• Title/Summary/Keyword: 말초신경

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Review of Experimental Researches on Bee Venom Pharmacopuncture Therapy for Chemotherapy-induced Peripheral Neuropathy (항암화학요법 유발 말초신경병증에 대한 봉독 약침 요법의 효과 및 기전에 대한 실험연구 고찰)

  • Kwon, Bo In;Woo, Yeonju;Kim, Joo-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.1
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    • pp.1-7
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    • 2021
  • Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common dose-limiting side effects of neurotoxic chemotherapeutic agents that lead to decreased quality of life and dose reduction, delay or even cessation of treatment. The purpose of this systematic review is to evaluate the effect and the underlying mechanisms of bee venom (BV) pharmacopuncture therapy for CIPN in animal models. We searched for the available experimental literature using BV for CIPN through the Pubmed databases. Ten experimental studies were finally included in this review. In the oxaliplatin or paclitaxel-induced CIPN animal model, BV significantly relieved pain caused both mechanical and cold stimulation. It was suggested that the effect of BV is mediated by the stimulation effect of spinal α1- and α2-adrenergic receptors as a potential mechanism. In the future, more experimental studies are needed.

Korean Medicine Treatments with Joripewon-tang for Chemotherapy-Induced Peripheral Neuropathy of Ovarian Cancer : Case Report (난소암의 항암화학요법 유발 만성 말초신경병증의 조리폐원탕 및 복합한의치료 치험 1례)

  • Ji-yoon, Yeum;Su-hyun, Kim;Seung-yun, Oh;Soo-jung, Park
    • Journal of Korean Traditional Oncology
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    • v.27 no.1
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    • pp.49-56
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    • 2022
  • Objective: This case report represented that Korean traditional medicine therapies can make effective results for chemotherapy-induced peripheral neuropathy(CIPN) patients. Methods: A 63-year-old female patient has been diagnosed with ovarian cancer(Sertoli-Leydig cell tumor). Total excision of uterus and appendages was operated, and Bleomycin, etoposide and cisplatin combination therapy was applied. After three cycles of chemotherapy, the severe side effects of neutropenia and CIPN occurred. Chemotherapy was terminated, but numbness and tingling pains in the limbs persisted for several months. We provided Korean medicine treatments including herbal medicine, pharmacopuncture, acupuncture, moxibustion and physiotherapies. Results: After treatments, the numbness and pain were reduced from 10 to 1 in hand and 6 to 0 on the numeric rating scale(NRS). Functional assessment of cancer therapy/Gynecologic oncology group neurotoxicity (FACT/GOG-NTX) score was improved from 58 to 97. Conclusion: According to these results, Korean medicine treatments could be considered effective for CIPN. Prospective studies are needed to confirm and expand these findings.

A Case Report of Chemotherapy-Induced Peripheral Neuropathy Treated with Modified Guibi-tang (귀비탕가미방으로 호전된 항암화학요법 유발 말초신경병증 치험 1례)

  • Park, Su Bin;Yoon, Jee-Hyun;Kim, Eun Hye;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.451-459
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    • 2022
  • Objective: The purpose of this study was to report the effectiveness of modified Guibi-tang in a patient suffering from chemotherapy-induced peripheral neuropathy (CIPN). Methods: A 54-year-old Korean female patient diagnosed with recurrent ovarian cancer had CIPN with other symptoms, such as anorexia, dyspepsia, insomnia, etc. She was diagnosed with Simbiyangheo and hence treated with a modified Guibi-tang. Neuropathic symptoms were assessed using a numerical rating scale (NRS) and a sensory score. Quality of life was assessed using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx). Results: After 14 days of treatment, the patients showed a decrease in NRS for bilateral limb pain and improvement in other symptoms, such as general weakness, insomnia, dizziness, and headache. Quality of life also increased. Conclusion: Modified Guibi-tang may be considered an optional treatment for CIPN if the patient is diagnosed with Simbiyangheo. Further studies are needed to confirm this finding.

Review about effects of sleep disturbances on Burning mouth syndrome (수면장애가 구강작열감 증후군에 미치는 영향에 대한 고찰)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.313-318
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    • 2013
  • The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.

A Study of the Clinical Application of Thermography in Musculoskeletal Disease (근골격계(筋骨格系) 영역(領域)에서 Thermography의 임상적(臨床的) 활용(活用)에 대(對)한 고찰(考察))

  • Shin, Hyun-Taeg;Chung, Seok-Hee;Lee, Jong-Soo;Kim, Sung-Soo;Shin, Hyun-Dae
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.47-67
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    • 2000
  • The purpose of this study is to assess the usefulness of thermography in patients with musculoskeletal disease. Thermography is noninvasive, easy to reading, objective and physiologic instrument by measuring and imaging infrared energy emitted from skin surface. Thermography can show the skin temperature changes in various conditions of the body with musculoskeletal disease. This literature review was done for the usefulness of thermography in diagnosing musculoskeletal disease. In conclusion, thermography was adapted in radiculopathy, MPS, peripheral neuropathy, RSD, Raynaud's phenomen, TMJ dysfunction, etc. It was useful as a secondary diagnostic method in those diseases, also possible as a primary diagnostic method in RSD, Raynaud's phenomen. And, it might be reliable tool for estimating disease procedure and consequence after treatment. But, the objectivity of the reading and the development of the operating method are required for further adaptation in musculoskeletal disease.

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Inhibitory Effects of ${\gamma}$-Aminobutyric Acid on the Contractility of Isolated Rat Vas Deferens (흰쥐의 적출 정관 수축성에 대한 ${\gamma}$-Aminobutyric Acid의 억제작용)

  • Ahn, Ki-Young;Kwon, Oh-Cheol;Ha, Jeoung-Hee;Lee, Kwang-Youn;Kim, Won-Joon
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.382-395
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    • 1992
  • GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle reaxing effects via $GABA_A$ receptor or $GABA_B$ receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may playa physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepiniphrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostastic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-$O_2/CO_2$ at $33^{\circ}C$. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a $GAB_A$ agonist, and baclofen, a $GABA_B$ agonist inhibited the electric field stimulation(EFS, 0.2Hz, 1mSec, 80 V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid(DAVA), a $GABA_B$ antagonist, but not by bicuculline, a $GABA_A$ mtagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine(NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible : and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractionsm 6. EFS-induced contraction was including 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP(mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine(3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic $GABA_B$ receptor on the excitatory neurons.

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Experimental Studies on Lead Toxicity in Domestic II. Histopathology (고양이의 납중독에 관한 실험적 연구 2. 조직병리학적 소견)

  • Hong Soon-Ho;Han Hong Ryul
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.485-505
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    • 1994
  • Lead toxicity was evaluated in forty-five cats on a balanced diet, treated with 0(control), 10, 100(low), 1, 000, 2, 000 and 4, 000(high)ppm of lead acetate orally on a body weight basis. The objectives were to describe the gross and histopathologic changes and to demonstrate what tissue lead concentrations correlate with the known dosages of lead. In subclinical lead toxicity, greater than 80% of the absorbed lead was deposited in the bone, whereas in more acute lead toxicity, 42% of absorbed lead was deposited in the bone and 36% and 20% of absorbed lead was deposited in the kidneys and in the liver, respectively. No gross lesions were found in the nervous system. Yellow-brown colored livers appear to be associated with lead toxicity. Neuronal necrosis in the cerebrum was the most predominant histopathologic finding. Astrocytic proliferation in the cerebral gray matter was observed in 1 high dose cat. Gliosis was noted in the cerebral cortex of 6 high dose cats. Two high dose cats had demyelination in the deepest layer of the cortical gray matter of the cerebrum. Extravasation of red cells and cavitation around the vessels were found in the cerebrum of 1 high dose cat. Six high dose cats had degeneration of Purkinje cells in the cerebellum. The microscopic findings in the peripheral nerves were ambiguous. In more acute toxicity, the cats had lead inclusions in the epithelial cells of proximal tubules of the kidneys of 7 cats and hepatocytes of the liver of S cats. These inclusions could be seen wlth H&E, but were more prominent with orcein staining. Two high dose cats had granulomas and connective tissue hyperplasia between tubules of the kidneys. Periportal hepatocyte vacuolization was observed in the liver of 22 cats. Vacuolization of seminiferous tubules and a reduced number of spermatogonia(indicative of reduced spermatogenesis) were found in the testis of 5 treated cats. Cystic ovaries were observed in 3 high dose cats and poor development of oogonia was found in 2 cats. The diagnosis of lead toxicity in cats can be suspected on the basis of the histopathologic lesions described, and can be of value in contributing to a diagnosis. A reliable diagnosis of lead poisoning can be helped utilizing tissue lead analysis(post molten)

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The Results of Surgical Treatments in the Peripheral Nerve Injuries (말초신경 손상 후 수술적 치료에 대한 고찰)

  • Chung, Moon-Sang;Park, Jin-Soo;Seo, Joong-Bae;Park, Yong-Bum
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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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.

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Relationship between Pain Reaction and Electrical Stimulation of Peripheral Nerve with Special Reference of Stimulatory Parameters (말초신경 자극시 자극의 강도, 빈도 및 기간의 변화가 동통반응에 미치는 영향)

  • Paik, Kwang-Sea;Leem, Joong-Woo;Kim, In-Kyo;Lee, Seung-Il;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.19 no.2
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    • pp.227-232
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    • 1985
  • Previously, we had reported that the electrical stimulation of peripheral nerve with stimlatory parameters of 20 V strength and 2 Hz frequency for 60 min resulted in reducing the pain reaction. The present study was performed to evaluate if the pain reaction was affected by the peripheral nerve stimulation with different stimulatory parameters in the decerebrated cat. The flexion reflex was used as an index of the pain reaction. The reflex was elicited by stimulating the sural nerve (stimulus strength of 20 $V\;\times\;0.5$msec) and recorded as a compound action potential from the motor nerve innervated to the posterior biceps femoris muscle. The common perneal nerve was selected as a peripheral nerve on which the electrical stimulation of various intensities and frequencies was applied. The results are summarized as follows : 1) The peripheral nerve stimulation with 100 mV strength, regardless of frequencies, did not affect the pain reaction induced by the sural nerve stimulation. 2) When the stimulus of 1V intensity and slow frequency (2 Hz) was applied to the peripheral nerve for 30 min or 60 min, the pain reaction was significantly reduced comparing to the control. However, this reduced pain reaction by the peripheral nerve stimulation was not reversed by the injection of naloxone (0.02 mg/kg) 3) High frequency stimulus (60 Hz) of 1V intensity for 30 or 60 min did not show any effects of affecting the pain reaction. These results suggest that the stimulus of relatively high intensity (at least 1V) and low frequency (2 Hz) is needed to elicite the analgesic effect by the peripheral nerve stimulation. By the 1V stimulus, $A\delta$ nerve fiber is activated. Therefore, an $A\delta$ or smaller nerve fibers must be activated for showing analgesia by the peripheral nerve stimulation. However, the mechanism of analgesia by the $A\delta$ nerve activation alone was not related to the endogeneous morphine system since the reduced pain reaction by the $A\delta$ fiber activation alone was not reversed by the treatment of naloxone.

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EXPERIMENTAL STUDY OF PERIPHERAL NERVE REGENERATION BY USING NON-TUBULAR NATURAL CELLULOSE MEMBRANE NERVE CONDUIT (비관형 천연 셀룰로오스막 도관을 이용한 말초신경 재생에 대한 실험적 연구)

  • Kim, Soung-Min;Lee, Jong-Ho;Lee, Suk-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.295-307
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    • 2006
  • Styela clava, called non-native tunicate or sea squirt, is habitat which include bays and harbors in Korea and several sites in the sea faced world. We fabricate cellulose membrane nerve conduit (CMNC) from this native sea squirt skin, and evaluate the capacity of promoting peripheral nerve regeneration in the rat sciatic nerve defect model. After processing the pure cellulose membrane from the sea squirt skin as we already published before, CMNC was designed as a non-tubular sheet with 14 mm length and 4 mm width. Total eleven male Spraque-Dawley rats (12 weeks, weighing 250 to 300g) were divided into sham group (n=2), silicone tube grafted control group (n=3) and experimental group (n=6). Each CMNC grafted nerve was evaluated after 4, 8 and 12 weeks in the experimental group, and after 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were all examined using image analyzer and electromicroscopic methods in the all groups. The regenerated axon and nerve sheath were found only in the inner surface of the CMNC after 4 weeks and became more thicker after 8 and 12 weeks. In the TEM study, CMNC grafted group showed more abundant organized myelinated nerve fibers with thickened extracellular matrix than silicone conduit grafted group after 12 weeks. The sciatic function index (SFI) and ankle stance angle (ASA) in the functional evaluation were $-47.2{\pm}3.9$, $35.5^{\circ}{\pm}4.9^{\circ}$ in CMNC grafted group (n=2) and $-80.4{\pm}7.4$, $29.2^{\circ}{\pm}5.3^{\circ}$ in silicone conduit grafted group (n=3), respectively. And the myelinated axon was 41.59% in CMNC group and 9.51% in silicone conduit group to the sham group. The development of a bioactive CMNC to replace autogenous nerve grafts offers a potential and available approach to improved peripheral nerve regeneration. As we already published before, small peptide fragment derived from the basement membrane matrix proteins of squirt skin, which is a kind of anchoring protein composed of glycocalyx, induced the effective axonal regeneration with rapid growth of Schwann cells beneath the inner surface of CMNC. So the possibilities of clinical application as a peripheral nerve regeneration will be able to be suggested.