• Title/Summary/Keyword: Nerve recovery

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CLINICAL STUDY OF SENSORY ALTERATIONS AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상분할 절단술 후 감각 변화에 관한 연구)

  • Choi, Jun-Young;Yoo, Jun-Yeol;Yoon, Bo-Keun;Leem, Dae-Ho;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.141-148
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    • 2010
  • The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.

Effects of Low Power Laser Irradiation on the Spinal Cord for the Functional Regeneration of Crushed Sciatic Nerve in Rats (흰쥐 좌골신경 압좌손상 후 척수분절의 저강도 레이저 조사가 운동기능 회복에 미치는 영향)

  • Kim, Souk-Boum;Kim, Dong-Hyun;Song, Ju-Min;Nam, Ki-Won;Kwon, Young-Shil;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.569-578
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    • 2001
  • The purpose of the present study was to examine the functional recovery of the crushed sciatic nerve of rats after low-power laser irradiation applied to the corresponding segments of the spinal cord. After a crushed injury on the left sciatic nerve in rats. low-power laser irradiation was applied transcutaneously to corresponding segments of the spinal cord immediately after suture the wound by using 2000 mW, 2000Hz, 830 nm CaAIAs(Gallium-aluminum-arsenide) semiconductor diode laser. The laser treatment was performed with 10 minutes daily for 4 successive weeks. Functional recovery was evaluated per weekly following injury by sciatic function index(SFI),using data obtained by walking track analysis. For four weeks after crush injury, experimental group had significantly greater functional improvement than control group(${\alpha}$=0.05). In a experimental group, SFI was significantly increased for three weeks, but control group not increased for two weeks. This study suggests that low-power laser irradiation applied directly to the spinal cord can improve functional recovery of the crushed sciatic nerve in rats.

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The Effect of EA and TENS on GAP-43 Expression in Spinal Cord after Rat Sciatic Nerve Crush Injury (전침자극과 경피신경전기자극이 흰쥐 좌골신경 압좌손상 후 척수내 GAP-43 발현에 미치는 영향)

  • Lee, Hyun-Min;Park, Eun-Se;Kim, Min-Hee;Kim, Souk-Boum;Kim, Dong-Hyun;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.18 no.1
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    • pp.65-73
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    • 2006
  • Purpose: The purpose of this study was to identify the effect of electroacupuncture(EA) and transcutaneous electric nerve stimulation(TENS) after sciatic nerve crush injury in rats. Methods: The EA for experimental group I (Exp I, n=15) and TENS for experimental group II (Exp II, n=15) was applied from post-injury day(PD) 1 to PD 14 after sciatic nerve injury using low frequency stimulator that gave electrical stimulation(15min/60Hz). In order observe the effect of EA and TENS, this study examined GAP-43 expression in rat lumbar spinal cord at the PD 1, PD 7 and PD 14. In addition, the stride length(SL) and toe out angle(TOA) were measured at the PD 7 and PD 4. Results; Exp I and Exp II had higher GAP-43 immunoreactivity than control group(PD 1, 7, 14). The SL of Exp I and Exp II were significantly higher than control group(PD 7, 14). The TOA of Exp I and Exp II were significantly lower than control group(PD 7, 14). Conclusion: EA and TENS application increased motor nerve recovery and expression of GAP-43 immunoreactivity after sciatic nerve crush injury. Therefore effect of TENS and EA had similar effect on nerve regeneration and functional recovery.

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Neuropathic cancer pain: prevalence, pathophysiology, and management

  • Yoon, So Young;Oh, Jeeyoung
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1058-1069
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    • 2018
  • Neuropathic cancer pain (NCP) is caused by nerve damage attributable to the cancer per se, and/or treatments including chemotherapy, radiotherapy, and surgery; the prevalence is reported to be as high as 40%. The etiologies of NCP include direct nerve invasion or nerve compression by the cancer, neural toxicity, chemotherapy, and radiotherapy. NCP is subdivided into plexopathy, radiculopathy, and peripheral neuropathies, among several other categories. The clinical characteristics of NCP differ from those of nociceptive pain in terms of both the hypersensitivity symptoms (burning, tingling, and an electrical sensation) and the hyposensitivity symptoms (numbness and muscle weakness). Recovery requires several months to years, even after recovery from injury. Management is complex; NCP does not usually respond to opioids, although treatments may feature both opioids and adjuvant drugs including antidepressants, anticonvulsants, and anti-arrhythmic agents, all of which improve the quality-of-life. This review addresses the pathophysiology, clinical characteristics and management of NCP, and factors rendering pain control difficult.

Preservation of Facial Nerve Function Repaired by Using Fibrin Glue-Coated Collagen Fleece for a Totally Transected Facial Nerve during Vestibular Schwannoma Surgery

  • Choi, Kyung-Sik;Kim, Min-Su;Jang, Sung-Ho;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.208-211
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    • 2014
  • Recently, the increasing rates of facial nerve preservation after vestibular schwannoma (VS) surgery have been achieved. However, the management of a partially or completely damaged facial nerve remains an important issue. The authors report a patient who was had a good recovery after a facial nerve reconstruction using fibrin glue-coated collagen fleece for a totally transected facial nerve during VS surgery. And, we verifed the anatomical preservation and functional outcome of the facial nerve with postoperative diffusion tensor (DT) imaging facial nerve tractography, electroneurography (ENoG) and House-Brackmann (HB) grade. DT imaging tractography at the 3rd postoperative day revealed preservation of facial nerve. And facial nerve degeneration ratio was 94.1% at 7th postoperative day ENoG. At postoperative 3 months and 1 year follow-up examination with DT imaging facial nerve tractography and ENoG, good results for facial nerve function were observed.

Nerve Cable Graft Interposition in Patients with Brachial Plexus Schwannoma: Case Reports

  • Han, Changsung;Ahn, Hyo Yeong;Kim, Yeong Dae;Lee, Chung Won
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.535-538
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    • 2021
  • Schwannomas are rare benign tumors that develop in Schwann cells lining peripheral nerves. Schwannomas of the brachial plexus are especially rare, accounting for 5% of all cases. Although several treatments can be considered, the exact method of treatment is unclear owing to the scarcity and sporadic occurrence of schwannomas. Tumor resection is performed in most cases, and nerve damage is inevitable in cases of neuroinvasive schwannoma. In this case series, we present our successful use of transposition of cable-grafted nerves for the treatment of schwannomas. We performed cable-grafted nerve interposition in addition to tumor resection, leading to increased recovery of nerve damage. To relieve postoperative symptoms and minimize sequelae, precise surgical tumor resection followed by nerve interposition using a cable-grafted nerve may be recommended.

Effect of Laparoscopic Nerve-sparing Radical Hysterectomy on Bladder Function, Intestinal Function Recovery and Quality of Sexual Life in Patients with Cervical Carcinoma

  • Chen, Long;Zhang, Wei-Na;Zhang, Sheng-Miao;Yang, Zhi-Hao;Zhang, Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10971-10975
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    • 2015
  • Objective: To investigate bladder and intestinal function recovery and quality of sexual life after laparoscopic nerve-sparing radical hysterectomy (LNRH) for treatment of early invasive cervical carcinoma. Methods: Subjects included patients who underwent radical hysterectomy by laparotomy who were randomly assigned to 2 groups: 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy (LRH). We assessed the patients general clinical information, surgical characteristics, pathological findings, and adjuvant therapies. A urodynamic study was used to assess bladder function. Intestinal function recovery and quality of sexual life were evaluated by questionnaire. Results: No significant differences were found in age, surgery characteristics, pathological findings, adjuvant therapies, and main adverse effects between the 2 groups. The mean duration of the postoperative catheterization (DPC) in group LNRH was shorter than that in group LRH (P < 0.001). The maximum flow rate, maximum cystometric capacity, maximum detrusor pressure and urinary complications in group LNRH were better than those in group LRH. The quality of sexual life evaluated according to the female sexual function index (FSFI) was better in group LNRH than in those who underwent LRH. The intestinal function of patients in group LNRH also recovered better compared with patients in group LRH.

Effect of Exercise on Neurotrophins, BDNF, NT-3, GAP43 Protein Expression and Axonal Regeneration after Sciatic Nerve Injury in F344 Rats (운동이 좌골신경 손상 F344쥐의 Neurotrophins, BDNF, NT-3, GAP-43 단백질 발현과 축삭재생에 미치는 영향)

  • Yoon Jin-Hwan;Seo Tae-Beom
    • Journal of Life Science
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    • v.16 no.3 s.76
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    • pp.464-471
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    • 2006
  • Peripheral nerve injuries are a commonly encountered clinical problem and often result in severe functional deficits. In the present study, the effects of treadmill exercise on neurotrophin expressions and functional recovery following sciatic crushed nerve injury were investigated. Animals were randomly assigned into four groups: the sciatic nerve injury group, the sciatic nerve injury and 3-day-exercise, the sciatic nerve injury and 7-days-exercise, and the sciatic nerve injury and 14-days-exercise groups. Sciatic nerve injury was caused by crushing the right sciatic nerve for 30 s using a surgical clip. A the light-exercise was applied to each of the exercise group over the respective number of days. In the present results, we identified enhanced axonal re-growth in the distal stump of the sciatic nerve 3-14 days after crush injury with treadmill training. Dorsal root ganglion (DRG) neuron when cultured from animals with nerve injury and treadmill training showed more enhanced neurite outgrowth than that of sedentary animals. Nerve growth factor (NGF) protein levels in low-intensity treadmill training group were highly induced in the injured sciatic nerves 3, 7 and 14 days after injury compared with sedentary group, and brain-derived neurotrophin factor (BDNF) protein levels in treadmill exercise group were highly induced in the injured sciatic nerve 3 days after injury compared with sedentary group. Then, treadmill exercise increased neurotrophic factors induced in the regenerating nerves. We further demonstrate that motor functional recovery after sciatic nerve injury was promoted by treadmill exercise. Thus, the present data provide a new evidence that treadmill exercise enhanced neurotrophins expression and axonal regeneration after sciatic nerve injury in rats.

Middle superior and anterior superior alveolar nerve injury following trauma to the maxillary sinus: a prospective clinico-radiographic evaluation

  • Sathish Radhakrishna;Eashwari Narayanan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.5
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    • pp.262-269
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    • 2023
  • Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

Proposed Mechanisms of Photobiomodulation (PBM) Mediated via the Stimulation of Mitochondrial Activity in Peripheral Nerve Injuries

  • Choi, Ji Eun
    • Medical Lasers
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    • v.10 no.4
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    • pp.195-200
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    • 2021
  • Evidence shows that nerve injury triggers mitochondrial dysfunction during axonal degeneration. Mitochondria play a pivotal role in axonal regeneration. Therefore, normalizing mitochondrial energy metabolism may represent an elective therapeutic strategy contributing to nerve recovery after damage. Photobiomodulation (PBM) induces a photobiological effect by stimulating mitochondrial activity. An increasing body of evidence demonstrates that PBM improves ATP generation and modulates many of the secondary mediators [reactive oxygen species (ROS), nitric oxide (NO), cyclic adenosine monophosphate (cAMP), and calcium ions (Ca2+)], which in turn activate multiple pathways involved in axonal regeneration.