• Title/Summary/Keyword: nerve block

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Treatment of intractable parotid sialocele occurred after open reduction-fixation of mandibular subcondylar fracture

  • Hwang, Jungil;You, Yong Chun;Burm, Jin Sik
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.157-161
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    • 2018
  • A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately $5{\times}3cm$ in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.

Non-adrenergic non-cholinergic relaxation and contraction in circular smooth muscle of bovine reticular groove (소(우(牛)) 식도구 윤상근의 비아드레날린 비콜린성 이완 및 수축)

  • Kang, Tong-mook;Han, Ho-jae;Yang, Il-suk
    • Korean Journal of Veterinary Research
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    • v.35 no.2
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    • pp.279-285
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    • 1995
  • To characterize non-adrenergic non-cholinergic(NANC) nerve mediated contractile responses in circular smooth muscle of bovine reticular groove, we investigated NANC relaxation and contraction induced by electric field stimulation to enteric nerves. In the presence of atropine($1{\mu}M$) and guanethidine($50{\mu}M$), electric field stimulation at frequency of 1 to 16Hz(square pulses, 0.5ms duration, 70V) evoked clear-cut relaxations through stimulations. Transient 'rebound contraction' was occured when the stimulus was switched off. All of the responses (relaxation and rebound contraction) were dose-dependently blocked by Nw-nitro-$_{\small{L}}$-arginine methyl ester(L-NAME), an inhibitor of nitric oxide synthesis, and methylene blue, and inhibitor of soluble guanylate cyclase. Tetraethyl ammonium(TEA), a potassium channel blocker, did not block the NANC relaxations.

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Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Kim, Myung-Hwan;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.165-167
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    • 2009
  • Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

Glial Mechanisms of Neuropathic Pain and Emerging Interventions

  • Jo, Daehyun;Chapman, C. Richard;Light, Alan R.
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.1-15
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    • 2009
  • Neuropathic pain is often refractory to intervention because of the complex etiology and an incomplete understanding of the mechanisms behind this type of pain. Glial cells, specifically microglia and astrocytes, are powerful modulators of pain and new targets of drug development for neuropathic pain. Glial activation could be the driving force behind chronic pain, maintaining the noxious signal transmission even after the original injury has healed. Glia express chemokine, purinergic, toll-like, glutaminergic and other receptors that enable them to respond to neural signals, and they can modulate neuronal synaptic function and neuronal excitability. Nerve injury upregulates multiple receptors in spinal microglia and astrocytes. Microglia influence neuronal communication by producing inflammatory products at the synapse, as do astrocytes because they completely encapsulate synapses and are in close contact with neuronal somas through gap junctions. Glia are the main source of inflammatory mediators in the central nervous system. New therapeutic strategies for neuropathic pain are emerging such as targeting the glial cells, novel pharmacologic approaches and gene therapy. Drugs targeting microglia and astrocytes, cytokine production, and neural structures including dorsal root ganglion are now under study, as is gene therapy. Isoform-specific inhibition will minimize the side effects produced by blocking all glia with a general inhibitor. Enhancing the anti-inflammatory cytokines could prove more beneficial than administering proinflammatory cytokine antagonists that block glial activation systemically. Research on therapeutic gene transfer to the central nervous system is underway, although obstacles prevent immediate clinical application.

A Case Report of Herpes zoster with acute pain by Yongdamsagan-tang(longdanxiegan-tang) (용담사간탕(龍膽瀉肝湯)을 이용한 대상포진(帶狀疱疹)의 급성기(急性期) 통증(痛症)에 대한 치험(治驗) 1례(例))

  • Park Young-Jun;Park Joo-Han;Heo Geum-Jeong;Nam Chang-Gyu;Sun Jung-Ki;Koo Chang-Mo
    • The Journal of Internal Korean Medicine
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    • v.24 no.1
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    • pp.151-156
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    • 2003
  • Herpes zoster is a viral disease characterized by unilateral radicular pain and vesicular eruptions that are generally limited to the dermatome innervated by single spinal or cranial sensory ganglion. The disease causes severe pain and in particular, put elderly patients in great risks and further it develops postherpetic nenralgia. Nowadays western medicine use antiviral durg(ex: acyclovir), analgesics, nerve block and etc for treatment of herpes zoster and pain control, but the effect is not much satisfactory. A 73-year-old patient, admitted to our hospital because of severe migrain. Two days later, her illness was diagnosed as herpes zoster so we administrated Yongdamsagan-tang. After the six-day of treatment, all symptoms improved, especially headache was cleared since the four day long administration of Yongdamsagan-tang.

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A Case of Unusual Tolosa-Hunt Syndrome (비전형 Tolosa-Hunt Syndrome 1예)

  • Lee, Sun-Sook;Kim, Kyung-Sook;Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.198-202
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    • 1989
  • The Tolosa-Hunt syndrome is one of the rare disease with facial, especially peri-orbital pain, and ophthalomoplegia associated mostly with granulomatous lesions in cavernous sinus or superior orbital fissure. In addition to ophthalmoplegia by multiple cranial nerve involvement, the sympathetic nervous system may also be involved leading to Horner's syndrome. A typical Tolosa-Hunt syndrome has a neuro-radiologic finding of an increased density in the involved region, and a laboratory finding of an elevated ESR, as well as a dramatic response to systemic corticosteroid therapy. An unusual case of the Tolosa-Hunt syndrome with normal radiologic and laboratory findings, unresponsive to systemic corticosteroid, and some response of pain relief to a stellate ganglion block, is presented.

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COMPLICATIONS ASSOCIATED WITH DENTAL IMPLANT SURGERY; CASE REPORT (임플란트 수술 시의 합병증; 증례 보고)

  • Lee, Hyun-Jin;Yeo, Duck-Sung;Lim, So-Yeon;An, Kyung-Mi;Sohn, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.173-180
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    • 2007
  • According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.

A Clinical Experience of Facial Nerve Palsy Treated by Magnetic Resonance Analyser and Drug Therapy -A case of facial palsy- (자기공명분석기와 약물요법을 이용한 안면신경마비의 치험 -1예 보고-)

  • Chun, Sung-Hong;Shin, Jae-Hwan;Jeon, Yong-Sub;Yoon, Suk-Jun;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.347-349
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    • 1995
  • A 43 year old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and drug therapy. Treatment of facial palsy is generally composed of stellate ganglion block(SGB), drug therapy and operative intervention. Short periods of exposure to appropriate magnetic resonance can beneficially modulate the balance of autonomic nervous system that are responsible for sympathetic overflow. It was concluded that recovery of facial palsy by application of both MRA and drug therapy was effective in patient who refused SGB.

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Secondary Trigeminal Neuralgia Caused by Pharyngeal Squamous Cell Carcinoma - A Case Report -

  • Kim, Min Seok;Ryu, Yong Jae;Park, Soo Young;Kim, Hye Young;An, Sangbum;Kim, Sung Woo
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.177-180
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    • 2013
  • Trigeminal neuralgia (TN) is characterized by recurrent paroxysms of unilateral facial pain that typically is severe, lancinating, and activated with cutaneous stimulation. There are two types of TN, classical TN and atypical TN. The pain nature of classical TN are the same as those described above, whereas atypical TN is characterized by constant, burning pain. We describe the case of a 49-year-old male presenting with right-sided facial pain. The patient was diagnosed with temporomandibular joint disorder at a dental clinic and was on medical treatment, but his symptoms worsened gradually. He was referred to our pain clinic for further evaluation. Radiologic evaluation, including MRI, showed a parapharyngeal tumor. For the relief of TN, a right mandibular nerve (V3) root block was performed at our pain clinic, and then he was scheduled for radiation and chemotherapy.

Computed Tomographic Findings of Navicular Syndrome in a Horse

  • Lee, Seyoung;Lee, Eun-bee;Park, Kyung-won;Jeong, Hyohoon;Kang, Tae-young;Seo, Jong-pil
    • Journal of Veterinary Clinics
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    • v.38 no.2
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    • pp.94-97
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    • 2021
  • An 18-year-old warmblood gelding was presented to Jeju National University Equine Hospital with chronic bilateral forelimb lameness. Navicular syndrome was suspected based on clinical findings, the hoof test, palmar digital nerve block, and radiographic results. Computed tomography (CT) was performed under general anesthesia. Bone cysts, enlarged vascular channels, sclerosis, and enthesophytes were identified in the navicular bone on CT images. Mineralization in the deep digital flexor tendon was also observed. CT can be a useful diagnostic tool for identifying lesions of the navicular bone and adjacent structures in horses. The horse was treated with an intra-bursal injection of triamcinolone and gentamicin. Lameness started to improve two days later and the horse was sound after two months of the injection. CT enabled us not only to diagnosis of navicular syndrome but also to determine the degree and extent of the lesions.