• 제목/요약/키워드: 말초신경

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Neurolymphomatosis Relapsed as Peripheral Neuropahty after Long-Term Complete Remission (오랜 기간 완전완화 후 말초신경병증으로 재발한 신경림프종증)

  • Hwang, Jun;Go, Pan-Woo;Seo, An-Na;Chae, Jong-Min;Kang, Byung-Wook;Lee, Jae-Hyuck;Suh, Jung-Kyu;Song, Hyun-Seok
    • Annals of Clinical Neurophysiology
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    • v.13 no.2
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    • pp.101-105
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    • 2011
  • Neurolymphomatosis, an uncommon manifestation of non-Hodgkin's lymphoma, is lymphomatous infiltration of peripheral nerves. We confirmed the diagnosis of neurolymphomatosis in a 75-year old woman with a history of complete remission of diffuse large B cell type lymphoma on the nasal cavity seven years ago. She complained of painful weakness of left leg and took the electrophysiologic study, extremity ultrasonography, fluorodeoxyglucose PET-CT, and extremity MRI serially. She was diagnosed as neurolymphomatosis by targeted posterior tibial nerve mass biopsy.

A Case of Early Malignant Change from Neurofibroma to Malignant Peripheral Nerve Sheath Tumor (제1형 신경섬유종증, 신경섬유종, 악성 말초신경초종)

  • Poo Reum Kang;Yeong Joon Kim;Sun Ju Oh;Hyoung Shin Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.45-48
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    • 2023
  • Malignant peripheral nerve sheath tumor (MPNST) is one of the soft tissue sarcoma believed to originate from neural crest cells. The patients with neurofibromatosis type I (NF1) have about 8-13% of the lifetime risk of the malignant transformation. Neurofibroma on patients with NF1 can be surgically resected and has good prognosis if approach to the tumor is possible. We experienced a case of a 50-year-old woman with NF who had incompletely resected neurofibroma, which presented a rapid malignant transformation to MPNST, 3 months after the first surgery. We reported this case with a brief review of literature.

Effects of Bupivacaine Pretreatment at the Periphery on the Expression of Mechanical Hyperalgesia in a Rat Model of Peripheral Neuropathy (백서의 말초신경 통증 모델에서 신경결찰 전 말초에 주입된 Bupivacaine이 기계적 통각과민의 발현에 미치는 영향)

  • Chung, Yong-Bo;Leem, Joong-Woo;Chung, Eun-Jung;Lee, Jung-Chan;Choi, Yoon
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.7-11
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    • 2001
  • Background: Although several mechanisms of causalgia, which results from a partial injury to the peripheral nerve trunk, have been proposed, whether or not antidromic impulses from the injured neurons contribute to the development of the mechanical hyperalgesia has not been studied. The purpose of this experiment is was to investigate the role of antidromic impulses to the peripheral sensory receptor site on the development of mechanical hyperalgesia in a rat model of peripheral neuropathy. Methods: Rats were prepared with tight ligation of by tightly ligating the left fifth and sixth lumbar spinal nerves. The effect of bupivacaine pretreatment on the development of mechanical hyperalgesia was evaluated by injecting 0.5% bupivacaine (0.3 ml) into the plantar surface of the left hind paw before the skin incision was made. For the control group, normal saline (0.3 ml) was injected instead of bupivacaine. To measure the mechanical hyperalgesia, paw withdrawal thresholds were measured using a series of von Frey hairs. Mechanical hyperalgesia was measured a the day before, and 1, 2, 3, 4, 7, and 14 days after the surgery. Results: The control group showed decreased withdrawal thresholds from the day after the surgery (the values were $14.0{\pm}0.5$, $8.9{\pm}1.3$, $8.4{\pm}1.6$, $6.9{\pm}1.2$, $8.8{\pm}1.5$, $10.5{\pm}1.3$, and $8.6{\pm}1.3$ g; at -1, 1, 2, 3, 4, 7, and 14 days after the surgery, respectively). However, withdrawal thresholds of the bupivacaine-pretreated group showed increased withdrawal thresholds for three days after the surgery ($14.5{\pm}0.3$, $12.6{\pm}1.4$, $12.7{\pm}1.1$, $10.5{\pm}1.3$ g; at 1, 1, 2, 3 days after the surgery). Conclusions: Our result suggests that antidromic impulses to the peripheral sensory receptors are at least partly responsible for the initial development of mechanical hyperalgesia in a rat model of peripheral neuropathy.

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A Study on the Localization of Neurofascin in the Myelinated Rat Sciatic Nerve Fibers (랫드 수초좌골신경섬유에서 Neurofascin분포에 대한 면역세포화학적 연구)

  • Chang, Byung-Hwa;You, Kwan-Hee;Lee, Jong-Hwan;Cho, Ik-Hyun;Bae, Chun-Sik;Park, Chang-Hyun;Han, Jeong-Mi;Choe, Nong-Hoon;Chang, Byung-Joon
    • Applied Microscopy
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    • v.36 no.2
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    • pp.131-140
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    • 2006
  • Neurofascin, one of the members of L1CAM, has been known to have some important roles during the development of nerve fibers. In order to investigate the role of neurofascin associated with the myelination of peripheral nerves, the localization of neurofascin in myelinated rat sciatic nerve fibers was studied with the immuno-fluorescence and immune-electron microscopy and the results are as follows; 1. According to the myelination is going on, neurofascin localization was dramatically changed in the sciatic nerve fibers. 2. In the myelinated fibers, neurofascin was weakly localized along the axolemma at the node of Ranvier. 3. Neurofascin was also apparantly localized at the non-compact area of Schwann cell membrane such as paranodal loop, Schmidt-Lantermann incisure, inner & outer mesaxons in the myelinated fibers. From the above results, neurofascin is likely to have a role to sustain the ideal gap of apposing membranes of Schwann cell, so it may enable to materials transport in the myelin sheath.

Schwannoma of the Extremities (사지에 발생한 신경초종)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Lee, An-Hi
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.148-154
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    • 2003
  • Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

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Effects Of Continuous Epidural Analgesia For Fractured Ribs (늑골골절 환자에서 지속적 경막외 신경차단에 의한 진통효과)

  • 안상구;김재영
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1017-1022
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    • 1996
  • Patients with fractured ribs necessarily suffer from severe chest ain, which prevents coughing, deep breathing and bronchial toilette, cause atelectasis and pulmonary shunting. Relief of chest pain is benecial to patients, providing consort and facilitating physiotherapy and effective expectoration. We compared the efficacy of pain relief be!ween continuous epidural analgesia and conventional intramlrscular analgesia in 20 patients with fractured ribs. Among 20 patients, epidural analgesia was done or 10 patients(experimental group) and the remainder ten received intramuscular analgesia(control group). The pain and ROM(range of motion) scores, vital sign, PaO2, forced vital capacity(FVC) and forced expiratory volume for 1 second(FEVI) were checked on immediate admission and 12, 24 hours, third, fifth, and seventh day after starting of continuous epidural block. The pain and ROM scores were decreased and the PaO2, FRC and FEVI were significantly increased in experimental group. The side effects of epidural analgesia were mild and reversible. With th se result, we can suggest that epidural analgesia is more effective for pain relief and restoration of pulmonary mechanics in patients with fractured ribs.

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Biochemical Changes of the Nerve Cells of Rats under Restraint Stress (구속스트레스에 의한 백서 신경세포의 생물학적 성상의 변화)

  • Lee, Dong-Sik;Chun, Yang-Hyun;Lee, Jin-Yong;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.181-187
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    • 2001
  • 스트레스가 인체의 항상성에 영향을 미쳐 다양한 질병 및 동통을 일으킬 수 있다는 것은 선학들의 연구에 의해 증명되어 왔다. 특히 정서적으로 중요한 구강안면영역에는 스트레스와 관련된 질병 및 동통이 많이 존재하는데, 이에대한 병리적 기전은 아직 뚜렷하게 밝혀져 있지 않다. 이에 저자는 스트레스와 말초 및 중추신경과의 병리적 관계를 알아보고자, 구속스트레스하에서 구강안면영역의 감각과 운동에 중요한 역할을 하는 삼차신경의 집합체인 삼차신경절과 뇌간조직의 단백질 변화를 western blot을 통해 살펴보았다. 실험동물은 생후 8주된 Sprague-Dawley계 웅성 백서 (323-367 g/bw)를 대조군 3마리, 실험군 15마리로 배정하였고 실험군은 실험 전기간에 걸쳐 구속스트레스를 부여하였다. 실험동물의 삼차신경절과 뇌간은 희생 즉시 적출되었으며, western blot을 시행하여 다음과 같은 결론을 얻었다. 1. 삼차신경절의 모든 군에서 약 18 KDa의 단백질이 균일하게 나타났다. 2. 뇌간의 모든 군에서 약 18 KDa 단백질이 발현되었으며, 정상 대조군, 실험 즉일, 1일, 3일, 7일에서는 뚜렷한 변화가 없었으나 실험 5일군에서는 현저한 감소를 보였다. 구속스트레스에 의해 뇌간의 5일군에서 약 18 KDa의 특수한 단백질이 뚜렷이 감소된 후 7일 군에서 다시 증가되었던 것은 스트레스에 의한 뇌간세포의 반응으로 생각되며, 뇌간에서와 다르게 삼차신경절에서는 그 변화가 나타나지 않았던 것은 스트레스에 대한 조직의 반응 차이라고 생각된다. 따라서 이를 명확하게 확인하기 위해서는 향후 수종의 스트레스와 관련된 단백질 변화에 대한 추가적인 연구가 필요하리라 사료된다.

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Peripheral Nerve Injuries Associated with Rotator Cuff Tears (견관절 회전근 개 파열과 동반된 말초 신경 손상)

  • Lee, Kwang-Won;Lee, Ho;Na, Kyu-Hyun;Choy, Won-Sik
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.117-122
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    • 2006
  • Purpose: The purpose of this study is to investigate the relationship between rotator cuff tear and nerve injury, and prevalence of nerve injury using electromyographic study. Materials and Methods: From May 2004 to Feb. 2005, 19 cases, who underwent surgery for full-thickness rotator cuff tear, were evaluated for nerve injury using electomyogram instruments preoperatively. Rotator cuff tears caused by acute high energy trauma were excluded in this study. Mean age was 59 (range, 45-87) years and mean duration of symptoms was 45 (range, 1-360) month. Results: There were six nerve injuries (31.6%). All of them were incomplete brachial plexus injuries, and mainly postganglionic lesions. Four cases among them had minor trauma history. There were no significant differences in terms of cuff tear size, range of motion, pain score and functional score between groups with and without nerve injury. Conclusion: This study showed high prevalence (31.6%) of nerve injury in full-thickness rotator cuff tear. So careful physical examination and evaluation for nerve injury are needed in rotator cuff tear.

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Mechanical Physiology of the Somatic Nervous System-(Mechanical Transmission Mechanism and Initial Local Excitation of Somatic Neurons)- (체성신경계(體性神經系)의 기계적(機械的) 생리학(生理學)- 기계적전달(機械的傳達)과 체성신경원(體性神經元)의 초발국소흥분(初發雇所興奮) -)

  • Kwak, Je-Hi
    • The Korean Journal of Physiology
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    • v.1 no.1
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    • pp.7-22
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    • 1967
  • 인간(人間)의 감각(感覺), 운동(運動), 사고등(思考等)에 직접관여(直接關與)하는 체성신경원(體性神經元)이 인체내(人體內)에 있어서 단일세포동물(單一細胞動物)과 비체성신경원(非體性神經元)과 같이 각종(各種)의 자극(刺戟)에 직접응(直接應)하므로써 기능적(機能的) 활동(活動)을 개시(開始)한다는 한연(漢然)한 예상하(豫想下)에서 말초(末梢)에서는 혹종(或種)의 통소(痛素)를, 중추(中樞)에서는 어떤 묘(妙)한 화학적(化學約)인 흥분전달물질(興奮傳達物質)을 탐구(探求)하고 있으며 말초(末梢)의 통흥분시발(痛興奮始發)과 대뇌피질(大腦皮質)의 기능발생(機能發生)같은 중요(重要)한 제기전(諸機轉)이 해명(解明)될 가능성(可能性)조차 보이지 않는 것이 체성신경생리학(體性神經生理學)의 현상(現狀)이다. 저자(著者)는 생태분리(生態分離)한 단일신경섬유실험(單一神經纖維實驗)과 임상적연구(臨床的硏究)로서 인체내(人體內)의 체성신경섬유(體性神經纖維)와 그 구심성종말(求心性終末)은 최종(最終) 공통기계적자극(共通機械的刺戟)을 받는 점(點)을 입증(立證)하고 뇌피질내(腦皮質內)의 입사(入射)에 의(依)한 Synapse 전달(傳達)이 기계적(機械的)인 점(點)과 모세혈관확대(毛細血管擴大)에 의(依)한 Glial Satellite 부(部)의 기계적전달(機械的傳達)과 Spine Koph 에서는 입사(入射) 없이도 Massage에 의(依)하여 초발탈분극(初發脫分極)이 발생(發生)될 필연성(必然性)을 지적(指摘)하는 동시(同時)에 저자(著者)가 부르는 ${\ulcorner}$체성신경계(體性神經系)의 기계적생리학(機械的生理學)${\lrcorner}$에 의(依)하면 난간(難間)에 속(屬)하는 대다수(大多數)의 신경현상(神經現象)과 정신현상(精神現象)이 구체적(具體的)이며 합리적(合理的)이요 또 실용적(實用的)으로 해명(解明)됨을 실례(實例)를 들어서 예시(例示)한다. 본연구(本硏究)는 습수만예(拾數萬例)의 단일신경섬유관찰(單一神經纖維觀察)과 수백예(數百例)의 임상적연구(臨床的硏究)와 최근고도(最近高度)로 발달(發達)된 기술(技術)에 의(依)한 징소생리학적(徵少生理學的) 제연구업속(諸硏究業續)과 전자현미경적형태학성과(電子顯徵鏡的形態學成果)를 종합(綜合)하므로써 성립(成立)된 것이요 하등(何等)적 무리(無理)한 억측(憶測)을 내포(內包)하지 않음을 확신(確信)한다.

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Clinical Observation of Bell's Palsy (침치료(鍼治療)에 의한 말초성(末梢性) 안면신경마비(顔面神經麻痺)의 임상적(臨床的) 관찰(觀察))

  • Kang, Sung-Keel;Kim, Yong-Suk
    • The Journal of Korean Medicine
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    • v.16 no.2 s.30
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    • pp.9-16
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    • 1995
  • Forty four patients with Bell's palsy were treated with acupuncture from onset and clinical observation was carried on from March 1994 through Feburary 1995. Acupuncture treatment was done 3 times per week and the acupuncture points were LI4 Hapkok, ST36 Choksamni, LI20 Yonghyang, BL2 Ch'anjuk, TE17 Yep'ung, ST4 Chich'ang, ST6 Hyopko, GV26 Sugu, CV24 Sungjang, GB14 Yangbaek and Ex-HN4 Oyo. They were inserted to a depth of 0.5 to 1.0 cm. After insertion, manipulation was carried on until the patients felt strong numbness or De Qi sensation induced by rotating or twisting needles. Through-needling in lengths varying from 2.0 to 3.5 cm was also applied from ST4 Chich'ang to ST6 Hyopko, from GV26 Sugu or CV24 Sungjang to ST4 Chich'ang and from GB14 Yangbaek to Ex-HN4 Oyo. The mean age was 39.3 and 63.6% of the patients were women, including one pregnant woman. There was no recurrent palsy in this study. By applying the House-Brackmann facial nerve grading scales, patients were evaluated weekly from the first treatment to judged recovery or the 7th week of the treatment. 86.4% of the patients were recovered completely within 7 weeks and the average healing period was 3.7 weeks.

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