• The Journal of Korean Medicine
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• v.32 no.3
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• pp.1-9
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• 2011

Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

• The Journal of Korean Medicine
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• v.28 no.3 s.71
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• pp.261-272
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• 2007

Objectives : This study was conducted to determine the analgesic effect of Acanthopanax sessiliflorus using the model of neuropathic pain and formalin-induced pain. Methods : A model of neuropathic pain was made by injuring the tibial nerve and sural nerve while the common peroneal nerve was maintained. After 2 weeks, the Acanthopanax sessiliflorus was orally administered to rats. The author performed behavioral teststo try out mechanical allodynia using von frey filament and cold allodynia using acetone, which are calculated by counting withdrawal response on foot. Thirty minutes after the Acanthopanax sessiliflorus injection in the abdominal cavity, the formalin test was performed. 2% formalin in a volume of $20{\mu}l$was injected subcutaneously into the plantar surface of the hindpaw with 26-G needle. To access formalin-induced pain behavior, paw licking time was measured every 5 min. Results : The Acanthopanax sessiliflorus 400mg/10ml/kg group showed significant decrease the withdrawal response of mechanical allodynia using von frey filament in the 10min, 30min, 60min and 120min increments compared with the control group. There were no significant differences in each group in the withdrawal response of cold allodynia using acetone. The Acanthopanax sessiliflorus group showed significant decrease in the formalin-induced pain behavior in the 15min, 20min and 25min increments compared with the control group. Conclusions : The Acanthopanax sessiliflorus may have a significant analgesic effect on the general pain as well as nerve injury pain.

• The Korean Journal of Pain
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• v.23 no.3
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• pp.166-171
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• 2010

Background: Neuropathic pain resulting from diverse causes is a chronic condition for which effective treatment is lacking. The goal of this study was to test whether dexamethasone exerts a preemptive analgesic effect with bupivacaine when injected perineurally in the spared nerve injury model. Methods: Fifty rats were randomly divided into five groups. Group 1 (control) was ligated but received no drugs. Group 2 was perineurally infiltrated (tibial and common peroneal nerves) with 0.4% bupivacaine (0.2 ml) and dexamethasone (0.8 mg) 10 minutes before surgery. Group 3 was infiltrated with 0.4% bupivacaine (0.2 ml) and dexamethasone (0.8 mg) after surgery. Group 4 was infiltrated with normal saline (0.2 ml) and dexamethasone (0.8 mg) 10 minutes before surgery. Group 5 was infiltrated with only 0.4% bupivacaine (0.2 ml) before surgery. Rat paw withdrawal thresholds were measured using the von Frey hair test before surgery as a baseline measurement and on postoperative days 3, 6, 9, 12, 15, 18 and 21. Results: In the group injected preoperatively with dexamethasone and bupivacaine, mechanical allodynia did not develop and mechanical threshold forces were significantly different compared with other groups, especially between postoperative days 3 and 9 (P < 0.05). Conclusions: In conclusion, preoperative infiltration of both dexamethasone and bupivacaine showed a significantly better analgesic effect than did infiltration of bupivacaine or dexamethasone alone in the spared nerve injury model, especially early on after surgery.

• The Korean Journal of Physiology
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• v.21 no.1
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• pp.67-77
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• 1987

Effect of intravenously injected clonidine on the flexion reflex was studied in 15 decerebrated and spinalized cats. The flexion reflex was elicited by electrical stimulation of the tibial nerve or the common peroneal nerve and it was recorded as single unit activity from filaments of the L6 or L7 ventral roots. In order to obtain the late flexion reflex discharges, $A{\delta}$ and C afferent fibers were stimulated with single or train electrical pulses respectively. The flexion reflex, especially the late component, was markedly inhibited after intravenous administration of clonidine. The clonidine-induced inhibition of the flexion reflex was compared before and after treatment of the animals respectively with yohimbine and naloxone. The inhibitory effect on the flexion reflex of clonidine was not altered by naloxone, a ${\mu}-opioid$ receptor blocker, whereas it was completely blocked by yohimbine, an ${\alpha}_2-adrenergic$ antagonist. These results indicate that clonidine inhibits the flexion reflex through excitation of ${\alpha}_2-adrenoceptors$ even at the spinal cord level.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.3
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• pp.672-676
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• 2003

To investigate the effect of acupuncture on Zusanli (ST 36) in this study, gastrin level of serum by radioimmunoassay was measured at 1, 3, 6 weeks in rats. In other groups, 1 mg/day omeprazole was administered for 1, 3, 6 weeks. Omeprazole increased significantly gastrin level of serum at 1, 3, 6 weeks in a time dependent manner. Acupuncture applied to the ST 36 acupoint decreased at 1, 3, 6 weeks. Furthermore, acupuncture applied to other acupoint, Yanglinquan (GB 34) did not produced significant effect. When the common peroneal nerve was dissected, acupuncture of ST 36 produced the change of gastrin level. These data suggest that acupuncture decreased gastrin level of serum in point specific way and that effect was not related with surrounding nerve.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.136-142
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• 2022

Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.88-92
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• 1998

The course of the sural nerve in the calf has been well documented, but there is a general lack of information concerning the distal course of the nerve. The purpose of this study was to describe the distal course of the sural nerve and its surgical implications. Seven fresh amputated specimens were dissected to show the anatomy of the sural nerve in the foot and ankle. At the level of about 10cm proximal to the plantar surface, the sural nerve coursed anteriorly and inferiorly away from the Achilles tendon. 2 to 4 lateral calcaneal branches arose. The first branch of the lateral calcaneal branches coursed along the lateral border of the Achilles tendon, and it arose at 8cm proximal to the plantar surface in 2 specimens, 12cm proximal to the plantar surface in 4 specimens, and at 12cm proximal to the plantar surface in one specimen. The main nerve trunk continued distally plantar to the peroneal tendons and divided into two terminal branches and crossed peroneus longus tendon at the level of the inferior border of the calcaneo-cuboid joint, at about 3cm(range, $2.5\sim3.0$)cm from the plantar surface. In conclusion, a longitudinal incision lateral to the Achilles tendon would cross the path of the sural nerve at about 10cm proximal to the plantar surface. When the first branch of them arise more than 10cm above the plantar surface, a logitudinal incision lateral to the Achilles tendon may be made without damage. The other lateral calcaneal branches will be cut when we make transverse incision paralled to the plantar surface. The terminal branch also may be in danger by the same transverse incision.

• Science of Emotion and Sensibility
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• v.19 no.4
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• pp.111-118
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• 2016

Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.79-86
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• 2012

Calcaneal fractures account for 2% of all fractures and approximately 60 to 70% of tarsal fractures. These fractures typically are the result of high-energy injury, such as a motor vehicle accident or a fall from a height. The potential for disabling malunion following intrarticular displaced calcaneal fracture is high, regardless of treatment. Fracture displacement typically results in loss of hindfoot height, varus and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systemic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity and shoe modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical manamgent.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.65-68
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• 1995

Pectus excavatum occasionally occurs in patients who have underlying cardiac disease, especially Marfan syndrome. This report describes a patient with pectus excavatum who had ascending aortic aneurysm with aortic regurgitation and anterior leaflet prolapse of mitral valve. This patient underwent replacement of aortic valve and ascending aorta with 25 mm SJM valved conduit graft[Bentall operation with Cabrol shunt , and mitral valve replacement with SJM 31 mm, the pectus excavatum was corrected at the time of completion of the intracardiac operation with the modified sternal turnover. This procedure offered excellent operative exposure for the inracardiac operation with prevention of low cardiac output after operation due to depressed sternum and maintained chest wall stability resulting good cosmetic chest wall appearance. This patient recovered and discharged in good postoperative result with minimal temporary peroneal nerve palsy in his left leg.