• Title/Summary/Keyword: peripheral nerve

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A proposal of injection points of botulinum toxin into temporal region for chronic migraine (만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시)

  • Kim, Young Gun;Bae, Jung Hee;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.1-6
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    • 2017
  • Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

A Literary Review on Needle Retaining Time: Centered on the Chinese Medical Journal (유침(留鍼)시간에 대한 문헌적 고찰: 중국 문헌을 중심으로)

  • Wang, Kai-Hsia;Lee, Eun-Sol;Cho, Hyun-Seok;Kim, Kyung-Ho
    • Journal of Acupuncture Research
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    • v.28 no.5
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    • pp.65-76
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    • 2011
  • Objectives : Study about needle retaining time. Methods : We reviewed the ancient and the present text of China with using the China academic journal(CAJ) of China national knowledge infrastructure(CNKI) Results & Conclusions : 1. Needle retaining time is important in acupuncture, because the therapy effect is influenced by it. 2. The time of needle retaining is up to those conditions like different disease, viscera and bowels(臟腑), meridian and collateral(經絡), obtaining Qi(得氣), seasons, constitution of the patients and acupuncture tools. In ${\ll}$Hwangdineijing(黃帝內經) ${\gg}$, needle retaining time is called by 'Zhiruzhichu(直入直出)', 'Jichu(疾出)', 'Liu(留)', 'Buliu(不留)', 'Jiuliu(久留)' and 'Liu ${\bigcirc}$ hu(留${\bigcirc}$呼)', and the time was shorter than nowadays. 3. The respiration number was counted to check needle retaining time but we can't find out any evidence. Recently in China, 'obtaining Qi(得氣)' and 'Qi arrival(氣至)' is used to check it. 4. Looking into clinical researches, different diseases need different needle retaining time. For example, 20~30min is appropriate time for musculoskeletal system. 60min is for circulatory system, 10~20min is for peripheral facial nerve paralysis. Insomnia and some stubborn diseases need longer time. Cold and heat(寒熱), deficiency and excess(虛實) are always influences the needle retaining as well. 5. It is important to figure out the most effective needle retaining time for different disease with the base of connection between needle retaining time and effect.

A Study on the Pain in Patients with Temporomandibular Disorders using Korean Pain Rating Scale (측두하악장애환자에서 한국어 통증척도를 이용한 통증에 관한 연구)

  • Yoing-Gyu Bae;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.169-180
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    • 1994
  • The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.

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Diagnostic Usefulness of Quantitative Sensory Test Comparison with Photoplethysmography (광용적맥파와 정량적 감각검사의 비교를 통한 진단적 유용성)

  • LEE, Sang-Bong;SEO, Jeong-Hyeok
    • Journal of the Korean Society of Radiology
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    • v.9 no.5
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    • pp.315-322
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    • 2015
  • The purposes of this study were to compare the sensitivities of two tests, QST(quantitative sensory test)and PPG(photoplethysmography) in normal adults. We evaluated the sensory thresholds of QST and PPG and diabetes mellitus test in 17 normal adults. The finding of this study can be summarized as follow :The diagnostic sensitivities of QST was similar to PPG. There is a direct correlation between the amount of Blood sugar and parasympathetic nerve in ANS. Concluded that the QST might be complement to NCS for early of diabetic polyneuropathy. A new diagnostic approach, QST was introduced and exploited for diagnosis. This study provides support for PPG performed a ANS analysis.

Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

  • Leung, Clement Chi Ming;Ghanem, Ali M.;Tos, Pierluigi;Ionac, Mihai;Froschauer, Stefan;Myers, Simon R.
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.304-311
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    • 2013
  • With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid), and EMBASE (Ovid) searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 centres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student-to-teacher ratios ranged from 2:1 to 8:1. Only two-thirds of courses offered in-vivo animal models. Instructions in microvascular end-to-end and end-to-side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re-assessment of patency after a 12 to 24 hours period. Globally, training in microsurgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global minimum standard for microsurgery training.

The Clinical Pathology Characteristics and Tetanus Quick Stick Evaluation for Tetanus Patients in Daegu Emergency Medical Center

  • Lee, Seung Jin;Lim, Soon Ok;Jeong, Jae Yeop;Park, Min Jeong;Park, Ju Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.46 no.1
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    • pp.12-16
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    • 2014
  • Tetanus has high lethality and can cause serious complication, so it is very important to have a quick and exact checkup and treatment. In this study, we conducted a study about clinical characteristics and types of tetanus patients in Daegu Emergency Medical Center and we studied possibility of Tetanos Quick Stick (TQS) as a selective check up to treat tentanus by comparing the results of local checkup kit measured from tetanus quick stick developed to check up tetanus antibody titer and results measured from ELISA (Enzyme-Linked Immunosorbent Assay). The result of the study showed that tetanus happens more to males, and by looking at season, tetanus happened most in summer (from June-August) as 19 cases (45.3%), and when patients come to the emergency medical center, the diagnosis name was electrolyte imbalance 14 cases (33.3%), peripheral nerve 11 cases (26.2%), Meningitis 8 cases (19.0%), drug addiction 7 cases (16.7%), and the patients who are diagnosed as tetanus at the beginning of hospitalization was 2 cases (4.8%). The result of TQS usefulness by comparing with ELISA, in TQS, 42 people was positive and 478 people was negative. it was positive when the result was over 0.1 IU/mL, 48 people was ELISA positive while 472 people was negative. TQS checkup has accuracy of 98%, sensitivity of 83.3%, specificity of 99.5%, positive predictability of 95.2% and negative predictability of 98.3%. The evaluation of current immunity statuses of tetanus patients is available for TQS checkup, and it has an advantage of preventing side effects coming from the injection of unnecessary vaccine and immunoglobulin, and it is thought that it can give help to emergency checkup and treatment at the beginning.

A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis (미만성 폐포 출혈을 동반한 급성 담낭염으로 발현한 Churg-Strauss 증후군 1예)

  • Kim, Ji Eun;Kim, Ki Uk;Park, Hye-Kyung;Jeon, Doo Soo;Kim, Yun Sung;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.225-229
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    • 2009
  • Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

Malignant Tumor of the Hand (수부에 발생한 악성 종양)

  • Park, Hong-Jun;Shin, Kyoo-Ho;Bae, Im-Don;Hahn, Soo-Bong;Kang, Eung-Shick
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.4
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    • pp.201-207
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    • 1999
  • Malignant tumors of the hand are very rare. Between 1989 and 1998, 17 patients with malignant tumors of the hand were evaluated for clinical features, prevalence, treatment and results. The mean age was 45 years and median duration of follow-up was 38 months. A painless mass was the most common symptom and the most common lesion was the digit. Fifteen cases of soft tissue and 2 cases of bone tumor were diagnosed. On pathology, soft tissue tumors were comprised of 8 cases of malignant melanoma, 2 cases of angiosarcoma and 1 case each of malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, extraskeletal chondrosarcoma, and squamous cell carcinoma. Bone tumors were metastatic tumors and each originated from the rectal cancer or lung cancer. Lymph node involvements were noted in 4 cases of malignant melanoma and 1 case of squamous cell carcinoma. Six cases of metacarpo-phalangeal joint disarticulation and 4 cases of phalanx amputation were performed. Wide excision, ray amputation and below-elbow amputation were also performed. Three cases expired due to metastasis and progression of the original lesion. Among the surviving 14 cases, a malignant melanoma had metastasis on the axillary lymph node and 13 cases showed no local recurrence or metastasis during the follow-up.

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Multiple Schwannomas in the Peripheral Nerve - 3 Cases Report - (말초신경에 생긴 다발성 신경초종 - 증례 보고 3예 -)

  • Kang, Ho-Jung;Lee, Dae-Young;Yoon, Hong-Kee;Hahn, Soo-Bong;Park, Chan-Il;Yang, Seok-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.105-109
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    • 2005
  • This journal reports three cases diagnosed with schwannomatosis in which no clinical symptoms of type 2 neurofibromatosis. The chief complain was pain. In adolescence and adult group, all masses were found. The locations were brachial plexus, popliteal fossa and hand. No hearing impairment, vertigo, tinnitus and visual disturbance was observed in any of the case. Family history was negative. In all cases, there was no evidence of vestibular schwannoma on cranial MRI imaging study. In all cases, Tinel sign was positive. Pathologic diagnosis was positive for schwannoma. Further study and case collection is needed to idenity the clinical manifestation, clinical course and genetic characteristic of schwannomatosis.

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Schwannoma of the Orbit

  • Kim, Kwang Seog;Jung, Jin Woo;Yoon, Kyung Chul;Kwon, Yu Jin;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.16 no.2
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    • pp.67-72
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    • 2015
  • Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.