• Journal of Yeungnam Medical Science
• /
• 제35권2호
• /
• pp.199-204
• /
• 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
• /
• 제13권2호
• /
• pp.191-195
• /
• 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
• /
• 제19권1호
• /
• pp.68-71
• /
• 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
• /
• 제8권2호
• /
• pp.367-370
• /
• 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
• /
• 제11권1호
• /
• pp.30-35
• /
• 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
• /
• 제19권2호
• /
• pp.202-206
• /
• 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
• /
• 제46권1호
• /
• pp.79-90
• /
• 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
• /
• 제3권1호
• /
• pp.27-33
• /
• 1990

성상신경절차단이 혈역학적 변화 및 차단부위의 피부온도에 마치는 영향을 알아보기 위하여 두경부와 어깨 및 상지에 통증을 호소하는 환자 45명 (남자 16명, 여자29명)을 대상으로 편측 성상신경절차단을 시행해 보았던 바 다음과 같은 결과를 얻었다. 1) 혈압의 변화 : 우측 성상신경절차단과 좌측 성상신경절차단의 어느 경우에서도 수축기 및 이완기 혈압에 마치는 영향은 거의 없었다. 2) 맥박수의 변화 : 우측 성상신경절차단후 30분과 60분에 각각 의의있는 맥박수의 감소를 나타내었으나 (p<0.05), 좌측 차단후에는 통계학적으로 의의있는 맥박수의 감소를 나타내지 않았다. 3) 차단측 상지피부온도의 변화 : 우측 성상신경절차단후에는 5분부터, 좌측차단후에는 10분부터 의의있는 피부온도의 상승 (p<0.01)을 보이기 시작하여 차단후 30분에 양측 모두에서 피부온도가 최대로 상승되었다가 60분에는 30분치에 비해 다소 하락하였다. 4) 시술환자 45명중 4명에서 성상신경절차단의 징후는 나타났으나 차단측상지의 피부온도 상숭은 동반되지 않았다. 이상의 결과로 미루어보아 제 6 경추 전결절에서 1.0% lidocaine 10 ml로 편측 성상신경절차단시에는 심순환계에 특별한 영향을 마치지 않았으며 또한 상지질환의 치료목적시에는 반드시 차단즉 상지피부온도의 상승을 확인하여야만 효과있는 차단이 이루어졌다고 판정할 수 있을 것으로 사료된다.

• 한국균학회지
• /
• 제35권2호
• /
• pp.85-95
• /
• 2007

독버섯인 갈황색 미치광이버섯의 균사체 추출물(EGM) 및 배양여액 농축물(SGB)의 생리활성을 탐색하였다. 다당류 및 단백질, 페놀화합물, 총 ${\beta}-glucan$ 함량은 EGM의 경우 각각 80.14%, 5.04%, 3.50 mg/ml, 5.95%이었으며, SGB는 78.68%, 4.75%, 3.32 mg/ml, 3.28%로 나타났다. 아질산염 소거능은 pH 1.2에서 EGM의 경우 100 mg/ml 처리 시 64.68%이었다. 환원력의 경우 EGM는 10 mg/ml 처리 시 0.54였으며, SGB는 100 mg/ml의 농도에서 0.87로 가장 높았고 10 mg/ml에서 0.57을 나타내었다. 그리고 linoleic acid의 자동산화 억제 실험에서 EGM의 경우 반응 30시간 이후에는 1 mg/ml 농도에서 합성항산화제인 butyl hydroxy toluene (BHT)나 vitamin E보다 높은 항산화활성을 나타내었다. 암세포 성장억제는 EGM의 경우 10 mg/ml의 농도에서 모든 세포에서 약 59%이상의 억제율을 보였으며, SGB의 경우 자궁암 세포인 HeLa에서 45%의 억제 효과를 나타낸 반면, 정상 간세포주인 NCTC에서도 76.76%의 억제를 나타내었다. 혈전용해 활성에서는 EGM의 경우 Streptokinase의 1,180 unit/g과 동일한 활성을 보였고, SGB는 1,011 unit/g을 나타내었다. ACE 저해활성에서 EGM의 경우 통상법에서는 $8.186{\pm}0.053%$이고, 전처리법에서는 $10.184{\pm}0.223$로 나타났으나, SGB의 경우 ACE 저해활성이 없는 것으로 나타났다. 항보체 활성의 경우 100 mg/ml농도에서 EGM의 경우 51.48%, SGB의 경우 62.65%의 활성도를 보였으며, 10 mg/ml 농도에서는 각각 7.01% 및 17.74%를 나타내었다. 체내 uric acid 생성인자인 xanthine oxidase 저해활성은 1 mg/ml 농도에서 EGM의 경우 9.53%, SGB의 경우 16.92%의 저해효과를 나타내었다.

• The Korean Journal of Pain
• /
• 제5권2호
• /
• pp.234-238
• /
• 1992

돌발성 난청 환자의 혈관 확장치료로서 histamine을 사용한 군과 SGB를 사용한 군을 회고적으로 비교한 결과 Histamine군에서는 19예 가운데 10예(52.8%), SGB군 30예 중 17예(56.1%)에 있어서 2~3주 이내에 개선을 보였다. SGB는 금기증이 거의 없으며 수기가 간단하고 부작용이 경미하므로 돌발성 난청의 치료에 있어서 histamine 치료의 좋은 대치 방법이 될 것으로 사료된다.