• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.138-143
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• 2005

In the high radial nerve palsy caused by displaced humeral shaft fracture, radial nerve have to be explored in the fracture site. 5 cases of the ruptured radial nerve at the fracture site of the humerus from January 1993 through January 2005 were treated at first by open reduction and internal fixation with plates and screws fixation and then defective radial nerves were grafted with autogenous sural nerves by microsurgical epineurial and or perineurial neurorrhaphy. At average 30.4 months follow-up, 5 cases were recovered from motor and sensory deficit with solid bony union of the humerus shaft fracture. Authors have confirmed that ruptured radial nerve in the humerus shaft fracture grafted with autogenous sural nerve with microsurgical epineurial and or perineurial neurorrhaphy would be expected good motor and sensory recovery.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.525-532
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• 2013

PURPOSE: The aim of this study was to compare the effects of different loading swimming exercises on muscle recovery after sciatic nerve crush injury in rats. METHODS: For this study, thirty-one Sprague-Dawley male rats were randomly divided into five groups. There were the negative control group (NCG, n=5), the positive control group (PCG, n=7), the low intensity swimming exercise group (LISEG, n=7), the moderate intensity swimming exercise group (MISEG, n=7) and the high intensity swimming exercise group (HISEG, n=5). Each rat was weighed to determine the lead weight to be attached to the base of its tail. Subsequently, the PCG, the LISEG, the MISEG and the HISEG were underwent standard unilateral sciatic nerve crush. The LISEG (no load), the MISEG (lead weight equivalent to 2% average body mass) and the HISEG (lead weight equivalent to 4% average body mass) were received the 10 minute swimming exercise in a day for 10 days. The NCG and PCG were not received with any therapeutic intervention. The diameter of the calf muscle and the level of serum lactate dehydrogenase (LDH) were measured to detect the effects of the swimming exercise. RESULT: The maximum diameter of the calf muscles was significantly increased after seventh swimming exercise in the LISEG, the MISEG and the HISEG compared with the PCG (p<0.05). However, there was no statistically significant difference between the LISEG, the MISEG and the HISEG. Also, the level of the serum LDH was significantly decreased in the LISEG, the MISEG and the HISEG compared with the PCG (p<0.05). CONCLUSION: Taken together, these results suggest that swimming exercise could accelerate muscle recovery processes after crush injury, but the different intensity of the swimming exercise does not affect healing processes.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.109-114
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• 2010

Objective : To evaluate the clinical outcome of coil embolization for unruptured intracranial aneurysm (UIA) with oculomotor nerve palsy (ONP) compared with surgical clipping. Methods : A total of 19 patients presented with ONP caused by UIAs between Jan 2004 and June 2008. Ten patients underwent coil embolization and nine patients surgical clipping. The following parameters were retrospectively analyzed to evaluate the differences in clinical outcome observed in both coil embolization and surgical clipping : 1) gender, 2) age, 3) location of the aneurysm, 4) duration of the symptom, and 5) degree of ONP. Results : Following treatment, complete symptomatic recovery or partial relief from ONP was observed in 15 patients. Seven of the ten patients were treated by coil embolization, compared to eight of the nine patients treated by surgical clipping (p = 0.582). Patient's gender, age, location of the aneurysm, size of the aneurysm, duration of symptom, and degree of the ONP did not statistically correlate with recovery of symptoms between the two groups. No significant differences were observed in mean improvement time in either group (55 days in coil embolization and 60 days in surgical clipping). Conclusion : This study indicates that no significant differences were observed in the clinical outcome between coil embolization and surgical clipping techniques in the treatment of aneurysms causing ONP. Coil embolization seems to be more feasible and safe treatment modality for the relief and recovery of oculomotor nerve palsy.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1120-1126
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• 2001

Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.148-154
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• 2012

Peripheral nerve injuries in the oral and maxillofacial regions require nerve repairs for the recovery of sensory and/or motor functions. Primary indications for the peripheral nerve grafts are injuries or continuity defects due to trauma, pathologic conditions, ablation surgery, or other diseases, that cannot regain normal functions without surgical interventions, including microneurosurgery. For the autogenous nerve graft, sural nerve and greater auricular nerve are the most common donor nerves in the oral and maxillofacial regions. The sural nerve has been widely used for this purpose, due to the ease of harvest, available nerve graft up to 30 to 40 cm in length, high fascicular density, a width of 1.5 to 3.0 mm, which is similar to that of the trigeminal nerve, and minimal branching and donor sity morbidity. Many different surgical techniques have been designed for the sural nerve harvesting, such as a single longitudinal incision, multiple stair-step incisions, use of nerve extractor or tendon stripper, and endoscopic approach. For a better understanding of the sural nerve graft and in avoiding of uneventful complications during these procedures as an oral and maxillofacial surgeon, the related surgical anatomies with their harvesting tips are summarized in this review article.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.279-284
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• 2007

Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

• The Journal of Korean Medicine
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• v.31 no.3
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• pp.79-97
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• 2010

Background: Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficit. Bee venom acupuncture has traditionally been used to treat several inflammatory diseases and chronic pain conditions. Objectives: The aims of this study were to compare the effects of bee venom (general bee venom, BV) and sweet bee venom (allergen-removed bee venom, SBV) acupuncture on the recovery rate of locomotor function, the expression of brain-derived neurotrophic factor (BDNF) in the sciatic nerve, and the expression of c-Fos in the brain following sciatic crushed nerve injury in rats, and to evaluate differences due to administration areas. Method: Walking track analysis, Western blot for BDNF and tyrosine receptor kinase B (TrkB), and immunohistochemistry for c-Fos were performed. In this study, comparative analyses of the effects of BV and SBV acupuncture in relation to administration sites, contralateral side or ipsilateral side, were conducted. Results: In the present result, sciatic function index (SFI) in walking track analysis significantly decreased following sciatic crushed nerve injury. The expressions of BDNF and TrkB in the sciatic nerve increased after induction of sciatic crushed nerve injury. C-Fos expression in the ventrolateral periaqueductal gray (vlPAG) and paraventricular nucleus (PVN) also increased. BV and SBV acupuncture treatment improved the SFI in walking track analysis. Treatment with SBV at 1mg/kg showed more potent enhancing effect on SFI compared to BV. Treatment with 1mg/kg BV or 1mg/kg SBV acupuncture suppressed the BDNF and TrkB expression in the sciatic nerve. BV and SBV acupuncture treatment also suppressed c-Fos expression in the PVN and vlPAG regions. Treatment with SBV at 1mg/kg showed more potent suppressing effect on c-Fos expression compared to BV when injected into the contralateral side of the injured nerve. Generally we could not find significant difference in the effects between contralateral side and ipsilateral side of the injured nerve. Conclusion: We have shown that BV and SBV acupuncture treatment can be used as the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.

• Journal of Life Science
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• v.16 no.1
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• pp.114-119
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• 2006

The purpose of this study was to determine effects of the Ga-As (Gallium-Arsenide) Dens-Bio laser on mechanically injured sciatic nerves of rats. The improvement of the injured rat sciatic nerve was evaluated by measuring of nerve conduction velocity and amplitude of compound muscle action potential. The sciatic nerves of forty male Sprague-Dawley rats were compressed with hemostatic forceps for 30 seconds. The experimental group was divided into 4 subgroups according to the duration of treatment. Lower power infrared laser irradiation was done transcutaneously to the injured sciatic nerve area, 3 minutes daily to each of four treatment groups for 1, 3, 5, and 7 weeks, respectively. Compound muscle action potential and nerve conduction velocity of sciatic nerve were obtained before nerve injury and at 1, 3, 5, and 7 weeks after injury. There were significant difference of the nerve conduction velocity and amplitudes of compound muscle action potential between the treatment group and non-treatment group at 1, 3, and 5 weeks after laser treatment. However, there were no differences found between the electrophysiologic parameters that were measured after 7 weeks in two groups. There was significant correlation between the increment of compound muscle action potential and nerve conduction velocity after time course according to laser treatment. In conclusion, the low power laser treatment had improved the sciatic nerve function, and therefore these results may provide the basic data to clarify the neurological recovery and treatment after incomplete peripheral nerve injury.

• Journal of Chest Surgery
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• v.11 no.3
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• pp.239-245
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• 1978

Recently, we experienced a case of rare neurilemmoma originated from intercostal nerve [9th] in the right chest wall in a 25 year old male officer. The tumor was incidentally found in the routine chest X ray, where the round well circumscribed mass tumor the ninth rib with notching and sclerotic margin, suggesting slowly growing benign benign of chest wall was revealed and the tumor mass was easily extirpated in the exploratory thoracotomy, with uneventful recovery. Grossly, the tumor was firm, partly soft and well circumscribed, measuring 4.5X3.0X 3.0 cm with yellowish smooth outer surface, attached with intercostal nerve trunk. Cut surface exhibits partly grayish white and largely hemorrhagic areas. Microscopically, the characteristic palisading arrangement of schwann cells and Verocay bodies are seen but dominant features are cystic degeneration and hemorrhage with organization and fibrosis. The sheath of intercostal nerve and capsule of neurilemmoma were con joined. There is no evidence of malignancy. The tumor was confirmed as neurilemmoma of intercostal nerve, Antony type B.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.139-141
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• 2011

Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery.