• Journal of Chest Surgery
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• v.31 no.6
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• pp.598-603
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• 1998

Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

• Korean Journal of Veterinary Research
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• v.43 no.1
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• pp.11-24
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• 2003

This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRY), Bartha strain, into the ductus deferens of rats. After survival times 4-5 days following injection of 2% WGA-HRP and PRV, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned ($30{\mu}m$). These sections were stained by HRP histochemical and PRY inummohistochemical staining methods, and observed with light microscope. The results were as follows ; 1. The location of sympathetic ganglia projecting to the ductus deferens were observed in pelvic ganglion, inferior mesenteric ganglion and L1-6 lwnbar sympathetic ganglia. 2. The location of spinal ganglia projecting to the ductus deferens were observed in T13-L6 spinal ganglia. 3. The PRY labeled neurons projecting to the ductus deferens were observed in lateral spinal nucleus, lamina I, II and X of cervical segments. In thoracic segments, PRY labeled neurons were observed in dorsomedial part of lamina I, II and III, and dorsolateral part of lamina IV and V. Densely labeled neurons were observed in intermediolateral nucleus. In first lumbar segment, labeled neurons were observed in intermediolateral nucleus and dorsal commisural nucleus. In sixth lumbar segment and sacral segments, dense labeled neurons were observed in sacral parasympathetic nuc., lamina IX and X. 4. In the medulla oblongata, PRV labeled neurons projecting to the ductus deferens were observed in the trigeminal spinal nuc., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular nuc., rostroventrolateral reticular nuc., area postrema, nuc. tractus solitarius, raphe obscurus nuc., raphe pallidus nuc., raphe magnus nuc., parapyramidal nuc., lateral reticular nuc., gigantocellular reticular nuc.. 5. In the pons, PRV labeled neurons projecting to the ductus deferens were ohserved in parabrachial nuc., Kolliker-Fuse nuc., locus cooruleus, subcooruleus nuc. and AS noradrenalin cells. 6. In midbrain, PRV labeled neurons projecting to the ductus deferens were observed in periaqueductal gray substance, substantia nigra and dorsal raphe nuc.. 7. In the diencephalon, PRV labeled neurons projecting to the ductus deferens were observed in paraventricular hypahalamic nuc., lateral hypothalamic nuc., retrochiasmatic nuc. and ventromedial hypothalamic nuc.. 8. In cerebrum, PRV labeled neurons projecting to the ductus deferens were observed in area 1 of parietal cortex. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat ductus deferens might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and PRV labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of smooth muscles in ductus deferens. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitaing the internal environment. These observations provide evidence for previously unknown projections from ductus deferens to spinal cord and brain which may be play an important neuroanatornical basic evidence in the regulation of ductus deferens function.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.171-175
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• 2005

Background: Hyperhidrosis is the troublesome disorder of excessive perspiration, which affects as much as 0.15-1% of the population. There are many methods for treating hyperhidrosis. In this report, we present our experience of dorsal percutaneous thoracic sympathetic ganglion block (TSGB) using 99.9% ethyl alcohol for treating palmar hyperhidrosis. Methods: Between March 1992 and July 2003, a total of 856 patients underwent TSGB for the treatment of palmar hyperhidrosis of which 625 were followed up for 2 years. There were 297 and 328 male and female patients, respectively, with a mean age of $23.9{\pm}7.7years$. TSGB was performed under fluoroscopic guidance using 99.9% ethyl alcohol at the T2 and T3 sympathetic ganglia. Results: In the 625 patients, the recurrence rates within the 1st and 2nd years were 29 and 8%, respectively. Compensatory sweating occurred in 42.1% of patients, which was severe in 7.5%. Of the 625 patients 21.0 and 36.9% were either very satisfied or relatively satisfied with the outcome, respectively. Conclusions: Our report confirms that TSGB may be a good alternative to endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.145-155
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• 2022

The purpose of this study is to evaluate the effectiveness of traditional Korean medicine treatment of cervical vertigo. Three patients were diagnosed as cervical vertigo with correlating symptoms of imbalance and dizziness with neck pain. The diagnosis of cervical vertigo is also dependent on excluding other vestibular disorders on the basis of history, examination, and vestibular function tests. They were treated by acupuncture, transcutaneous electrical nerve stimulation therapy and low-intensity pulsed ultrasound at acupoints and sympathetic ganglion chain of their cervical and upper thoracic region. The evaluation of clinical outcome was done by numeric rating scale (NRS), dizziness handicap inventory (DHI) and neck disability index (NDI), EuroQol-five dimensions questionnaire (EQ-5D) index. After the treatment, the value of their NRS, NDI, DHI was significantly decreased and their EQ-5D index was significantly increased. The traditional Korean medicine treatment at cervical and upper thoracic region could be an effective way to treat cervical vertigo.

• The Korean Journal of Zoology
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• v.36 no.1
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• pp.116-122
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• 1993

An immunocytochemical investigation has been carried out to localize serotoninimmunoreactive (5-HTi) neurons in suboesophageal ganglion of fifth instar lawn of cabbage worm Pieris rupae. The 285-HTi cell bodies were identified in the rind of suboesophaseal ganglion. The four 5-HTi cell bodies of them are 18rge in size (about 35 Um), while the remaining cell bodies are medium-sized (about 15 Uml. The 5-HTi nerve processes are abundantly located in central large neuropil, circumoesophageal connectives which join the suboesophaseal ganglion to the tritocerebrum of the brain, and connectives between the suboesophageal and the first thoracic ganglia. These results indicate that the 5-HTi nerve fibers, which constitute the central large neuropil, have structural connections with the above two connectives. Especially in central large neuropil, many 5-HTi nenre fibers form a large circular bundle, in which a 5-HTi nerve fiber bundle is crossing.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.23-38
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• 2009

Objectives : The purpose of this morphological studies was to investigate the relations between Sanyinjiao(Sp6), Yinlingquan(Sp9) and pancreas of rats using peudorabies virus(PRV). Methods : We observed labeled neurons following the injection of PRV, Bartha strain, into the Sanyinjiao(Sp6), Yinlingquan(Sp9) and pancreas of rats. After survival times of 4 days following the injection of PRV, the rats were perfused, and their spinal ganglia, spinal cord and brain stem were frozen sectioned($35{\mu}m$). These sections were strained by PRV immunohistchemical staining methods and observed with light microscope. Results : The results were as follows. 1. In the spinal ganglia, the overlap areas of PRV labeled neurons projecting to Sanyinjiao(Sp6), Yinlingquan(Sp9) and pancreas were observed in T10-13 dorsal root ganglia. 2. In the spinal cord, the overlap areas of PRV labeled neurons projecting to Sanyinjiao(Sp6), Yinlingquan(Sp9) and pancreas were lamina I, IV, V, VII, IX, X, intermediolateral nucleus(IML), intermediomedial nucleus(IMM) in thoracic segments. In lumbar segments, the overlap areas of PRV labeled neuron were lamina I, IV, V, VI, IX, X and IMM. In sacral segments, the overlap areas of PRV labeled neuron were lamina I, IV, V, VI, VII, IX, X. 3. In the brain, the overlap areas of PRV labeled neurons projecting to Sanyinjiao(Sp6), Yinlingquan(Sp9) and pancreas were area postrema, nucleus tractus solitarius, caudoventrolateral reticular nu., medullary reticular nu., lateral paragigantocellular nu., C3 adrenalin cells, gigantocellular nu., raphe pallidus nu., raphe obscurus nu., ambiguus nu., raphe magnus nu., pontine reticular formation, A5 cell group, subcoeruleus nu., locus coeruleus, Barringnton's nu., $K{\ddot{o}}lliker$-Fuse nu., dorsal raphe nu., Edinger-Westphal nu., central gray matter, perifornical nu., dorsomedial hypothalamic nu., arcuate nu., lateral hypothalamic nu., paraventricular hypothalamic nu., hindlimb area. Conclusions : In conclusion, these results suggest that the interrelationship of meridian(spleen meridian), acupoints(Sp6 and Sp9) and viscera(pancreas) may be related the central autonomic centers.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.4
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• pp.805-817
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• 2009

This study was to investigate central localization of neurons projecting to the urinary bladder and urinary bladder-related acupoints(Wijung, $BL_{40}$) and neurons of immunoreactive to hormones and hormone receptors regulating urinary bladder function by using peudorabies virus(PRV). In this experiment, Bartha's strain of pseudorabies virus was used in rats to trace central localization of urinary bladder-related neurons and urinary bladder-related acupoints($BL_{40}$) which can regulate urinary system. PRV was injected into the urinary bladder and acupoints($BL_{40}$) related urinary system. After six days survival of rats, mainly common labeled neurons projecting to the urinary bladder and urinary bladder-related acupoints were identified in spinal cord, medulla, pons and diencephalon by PRV immunohistochemical staining method. First-order PRV labeled neurons projecting to urinary bladder and urinary bladder-related acupoints were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled preganglionic neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in the lateral horn area(sacral parasympathetic nucleus and intermediolateral nucleus), lamina V-X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting to urinary bladder and Wijung($BL_{40}$) was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus of tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, Barrington's nucleus and periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the paraventricular nucleus and a few ones were in the lateral hypothalamic nucleus, posterior hypothalamic nucleus, ventromedial hypothalamic nucleus, arcuate nucleus, median eminence, perifornical nucleus, periventricular nucleus and suprachiasmatic nucleus. In cerebral cortex, PRV labeled neurons were marked mostly in the frontal cortex, 1,2 area, hind limb area, agranular insular cortex. Immunoreactive neurons to Corticotropin releasiing factor(CRF), Corticotropin releasiing factor-receptor(CRF-R), c-fos and serotonin were a part of labeled areas among the virus-labeled neurons of urinary bladder and Wijung($BL_{40}$). The commonly labeled areas were nucleus tractus solitarius, area postrema, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), locus coeruleus, A5 cell group, Barrington,s nucleus, arcuate nucleus, paraventricular nucleus, frontal cortex 1, 2 area, hind limb, and perirhinal(agranular insular) cortex. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of urinary bladder-relate organs and it was revealed by tracing PRV labeled neurons projecting urinary bladder and urinary bladder-related acupoints. These commonly labeled areas often overlap with the neurons connected with hormones and hormone receptors related to urination.

• International Journal of Industrial Entomology and Biomaterials
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• v.3 no.2
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• pp.177-185
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• 2001

This study has been carried out to determine localization of Manduca sexta allatotropin (Mas-AT) neuropeptide in developing ventral nerve cord of the silk moth Bombyx mori with polyclonal antisera against Mas-AT. Suboesophageal ganglion (SOG) of the second to fifth instar larvae and 3-day-old pupae showed two to ten Mas-AT-immunoreactive (Mas-AT-IR) cell bodies. There were two to three pairs of labeled cell bodies in each thoracic ganglion (TG) from third instar larvae to adults, with the exception of TG from prepupae. One pair of labeled cell bodies was localized in each abdominal ganglion (AG) 1 to 6 from third instar larvae to 3-day-old pupae, whereas in 5-day-old pupae to adults there was one pair in a similar location of AG 1 to 5. The seventh neuromeres of terminal abdominal ganglia (TAG) from third instar Iarvae to 3- day-old pupae contained four labeled large cell bodies. In each of AG 1 to 7, these cell bodies showed similar allatotropin-immunoreactivity in appearance. Some labeled axons, projected from Mas-AT-lR cells in each of those AG, were extended to the nerves N 1 and N 2.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.595-601
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• 2003

Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.