• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1120-1126
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• 2001

Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.36-42
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• 2015

Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.

• Korean Journal of Acupuncture
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• v.34 no.1
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• pp.1-7
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• 2017

Objectives : The purpose of this study was to evaluate effects of taping therapy on recovery of behavioral symptoms and neural excitability of the lumbar spinal cord in rat model for ankle sprain. Methods : Adult Sprague-Dawley rats was used and divided into 3 experimental groups: normal group(n=6), ankle sprain(n=6), and ankle sprain with taping treatment(n=6). In order to induce ankle sprain the right ankle joint was injured with 4~5 repetitive over-flexions and over-extensions manually. The severity of joint pain was evaluated by measuring foot weight bearing force ratio(FWBRF) of the hind limb and the injury-induced edema formation by diameter of the joint following ankle sprain. The changes of neural excitability in the lumbar spinal cord was tested by observation of cFos protein expression, a metabolic marker for neural excitation. Results : Severity of ankle injury induced in this experiment coincided with Grade 1 ankle sprain. Compared with ankle sprain group, ankle sprain＋taping showed a significant reductions of joint pain as well as of edema formation at the ankle joint following ankle sprain. There was significant upregulation of cFos-immunoreactive neurons in the lumbar spinal cord 24 hours after ankle sprain. In contrast, taping therapy resulted in significant inhibition of cFos-immunoreactive neurons in the lumbar spinal cord. Conclusions : Collectively, these results suggest that taping therapy may be an alternative therapeutic intervention for symptom recovery of the mild ankle sprain.

• Neurospine
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• v.15 no.4
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• pp.368-375
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• 2018

Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2003.11a
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• pp.62-62
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• 2003

It is now convincing that free radical generation is involved in the pathophy siological mechanisms of ischemic stroke, particularly in ischemia-reperfusion injury. The present study, therefore, examined neuroprotective effect of aloesin isolated from Aloe vera, which was known to have antioxidative activity, in a rat model of transient focal cerebral ischemia. Transient focal cerebral ischemia was induced by occlusion of middle cerebral artery for 2 hr with a silicone-coated 4-0 nylon monofilament in male Sprague-Dawley rats under isoflurane anesthesia Aloesin (1, 3, 10, 30 and 50 mg/kg/injection) was administered intravenously 3 times at 0.5, 2 and 4 hr after onset of ischemia. Neurological score was measured 24 hr after onset of ischemia immediately before sacrifice. Seven serial coronal slices of the brain were stained with 2,3,5-triphenyltetrazolium chloride and infarct size was measured using a computerized image analyzer. Treatment with the close of 1 or 50 mg/kg did not significantly reduce infarct volume compared with the saline vehicle-treated control group. However, treatments with the closes of 3 and 10 mg/kg significantly reduced both infarct volume and edema by approximately 47% compared with the control group, producing remarkable behavioral recovery effect. Treatment with the close of 30 mg/kg also significantly reduced infarct volume to a lesser extent by approximately 33% compared with the control group, but produced similar degree of behavioral recovery effect. In addition, general pharmacological studies showed that aloesin was a quite safe compound. The results suggest that aloesin can serve as a lead chemical for the development of neuroprotective agents by providing neuroprotection against focal ischemic neuronal injury.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.1
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• pp.80-91
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• 2024

Backgrounds/Aims: Optimal intravenous fluid management during the perioperative period for patients undergoing pancreaticoduodenectomy (PD) within the framework of enhanced recovery after surgery (ERAS) is unclear. Studies have indicated that excessive total body salt and water can contribute to the development of oedema, leading to increased morbidity and extended hospital stays. This study aimed to assess the effects of an intravenous therapy regimen during postoperative day (POD) 0 to 2 in PD patients within ERAS. Methods: A retrospective interventional cohort study was conducted, and it involved all PD patients before and after implementation of ERAS (2009-2017). In the ERAS group, a targeted maintenance fluid regimen of 20 mL/kg/day with a sodium requirement of 0.5 mmoL/kg/day was administered. Outcome measures included the mmol of sodium and chloride administered, length of stay, and morbidity (postoperative pancreatic fistula, POPF; acute kidney injury, AKI; ileus). Results: The study included 169 patients, with a mean age of 64 ± 11.3 years. Following implementation of the intravenous fluid therapy protocol, there was a significant reduction in chloride and sodium loading. However, in the multivariable analysis, chloride administered (mmoL/kg) did not independently influence the length of stay; or rates of POPF, ileus, or AKI (p > 0.05). Conclusions: The findings suggested that a postoperative intravenous fluid therapy regimen did not significantly impact morbidity. Notably, there was a trend towards reduced length of stay within an increasingly comorbid patient cohort. This targeted fluid regimen appears to be safe for PD patients within the ERAS program. Further prospective research is needed to explore this area.

• Journal of Korean Medicine Rehabilitation
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• v.34 no.3
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• pp.107-117
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• 2024

The objective of this study is to report the clinical effects of applying an integrated rehabilitation protocol to four patients with traumatic cervical spinal cord injuries. The treatments applied included acupuncture, cupping and moxibustion, chuna manual therapy, functional electrical stimulation, and other physical therapies. The evaluation methods included American Spinal Injury Association Impairment Scale, functional independence measure (FIM), modified Barthel index (MBI), numeric rating scale (NRS) and other scales. All patients presented marked improvements in FIM, MBI, NRS and other scales, along with increased muscle strength in the manual muscle test. The application of our protocol resulted in clear clinical benefits and enhanced the recovery and quality of life for the patients in this study.

• Molecules and Cells
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• v.42 no.9
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• pp.672-685
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• 2019

Currently, liver transplantation is the only available remedy for patients with end-stage liver disease. Conservation of transplanted liver graft is the most important issue as it directly related to patient survival. Carbonyl reductase 1 (CBR1) protects cells against oxidative stress and cell death by inactivating cellular membrane-derived lipid aldehydes. Ischemia-reperfusion (I/R) injury during living-donor liver transplantation is known to form reactive oxygen species. Thus, the objective of this study was to investigate whether CBR1 transcription might be increased during liver I/R injury and whether such increase might protect liver against I/R injury. Our results revealed that transcription factor Nrf2 could induce CBR1 transcription in liver of mice during I/R. Pre-treatment with sulforaphane, an activator of Nrf2, increased CBR1 expression, decreased liver enzymes such as aspartate aminotransferase and alanine transaminase, and reduced I/R-related pathological changes. Using oxygen-glucose deprivation and recovery model of human normal liver cell line, it was found that oxidative stress markers and lipid peroxidation products were significantly lowered in cells overexpressing CBR1. Conversely, CBR1 knockdown cells expressed elevated levels of oxidative stress proteins compared to the parental cell line. We also observed that Nrf2 and CBR1 were overexpressed during liver transplantation in clinical samples. These results suggest that CBR1 expression during liver I/R injury is regulated by transcription factor Nrf2. In addition, CBR1 can reduce free radicals and prevent lipid peroxidation. Taken together, CBR1 induction might be a therapeutic strategy for relieving liver I/R injury during liver transplantation.

• Journal of Korean Dental Science
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• v.4 no.1
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• pp.14-19
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• 2011

Purpose: The aim of our study was to evaluate natural recovery of neurologic injury after minor dental surgery based on subjective neurologic evaluation. Materials and Methods: From December 2005 through July 2009, 30 patients from Seoul National University Bundang Hospital were identified as having been treated with minor dental surgery. The patients were composed of 12 men and 18 women, with a mean age of 50.6 years. The median duration of this study was 62 weeks. Results: The patients were treated by implants (17 cases), tooth extractions (6 cases), bone grafts (4 cases), inferior alveolar nerve transpositions (2 cases) and periodontal surgery (1 case) prior to the occurrence of altered sensation. Areas of altered sensation after minor surgery included the lip (36.7%), chin (30.0%) and tooth (21.7%), and at final follow-up, there was no change of ranking. Altered sensations expressed by patients included numbness (33.3%), discomfort (22.9%), relieving sense (14.6%), tingling (14.6%) and itching (14.6%). There was no change of ranking of altered sensation at the last follow-up. Patients experienced the altered sensation always (47.8%), during tactile stimulation (26.1%), when chewing food (13.0%), and talking (13.0%). Mean visual analogue scale (VAS) was $3.43{\pm}2.84$ for pain and $6.64{\pm}2.72$ for paresthesia. VAS of pain was decreased significantly between the first visit and the end of follow-up, and paresthesia also showed a significant difference. Conclusion: Altered sensations may occur at any time after minor dental surgery, but we observed that natural recovery of altered sensation occurred as time went on.

• Herbal Formula Science
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• v.11 no.1
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• pp.129-149
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• 2003

Liver is an important target of the toxicity of drugs, xenobiotics and oxidative stress. Acetaminophen pverdose causes acute liver injury in both humans and animals. This study was performed to observe the effect of sachunwhan and its component groups on recovery of hepatoxicity in acetaminophen treated rats. The experimental group was divided into 4 groups: sachungwhan(SC), samultang group(SC-1: 當歸, 川芎), chungyul group(SC-2: 龍膽草, 大黃, 梔子), and haepyo group(SC-3:羌活, 防風). Under the same condition Normal group was fed basal diet and water; Control group was injected acetaminophen and fed basal diet for 2 weeks; Experimental groups were injected acetaminophen and fed each extracts for 2 weeks respectively. The results were obtained as follows: 1. In the study on antioxidative defense system in vivo, SC reduced the amount of lipid peroxide in both serum and liver and showed activity on antioxidative enzymes such as catalase, glutathion. Other groups had effect only on glutathion. 2. In the study on hepatotoxicity(GOT, GPT, ${\gamma}$-GTP, ALP, LDH, Bilirubin), SC had a significant effect on recovery of hepatoxicity in acetaminophen treated rats. Other groups had no effect except SC-1 having effect on ${\gamma}$-GTP. As results shown, only Sachungwhan(SC) has significant effects on recovery of hepatoxicity and antioxidative defense system in vivo. These results suggest that Sachungwhan(SC) made antioxidative defense system active and it seemed to be very important to its effect on recovery of hepatoxicity. In the other hand, Component groups had no effect on recoverv of hepatoxicity and antioxidative defense system in vivo. This was thought that component drugs' cooperative synergy effect would be important to Sachungwhan(SC)'s effects mentioned in this paper.