• 대한소아치과학회지
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• 제25권1호
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• pp.249-256
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• 1998

Glial fibrillary acidic proteins (GFAP) are a group of intermediate filaments that are distributed in the cytoplasm of glial cells. GFAP immunoreactivity (GFAP-IR) increase after central and peripheral nerve injuries. The purpose of this study was to determine change of GFAP-IR in rat trigeminal ganglion satellite cells following the axotomy of inferior alveolar nerve(IAN). The immunohistochemistry was carried out using the avidin-biotin-peroxidase complex(ABC) method. 1. Control group : Astrocytes in central root of trigeminal ganglion had strong GFAP-IR, but satellite cells of trigeminal ganglion occasionally had GFAP-IR. The patterns of reactivity in satellite cells of trigeminal ganglion were not concenturated in any specific region of trigeminal ganglion. 2. Three day group after IAN axotomy : There were highly GFAP-IR in satellite cells of trigeminal ganglion in mandibular region. GFAP-IR in maxillary and ophthalmic regions were less intense compared to mandibular region. 3. Seven day group after IAN axotomy : GFAP-IR that were increased compared to control group were seen in the mandibular region. But GFAP-IR were less intense compared to three day group. These results suggest that GFAP-IR increase in specific region of trigeminal ganglion following peripheral axotomy. therefore we suppose that GFAP study offer research tool in trigeminal neuralgia.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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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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• 제39권
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• pp.29.1-29.5
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• 2017

Background: The surgical extraction of the third molar is the most frequently encountered procedure in oral and maxillofacial surgery and is related with a variety of complications. This study examined the efficacy of intentional partial odontectomy (IPO) in the third molars which have no periapical lesions and are located near important anatomical structures such as inferior alveolar nerve. Methods: Seven patients (four males, three females, $39.1{\pm}11.6years$), who received IPO to reduce the risk of inferior alveolar nerve injury (IANI), were followed long-term. The treated teeth were horizontally impacted third molars in the mandibular left (n = 5) or mandibular right (n = 4) areas and were all ankylosed with the surrounding alveolar bone. During the IPO, the bone around the crown was removed to expose the crown, and then the tooth was resected at cement-enamel junction (CEJ). Any secondary trauma to the healthy root was minimized and remained intact after primary suture. Results: The mean follow-up time was $63.2{\pm}29.8months$, and all sites showed good bone healing after the crown removal. Also, sensory abnormality was not found in any patients after IPO. In one patient, the bone fragments erupted 4 months after IPO. In other patient, an implant placed on second molar site adjacent to the third molar that received IPO was explanted about 2 years after the patient's persistent discomfort. Conclusions: In case where high risk of IANI exists, IPO may be chosen alternatively to surgical extraction to reduce the risk of nerve damage.

• 동의신경정신과학회지
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• 제24권3호
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• pp.309-320
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• 2013

Objectives : There is a possibility LRE as remedy in Alzheimer disease (AD), but it's nerve protection effect and mechanism have to be elucidate. In this research, we applied LRE on $A{\beta}_{25-35}$ pre-treated SH-SY5Y cells, to find out the nerve protection effect and mechanism in AD cell model. Methods : We tried to confirm that effect by experimenting with 20, 50, and $100{\mu}g/ml$ concentration of LRE as a medicine. Next experiment, we assessed damage effect which induced $A{\beta}_{25-35}$, known to cause AD, on SH-SY5Y cell. In addition, cellular viability test is executed under $H_2O_2$ treatment condition in a SH-SY5Y cell. Results : 1. In $A{\beta}_{25-35}$ treated SH-SY5Y cell, LRE exhibited an anti-phosphorylation effect about tau protein, JNK, and IKB. 2. LRE prevent nerve cell apoptosis, which indued $A{\beta}_{25-35}$ and oxidative stress, modify JNK engaged synaptic structure and $NF{\kappa}B$ induced p75-neurotrophin receptor polymorphism. Conclusions : We found that LRE prevented oxidative stress-induced cellular destruction, for example, increased SOD activity of $A{\beta}_{25-35}$ treated SH-SY5Y cell and reduced toxicity of oxygen free radical. Consequently, the ingredients of LRE have a role as a catalyzer for $A{\beta}_{25-35}$ clearance and as scavenger for active oxygen free radical.

• Applied Microscopy
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• 제44권1호
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• pp.15-20
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• 2014

Cytokeratin 19 (CK19) expressed in epidermis of skin, bulge region of hair follicle, outermost layer of outer root sheath and proximal and distal to bulge. Vimentin is a fibrous protein that localized in cytoplasm of fibroblast and forms cytoskeleton to maintain shape of cell and nucleus. In this study, CK19 and vimentin in skin were confirmed with light, fluorescence and transmission electron microscope. As a result, CK19 was localized epidermis, hair follicles, outer root sheath and nucleus of Merkel's cell. However, vimentin was localized some epidermis, dermis, hypodermis and nucleus of Merkel's cell. The role of CK19 is self-renewal and homeostasis in skin. Also, hair follicle regeneration and hair growth is known to be related. It is supposed that required of structural proteins that make up cytoskeleton is increased. Thereby, expression of CK19 is increased. It is considered that vimentin localized in order to stabilize structure of cell and cytoskeleton of fibroblasts. Also, CK19 and vimentin present in nuclei of Merkel's cell, and to act as a fibrous protein that make up end of a nerve fiber present in Merkel's cell and paracrine function of Merkel's cell.

• The Korean Journal of Physiology and Pharmacology
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• 제3권1호
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• pp.101-117
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• 1999

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease of unknown etiology in which the upper and lower motor neurons are progressively destroyed. Recent evidences support the role of autoimmune mechanisms in the pathogenesis of ALS. This study investigated the effects of sera from ALS patients on neuromuscular transmission in phrenic nerve-hemidiaphragm preparations and on calcium currents of single isolated dorsal root ganglion (DRG) cells in mice. Mice were injected with either control sera from healthy adults or ALS sera from 18 patients with ALS of sporadic form, for three days. Miniature end plate potential (MEPP) and nerve-evoked end plate potential (EPP) were measured using intracellular recording technique and the quantal content was determined. Single isolated DRG cells were voltage-clamped with the whole-cell configuration and membrane currents were recorded. Sera from 14 of 18 ALS patients caused a significant increase in MEPP frequency in normal Ringer's solution $(4.62{\pm}0.14\;Hz)$ compared with the control $(2.18{\pm}0.15\;Hz).$ In a high $Mg^{2+}/low\;Ca^{2+}$ solution, sera from 13 of 18 ALS patients caused a significant increase in MEPP frequency, from $2.18{\pm}0.31$ Hz to $6.09{\pm}0.38$ Hz. Sera from 11 of 18 patients produced a significant increase of nerve-evoked EPP amplitude, from $0.92{\pm}0.05$ mV to $1.30{\pm}0.04$ mV, while the other seven ALS sera did not alter EPP amplitude. In the ALS group, EPP quantal content was also elevated by the sera of 14 patients (from $1.49{\pm}0.07$ to $2.35{\pm}0.07).$ MEPP frequency and amplitude in wobbler mouse were $4.03{\pm}0.53$ Hz and $1.37{\pm}0.18$ mV, respectively, which were significantly higher than those of wobbler controls (wobblers without the symptoms of wobbler). Sera from ALS patients significantly reduced HVA calcium currents of DRG cells to 42.7% at -10 mV. Furthermore, the inactivation curve shifted to more negative potentials with its half-inactivation potential changed by 6.98 mV. There were, however, significant changes neither in the reversal potential of $I_{Ca}$ nor in the I-V curve. From these results it was concluded that: 1) The serum factors of sporadic ALS patients increase neuromuscular transmission and can alter motor nerve terminal presynaptic function. This suggests that ALS serum factors may play an important role in the early stage of ALS, and 2) Calcium currents in DRG cells were reduced and rapidly inactivated by ALS sera, suggesting that in these cells, ALS serum factors may exert interaction with the calcium channel.

• The Korean Journal of Physiology
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• 제23권1호
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• pp.129-138
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• 1989

척수 전근내 구심신경의 특성을 알아보기 위하여 고양이에서 L7 척수 전근을 전기자극하여 유발되는 동맥혈압의 변동을 관찰하였다. morphine을 정맥내 혹은 직접 척수에 투여하여 그 효과를 관찰하였으며 척수에 부분적인 손상을 가하여 척수 전근의 구심정보가 척수의 어느 부위를 통하여 중추로 올라가 승압반응을 유발하는지를 결정하여 다음과 같은 결과를 얻었다. 1. 척수전근을 C-강도, 높은 빈도로 자극하면 현저한 승압반응을 유발하였으며 낮은 빈도로 자극할 때에는 피부 혹은 근육감각신경을 자극할 때 보이는 감압반응이 유발되지 않았다. 2. 경수부위를 절단하였을 경우 승압반응이 소실되어 승압반응이 전적으로 척수 상부구조를 통하여 일어남을 알 수 있었다. 3. 승압 반응의 척수내 상행경로는 척수의 dorsolateral funiculus에 양측성으로 존재하였다. 4. 정맥내로 주사한 morphine은 척수 전근내 구심섬유가 자극되어 유발되는 승압반응을 강화시켰으나 척수에 직접 투여한 morphine은 승압반응을 억제하였다. 이상의 결과로부터 척수 전근내에 존재하는 구심성 섬유들은 기능적으로 근육 감각신경 중에 승압반응을 유발하는 C-섬유와 유사한 성질을 갖는다고 사료된다.

• Journal of Korean Neurosurgical Society
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• 제56권6호
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• pp.521-526
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• 2014

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure. Conservative treatment and needle aspiration was performed, but not effective to relieve patient's symptoms. The patient underwent revision surgery to remove the gaseous cyst. Her leg pain was improved after the second operation.

• 한방재활의학과학회지
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• 제18권4호
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• pp.39-61
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• 2008

목적 : 좌골신경 압좌손상으로 유발된 쥐의 모델을 이용하여 손상된 말초신경의 재생효과에 관한 침자극 효과를 세포분자학적, 조직학적 관점에서 연구하였다. 아울러 손상 좌골신경을 지배하는 척수신경근과 가까운 부위 경혈자극과 좌골신경이 지배하는 말초부위 경혈자극과의 침자극 효과를 비교 연구하였다. 방법 : 한쪽 좌골신경에 압좌손상을 유발 한 실험쥐들을 1주, 2주로 나눈 뒤 각각에 대해 격일로 1주군은 3회, 2주군은 6회의 침자극을 시행하였다. 손상 좌골신경의 재생효과를 비교실험하기 위해 정상군, 압좌손상만을 유발한 실험군, 침자극 군으로 나누었다. 침자극 군 중 한 군은 손상신경을 지배하는 척수신경근에 가장 가까운 2개의 화타협척혈(EX B2)에 자침(근위부 자극군)하였고, 다른 한 군은 말초부위에 위치한 족삼리혈(ST 36)과 위중혈(BL 40) 2곳에 자침(원위부 자극군)하였다. 실험 후 각각의 조직을 분리하여 Western blotting 혹은 Hoechst staining으로 Gap-43, Cdc2, Cdk2, Erk1/2 단백질을 분석 및 좌골신경의 각 세포수를 측정하였다. Retrograde tracing을 통해 L5의 DRG와 척수에서 말초신경 재생 효과를 관찰하였고, Immunofluorescence staining을 통해 신경돌기 가지의 신장 정도를 파악하였다. 결과 : 좌골신경 손상 7일된 실험쥐의 근위부와 원위부 침자극군에서 GAP-43와 Cdc2 단백질수준이 향상된 것으로 나타났다. Cdk2 단백질수준은 압좌손상 실험군에서 강하게 증가하였지만 침자극군과 비교해서 별다른 차이는 보이지 않았다. Phospho-Erk1/2 단백질수준은 침자극군에서 향상된 것으로 나타났다. 손상 7일과 14일 된 실험쥐의 손상 원위부에서 슈반세포 수가 증가하였으며 특히 근위부 침자극군에서 더욱 증가한 것으로 나타났다. Retrograde tracing을 이용한 검사 결과 침자극군에서 L5의 DRG와 척수의 염색 세포 수가 증가된 것으로 나타나 침자극이 축삭재생에 효과적인 것으로 나타났다. L5의 DRG 감각신경의 신경돌기 가지 신장정도 및 GAP-43 단백질의 발현 정도를 측정한 결과 근위부 침자극군에서 효과적으로 GAP-43 단백질의 발현 및 신경돌기 가지가 신장된 것으로 나타났다. 결론 : 본 실험결과 침치료가 손상 좌골신경의 재생에 효과적인 것으로 보여지며, 특히 손상된 좌골신경을 지배하는 척수신경근 주위 화타협척혈에 대한 침자극이 말초부위의 침자극에 비해 신경재생에 더욱 효과적인 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.85-90
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• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.