• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.148-154
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• 2005

Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.4
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• pp.1041-1054
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• 2004

Electroacupuncture (EA) has been reported to increase pain threshold, and to enhance the NK cell activity by up-regulation of IFN-γ and endogenous β-endolphin. For the purpose of understanding the molecular mechanism of EA stimulation, we analyzed the gene expression profile of rat hypothalamus, treated on Zusanli (ST36) with EA, in comparison with control group by oligonucleotide chip microarray (Affymetrix GeneChip Rat Neurobiology U34 Array) and real-time RT-PCR. Sprague-Dawley (S-D) male rats were stimulated at the Zusanli (ST36) acupoint in restriction holder. Simultaneously the control group was given only holder stress without EA stimulation. In order to prove the appropriateness of EA treatment, we measured spleen NK cell activity with standard 51Cr release assay. NK cell activity of EA group was significantly increased comparing to control group. The microarray and PCR results show that EA treatment up-regulates expression of genes associated with 1) nerve growth such as NGF induced factor A and VGF, 2) signal transduction such as 5HT3 receptor subunit, AMPA receptor binding protein and Na-dependent neurotransmitter transporter, and 3) anti-oxidation such as superoxide dismutase and glutathione S-transferase. In addition, the activity of the anti-oxidative enzyme, SOD of hypothalamus, liver and RBC was enhanced compared to that of control. The list of differentially expressed genes may implicate further insight on the mechanism of acupuncture effects.

• Biomolecules & Therapeutics
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• v.5 no.1
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• pp.94-99
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• 1997

Capsaicin is known to be an analgesic agent, affecting the synthesis, storage, , transport and release of substance p, the principal neurotransmitter of pain from periphery to the central nervous system(CNS). DA-5018, a newly synthesized capsaicin derivative has shown potent analgesic effect comparable to that of morphine in various rat models of experimentally inducted acute pairs. In this study the mechanism of analgesic actlvity of DA-5018 was examined. First, the electrically-evoked contraction of guinea pig trachea was inhibited by DA-5018 and these inhibition was recovered by incubation with capsafepine(3$\muM$), capsaicin receptor antagonist and this result suggested that DA-5018 has affinity on capsaicin receptor. The correlation between the norciceptive threshold and the release of substance P was evaluated. In vivo perfusion of slices of the rat spinal cord with DA-5018(10, 100$\muM$) produced a significant increase of the release of substance P and this increase was less than that of capsaicin(10$\muM$). The norciceptive threshold of rat treated with DA-5018(1 mg/kg, p.o) in tall pinch test increased from 2.9$\pm$0.3 to 23.5 $\pm$6.61. Tail pinch latency increased to a maximun at 15 min after DA-5018 treatment and then declined to control values by 120 min. The capsaicin-evoked release ot substance P from the spinal cord slices of rat treated with DA-5018 reduced from 2.38$\pm$ 0.79 to 0.69$\pm$ 0.26 pg/mg wet weight. This reduction reached to a minium at 15 min after DA-5018 treatment and then recovered to control value by 120 min. These results mean that analgesic activity of DA-5018 is due to release of substance P The effect of DA-5018 cream on electrically-evoked neurogenic inflammation of rat saphenous nerve was compared with capsaicin (zostrix-HP). DA-5018 showed 34% inhibition of the neurogenic extravasation while capsaicin showed significant 67% inhibition. This result indicates that the potency of DA-5018 in the release of substance P is less than that of capsaicin. These results suggest that the release of substance P is partially involved in the mechanism of analgesic action of DA-50l8.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.464-468
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• 2015

A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.19-25
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• 2009

Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

• The Journal of Korean Medicine
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• v.29 no.1
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• pp.146-155
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• 2008

Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.2
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• pp.128-138
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• 2009

Objectives : The purpose of this study is to make a survey on the oriental medical care and to enlarge the domain of oriental medical treatment concerning facial paralysis. Methods : From May 2008 to April 2009, a clinical study was done on 100 inpatients who were diagnosed and treated as facial nerve paralysis at Mok-dong Oriental Medicine Hospital, Dong-shin University Results : The result were as the following 1. The distribution of sex: male 35%, female 65%. The distribution of age was disclosed that fifty was the most in 22 cases(22%). 2. The distribution of the region of facial palsy: Lt 58%(male 23%, female 35%) Rt 41%(male 11%, female 30%) 3. In distribution of contributing frequence in month, June was the most in number(12%) and in season, spring, summer, winter were the same percentage(26%). 4. In distribution of cause, stress(34%), excessive labor(25%), unknown(22%) were investigated higher than other conditions. 5. The distribution of past history: hypertension 14%, diabetes mellitus 4%, both(hypertension, diabetes mellitus) 6% 6. The distribution of period before admission: within a week 80%, 1$\sim$2 week 8%, 3$\sim$4 week 6% in order. 7. The distribution of attended symptoms: mastoid pain 43 cases, dryness of eye 26 cases, tearing 22 cases, headache 12 cases, dizziness 9 cases in order. 8. Other offices patients visited before coming to this clinic: oriental clinic or hospital 35%, local clinic or hospital 29%, none 26%, both(oriental clinic & local clinic) 10%. 9. The distribution of House-Brackmann grade on admission: Gr III 38%, Gr IV 26%, Gr II 22%, Gr V 14% in order. 10. The distribution of House-Brackmann grade on discharge: Gr II 34%, Gr I 32%, Gr III 22%, Gr V 7%, Gr IV 5% in order.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1143-1147
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• 1996

Video-assisted thoracic surgery(VATS) is emerging as a potentially less invasive means of managing a wide variety of thoracic disorders. VATS was performed in 46 cases, in the Department of Thoracic & Cardiovascular Surgery of Chonbuk national University Hospital from August 1992 to July 1995. There were 20 men and 26 women, whose age ranged from 14 to 56 years. They were diagnosed hyperhidrosis in 21 cases, mediastinal tumor in 12 cases, pneumothorax in· 10 cases, and one case each of lelomyoma of the esophagus, Raynaud's syndrome, Burger's disease. Operation time averaged 89.7 minutes, and no patient was converted to d thoracotomy. The number of troche used, period of chest tube drainage, and postoperative hospitalization were 3, 1.8 days, and 4.B days, respectively. The postoperative complication ocurred in 5 cases (remnant pneumothorax 1 case, phrenic nerve aralysis 1 case, persistant air leakage 2 cases, compensatory hyperhidrosis 1 case). One patient with persistent air leak was managed by thoracotomy on postoperative) days, and the other patient by chemical pleurodesis. One patient diagnosed pathologically as thymic carcinoma, was managed by radiation therapy. There was no postoperative death. VATS has the benefits of reduced postoperative pain and postoperative hospitalization, and good cutsmetic effect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.447-455
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• 1995

Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.