• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.121-127
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• 1996

Peripheral nerve injury occurs mostly by trauma and is usually associated with fracture of bone and joint, muscular injury and tendon injury and it also evokes paralysis and anesthesia. When treatment of peripheral nerve injury is considered,, the modality of treatment is decided by the general condition of the patient, type of injury, associated injuries and the condition of wound. To get the maximum results, surgical treatment and reconstruction and rehabilitation should all go in hand-in-hand. From January 1985 to December 1994, we observed 61 patients that had operation without reconstruction due to peripheral nerve injury with a follow-up period of more than 1 year. Among the 61 patients, 44 were men(72%) and 17 were women(28%). Follow-up period was average 19 months. Age distribution was mostly in their twenties with a mean age of 28 years. Time interval of operation after injury was average 11 months. Trauma was the main cause of peripheral nerve injuries with a proportion of 87%. 31 patients had neurorrhaphy, in which case 14 patients had stay suture and 17 patients did not. 14 patients had nerve graft, and 16 patients had neurolysis. We used our scales to compare the results of surgery on the basis of British Research Council System. We gave scores to every sensory and motor scale to estimate functional improvement and emphasized on motor functional improvement. The total score = sensory score + ($2{\times}motor$ score). We considered 8-9 points as excellent, 6-7 points as good, 2-5 points as fair, 0-1 points as poor result. We considered excellent and good as much improved. Excellent and good results were obtained in 13 out of 14 neurorrhaphy with stay suture(93%), 12 out of 17 neurorrhaphy without stay suture(71%), 6 out of 14 nerve graft(43%), 12 out of 16 neurolysis(75%). Among the patients with neurorrhaphy done within 3 months, 11 out of 14(86%) showed improvement, but among the patients after 4 months 3 out of 17(76%) showed improvement. 84% of improvement was observed in the patients with time interval from injury to surgery within 3 months, and 64% in the patients with time interval after 4 months. In the aspect of age, 77% with the age below 20 years, 70% with the age between 21 and 30 years, 66% with the age above 31 years showed improvement. We conclude that considering degree of injury, time interval from injury and age with the adequate method of treatment, we can obtain good results from surgery.

• The Korean Journal of Pain
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• 제19권1호
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• pp.33-44
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• 2006

Background: Peripheral nerve injury leads to neuropathic pain, including mechanical hyperalgesia (MH). Nerve discharges produced by an injury to the primary afferents cause the release of glutamate from both central and peripheral terminals. While the role of centrally released glutamate in MH has been well studied, relatively little is known about its peripheral role. This study was carried out to determine if the peripherally conducting nerve impulses and peripheral glutamate receptors contribute to the generation of neuropathic pain. Methods: Rats that had previously received a left L5 dorsal rhizotomy were subjected to a spinal nerve lesion (SNL) or brief electrical stimulation (ES, 4 Hz pulses for 5 min) of the left L5 spinal nerve. The paw withdrawal threshold (PWT) to von Frey filaments was measured. The effects of an intraplantar (i.pl.) injection of a glutamate receptor (GluR) antagonist or agonist on the changes in the SNL- or ES-produced PWT was investigated. Results: SNL produced MH, as evidenced by decrease in the PWT, which lasted for more than 42 days. ES also produced MH lasting for 7 days. MK-801 (NMDAR antagonist), DL-AP3 (group-I mGluR antagonist), and APDC (group-II mGluR agonist) delayed the onset of MH when an i.pl. injection was given before SNL. The same application blocked the onset of ES-induced MH. NBQX (AMPA receptor antagonist) had no effect on either the SNL- or ES-induced onset of MH. When drugs were given after SNL or ES, MK-801 reversed the MH, whereas NBQX, DL-AP3, and APDC had no effect. Conclusions: Peripherally conducting impulses play an important role in the generation of neuropathic pain, which is mediated by the peripheral glutamate receptors.

• 대한후두음성언어의학회지
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• 제20권2호
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• pp.105-109
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• 2009

The laryngeal peripheral nerve system is presented on the basis of our results in the animal. This present paper forcused on the localization of each laryngeal motoneuron, the myotopical arrangements of motoneurons innervating the pharyngeal and esophageal striated muscles whitin the nucleus ambiguous in the motor nerve supply, and the pathway to the larynx in the sensory and symphathetic nerve supplies. Regarding the parasympathetic nerve supply, the neural ganglia and the ganglionic cells in and around the laryngeal nerves and in the laryngeal framework are demonstrated. Most of this innervations, however, is still unclear. In addition, we presented about external branch of superior laryngeal nerve and inferior laryngeal nerve. Discuss from the literature are also reported.

• 한국환경보건학회지
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• 제24권3호
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• pp.35-40
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• 1998

This study was conducted to examine the pathological changes of rat peripheral nervous system during exposure to tellurium known to be a demyelinating agent by using teasing nerve fiber method and quantitative light microscopic analysis by image analyzer. The pellet containing 1.2% of tellurium were fed for 3, 5, 7, 9, 13 days to male wistar rats (21 days old) and then neurologic symptom and the feature of nerve fiber myelination were studied. From this study, following results were obtained. In 3 days treated group, it showed various neurologic symptom and teased nerve fiber showed slight irregularity of the myeline sheath. In 5 days and 7 days treated groups, it showed the segmental demyetination in larger size fiber and widening of nodes of ranvier. In 9 days and 13 days treated groups, the remyelinated fibers were observed and it was generally small in size. We consequently suggest that teasing nerve fiber method and quantitative analysis of nerve fiber were useful pathologic screening method of neurotoxicity of the peripheral nervous system.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.109-113
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• 2011

Objective : Peripheral neuropathy is characterized by hyperalgesia, spontaneous burning pain, and allodynia. The purpose of this study was to investigate the effect of rolipram, a phosphodiesterase-4-specific inhibitor, in a segmental spinal nerve ligation model in rats. Methods : Both the L5 and L6 spinal nerves of the left side of the rats were ligated. Phosphodiesterase-4 inhibitor (rolipram) and saline (vehicle) were administered intraperitoneally. We measured mechanical allodynia using von Frey filaments and a nerve conduction study. Results : The mechanical allodynia, which began to manifest on the first day, peaked within 2 days. Multiple intraperitoneal injections of rolipram ameliorated the mechanical allodynia. Furthermore, an intraperitoneal administration of rolipram improved the development of pain behavior and nerve conduction velocity. Conclusion : This study suggests that the phosphodiesterase-4 inhibitor, rolipram, alleviates mechanical allodynia induced by segmental spinal nerve ligation in rats. This finding may have clinical implications.

• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.415-432
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• 2000

In mammals. axotomy of peripheral nerve leads to a complex. These events include swelling of cell body, disappearance of Nissl substance. Proximal and distal axon undergoes a variable deriable degree of traumatic degeneration and wallerian degeneration, respectively. Nerve injury may result in cell death or regeneration. Molecular changes include proliferation of Schwann cells, upregulation of neurotropism, neural cell adhesion molecules and cytokine. Also growth cone plays an essential role in axon guidance through interaction of cytoskeleton. We review cellular and molecular events after nerve injury and describe nerve regeneration and associated proteins.

• Journal of Korean Neurosurgical Society
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• 제53권2호
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• pp.65-71
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• 2013

Objective : In order to develop a novel nerve guidance channel using porcine small intestinal submucosa (SIS) for nerve regeneration, we investigated the possibility of SIS, a tissue consisting of acellular collagen material without cellular immunogenicity, and containing many kinds of growth factors, as a natural material with a new bioactive functionality. Methods : Left sciatic nerves were cut 5 mm in length, in 14 Sprague-Dawley rats. Grafts between the cut nerve ends were performed with a silicone tube (Silicon group, n=7) and rolled porcine SIS (SIS group, n=7). All rats underwent a motor function test and an electromyography (EMG) study on 4 and 10 weeks after grafting. After last EMG studies, the grafts, including proximal and distal nerve segments, were retrieved for histological analysis. Results : Foot ulcers, due to hypesthesia, were fewer in SIS group than in Silicon group. The run time tests for motor function study were 2.67 seconds in Silicon group and 5.92 seconds in SIS group. Rats in SIS group showed a better EMG response for distal motor latency and amplitude than in Silicon group. Histologically, all grafts contained some axons and myelination. However, the number of axons and the degree of myelination were significantly higher in SIS group than Silicon group. Conclusion : These results show that the porcine SIS was an excellent option as a natural biomaterial for peripheral nerve regeneration since this material contains many kinds of nerve growth factors. Furthermore, it could be used as a biocompatible barrier covering neural tissue.

• Archives of Reconstructive Microsurgery
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• 제1권1호
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• pp.39-44
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• 1992

Benign peripheral nerve tumors, although infrequent, must be considered as a possible cause of pain and disability in the extremities. There are three varieties of these tumors that are of clinical importance: neurilemmomas, neurofibromas, and post-traumatic neuroma. Neurilemmomas are the most common primary solitary tumor of the peripheral nerve trunks, and are almost always benign, Neurofibromas may occur as a solitary nerve tumor, but can present as multiple lesions as in von Recklinghausen's disease. Clinically, this tumor may presents as a solitary mass in the subcutaneous tissue which is centrally located with the nerve fibers travelling through the tumor mass. Traumatic neuroma is the proliferation of nerve elements with connective tissue during the process of regeneration from severed nerves undergoing Wallerian degeration, and is therefore not a true neoplasm. A neuroma-in-countinuity is the result of partial severance of a nerve, or of a crushing or traction injury in which all or part of the epineurium and perineurium is intact. We experienced each of the three varieties. With magnification, the neurilemmoma was removed by meticulous dissection from the parent nerve preserving the normal fascicles to which it was attached. The neurofibroma was excised and the nerve was reconstructed with interposed vein graft and the neuroma-in-continuity was excised and reconstructed with sural nerve graft. We report histologic characteristics of each tumors and the methods to repair the nerve defects after tumor excision with brief discussion.

• Applied Microscopy
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• 제32권1호
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• pp.1-8
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• 2002

손상된 말초신경이 정상상태로 회복되는데 침이 어떤 영향을 미치는지 확인하기 위하여 좌골신경을 인위적으로 손상시킨 후 침을 처리한 군 (AG)과 자연적으로 치유된 군 (CG)의 좌골신경내의 유발전위 증가율, 척수내 효소활성도의 변화 및 좌골신경의 미세구조를 비교.관찰하였다. 유발전위 증가율은 CG에서보다 AG에서 높았고, acid phosphatase 활성도는 1CG와 2AG에서 높게 나타났으나 시간이 경과함에 따라 정상상태로 회복되는 경향을 보였다. 손상된 좌골신경의 미세구조적 변화는 CG보다 AG에서 높은 회복율을 나타내었으며 단지 AG에서만 좌골신경 주위에 지방조직이 발달되어있는 것이 관찰되었다. 이상과 같이 손상된 말초신경이 정상상태로 회복되는 속도는 전자침을 처리한 군에서 높았으며, 특히 다른 치료기간보다 초기시기에서 침의 효과가 매우 높다는 것이 확인되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.228-233
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• 2004

Summary: The malignant peripheral nerve sheath tumor(MPNST) is an aggressive neoplasm and can either arise independently or result from malignant change in preexisting neurofibromatosis (von Recklinghausen's disease). Its histologic characteristics remain controversial, but currently it is believed that the schwann cell is the origin of the peripheral nerve sheath tumors. MPNST is an uncommon neoplasm of the head and neck region, and its presentation in the oral cavity is quite rare. In this study, we report a patient with a rare case of a MPNST involving the maxilla. A case report: A 29-year-old female presented with a chief complaint of painless swelling with bleeding tendency on the left maxillary tuberosity area 2 months ago. Clinical examination showed a $5.0{\times}3.0cm^2$ sized, indurative swelling on the site. Conventional radiographs showed a relatively well-defined soft tissue mass involving the left maxillary sinus, and destruction of the anterior, posterolateral walls of the left maxillary sinus. Subtotal maxillectomy and split-thickness skin graft from thigh were undertaken. In histochemical and immunohistochemical studies, the specimen revealed positive reactivities to Vimentin and S-100 protein. Final diagnosis was made as MPNST.