• 동의생리병리학회지
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• 제22권2호
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• pp.431-437
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• 2008

Sengmaek-san(Shengmai-san; SMS) is used in oriental medicine as one of the key herbal medicine for treating diverse symptoms including cardiovascular and neurological disorders. In the present study, the effects of SMS on axonal regeneration were investigated in the rat model given sciatic nerve injury. SMS treatment enhanced axonal regrowth into and the number of non-neuronal cells in the distal area after crush injury. GAP-43 protein levels were increased in the injured sciatic nerve compared to intact nerve and further upreguated by SMS treatment. GAP-43 protein was increased similarly in the dorsal root ganglion (DRG) at lumbar 4 - 6 by nerve injury and SMS treatment, suggesting GAP-43 induction at gene expression level. SMS-mediated increase in phospho-Erk1/2 protein was observed in the DRG as well as in the injured nerve implying its retrograde transport into the cell body as the process of lesion signal transmission. The present findings suggest that SMS may be involved in enhanced axonal regeneration via dynamic regulation of regeneration-associated proteins.

• Archives of Reconstructive Microsurgery
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• 제12권1호
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• pp.1-12
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• 2003

The bridging of nerve gaps is still one of the major problems in peripheral nerve surgery. To evaluate the role of silicon tube in nerve regeneration, gaps were made by resection of tibial components of sciatic nerves of twenty-five New Zealand rabbits. The gaps were divided into five groups. In group I, the tibial components of sciatic nerves were isolated and the incision immediately closed. In group II, 1-cm segments of the nerve were removed and the silicon tubes filled with autogenous skeletal muscle were sutured in place. In group III, 1-cm segments of the nerve were removed and the silicon tubes filled without muscle were sutured in place. In group IV, 2-cm segments of the nerve were removed and the silicon tubes filled with autogenous skeletal muscle were sutured in place. In group V, 2-cm segments of the nerve were removed and the silicon tubes filled without muscle were sutured in place. At 16th week, the eletromyography, the light and transmission electron microscopy were performed. Nerve conduction study stimulating sciatic nerve proximal to the lesion and recording at gastrocnemius muscle showed that the compound muscle action potentials of the group II with 1 cm nerve defect filled with muscle were higher amplitudes than the group III without muscle. Compound muscle action potentials of the group IV with 2 cm defect filled with muscle showed similar results in comparison with the group V. The light and transmission electron microscpy showed that a good morphological pattern of nerve regeneration in 1 cm gap than 2 cm and in gap with muscle than gap without muscle.

• Journal of Yeungnam Medical Science
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• 제38권3호
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• pp.258-263
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• 2021

Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.

• 대한한의학회지
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• 제31권3호
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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.

• 대한한의학회지
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• 제29권5호
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• pp.14-28
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• 2008

Objective : This study was carried out to understand effects of ginseng(hearinafter ; GS, Panax Ginseng) extract on regeneration responses on injured sciatic nerves in rats. Methods :Using white mouse, we damaged sciatic nerve & central nerve, and then applied GS to the lesion. Then we observed regeneration of axon and non-neuron. Results : 1. NF-200 protein immunostaining for the visualization of axons showed more distal elongation of sciatic nerve axons in GS-treated group than saline-treated control 3 and 7 days after crush injury. 2. GAP-43 protein was increased in the injured sciatic nerve and further increased by GS treatment. Enhanced GAP-43 protein signals were also observed in DRG prepared from the rats given nerve injury and GS treatment. 3. GS treatment in vivo induced enhanced neurite outgrowth in preconditioned DRG sensory neurons. In vitro treatment of GS on sensory neurons from intact DRG also caused increased neurite outgrowth. 4. Phospho-Erk1/2 protein levels were higher in the injured nerve treated with GS than saline. Phospho-Erk1/2 protein signals were mostly found in the axons in the injured nerve. 5. NGF and Cdc2 protein levels showed slight increases in the injured nerves of GS-treated group compared to saline-treated group. 6. The number of Schwann cell population was significantly increased by GS treatment in the injured sciatic nerve. GS treatment with cultured Schwann cells increased proliferation and Cdc2 protein signals. 7. GS pretreatment into the injured spinal cord generated increased astrocyte proliferation and oligodendrocytes in culture. In vitro treatment of GS resulted in more differentiated pericytoplasmic processes compared with saline treatment. 8. More arborization around the injury cavity and the occurrence at the caudal region of CST axons were observed in GS-treated group than in saline-treated group. Conclusion :GS extract may have the growth-promoting activity on regenerating axons in both peripheral and central nervous systems.

• 대한수의학회지
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• 제41권4호
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• pp.591-596
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• 2001

The chicks from 6 field broiler farms revealed peripheral neuropathy including leg weakness, curled toes and drooped wings. Grossly distinctive enlargements of sciatic nerve, branchial nerve and lumbar nerve were observed in the chicks. Histologically nerve lesions consisted of demyelination of myelin sheaths, Schwann cell proliferation and swelling, and interstitial edema in the peripheral nerves of all birds examined. Axonal swelling and infiltration of small lymphocytes were observed, but not a primary lesion. After treatment of riboflavin, neurological disorder was markedly recovered. From these results, it is suggested that the peripheral nerve lesions in these cases were caused by dietary riboflavin deficiency.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.148-151
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• 2021

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

• Clinical Pain
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• 제20권1호
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• pp.53-57
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• 2021

We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

• The Korean Journal of Pain
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• 제13권2호
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• pp.149-155
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• 2000

Background: Pulsed radiofrequency (RF) lesioning is a painless procedure and causes no neurodestruction and neuritis-like reaction are common following conventional RF lesioning. There is little data about the effect of pulsed RF especially with regard to its suitability for the treatment of acute pain. The possibility of a placebo effect cannot be ruled out because a double-blind study was not performed in previous studies. There is also no neuropathologic study about pulsed RF. Methods: The rats were anesthetized with sodium pentobarbital (40 mg/kg, i.p.; supplemented as necessary). The common sciatic nerve was exposed by blunt dissection through biceps femoris. Pulsed RF was administered to the common sciatic nerve using a 30 ms/s pulse with for 120 seconds. The temperature reached was no more than $42^{\circ}C$. Analgesia was determined using hot-plate assay shortly and, 3 days and 1 week before, and 2 weeks after operation. Lesions were examined with LM (light microscope) and EM (electron microscope) 2 weeks later. Results: There were no differences in response latencies between the control and experimental group. There were many vacuoles with hyaline bodies in the Schwann cell cytoplasm rather than axon in LM and larger electron dense bodies. No changes were found in the axon or unmyelinated fibers. Only small changes were found in the sheaths of myelinated fibers and Schwann cells. Conclusions: We therefore do think that any analgesic effect of pulsed RF is not a result of block of neural conduction. But rather than it can be attributed to others factors. It was also ineffective as a treatment for acute pain such as that caused by the hot-plate test.