• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.161-168
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• 2017

Peripheral nerve blocks are commonly used for surgical anesthesia, postoperative analgesia, and to reduce opioid requirements. Although these blocks have traditionally been carried out using local anesthetics, single-injection techniques can be short-lived and limited by the relatively brief duration of action of currently available local anesthetics. Increasing the dose or concentration of local anesthetics may prolong the duration of analgesia, but may also increase the risk such as unwanted motor weakness or systemic toxicity of local anesthetics. Numerous adjuvant medications have been added to local anesthetics to prolong the durations of anesthesia and analgesia achieved by peripheral nerve blocks, and currently, a number of different adjuvants are used to improve quality of the block. This article will review the several nerve block adjuvants used in combination with local anesthetics to provide blockade of peripheral nerves in clinical practice, describing the rationale for their use in peripheral nerve blocks, and the evidence for their effectiveness.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.72-75
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• 2012

Ischemic monomelic neuropathy and myopathy are rare complications of peripheral arterial occlusive disease. We report a case of ischemic monomelic neuropathy of the right sural, common peroneal and posterior tibial nerves and ischemic myopathy of the right tibialis anterior resulting from the occlusion of the right common femoral arteries despite successful revascularization. Ischemic monomelic neuropathy and myopathy can occur as a result of occlusion of the specific peripheral artery.

• 척추신경추나의학회지
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• 제14권1호
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• pp.1-11
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• 2019

Objectives : The purpose of this study is to review clinical studies about the effect of chuna manual therapy (CMT) for peripheral facial paralysis in children. Methods : In this review, we searched 11 electronic databases (Pubmed, Cochrane Library, EMBASE, CINAHL, CAJ, Oasis, NDSL, KISS, RISS, KISTI, Dbpia); We concluded our literature search in April 23, 2019. We included only randomized controlled trials (RCTs) of testing CMT for peripheral facial paralysis in children. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. The meta-analysis was performed by synthesizing outcome data of total efficacy rate (TER). Results : After screening papers, a total of 6 RCTs were selected and analyzed. In the 6 RCTs, patients(n=15-60 per study) were randomized into groups for treatment and control. Specifically, the treatment group received CMT, while the control group was concurrently given usual care, such as acupuncture and medicine. The meta-analysis showed that the treatment group receiving CMT alone showed significant improvement in TER, compared to the control group receiving acupuncture therapy alone(P<0.05). And the treatment group receiving CMT combined with usual care showed positive results, in terms of TER, compared to the control group receiving usual care, but was not statistically significant(P>0.05). Conclusions : Our analysis suggests that CMT has therapeutic effects for peripheral facial paralysis in children. However, to confirm this result, further investigation accompanied by high quality studies is required.

• 대한영상의학회지
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• 제81권1호
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• pp.81-100
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• 2020

말초신경병증의 진단을 위해 MR neurography의 사용이 점차 증가하고 있다. 고대조도와 고해상도로 말초신경을 직접 영상화한 MR 영상을 MR neurography라고 하고, 지방억제 T2 강조영상과 확산강조영상이 흔히 사용되는 시퀀스이다. 작은 직경, 복잡한 해부학적 구조를 가진 말초신경을 합리적 시간 안에 영상화하기 위해서 최신의 isotropic 3차원 기법, 다양한 고속영상기법, post-processing 영상 기법 등이 사용된다. 이런 발전들로 인해 MR neurography가 유용하게 사용되지만 항상 적절한 MR neurography 영상을 얻을 수 있는 것은 아니다. 적절한 MR neurography 영상을 얻기 위해 영상의학과 의사가 고려해야 할 다음의 몇 가지 쟁점들이 있다. 이에는 적절한 표준 프로토콜의 선책, 지방억제 기법의 선택, 해상도와 field of view와 slice thickness 간의 상호 관계의 이해, 적절한 post-processing 영상 기법의 적용, 2차원 영상획득 기법과 3차원 영상획득 기법의 장단점, 근위부 말초신경과 말단부 말초신경의 T2 대조도의 차이, 말초신경에 인접한 정맥이 MR neurography에 미치는 영향, 확산강조영상에서 기하학적 왜곡의 발생과 적절한 b value의 선택 등이다. 이런 쟁점들을 잘 이해하는 것이 경험이 적은 영상의학과 의사가 적절한 MR neurography 영상을 얻고, 말초신경병증을 정확히 평가하는 데 많은 도움이 될 것이다.

• Applied Microscopy
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• 제32권1호
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• pp.67-80
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• 2002

좌골신경 재생에 미치는 녹용의 효과를 알아보기 위해 300 gm 내외의 수컷 Sprague-Dawley계 랫드에 체중 100 gm당 1.5 ml의 수용성 녹용추출물을 각각 1주, 2주, 3주간 매일 1회씩 경구 투여한 후 양쪽 하지의 좌골신경을 절단하였다. 6시간 경과 후 절단부의 근위부에서 절취한 좌골신경을 통상적인 전자현미경기법으로 처리하여 관찰한 바 다음과 같은 결과를 얻었다. 1. 정상대조군의 좌골신경은 신경마디에서 axonal sprouting이 관찰되지 않았고, 전자밀도가 높은 축삭막의 돌출구조가 종종 관찰되었다. 2. 생리식염수 투여군의 좌골신경의 신경마디에서 axonal sprouts의 형성이 관찰되었으며, 그 길이는 대부분 짧았고, 내부에 많은 소포와 공포를 함유하고 있었으며 일부에서는 신경세사를 비롯한 세포소기관을 가지고 있었다. 각각 100개씩의 세로절단된 신경마디에서 sprouts 의 존재여부를 계수한 바 1주 투여군에서 29개(29%), 2주 투여군에서 32개 (32%), 3주 투여군에서 30개 (30%)로 각각 나타났다. 3. 녹용 투여군의 좌골신경의 신경마디에서 axonal sprouts의 형성이 관찰되었고 대부분 그 길이가 짧았으나 2주 투여군과 3주 투여군에서 종종 긴 sprouts가 관찰되었다. Sprouts의 내부에는 많은 소포와 공포를 함유하고 있었고 종종 신경세사, 사립체 등의 소기관을 함유하고 있는 경우도 있었다. 각각 100개씩의 세로절단된 신경마디에서 계수한 sprouts의 수는 1주 투여군에서 38개 (38%), 2주 투여군에서 46개 (46%), 3주 투여군에서 48개(48%)로 각각 나타났다. 이상의 결과로부터 녹용추출물의 선투여는 절단좌골신경의 sprout 형성을 촉진함을 알 수 있었고, 이는 녹용이 말초신경의 재생에 효과가 있음을 시사한다고 생각된다.와 전자밀도가 낮은 소포들이 혼합된 형과 전자밀도가 낮은 소포들로만 이루어진 연접체 등 두 종류를 소지하고 있어 두 종간 차이가 확인되었다.흰쥐 전뇌 기저부 Meynert기저핵에서의 ChAT면역반응 신경세포들은 출생 후 발생과정에서 세포소기관과 신경돌기들의 분화에 따른 세포체 부피의 증가, 분화된 세포형들의 출현 율의 증가 및 세포의 손실이 없는 상태에서 세포 응축 등의 과정을 통하여 세포들이 분화한다고 생각된다.\mu}m$정도로 세포질 대비 매우 컸다. 이들은 다양한 크기의 전자밀도가 높은 둥근 과립(직경 $1\sim0.2{\mu}m$)을 소지하고 있었으며, 세포의 표면은 여러 형태의 사상족(filopodia)들을 뻗어 노쇠한 세포들을 포식하였다. 신경망(neuropiles)들은 신경분비세포를 둘러싸고 있었으며, 신경섬유 속에서 다양한 종류의 연접소포들(synaptic vesicles)이 관찰되었는데, 전자밀도, 크기 그리고 모양에 따라 6종류로 분류되었다.로 확인되었다. 방사대는 외측에 않은 homogeneous layer와 내측에 2개의 두꺼운 helicoidal layers (zona radiata interna and zona radials externa)총 3개의 구조물로 구성되어 있었다. 정상적인 환경조건에서 볼 때 난포는 난형성과 생식소에서 분비되는 스테로이드 흐르몬의 생성에 충분할 만큼 조직의 발달과 호르몬의 주기적인 분비에 영향을 주는 것으로 나타났다.%o보다 20%o, 30%o에 적응(適應)된 개체의 신장조직(腎臟組織)에서 더많이 발생되었다. 틸라피아의 신사구체(腎絲球體)는 담수(淡水)에서 10%o의 해수(海水)로 이주된지 14일(日) 이후에 신장(腎臟)에서 수축된 것으로 나타났다. 30%o의 해수(海水)에 적응(適應)된 틸라피아의 평균 신사구체(腎絲球體)의 면적은

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.96-107
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• 1995

The purpose of this experimental study was to examine and compare the regeneration capacity between crushed nerve & transected nerve. For this study, 20 Sprague-Dawley female albino rats were used as experimental animals and divided into two groups. In group 1, the sciatic nerves were crushed 6mm. in length for 1 min. using maximum force with a needle holder. In group 2, the sciatic nerves were resected 6mm. in length and the gaps were encased by inserting the proximal and distal stumps into each end of silicone tubes. The animals were sacrificed 1 month & 2 months after the experiment. All specimens were fixed in 2.5% glutaraldehyde and 1% Osmium tetroxide solution then embedded in epon 812 and were cross-sectioned at $1{\mu}m.$ After these procedures, specimens were observed under Light microscope. The results obtained were as follows. 1. Group 1 showed greter diameters of regenerating nerves than group 2. 2. Group 1 showed greater number of axons than group 2.

• 대한한방내과학회지
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• 제33권2호
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• pp.126-144
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• 2012

Background : Peripheral nerves more rapidly recover than central nerves. However, it has been known that the degree of reaction of axons of peripheral nerves is affected by distinctive characteristics of axons and environmental factors near the axons. Taxol is a widely used medicine as for ovarian, breast, lung and gastric cancer. However it causes patients difficulties under treatment due to its toxic and side effects, which include persistent pain. Objectives : This study reviewed how SJT extract in vitro and in vivo affects nerve tissues of a sciatic nerve damaged by Taxol. It also studied how SJT extract in vivo affects axons of the sciatic nerve after the sciatic nerve was damaged by pressing. Methods : After vehicle, Taxol, and Taxol plus SJT were treated respectively for tissue of the sciatic nerve in vitro and then tissues were observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and anti-cdc2. SJT was also oral medicated by injecting Taxol into the sciatic nerve of in vivo rats. Tissues of the sciatic nerve and axons of DRG sensory nerves were then observed using Neurofilament 200, Hoechst, ${\beta}$-tubulin, $S100{\beta}$, caspase-3 and p-Erk1/2. After inflicting pressing damage to the sciatic nerve of in vivo rats, tissues of the sciatic nerve and DRG sensory nerve were observed using Neurofilament 200, Hoechst, $S100{\beta}$, caspase-3, anti-cdc2, phospho-vimentin, ${\beta}1$-integrin, Dil reverse tracking and p-Erk1/2. Results : The group of in vitro Taxol plus SJT treatment had meaningful effects after sciatic nerve tissue was damaged by Taxol. The group of in vivo SJT treatment had effects of regenerating Schwann cells and axons which were damaged by Taxol treatment. The group of in vivo SJT had effects of regenerating axons in damaged areas after the sciatic nerve was damaged by pressing, and also had variations of distribution in Schwann cells at DRG sensory nerves and axons. Conclusions : This study confirmed that SJT treatment is effective for growth of axons in the sciatic nerve tissues and improvement of Schwann cells after axons of the sciatic nerve tissues was damaged. After tissues of sciatic nerve was damaged by pressing in vivo, SJT treatment had effects on promoting regeneration of axon in the damaged area and reactional capabilities in axons of DRG sensory nerves.

• 대한골관절종양학회지
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• 제19권2호
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• pp.83-86
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• 2013

말초 신경에 발생하는 결절종은 일부 보고된 바는 있으나, 발생 빈도는 드문 것으로 되어있으며 발생 부위는 비골 신경이 가장 흔한 것으로 보고되고 있다. 이외에도 요골 신경, 척골 신경, 정중 신경, 좌골 신경, 경골 신경 및 후 골간신경에 발생한 경우도 보고되고 있다. 저자들은 내측 족저 신경에 발생한 신경 내 결절종 1예와 총 비골 신경에 발생한 신경 내 결절종 1예를 신경학적 후유증 없이 치료하여 이를 보고하고자 한다.

• 대한장애인치과학회지
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• 제11권1호
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• pp.9-16
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• 2015

Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

• 혜화의학회지
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• 제25권1호
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• pp.99-108
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• 2016

While axons in the peripheral nerve can regenerate and lead to functional recovery to a certain extent after injury, its efficacy varies depending on the severity and duration of the injury. Here, we investigated the effects of Boyanghwano-tang (BYHOT) treatment on the regenerative responses in the sciatic nerves after prolonged transection and coaptation surgery. In mice given crush injury, axonal regeneration was completed when analyzed 1 week later and did not show any difference in regenerative reponses in the distal portion of the nerve between saline- and BYHOT-treated groups. In animal models with transection and reconnection, axonal regeneration was markedly retarded compared to animals with crush injury. Regenerating axons were extended into the reconnected distal portion of the nerve more actively in animals treated with BYHOT than saline controls. Cdc2 protein was similarly induced in nerves with crush injury and with transection and recollection, and its level was lower in BYHOT-treated animal than saline control when measured 2 weeks after nerve reconnection. These results suggest that BYHOT may be useful to promote axonal regeneration in the peripheral nerve after severe injury.