseudorabies virus (PrV) infection in the nervous tissues of randomly selected pigs was determined via nested and real-time PCR. The nervous tissues, including the trigeminal ganglion (TG), olfactory bulb (OB), and brain stem (BS), were collected from the heads of 40 randomly selected pigs. The majority of the nervous tissues from the selected pigs evidenced a positively amplified band on nested PCR. In particular, nested PCR targeted to the PrV glycoprotein B (gB) gene yielded positive results in all of the BS samples. Nested PCR for either the gE or gG gene produced positive bands in a less number of nervous tissues ($57.5\%$ and $42.5\%$, respectively). Real-time PCR revealed that the examined tissues harbored large copy numbers of latent PrV DNA, ranging between $10^{0.1}\;and\;10^{7.2}(1-1.58{\times}10^7)$ copies per $1{\mu}g$ of genomic DNA. Real-time PCR targeted to the PrV gE gene exhibited an accumulated fluorescence of reporter dye at levels above threshold, thereby indicating a higher prevalence than was observed on the nested PCR ($100\%$ for BS, $92\%$ for OB, and $85\%$ for TG). These results indicate that a large number of farm-grown pigs are latently infected with a field PrV strain with a variety of copy numbers. This result is similar to what was found in association with the human herpes virus.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.85-90
• /
• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.120-123
• /
• 2001

Objectives : The present study was performed to analyze results of hydroxyurea treatment for unresectable and recurrent meningiomas as adjuvant chemotherapeutic agent. Material and Methods : Among 87 cases of meningioma patients who treated surgically between Jauary 1988 and December 1997 in our department, unresectable and recurrent cases were 4 cases. Histologically, 3 cases were meningothelial type, 1 case was angiomatous type. Tumor orgin was cerebellopontine angle(CPA) in 3 cases, cavernous sinus in 1 case. Three of 4 cases received radiation treatment. All patients received a daily dosage of 20mg/kg/day of hydroxyurea. Hematological monitorning was performed monthly and tumor measurement was assessed by MR imaging before treatment and every 6 months. Mean follow-up period was 34 months. Rerults : All cases showed no enlargement of tumor mass without any shrinkage. Trigeminal neuralgia in 1 case was improved and external herniation of brain on craniectomy site in 1 case was shrunken. None of the patients had any serious side effects. White blood cell count fell below $3000/{\mu}l$ in 1 case, but recovered 2 weeks later with cessation of medication. Conclusion : Hydroxyurea stopped cell growth by triggering the apoptotic cascade. Our preliminary data indicate that hydroxyurea provides adjuvant medical treatment in patients of unresectable and recurrent meningiomas

• Journal of Acupuncture Research
• /
• v.36 no.4
• /
• pp.245-250
• /
• 2019

Background: This study was designed to evaluate the clinical safety of Bee Venom (BV) pharmacopuncture at craniofacial acupuncture points. Methods: This was a retrospective study of 108 patients diagnosed with peripheral facial paralysis, trigeminal neuralgia, or facial spasm who were admitted to Kyung Hee University Korean Medicine Hospital at Gangdong, from April 1st, 2017 to August 30th, 2017. Patients were allocated into either, Group 1 (the non-allergy group of patients who did not have an allergic reaction to BV) or Group 2, the group who had allergic reactions to BV. To evaluate the clinical safety of BV pharmacopuncture after each treatment, several criteria were used to measure any side effects: outcome, Common Terminology Criteria for Adverse Events scale, Mueller HL scale, treatment decision after adverse reaction, causality, measures performed for patients with adverse reactions, and efficacy assessment. Results: BV pharmacopuncture delivered in 0.1-0.2 mL at a concentration of 1:30,000 at the craniofacial acupuncture points, showed no statistically significant differences in baseline characteristics between non-allergy Group 1 and allergy Group 2. Amongst the 108 patients, 11 reported side effects after BV pharmacopuncture treatment. These adverse events included rash (n = 7), pruritus (n = 5), swelling (n = 1), vesicles (n = 1), erythema (n = 1), and hives (n = 1). All side effects resolved without sequelae. Conclusion: In this study, BV pharmacopuncture delivered at low doses at the craniofacial acupuncture points, resulted in 10% of patients experiencing non serious side effects suggesting that BV pharmacopuncture was clinically well tolerated.