• Title/Summary/Keyword: Nerve pain

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Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

Neurotropin protects rotator cuff tendon cells from lidocaine-induced cell death

  • Abe, Ryunosuke;Ohzono, Hiroki;Gotoh, Masafumi;Nakamura, Yosuke;Honda, Hirokazu;Nakamura, Hidehiro;Kume, Shinichiro;Okawa, Takahiro;Shiba, Naoto
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.224-230
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    • 2021
  • Background: Local anesthetics often are used in rotator cuff tears as therapeutic tools, although some cases have reported that they have detrimental effects. Neurotropin (NTP) is used widely in Japan as a treatment for various chronic pain conditions and is shown to have protective effects on cartilage and nerve cells. In this study, we investigated the protective effect of NTP against lidocaine-induced cytotoxicity. Methods: Tenocytes from rotator cuff tendons were incubated with lidocaine, NTP, lidocaine with NTP, and a control medium. Cell viability was evaluated using the WST-8 assay. Cell apoptosis was detected via annexin V staining using flow cytometry. The expression of BCL-2 and cytochrome c, which are involved in the intrinsic mitochondrial pathway of apoptosis, was evaluated via Western blotting and immunohistochemical staining. Results: In the cell viability assay, lidocaine decreased cell viability in a dose-dependent manner, and NTP did not affect cell viability. Moreover, NTP significantly inhibited the cytotoxic effect of lidocaine. The flow cytometry analysis showed that lidocaine significantly induced apoptosis in tenocytes, and NTP considerably inhibited this lidocaine-induced apoptosis. Western blotting experiments showed that lidocaine decreased the protein expression of BCL-2, and that NTP conserved the expression of BCL-2, even when used with lidocaine. Immunohistochemical staining for cytochrome c showed that 0.1% lidocaine increased cytochrome c-positive cells, and NTP suppressed lidocaine-induced cytochrome c expression. Conclusions: NTP suppresses lidocaine-induced apoptosis of tenocytes by inhibiting the mitochondrial apoptotic pathway. Intra-articular/bursal injection of NTP with lidocaine could protect tenocytes in rotator cuff tendons against lidocaine-induced apoptosis.

Oblique Axis Hypothenar Free Flaps: Tips for Harvesting Larger Flaps with Minimal Donor Site Morbidity

  • Sang Ho Oh;Jae In Chung
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.279-287
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    • 2023
  • Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm2. There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.

Poisonous Substances from Mushrooms (버섯의 유독물질 (有毒物質))

  • Cho, Jae-Hyun;Lee, Tae-Seong;Kim, Bo-Min;Hwang, Byang-Ho
    • Journal of Forest and Environmental Science
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    • v.26 no.1
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    • pp.37-51
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    • 2010
  • A mushroom as a functional food material is being increasingly used in these days. It has been that about 1,500 species of mushrooms grow naturally in Asia. Among them about 700 species are edible, but about 30-50 species are poisonous. Even a poisonous mushroom is a very interesting subject for the dietary life research from biochemical viewpoint due to the fact that any mushroom can be the physiological active material. Not a few identified poisonous materials are being used as research reagents thus far. It is suggested that more useful materials could be obtained by progresses in future researches. The identification of the poisonous ingredient can open up a route for mushroom intoxication cure. It is known that cell destruction and troubles on skin, liver, and kidney troubles can be occurred from mushroom intoxication. Recently the author reported as a collection of treatises regarding anti-tumor substances of mushroom (2005), antibiotic substances of mushroom (2006), living-body functional and control substance (2007), and medicinal mushroom commonly used in Korean herbal medicines (2008). In this sequel, published research data on protoplasm, nerve, stomach and intestines, malodor, and acute pain poison of mushroom are collected and reported.

Accessory infraorbital foramen location using cone-beam computed tomography

  • Daesung An;Kumar K C;Chakorn Vorakulpipat;Supak Ngamsom;Thongnard Kumchai;Sunya Ruangsitt;Teeranut Chaiyasamut;Natthamet Wongsirichat
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.5
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    • pp.257-264
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    • 2023
  • Background: Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods: We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results: In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions: A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.

Clinical Features and Radiological Differential Diagnoses of Symptomatic Sesamoid Bones and Accessory Ossicles: A Pictorial Essay (증상이 있는 종자골과 부골의 임상적 소견과 영상적 감별진단: 임상화보)

  • Hyun Gun Kim;Hee Young Choi;Ji Seon Park;Kyung Nam Ryu;So Young Park;Wook Jin
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.82-98
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    • 2021
  • Sesamoid bones and accessory ossicles are normal anatomic variants with varying morphological appearances and incidences. They are usually small osseous fragments with well-corticated margins located adjacent to the joint space and bone. Patients with sesamoid bones and accessory ossicles are usually asymptomatic and commonly encountered in clinical practice. These sesamoids and accessory bones are occasionally painful because of fractures, dislocations, degenerative changes, avascular necrosis, accessory bone infections, or abnormalities of the adjacent tissue, such as nerve entrapment, tenosynovitis, or soft tissue impingement. This article aimed to illustrate the imaging features of symptomatic sesamoids bones and accessory ossicles at various anatomic locations and describe their clinical features and radiological differential diagnosis.

Bell's palsy after concomitant chemoradiotherapy: a case report and literature review

  • Sul Gi Choi;Ji Seok Oh;Hoon Myoung;Mi Hyun Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.2
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    • pp.129-135
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    • 2024
  • Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell's palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell's palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell's palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell's palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell's palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell's palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell's palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.

A cadaveric study investigating the spread of injectate following an interspace between the popliteal artery and the capsule of the posterior knee block in a neonatal sample: a pilot study

  • Sabashnee Govender-Davies;Llewellyn Davies;Sashrika Pillay-Addinall
    • Anatomy and Cell Biology
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    • v.57 no.2
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    • pp.229-237
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    • 2024
  • The infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (IPACK) block, is a novel ultrasound-guided technique used for postoperative pain management of the knee. The success of the block is attributed to the spread of injectate between the capsule of the knee and the popliteal artery. This novel technique is believed to target the articular branches of the tibial, common fibular (peroneal) and obturator nerves. However, the extent of the spread in a paediatric population is unknown. Therefore, this study aims to evaluate the spread of the IPACK block. Using ultrasound guidance, the IPACK block was replicated bilaterally in neonatal cadavers. Methylene blue dye (0.3 ml/kg) was injected proximally and distally. Subsequently, cadavers were dissected to determine the injectate spread. Proximal injections resulted in staining of some of the articular branches, while the distal injections resulted in staining of all four articular branches. Additional staining of the superior lateral and medial genicular nerves was noted irrespective of the technique. Overall, both injections resulted in posterior, anterolateral spread with limited medial spread. Results from this study reveal preservation of the main nerve trunks following the proximal technique, while the distal technique displayed greater staining of the articular branches. We believe that the block can be seen as a more holistic and viable alternative to lower limb blocks for the paediatric population, as it allows for a wider spread in the posterior and medial-lateral compartments of the knee.

Recent study of Acupuncture in Treatment of Urianry Disturbance (배뇨장애(排尿障碍)에 대한 침구치료(鍼灸治療)의 연구동향(硏究動向))

  • Kim, Kyung-tai;Ko, Young-jin;Kim, Yong-suk;Kim, Chang-hwan
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.123-135
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    • 2005
  • Objective : The aim of this study was to rivew systemically literature and clinical trials in the treatment of urinary incontinence or lower urinary tract syndrome(LUTS). Methods : Computerized literature searches were carried out on two electronic database, and computerized searching on some korea oriental medicine journals in library of Kyung-Hee Medical center. Results : 1. Three reports of review study, six reports of experimental study and fourteen reports of clinical trials were collected and reviewed. Three reports of review study were all printed in the korea oriental medicine journal. From 2000, researches and studies have been increased in quantity and improved in quality. 2. Urinary disturbance include variable symptoms of lower urinary tract symptoms, urinary incontinence, in theaspect of Oriental medicine these symptoms are anurin, dysuria, urinary incontinence, nochumal enuresis, uracratia and so on. 3. Roughly physiological procedure of Acupuncture in Treatment of Urianry Disturbance may be that effect of acupuncture stimulation for parasympathetic nerve, sleep-arousal system in cerebrum, pontine/spinal urination center and pudendal/pelvic nerve affect bladder in expansion of bladder capacity, inhibition of urinary contraction and affection in periurethral muscle by continuous excitement of spinal annular circuit and synapse of neuron. 4. Clinical result for acupuncture treatment in urinary disturbance is summarized that acupuncture treatment in urianation disturbance of Neurogenic Bladder, Incontinence, Cycitis, Nocturnal Enuresis, Prostatitis/Pelvic Pain Syndrom and so on is significant clinical trials and technique. Conclusion : Hereafter, in the old age society these variable urinary disturbance patients are increased and desire of treatment may be also increased. So study of various and formal treatment and tecnnique is needed.

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The Study on the Validity of the OHIP 14 (Oral Health Impact Profile 14) Using Health Index on Elderly Population, Gangneung City (강릉시 노인의 임상지표를 이용한 OHIP 14 (Oral Health Impact Profile 14)의 타당도 연구)

  • Lee, Ji-Youn
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.475-483
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    • 2009
  • Subjects of the research were 668 elderly people aged over 65 from Gangneung city. OHIP 14 went through a first translation from English to Korean, discussion among experts, a second translation from Korean to English, and then the translation was approved. After the primary and main research were carried out, validity and correlation coefficient with the outcome of oral and mental health examination were studied. OHIP 14 in terms of the perception of oral health was relevant to the perception of overall health and oral health, the necessity of dental treatment, the satisfaction about oral health, the level of pain from observation, and the satisfaction about artificial tooth. OHIP 14 on account of oral health state was related to the number of present natural teeth, the necessity of dental treatment, and the status of no teeth. OHIP 14 according to overall health was correlated to the number of ailments, the state of mind, nerve systems, bones and sinews, digestive systems, urogenital systems, cerebrovascular systems, respiratory systems, eyes, ears, and dementia. OHIP 14 according to the perception of oral health showed a significant difference in the perception of overall health and oral health, the level of pain in terms of observation, and the satisfaction on artificial tooth. OHIP 14 on account of oral health state demonstrated a meaningful difference in the number of present natural teeth, the necessity of dental treatment, and status of no teeth. OHIP 14 in terms of overall health exhibited considerable difference in the state of mind, nerve systems, bones and sinews, digestive systems, cerebrovascular systems, respiratory systems, ears, and dementia. From the study, it was proven that there was relevance between the validity of OHIP 14 and the perception of oral health, the state of oral health, and the state of overall health in the experiment on some Korean elderly people.

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