• Title/Summary/Keyword: Plexus

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Brachial Neuritis - A Case Report - (상완 신경총 신경염 - 증례 보고 -)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Youn, Dong-Jin;Kim, Eu-Gene;Ha, Jung-Ki
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.246-250
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    • 2006
  • Brachial neuritis is a rare disorder of unknown etiology that affects the lower motor neurons of the brachial plexus. The clinical course is characterized by acute onset of severe pain followed by weakness and gradual recovery. Among diagnostic tests, electromyography may be useful. The brachial neuritis has been confused with other painful shoulder conditions. The awareness of this disorder helps prevent unwarranted diagnostic studies & treatment. The authors report a case of brachial neuritis.

Multiple Neurolytic Block for Advanced Cancer Pain (다양한 교감신경차단이 필요했던 복부 암성통증)

  • Kim, Soo-Hwan;Park, Woo-Young;Yoon, Duck-Mi
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.51-54
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    • 2008
  • Qualify of life is the main consideration in pain management and palliative care for patients with advanced cancer. Cancer pain is primarily relieved with pharmacological therapy including aretaminophen, nonsteroidal anti-inflammatory drugs, adjuvant analgesics, and opioids. In addition to pharmacological therapy, the neurolytic celiac plexus block is claimed to be an effective approach in management of advanced pancreatic cancer pain. We report our patient who has been treated for advanced cancer pain with multiple neurolytic blocks. The clinical result suggests that combined neurolytic blocks improved the quality of life of patient who had advanced ranter pain by reducing both the intensity of pain and opioid consumption, without serious complications.

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Surgery of Parasplenial Arteriovenous Malformation with Preservation of Vision - A Case Report - (부뇌량팽대 동정맥 기형의 수술에서 시야의 보존 - 증례보고 -)

  • Joo, Jin Yang;Ahn, Jung Yong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.815-821
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    • 2000
  • Parasplenial arteriovenous malformations(AVMs) are rare vascular malformations which have distinct clinical and anatomical features. They are situated at the confluence of the hippocampus, isthmus of the cingulate gyrus and the gyrus occipitotemporalis medialis. These lesions are anterior to the calcarine sulcus and their apex extends towards the medial surface of the trigonum. Posterolaterally, these lesions are in close proximity to the visual cortex and optic radiation. The objectives in the surgery of parasplenial AVMs are complete resection of the lesions and preservation of vision. These objectives must be achieved with comprehensive understanding of the following anatomical features :1) the deep central location of the lesions within eloquent brain tissue ; 2) the lack of cortical representation of the AVMs that requires retraction of visual cortex ; 3) deep arterial supply ; 4) deep venous drainage ; 5) juxtaposition to the choroid plexus with which arterial supply and venous drainage are shared. A 16-year-old female student presented with intraventricular hemorrhage from a right parasplenial-subtrigonal AVM. The lesion, fed by posterior cerebral artery and drained into the vein of Galen, was successfully treated by the inter-hemispheric parietooccipital approach. To avoid visual field defect a small incision was made on precuneus anterior to the calcarine sulcus. In this report, the authors describe a surgical approach with special consideration on preservation of visual field.

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Collet-Sicard Syndrome Induced by Neck Mass : 2 Cases (경부 종물로 유발된 Collet-Sicard Syndrome 2례)

  • Kwon, Do-Young;Lee, Jong-Mun;Koh, Seong-Beom;Kim, Byung-Jo;Park, Min-Kyu;Park, Kun-Woo;Lee, Dae-Hie
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.74-77
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    • 2002
  • Collet-Sicard Syndrome is one of the variant of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. The possible causes of these multiple lower cranial nerve palsy are variable, including metastasis of systemic malignancy to the base of skull, primary tumor of head and neck, vascular complication, trauma and so on. We experienced two men visited to our clinic with symptoms of headache, hoarsness, swallowing difficulty and showed the evidence of cranial nerve palsy on neurologic examination. Magnetic resonance imaging and computed tomography demonstrated oropharyngeal and hypopharyngeal tumor and electrodiagnostic study supported the diagnosis.

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Granular cell tumor of the esophagus in an adolescent

  • Lee, Ji Sun;Ko, Kyung Ok;Lim, Jae Woo;Cheon, Eun Jeong;Kim, Young Jin;Son, Jang Sin;Yoon, Jung Min
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.88-91
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    • 2016
  • Esophageal granular cell tumor (GCT) is a rare neoplasm originating from the Schwann cells of the submucosal neuronal plexus. Histology is the gold standard for its diagnosis. Endoscopic resection or surgical excision should be considered, depending on the potential for malignancy. Here, we report a case of an esophageal GCT in an adolescent. A 12-year-old boy presented with a 1-year history of dysphagia and vomiting. Upper gastrointestinal endoscopic examination and esophagography showed narrowing of the midesophagus, and computed tomography angiography of the thoracic aorta revealed an esophageal or periesophageal mass posterior to the paratracheal segment of the esophagus. The tumor was surgically excised, and based on the pathological findings, esophageal GCT was diagnosed.

Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus

  • Kim, Hyun Sik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.532-538
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    • 2020
  • Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

Sacral Nerve Stimulation for Treatment of Intractable Pain Associated with Cauda Equina Syndrome

  • Kim, Jong-Hoon;Hong, Joo-Chul;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.473-476
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    • 2010
  • Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

Chongkukjang Mucilage Stimulates Immunohistochemical Activities of Gastrointestinal Tract in Rats

  • Lee, Chang-Hyun;Yang, Eun-In;Song, Geun-Seoup;Chai, Ok-Hee;Kim, Young-Soo
    • Food Science and Biotechnology
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    • v.14 no.6
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    • pp.813-817
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    • 2005
  • We investigated the effect of a viscous substance from chongkukjang (chongkukjang mucilage) on immunohistochemical reactions in rat gastrointestinal (GI) tracts, Rats fed a steady diet of chongkukjang mucilage showed an increase in the immunoreactive densities of gastrin and serotonin in the pyloric region of their stomachs and duodenal villi, The number of gastrin and serotonin immunoreactive cells was significantly higher in the experimental group than in the control group. Feeding on dietary chongkukjang mucilage increased the immunohistochemical densities of $CD4^+$ and $CD8^+$ lymphocytes in the mucosa and submucosa of the rats' gastroduodenal region. The universal nitric oxide synthase (uNOS)-immunoreactive neurons and nerve fibers were strongly stained in the vascular walls of the submucosa and myenteric plexus in rats fed the test diet. The results indicate that the intake of chongkukjang mucilage could increase mucosal immune activity, gastrointestinal motility, and blood circulation in the GI tract.

The Axillary Approach to Raising the Latissimus Dorsi Free Flap for Facial Re-Animation: A Descriptive Surgical Technique

  • Leckenby, Jonathan;Butler, Daniel;Grobbelaar, Adriaan
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.73-77
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    • 2015
  • The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.

Male Nipple Reduction using Modified Pentahedral Excision (변형된 오면체 모양 절제법을 이용한 남성 유두축소술)

  • Yoon, Sang Yub;Kang, Min Gu
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.779-783
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    • 2009
  • Purpose: Male hypertrophic nipples can lead to psychological distress and physical discomfort. The authors present a new technique of male nipple reduction and describe its advantages Methods: The neonipple is designed to reduce diameter and height of nipple while preserving the subdermal plexus. After the central wedge excision, additional four triangular section of nipple skin is excised. One of the remaining two flaps is amputated partially and both flaps were approximated using 4 - 0 PDS and 6 - 0 Nylon sutures. Results: Between December of 2007 and January of 2009, 52 nipple reductions were performed in 30 male patients(mean = 29.5 years). Postoperative recovery was rapid and few complications were encountered. The mean diameter of the hypertrophic nipple was $9.1{\pm}2.5mm$(range, 7 to 15 mm). The mean diameter of the neonipple was $5.0{\pm}0.7mm$(range, 4 to 6 mm), with an average reduction of $3.8{\pm}0.6mm$(range, 2 to 11 mm). At follow-up, the neonipple had a natural appearance, with less projection and an inconspicuous scar. Conclusion: The wedge and triangular skin excision and partial amputation are easy to perform and yields consistent results. This technique decreases both the diameter and height of any size nipple and can be modified to meet patient preferences.