• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.199-204
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• 2018

Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.191-195
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• 2000

Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.68-71
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• 2006

Background: Stellate ganglion block (SGB) is a selective sympathetic blockade that affects the head, neck and the upper extremities. It is an important method that has been frequently used in pain clinics due to its wide range of indications. But there were some problem with performing SGB at C6 or C7. Thus, various techniques have been recently introduced to successfully perform SGB; among them, there is the oblique approach. This study was performed to evaluate the effectiveness of the oblique approach for performing SGB in C7. Methods: Forty six patients with sudden hearing loss were studied. In group I, the patient underwent C7 oblique SGB with 1% mepivacaine (3 ml) under fluoroscopic guidance. In group II, the patients underwent the C7 classical anterior approach SGB with 1% mepivaine (5 ml) under fluoroscopic guidance. We compared the occurrence of Horner's syndrome, the side effects and the changes of temperature of the skin of the hand. Results: The rate of Horner's syndrome was 81.5% in the group I and 84.2% in the group II. The rate of incurring increased skin temperature (${\geq}34^{\circ}C$) of the fingers was 77.7% and 79.4% in each group, respectively. Conclusions: The C7 oblique approach for SGB showed the same SGB effect compared with the C7 anterior approach for SGB, and there were also fewer complications. We conclude that C7 oblique SGB may be a beneficial method for treating patients with this particular malady.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.367-370
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• 1995

We experienced two case of persistent Horner's syndrome which might be side effect of stellate ganglin block(SGB). Case one, a 35 year old male patient with severe pain and hyperesthesia of the right thumb. We performed repeated SGB with 1% mepivacaine 5 ml on the right side daily. After 9 times of SGB, he had continued ptosis, photophobia for one month and miosis for 6 months. Second case, the patients was a 21 year old male. He visited at our pain clinic to be cured of both sudden deafness which had begun two week ago. We performed SGB on both sides alternatively twice a day. About a week later, hearing ability of the left ear was recovered. After then we performed SGB only the right side. 34 SGB was performed in two months after that he got persistent Horner's syndrome.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.30-35
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• 1998

Background: Idiopathic sudden sensorineural hearing loss(ISSHL) has been generally defined as an abrupt loss of auditory acuity without precipitating factors. Since ISSHL was first described as a disease entity, numerous reports assessing a variety of treatment regimens have been published. But its etiology, pathogenesis, treatment, and prognosis are controversial at the present time. Stellate ganglion block(SGB) has been used for the treatment of ISSHL by vasodilatation and increased blood flow to the inner ear. Methods: We reviewed the records of 152 patients to investigate the efficacy of SGB for ISSHL. The control group was managed with medications such as hypaque, heparin, steroid, nicotinic acid, and vitamins. The SGB group was managed with SGB and the same medications. SGB was performed with 8 ml of 1.0% mepivacaine. The efficacy of treatment was evaluated by pure-tone average following therapy. The recovery of hearing was defined as Siegel's criteria I, II, or III. Results: The recovery rate of the SGB group was higher than that of the control group(61.5 vs. 42.9%, p<0.05). The recovery rate was higher in patients who were treated early, within 7 days from the onset of symptoms, especially in the SGB group(79.7%). And in the case that initial hearing loss was severe (>70dB), the SGB group had a higher recovery rate(64.2%) than the control group(42.5%). Conclusions: SGB is thought to be a useful therapy for ISSHL, especially in the patients who were treated soon after onset or whose initial hearing loss was severe.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.202-206
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• 2006

Background: Stellate ganglion block (SGB) might be associated with changes in the blood pressure (BP) and heart rate (HR). The heart rate variability (HRV) shows the balance state between sympathetic and parasympathetic activities of the heart. The changes in these parameters of the HRV were studied to evaluate the possible mechanism of SGB in changing the BP. Methods: SGB was performed on 26 patients, using a paratracheal technique at the C6 level, and 8 ml of 1% mepivacaine injected. The success was confirmed by check the Horner's syndrome. The BP, HR and HRV were measured before and 5, 15, 30, 45 and 60 minutes after the SGB. Results: The increases in the BP from the baseline throughout the study period were statistically, but not clinically significant. The HR and LF/HF (low frequency/high frequency) ratio were increased at 5 and 45 min, respectively, after the administration of the SGB. In a comparison of left and right SGB, no significant differences were found in the BP, HR and HRV. A correlation analysis showed that an increased BP was significantly related with the changes in the LF/HF ratio and LF at 15 and 30 minutes, respectively, after the SGB. Dividing the patients into two groups; an increased BP greater and less than 20% of that at the baseline INC and NOT groups, respectively, hoarseness occurred more often in the INC group (P = 0.02). Conclusions: It was concluded that SGB itself does not clinically increase the BP and HR in normal hemodynamic patients. However, the loss of balance between the sympathetic and parasympathetic nerve system, attenuation of the baroreceptor reflex and hoarseness are minor causes of the increase in the BP following SGB; therefore, further studies will be required.

• Journal of Ginseng Research
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• v.46 no.1
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• pp.79-90
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• 2022

Background: Herbal medicines are popular approaches to capably prevent and treat obesity and its related diseases. Excessive exposure to dietary lipids causes oxidative stress and inflammation, which possibly induces cellular senescence and contribute the damaging effects in brain. The potential roles of selective enhanced ginsenoside in regulating high fat diet (HFD)-induced brain damage remain unknown. Methods: The protection function of Ginsenoside F1-enhanced mixture (SGB121) was evaluated by in vivo and in vitro experiments. Human primary astrocytes and SH-SY5Y cells were treated with palmitic acid conjugated Bovine Serum Albumin, and the effects of SGB121 were determined by MTT and lipid uptake assays. For in vivo tests, C57BL/6J mice were fed with high fat diet for 3 months with or without SGB121 administration. Thereafter, immunohistochemistry, western blot, PCR and ELISA assays were conducted with brain tissues. Results and conclusion: SGB121 selectively suppressed HFD-induced oxidative stress and cellular senescence in brain, and reduced subsequent inflammation responses manifested by abrogated secretion of IL-6, IL-1β and TNFα via NF-κB signaling pathway. Interestingly, SGB121 protects against HFD-induced damage by improving mitophagy and endoplasmic reticulum-stress associated autophagy flux and inhibiting apoptosis. In addition, SGB121 regulates lipid uptake and accumulation by FATP4 and PPARα. SGB121 significantly abates excessively phosphorylated tau protein in the cortex and GFAP activation in corpus callosum. Together, our results suggest that SGB121 is able to favor the resistance of brain to HFD-induced damage, therefore provide explicit evidence of the potential to be a functional food.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.27-33
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• 1990

In the past decades there has been a growth of interest in the use of stellate ganglion block (SGB) as part of the diagnosis and therapy for the disease of the head, neck and upper extremities. For the evaluation of changes in hemodynamics and temperature of the affected extremity after the SGB, unilateral SGB (either right or left) was performed by local injection of 10 ml of 1% lidocaine without epinephrine in 45 patients (right side SGB: 25, left side SGB: 20) with various diseases. Systolic and diastolic blood pressure, pulse rate and skin temperature of the ipsilateral hand were studied before and 1, 2, 3, 4, 5, 10, 15, 30 and 60 minutes after the block. The results were as follows: 1) Changes of blood pressure: Systolic and distolic blood pressure after either right or left side SGB showed no statistically significant change. 2) Changes of pulse rate: While the left side SGB showed a mild decrease without statistical significance, the right side SGB showed a statistically significant decrease at 30 and 60 minutes after the block (p<0.05). 3) Changes of skin temperature of the blocked hand: Either side SGB produced a gradual increase in temperature with time and showed statistical significance from 10 minutes in the left side block (p<0.01), and a from 10 minutes after the block in the right side (p<0.01). Both sides SGB showed a maximal increase at 30 minutes after the block and a small decrease at 60 minutes after the block compared to the 30 minutes value. 4) Despite the successful SGB. 4 of 45 patients failed to produce a significant increase in skin temperature on the affected upper extremity. In conclusion, unilateral SGB with 1% lidocaine at the 6th cervical vertebral level is a safe method for use on an outpatient basis, and an increase in skin temperature in the affected upper extremity is necessary to confirm the successful therapeutic effect on disease of the upper extremity.

• The Korean Journal of Mycology
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• v.35 no.2
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• pp.85-95
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• 2007

This study was carried out to investigate the physiological activities of the ethanol extract from Gymnopilus spectabilis mycelium (EGM) and of the supernatant obtained from fermentation broth (SGB). The contents of polysaccharides, phenol compounds and total ${\beta}-glucans$ of EGM were found to be 80.14%, 3.5 mg/ml and 5.91%, respectively and those for SGB were 78.68%, 3.32 mg/ml and 3.28%, respectively. Both EGM and SGB exhibited dose-dependent nitrate-scavenging abilities at pH 1.2. In addition, both EGM and SGB on the autoxidation rate of the linoleic acid demonstrated powerful antioxidant activities at 1 mg/ml level. With respect to fibrolytic activity, EGM showed 1,180 unit/g, which was the same activity as streptokinase, while SGB was 1,011 unit/g. The angiotensin converting enzyme inhibition activity of EMG determined by both the normal and pretreatment methods were estimated to be 8.2% and 10.2%, respectively. However, SGB showed no corresponding activity. The growth inhibitory effects of EGM on AGS, A549, HeLa and NCTC cells were over 58.88%, respectively. And the growth inhibitory effects of the SGB on HeLa and NCTC cells were 44.92 and 76.76%, respectively. Also, EGM and SGB activated the components of the alternative complement pathway from 51 and 62% at the concentration of 100 mg/ml, The xanthine oxidase inhibition activities of EGM and SGB (1 mg/ml) were 9.53 and 16.92%, respectively.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.234-238
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• 1992

We compared the effectiveness of vasodilator therapy with histamine and stellate ganglion block(SGB) for the treatment of sudden sensoryneural hearing impairment retrospctively. 24 patients were treated with histamine and nicotinic acid(histamine group), and 30 patients were treated with SGB(SGB group). Corticosteroids and low molecular weight dextran($Rheomacrodex^{(R)}$) were given to all patients. The degree of hearing impairment and the evidence of improvement were checked with audiogram. 52.8%(10 out of l9 follow-up ckecked patients) of patients in histamine group and 56.7%(17 out of 30) of patients in SGB group had improved within three weeks of treatment, which means both histamine and SGB are equally effective. As a consequence, we concluded that SGB ia a good substitute for histamine as a vasodilator therapy for sudden sensoryneural hearing impairment with minimal complication, few absolute contraindications, and simple and safe technique.