• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.739-748
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• 2006

Background: The purpose of this study is to ascertain the neuroprotective effect of cyclosporin A on the 25-min surgical ischemia model in the spinal cords of rabbits with neuropathological correlation and histoimmunochemical analyses, Material and Method: Thirty-two New Zealand white rabbits were randomly divided into four groups: Rabbits were randomly divided into four groups: the control 12 group (n=8), the control 17 group (n=8), the cyclosporin Cs2 group (n=8), and the cyclosporin Cs7 group (n=8). The 12 group underwent a 25-min aortic cross- clamp without intervention and were sacrificed on the 2nd day postoperatively, while the 17 group underwent a 25- min of aortic cross-clamp without intervention and were sacrificed on the 7th day postoperatively. The Cs2 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the End day postoperatively, while the Cs7 group received cyclosporin A (25 mg/kg) intravenously 15 min after the 25-min cross-clamp and were sacrificed on the 7th day postoperatively. The rabbits underwent 25-min surgical aortic cross-clamp. Neurologic functions were evaluated on the 2nd day and 7th postoperative day using Tarlov scoring system. After scoring neurologic function, all rabbits were sacrificed for histopathologic observation. Result: All rabbits survived the experimental procedure. The values of Tarlov score did not show any differences between the control and cyclosporin groups on the 2nd day. The scores of group Cs7 ($2.75{\pm}0.89$) were significantly higher than those of group 17 ($1.25{\pm}1.39$) on the 7th day (p<0,05). On the histologic exanminations, specimens of the spinal cord showed necrosis and apoptosis. The pathologic scores of group Cs7 ($1,0{\pm}0.53$) was less than those of group 17 ($2.13{\pm}1.36$, p<0.05). TUNEL staing showed apoptosis of the specimen in group 12 and Cs2 but there was no stastically significant difference between groups on the score. There were more overexpression of HSP70 and nNOS in cyclosporine group than in control group. Conclusion: We think that cyclosporin A may decrease neuronal cell death with induced upregulation of HSP70 against 25-min ischemia of the spiral cord in the rabbit.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.77-81
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• 1997

Background : We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method : RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium ($Isovist^{(R)}$-300, Sobering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results : Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion : We concluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.247-250
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• 2000

Recently, some authors reported that discogenic low back pain should be regarded as a referred pain in respect of neural pathway. The afferent pathways of discogenic low back pain is transmitted mainly by sympathetic afferent fibres from the sinuvertebral nerves in the second lumbar nerve root. This pain arises from the lumbar intervertebral discs, and it had been transmitted mainly through the sympathetic afferent fibres contained in the second lumbar spinal nerve root. Second lumbar dermatome corresponds to the low back area. We experienced a case of low back pain which could not be controlled by conventional therapy and progressed wax and wane. The CT finding showed bulging disc between $L_4$ and $L_5$ and spinal stenosis in $L_4$ area. And epiduroscopic feature showed severe adhesion in $L_4$, $L_5$ and $S_1$. After we blocked $L_2$ root, pain score decreased 10 to 2. Therefore, the $L_2$ root block may be a useful diagnostic procedure as well as provide therapeutic value.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.161-164
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• 2005

Background: Chemical lumbar sympathetic ganglion block could potentially be used to treat plantar hyperhidrosis; therefore, we analyzed the outcome of lumbar sympathetic ganglion block using alcohol for the treatment of plantar hyperhidrosis. Methods: Between March 1992 and June 2003, 356 patients with plantar hyperhidrosis underwent lumbar sympathetic ganglion block using alcohol. All 356 patients were followed up for 2 years and the results evaluated. There were 185 and 171 male and female patients, respectively, with a mean age of 25.1 years, ranging from 15.3 to 56.5 years old. Lumbar sympathetic ganglion block using alcohol was performed with fluoroscopic guidance under local anesthesia. Results: The recurrence rate after 2 years was 34%. Compensatory hyperhidrosis, ejaculation failure, lower back pain and genitofemoral neuritis developed as complications in 132, 4, 12 and 2 patients, respectively. Of the 356 patients, 65% were satisfied. Conclusions: Lumbar sympathetic ganglion block using alcohol is an effective and safe method for the treatment of plantar hyperhidrosis, but more information about the complications and relatively high recurrence rates should be provided to the patient.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.107-115
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• 2016

The occurrence of brain stem stroke after lumbar selective nerve root block seem to be an uncommon event comparing it to after cervical selective nerve root block. We recently experienced a 60-year-old man who were diagnosed as left lateral medullary infarction (Wallenberg's syndrome) after lumbar selective nerve root block. He was treated by traditional Korean medicine with acupunture, Pulsed electromagetic therapy (PEMT), herb medicine. The range of motion of upper and lower extremity, manual muscle test, Korean version of Berg balance scale (K-BBS) and Korean version of Barthel index (K-MBI) were adopted to measure the resulting recovery after 4 weeks treatment. Traditional Korean medicine was effective for rehabilitation of patient. Further studies are needed to set up and Korean medical protocol for Wallenberg's syndrome.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1177-1181
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• 2001

Objective : Thoracoscopic T2 sympathicotomy had been performed as a simple and effective method in treating palmar hyperhidrosis, but some patients are not satisfied with the result of sympathicotomy due to compensatory hyperhidrosis. Therefore, a more limited T2 sympathicotomy using 2mm endoscope was introduced. We made a comparison between conventional T2 sympathicotomy and limited T2 sympathicotomy on operative results and compensatory hyperhidrosis. Material and Method : From January 1998 to April 2000, 56 patients were treated by video assisted endoscopic thoracic sympathicotomy. Thirty patients of these underwent T2 sympathicotomy(Group A), and the remainders underwent limited T2 sympathicotomy(Group B). The limited T2 sympathicotomy is coagulation of the interganglionic fibers of T2 sympathetic ganglion on T2 rib head. The comparative analysis between two groups was based on the medical records and telephone interview results. Result : All patients were treated for excessive sweating on palms with 2mm endoscopic sympathicotmy. There were no mortalities, life-threatening complications except one recurrent patient who was treated successfully with reoperation( endoscopic sympathicotomy). Compensatory hyperhidrosis was common in group A. An individual satisfactory rate for the operations was higher in group B than in group A. Conclusion : The limited T2 sympathicotomy considered to be a more effective and less complicated method than the T2 sympathicotomy for the treatment of palmar hyperhidrosis.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.104-107
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• 2018

While most benign hiccups can be controlled with empirical therapy, intractable hiccups lasting longer than one month tend to have significant adverse effects with obscure etiology. Treatment strategies for intractable hiccups have not been established. Only a few sporadic cases of bilateral phrenic nerve blockage have been reported. Here, we report a case of intractable hiccups that lasted five weeks in a 56-year-old male patient with a lung cancer above the right diaphragm. We hypothesized that his intractable hiccups were caused by irritation and mass effect caused by the lung cancer. We performed an ultrasound-guided right unilateral phrenic nerve pulsed radiofrequency treatment, and the patient's intractable hiccups were successfully managed without complication.

• Advances in pediatric surgery
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• v.20 no.1
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1628-1633
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• 2021

Spinal epidural arteriovenous fistulas (SEDAVFs) are rare spinal vascular malformations that are difficult to diagnose and treat. SEDAVFs can be asymptomatic; however, symptoms can arise from the compression of adjacent nerve roots by dilated vein and perimedullary venous reflux, caused by shunting into the epidural venous plexus. A 31-year-old male presented to our institution with a 2-year history of progressively worsening low-back pain, radiating thigh pain, and sensory changes in his lower extremities. MRI and CT angiography demonstrated dilated epidural vascular lesion compressing the nerve root. The SEDAVF was embolized with multiple coils, which alleviated the nerve root compression from the engorged venous varix and improved the patient's radiculopathy. Our experience from this case shows that endovascular coil embolization using the transarterial approach can be an effective treatment for SEDAVF and an alternative to surgical ligations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.132-135
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• 2019

Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.