• The Korean Journal of Physiology
• /
• v.26 no.2
• /
• pp.143-150
• /
• 1992

The purpose of this study is to obtain the effective concentration of capsaicin to relieve pain with no change in the number of C-fibers and its effective duration for pain relief. Capsaicin has been used extremely as a experimental tool and as topical medications for acute or chronic tissue injuries and partial nerve injury is the main cause of causalgiform pain disorders in humans. Here, the left sciatic nerve was ligated unilaterally at the high level of the thigh to prepare an animal model of this pain condition. The rat developed guarding behavior of the ipsilateral hind paw within a few hours after the operation and this behavior was maintained for several months thereafter, suggesting the possibility of spontaneous pain. These animals were divided into two groups(4-week & 8-week) and each group was subdivided into five groups by different concentration (0.05, 0.1, 0.5, 1.0 & 2.0%). Each capsaicin concentration was treated locally on the spinal cord-side of the ligated nerve and the foot withdrawal latency was measured. Thereafter, the dorsal roots of L5 were removed from both sides immediately after in tracardial perfusion for the counting of C-fibers by the histological procedure. There were no significant differences in the foot-withdrawal latency and the number of C-fibers between the left side treated with 0.05% capsaicin and the right side treated with the vehicle. However, latencies of the left sides treated with 0.1, 0.5, and 1.0% capsaicin increased significantly throughout 4-6 weeks with almost no change in the number of C-fibers, and the latencies showed the trends to approach slowly to those of the conditions after operation. The latency of subgroup treated with 2.0% increased by approximate 10% more than that of the right side throughout 8 weeks, and the number of C-fibers decreased by about 30% or more These results suggest that the elevated latency with capsaicin(0.1-1.0%) treatment is due to the inhibition of impulse transmission throughout the primary afferent fiber and the data from 2.0% are due to partial destruction of C-fibers. Therefore, capsaicin concentrations from 0.1% to 1.0% are probably very effective for the treatment of causalgiform pain with almost no destruction of C-fibers.

• The Korean Journal of Pain
• /
• v.10 no.2
• /
• pp.241-245
• /
• 1997

Persistent hiccup is defined as duration lasting longer than 48 hours. Reflex arc of hiccup is divided into three parts : afferent, central, efferent. Afferent portion of the neural pathway of hiccup formation is composed of vagus nerve, phrenic nerve, and sympathetic chain arising from T6 to T12. Efferent limb is phrenic nerve. Hiccup center is located in brain stem, midbrain, reticular system and hypothalamus. Persistent hiccup is very difficult to treat by conventional methods. We performed cervical epidural block of the phrenic nerve root for three patients suffering from persistent hiccup. The therapeutic effect was perfect. The mechanism of the cervical epidural block is not yet defined however it is thought to block the efferent nerve fibers and suppress the reflex arc of hiccup. We conclude cervical epidural block is relatively safe and very effective for treating persistent hiccup.

• Journal of Korean Foot and Ankle Society
• /
• v.17 no.4
• /
• pp.251-256
• /
• 2013

Neuropathy is a common complication of diabetes. It is characterized by a progressive loss of peripheral nerve fibers. The development of the neuropathy is linked to poor glycemic control, age, and the duration of diabetes. Peripheral sensory polyneuropathy is the most common type in neuropathy. Diabetic neuropathy is the most significant etiologic factor of the foot ulcer that may leads to amputation. Current treatments in diabetic neuropathy have no definitive effects on repair or reverse the damaged nerve but only to relieve of symptoms, especially on pain. When the focal compressive neuropathy is combined with diabetic neuropathy, the nerve would be more vulnerable and symptoms might get worse. Surgery is indicated for decompression of an entrapped nerve, like posterior tibial nerve in tarsal tunnel, after failure of the initial conservative treatments.

• Journal of Electrodiagnosis and Neuromuscular Diseases
• /
• v.20 no.2
• /
• pp.77-83
• /
• 2018

Small fiber neuropathy (SFN) mainly affects thinly myelinated $A{\delta}$-fibers and unmyelinated C-fibers presented with neuropathic pain like burning feet or numbness. Many conditions are known as a causes of SFN, metabolic derangement, especially glucose intolerance, is the most frequent cause of SFN. It has been hard to diagnose SFN because there has been lack of specialized test for small nerve fiber. Quantification of intraepidermal nerve fiber density using skin biopsy is promising method to diagnose SFN. A skin biopsy also could give helps to research pathophysiology of SFN by specialized stain method.

• The Korean Journal of Pain
• /
• v.14 no.1
• /
• pp.83-92
• /
• 2001

Background: This study was undertaken to observe the functional changes of the hind limb and histopathological changes in the sciatic nerve after an injection of alcohol or phenol, which are commonly used neurolytic agents, highlighting the time of recovery. Methods: Forty-eight Sprague-Dawley rats weighing 200-300 g were used for the experiment. Histopathological changes under the electron microscope, were observed in the distal part of the sciatic nerve, into which 0.1 ml of alcohol or phenol was injected. This was severed in 3 rats of each group at 10 minutes, 1 hour, 24 hours, 3 days, 1, 2, 4 and 6 weeks later. The functional changes in the hind limbs were observed for 6 weeks by noting their walking pattern. Results: Following the injection of alcohol or phenol into the right sciatic nerve, the right hind limb showed a severe pronounced motor weakness and obvious gait changes. About 2 weeks later, gradual improvement of gait changes began, and after 6 weeks, the motor weakness and gait changes were no longer perceptible in both groups. The findings of any histopathological change were similar in both alcohol or phenol groups. At 10 minutes after injection, destructive lesions were confined to the unmyelinated fibers and the myelin sheath of small the myelinated fibers. On the 3rd day and at 1 week, pathologic changes in axonal fibers and Schwann cells were in being phagocytized in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared at the same time a myelin disintegration and axonolysis. At 6 weeks, neural regeneration was similar to that of the contralateral control group. Conclusions: These results suggest that functional and histopathological changes, after injection of neurolytics into the peripheral nerves, are quite similar in both alcohol and phenol groups. The progression of functional and histopathological changes become more obvious according to the time interval following the injection. Consequently, side effects that develop following the use of alcohol or phenol may begin to improve around the time that nerve regeneration occurs, i.e., two to four weeks later.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.494-497
• /
• 2011

Purpose: Schwannoma, a benign peripheral nerve tumor, is slow-growing, encapsulated neoplasm that originates from the Schwann cell of the nerve sheath. Schwannoma most frequently involves the major nerve. Schwannoma occurring in the superficial radial nerve rare. This is a report of our experience with schwannoma arising from the superficial radial nerve with neurologic symptom. Methods: A 55-year-old woman presented with eight-month history of progressive numbness and paresthesia in dorsum of the thumb and index finger. Physical examination revealed a localized mass on the midforearm. Sonographic examination showed an ovoid, heterogenous, hypoechoic lesion, located eccentrically in related to the superficial radial nerve. The lesion was mobile in the transverse but not in the longitudinal axis of the nerve, which was thought to favour schwannoma rather than neurofibroma. At operation, a $20{\times}15mm$ ovoid, yellowish grey mass was seen arising from the superficial radial nerve. The tumor present as eccentric masses over which the nerve fibers are splayed. Using operating microscope, the tumor was removed, preserving the surrounding nerve. Results: Histology confirmed that the mass was a benign schwannoma. There were no postoperative complications. After two months the patient had no clinically demonstrable sensory deficit. Conclusion: An unsusual case of a schwannoma of the superficial radial nerve is presented. In case with neurologic symptom, prompt surgical decompression must be made to prevent further nerve damage and to restore nerve function early.

• The Korean Journal of Physiology
• /
• v.21 no.1
• /
• pp.59-66
• /
• 1987

This study was aimed to investigate whether the conduction velocity of nerve impulses through the ventral afferent fibers is constant along their entire courses in dorsal as well as in ventral roots. Cats were anesthetized with ${\alpha}-chloralose$ (60 mg/kg, i.p.) and artificially ventilated. Laminectomies were done on L4-S1 spinal vertebrae to expose the lumbosacral spiral cord. Both ventral and dorsal roots of L7 or S1 spinal segments were isolated and cut near the spinal cord. Ventral roots were placed on 6-lead stimulating electrodes and stimulated with supra C-threshold intensity. Divided dorsal root fascicles were placed on bipolar recording electrodes and single fiber units activated by the stimulation of the ventral roots were identified. Followings are the results obtained: 1) A total of 27 VRA units were identified. 10 units of them conducted impulses slower than 2 m/sec. Conduction velocities of the remaining units were in the range of 3.11-20.91 m/sec. 2) In 12 Units conduction velocities Of the VRA units through dorsal$(CV_{DR})$ and venral root$(CV_{DR})$ were determined respectively. There was a tendency to conduct impulses faster through dorsal roots$(CV_{DR}=8.19{\pm}3.26\;m/sec)$ than ventral roots$(CV_{DR}=3.46{\pm}1.02\;m/sec)$. From the above results we confirmed that there exist nerve fibers in continuity between the spinal ventral and dorsal roots but we could not ascertain whether there is a change in conduction velocity through the entire course of ventral afferent unit.

• Korean Journal of Veterinary Research
• /
• v.39 no.3
• /
• pp.435-447
• /
• 1999

The localization of substance P(SP), calcitonin gene-related peptide(CGRP) and three calcium binding proteins, calbindin D-28k(CB), calretinin(CR) and parvalbumin(PA) was immunohistochemically examined in the myenteric and submucous plexuses of Korean native goat duodenum. In the neurons of myenteric and submucous plexuses of duodenum, immunoreactivities of SP, CGRP and CB were confirmed in both nerve cell bodies and fibers. In contrast, CR immunoreactivity was found only in nerve fibers of myenteric plexuses, while PA immunoreactivity was found only in nerve cell bodies of submucous plexuses. In the inner circular muscle layer, dense SP-like immunoreactive fibers were prominent but only a few CGRP-like immunoreactivities were observed. Most of SP- and CGRP-like immunoreactive neurons of both plexuses colocalized with CB. This result showed that SP and CGRP may have a important role for the movement of small intestine. The colocalizations of CB with SP or CGRP in myenteric and submucous plexuses suggest that CB may serve neuromodulatory role for SP- and CGRP-immunoreacted neurons on the movement of intestinal wall.

• The Korean Journal of Pain
• /
• v.29 no.1
• /
• pp.3-11
• /
• 2016

A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration.

• The Korean Journal of Physiology
• /
• v.28 no.2
• /
• pp.123-132
• /
• 1994

The present study was undertaken to elucidate the desensitization of cutaneous receptors and the conduction block of the afferent nerves induced by direct application of allyl isotheocyanate (mustard oil) to the receptive field (RF) or onto the afferent nerve, respectively. Dorsal horn cell responses to mechanical stimulations of RF were completely suppressed when mustard oil was applied to either the afferent nerve or the whole area of RF. C-fiber responses of dorsal horn cells were more susceptive to mustard oil than A-fiber activities. This was confirmed by the experiment in which the compound action potentials recorded from rat tibial nerve before and after topical application of mustard oil were compared. The higher the concentration of mustard oil and the longer the application time, the more powerful desensitization or conduction block was induced. From the results of the present study, it is suggested that the desensitization of the afferent fiber and sensory receptors induced by mustard oil results mainly from the conduction block of C-fiber in the primary afferent nerve.