• International Journal of Oral Biology
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• v.46 no.3
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• pp.119-126
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• 2021

Activation of transient receptor potential vanilloid 1 (TRPV1), a calcium permeable channel expressed in primary sensory neurons, induces the release of glutamate from their central and peripheral afferents during normal acute and pathological pain. However, little information is available regarding the glutamate release mechanism associated with TRPV1 activation in primary sensory neurons. To address this issue, we investigated the expression of vesicular glutamate transporter (VGLUT) in TRPV1-immunopositive (+) neurons in the rat trigeminal ganglion (TG) under normal and complete Freund's adjuvant (CFA)-induced inflammatory pain conditions using behavioral testing as well as double immunofluorescence staining with antisera against TRPV1 and VGLUT1 or VGLUT2. TRPV1 was primarily expressed in small and medium-sized TG neurons. TRPV1+ neurons constituted approximately 27% of all TG neurons. Among all TRPV1+ neurons, the proportion of TRPV1+ neurons coexpressing VGLUT1 (VGLUT1+/TRPV1+ neurons) and VGLUT2 (VGLUT2+/TRPV1+ neurons) was 0.4% ± 0.2% and 22.4% ± 2.8%, respectively. The proportion of TRPV1+ and VGLUT2+ neurons was higher in the CFA group than in the control group (TRPV1+ neurons: 31.5% ± 2.5% vs. 26.5% ± 1.2%, VGLUT2+ neurons: 31.8% ± 1.1% vs. 24.6% ± 1.5%, p < 0.05), whereas the proportion of VGLUT1+, VGLUT1+/TRPV1+, and VGLUT2+/TRPV1+ neurons did not differ significantly between the CFA and control groups. These findings together suggest that VGLUT2, a major isoform of VGLUTs, is involved in TRPV1 activation-associated glutamate release during normal acute and inflammatory pain.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.299-301
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• 1998

Stellate ganglion block is frequently effective on the pain of head and upper extremities. However, if the degree and duration of pain relief does not increase with repeated blocks, we may consider the neurolytic procedure on the stellate ganglion. A patient sufferring from the pain in the region of ophthalmic branch of left trigeminal nerve and left eyeball region had been treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain relief did not increase. We performed the radiofrequency thermocoagulation of stellate ganglion at the operation room under fluoroscopy. Patient got pain relief immediately after the procedure without any remarkable complication except a mild ptosis, which was shown before the procedure. We may give priority to radiofrequency thermocoagulation for stellate ganglion neurolysis due to its simplicity and safty.

• The Journal of the Korean dental association
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• v.11 no.10
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• pp.663-665
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• 1973

The shape, length, width and depth of the semilunar ganglion were examined in 30 Korean cadavers, which were used for dissection in Seoul Dental College from 1970 to 1973. The results obtained were as follow : 1. The semilunar shape with 4-6mm in width of the semilunar ganglion was the most common type in 86.7% 2. The length, width and depth of the semilunar ganglion were 17.1, 5.3 and 3.2mm, respectively.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.827-836
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• 2021

Objective : Trigeminal neuralgia is one of the most common causes of facial pain. Our aim is to investigate the efficacy and borders of percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods : Between May 2007 and April 2017, 156 patients with trigeminal neuralgia were treated with radiofrequency thermocoagulation. These 156 patients underwent 209 procedures. In our study, we investigated the early and late results of percutaneous radiofrequency thermocoagulation under guiding fluoroscopic imaging in the treatment of trigeminal neuralgia. Barrow Neurological Institute (BNI) pain scale was used for grading the early results. In addition, Kaplan-Meier survival analysis was used to assess long-term outcomes. Of the 156 patients who underwent radiofrequency thermocoagulation for trigeminal neuralgia, 45 had additional disease. Patients with this condition were evaluated with their comorbidities. Early and late results were compared with those without comorbidity. Results : In 193 of 209 interventions BNI pain scale I to III results were obtained. Out of the 193 successful operation 136 patients (65.07%) were discharged as BNI I, 14 (6.70%) as BNI II, 43 (20.58%) as BNI III. Sixteen patients (7.65%) remained uncontrolled (BNI IV and V). While the treatment results of trigeminal neuralgia patients with comorbidity seem more successful in the early period, this difference was not observed in follow-up examinations. Conclusion : Finally, we concluded that percutaneous radiofrequency thermocoagulation of the Gasserian ganglion is a safe and effective method in the treatment of trigeminal neuralgia. However, over time, the effectiveness of the treatment decreases. Neverthless, the reapprability of this intervention gives it a distinct advantage.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.191-195
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• 1991

Trigeminal neuralgia(tic douloureux) is a common clinical syndrome which is characterized by a painful facial condition. The clinician must be able to identify a patient with tic douloureux because this most severe pain syndrome can almost always be controlled. Gangliolysis is the most recent development in the long history of destructive procedures for tic douloureux. H$\ddot{a}$kason pioneered a technique of placing a needle for injecting glycerol into the trigeminal cistern which he found safe and effective for pain control. In August at 1991, I injected pure sterile glycerol three times into the cistern of trigeminal ganglion using the H$\ddot{a}$rtel approach to relieve a patient from pain. The results were as follows; 1) The response of pain relief to a glycerol gangliolysis was excellent. 2) As a complication, there were mild sensory deficit, transient headache and herpes simplex around the mouth angle.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.104-108
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• 2018

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

• International Journal of Oral Biology
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• v.36 no.4
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• pp.167-172
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• 2011

LAR-RPTP (leukocyte common antigen-related receptor protein tyrosine phosphatase) is an important regulator in the nervous system, but little is known about its expression pattern in rat trigeminal ganglion (TG) neurons. To examine whether LAR-RPTP is expressed in the TG in the current study, we sacrificed rats at 0, 7, 10 and 56 day postpartum (dpp) and a second group of rats at 3 and 5 days after an experimental tooth extraction as a TG injury model. RT-PCR was then used to determine the level of LAR-RPTP expression in the TG and immunohistology was employed to detect the subcellular localization of the protein. The mRNA expression of LAR-RPTP during the developmental stages in the TG was found to gradually increase. After experimental tooth extraction however, these transcript levels had significantly decreased at three days. LAR-RPTP protein signals in the TG were found to be cytoplasmic in the normal animals but interestingly, at five days after an experimental tooth extraction, these signals were rare. These results indicate that LAR-RPTP may be regulated during both the developmental as well as regenerative processes that take place in the TG. This further suggests that LAR-RPTP is not only involved in primary axonogenesis but possibly also in the molecular control of axons during TG repair.

• International Journal of Oral Biology
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• v.38 no.1
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• pp.13-19
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• 2013

Various voltage-gated $K^+$ currents were recently described in dorsal root ganglion (DRG) neurons. However, the characterization and diversity of voltage-gated $K^+$ currents have not been well studied in trigeminal root ganglion (TRG) neurons, which are similar to the DRG neurons in terms of physiological roles and anatomy. This study was aimed to investigate the characteristics and diversity of voltage-gated $K^+$ currents in acutely isolated TRG neurons of rat using whole cell patch clamp techniques. The first type (type I) had a rapid, transient outward current ($I_A$) with the largest current size having a slow inactivation rate and a sustained delayed rectifier outward current ($I_K$) that was small in size having a fast inactivation rate. The $I_A$ currents of this type were mostly blocked by TEA and 4-AP, K channel blockers whereas the $I_K$ current was inhibited by TEA but not by 4-AP. The second type had a large $I_A$ current with a slow inactivation rate and a medium size-sustained delayed $I_K$ current with a slow inactivation rate. In this second type (type II), the sensitivities of the $I_A$ or $I_K$ current by TEA and 4-AP were similar to those of the type I. The third type (type III) had a medium sized $I_A$ current with a fast inactivation rate and a large sustained $I_K$ current with the slow inactivation rate. In type III current, TEA decreased both $I_A$ and $I_K$ but 4-AP only blocked $I_A$ current. The fourth type (type IV) had a smallest $I_A$ with a fast inactivation rate and a large $I_K$ current with a slow inactivation rate. TEA or 4-AP similarly decreased the $I_A$ but the $I_K$ was only blocked by 4-AP. These findings suggest that at least four different voltage-gated $K^+$ currents in biophysical and pharmacological properties exist in the TRG neurons of rats.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.167-170
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• 2009

Pharmacological management is the first choice for treatment of the trigeminal neuralgia patients; however, if this mode of treatment fails a minimally invasive procedure should be performed. One of the most commonly used procedures is conventional radiofrequency lesioning of the Gasserian ganglion. Despite its popularity and success rate, this technique has disadvantages such as diminished corneal reflex, masseter weakness, numbness and anesthesia dolorosa. As a result, many studies have been conducted in an attempt to find a better method of treating trigeminal neuralgia. We report here a case of a trigeminal neuralgia patient that was treated with pulsed radiofrequency lesioning of the supraorbital and supratrochlear nerve due to pain in the frontal head that was refractory to the pharmacological treatments. Following the procedure, the Visual Analogue Scale score for pain decreased to 1-2/10 and the pain relief persisted for 7 months. These results indicate that pulsed radiofrequency treatment of the peripheral nerve may be useful for trigeminal neuralgia patients that do not respond to pharmacological treatments.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.260-265
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• 2014

Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.