• Title/Summary/Keyword: neurogenic pain

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Spontaneous Spinal Epidural Hematoma in an Infant : A Case Report and Review of the Literature

  • Lim, Jae-Joon;Yoon, Soo-Han;Cho, Ki-Hong;Kim, Sang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.84-87
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    • 2008
  • Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

Chain-branched Acyclic Phenethylthiocarbamates as Vanilloid Receptor Antagonists

  • Kim, Hee-Doo;Yoon, Jung-Wha;Choi, Hye-Young;Lee, Hyun-Joo;Ryu, Chong-Hyun;Park, Young-Ho;Suh, Young-Ger;Oh, Uh-Taek;Park, Hyeung-Guen
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.241.3-242
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    • 2003
  • By acting on vanilloid receptor(VR1). capsaicin excites and then desensitizes a subset of primary neurons involved in nociception, neurogenic inflammation, and a variety of local regulatory functions. Due to this unique biological activity, VR1 is at present one of the most attractive targets for the treatment of pain. However, despite the concentrated effort on agonists, they have been exposed to the side effects such as pungency and/or hypothermia responses. (omitted)

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Clinical Evaluation of the Mediastinal Tumors and Cysts -26 cases report- (종격동 종양의 임상적 고찰)

  • 신호승
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.745-749
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    • 1990
  • A wide variety of histologically or clinically different tumors and cysts can occur from the many anatomical structures located within the mediastinum. We report the analysis of the 26 cases of mediastinal tumors and cysts, experienced in the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University from March 1983 to February 1990. Sex ratio of male to female was 1:1.16 and mean age was 33.4 years. Malignant tumors were 8 cases[30.7%], benign tumors were 18 cases[69.2%] The most common histologic types were thymoma, 6 cases[23%] and teratoma, 6 cases [23%] followed by neurogenic tumor, 4 cases[15%] and mediastinal tuberculoma, 3 cases [11.5%]. The most frequent symptoms were chest pain and discomfort. Most of benign tumors were completely removed and malignant tumors were treated with anticancer chemotherapy and radiotherapy after operation. Postoperative complications were developed in 4 cases[15.3%] and hospital mortality was 3.8%.

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Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve (후경골 신경에서 기인한 신경초종의 재발로 발생한 족근관 증후군)

  • Kim, Jae Young;Lee, Hye Kyung;Cho, Jaeho
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.36-39
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    • 2014
  • Tarsal tunnel syndrome is defined as a compressive neuropathy of the posterior tibial nerve in the tarsal canal. Schwannoma is a benign tumor that arises from the peripheral nerve sheath. It presents as a discrete, often tender, and palpable nodule associated with neurogenic pain or paresthesia when compressed or traumatized. The growth rate is usually slow, and these lesions seldom exceed 2 cm in diameter. In addition, local recurrence occurs less than 5%. We report on a case of tarsal tunnel syndrome caused by a large recurred space-occupying lesion measuring $4.3{\times}2.7{\times}2.7cm^3$.

Multiple Primary Cardiac Malignant Peripheral Nerve Sheath Tumors in the Left Atrium: Case Report

  • Li, Junfei;Chen, Qiansu;Yu, Shaomei;Yang, Siyuan
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.422-424
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    • 2021
  • Malignant peripheral nerve sheath tumors are rare sarcomas of the heart. Herein, we report the case of a 24-year-old man who complained of dyspnea, cough, and upper left back pain. He was found to have multiple primary heart tumors obstructing the right superior pulmonary vein in the left atrium, which were diagnosed as malignant peripheral nerve sheath tumors. The patient underwent successful resection of the tumors and immunohistochemistry was utilized for diagnosis.

Characterization of Electroacupuncture Effects on the Responses of Rat Dorsal Horn Neurons to Noxious Stimulation (전침자극이 흰쥐척수후각세포의 유해자극반응에 미치는 효과의 특성)

  • Shin, Hong-kee;Park, Dong-suk;Lee, Seo-eun;Kim, Jin-hyuk
    • Journal of Acupuncture Research
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    • v.19 no.4
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    • pp.167-182
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    • 2002
  • This experiment was designed to investigate the effects of electroacupuncture (EA) on chronic pains and factors that affected EA effects. The responses of wide dynamic range (WDR) cells to electrical stimulation of $A{\delta}$ & C afferent fibers were used as an index of pain in rats with chronic pains induced by intraplantar injection of complete Freund's adjuvant or peripheral nerve injury. In rats with chronic pains, low (2Hz) and high (100Hz) frequency EA stimulation applied to zusanli caused the inhibition of WDR cell responses in about 60% of rats and the inhibitory actions were dependent on the stimulus strength. EA stimulation also induced an excitation of WDR cell responses in 23.9% of rats and no effect in 15.8% of rats. However, it seemed that in normal rats compared to the rat with chronic pains, the incidence of which EA stimulation caused the excitation or no effect was high. Reversible spinalization almost completely blocked EA-induced inhibitory or excitatory effects. EA stimulation more frequently induced the excitation of WDR cell responses in lightly anesthetized (0.6%) rats and the enhanced responses of WDR cells were inhibited by EA stimulation in the rat anesthetized with 1.5% enflurane. These experimental findings suggest that in rats with chronic pain, EA stimulation inhibited WDR cell responses to slow $A{\delta}$ and C fiber stimulation and EA-induced inhibitory action was under the control of descending inhibitory system and degree of anesthesia.

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A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease

  • Hyun, Seung-Jae;Yoon, Seung Hwan;Kim, Joo Han;Oh, Jae Keun;Lee, Chang-Hyun;Shin, Jun Jae;Kang, Jiin;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.562-574
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    • 2021
  • Objective : This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF). Methods : This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group. Post-operative observations were performed at 12, 24, and 48 weeks. The spinal fusion rate on computed tomography scans and X-rays films, Visual analog scale pain scores, Oswestry disability index and SF-36 quality of life (QOL) scores were used for the efficacy evaluation. The incidence rate of adverse device effects (ADEs) and serious adverse device effects (SADEs) were used for safety evaluation. Results : The spinal fusion rate at 12 weeks for the DBM gel with rhBMP-2 group was higher with 73.68% compared to 58.82% for the DBM gel group. The 24 and 48 weeks were 72.22% and 82.86% for the DBM gel with rhBMP-2 group and 78.79% and 78.13%, respectively, for the DBM gel group. However, there were no significant differences between two groups in the spinal fusion rate at 12, 24, and 48 weeks post-treatment (p=0.1817, p=0.5272, p=0.6247). There was no significant difference between the two groups in the incidence rate of ADEs (p=0.3836). For ADEs in the experimental group, 'Pyrexia' (5.00%) was the most common ADE, followed by 'Hypesthesia', 'Paresthesia', 'Transient peripheral paralysis', 'Spondylitis' and 'Insomnia' (2.50%, respectively). ADEs reported in control group included 'Pyrexia', 'Chest discomfort', 'Pain', 'Osteoarthritis', 'Nephropathy toxic', 'Neurogenic bladder', 'Liver function analyses' and 'Urticaria' (2.86%, respectively). There was no significant difference between the two groups in the incidence rate of SADEs (p=0.6594). For SADE in the experimental group, ''Pyrexia' and 'Spondylitis' were 2.50%. SADE reported in the control group included 'Chest discomfort', 'Osteoarthritis' and 'Neurogenic bladder'. All SADEs described above were resolved after medical treatment. Conclusion : This study demonstrated that the spinal fusion rates of DBM gel group and DBM gel with rhBMP-2 group were not significantly different. But, this study provides knowledge regarding the earlier postoperative effect of rhBMP-2 containing DBM gel and also supports the idea that the longer term follow-up results are essential to confirm the safety and effectiveness.

Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

  • Lee, Kwang Yeol;Kim, Sae Hoon;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.30-36
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    • 2017
  • Background: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. Methods: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. Results: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5-9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0-5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45-77] to 89.3 [range, 81-100], p=0.029), and ASES score (52.3 [range, 30-77] to 90.0 [range, 80-100], p=0.002). There was no healing failure on imaging. Conclusions: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.

EFFECT OF CAPSAICIN AND EUGENOL ON ICGRP (IMMUNOREACTIVE CALCITONIN GENE-RELATED PEPTIDE) RELEASE FROM RAT LUMBAR SPINAL CORD. (백서 척수에서 Capsaicin과 Eugenol이 iCGRP (immunoreactive calcitonin gene-related peptide) 분비 조절에 미치는 영향.)

  • 오원만;김원재;최남기;박상원;황인남;김선헌
    • Restorative Dentistry and Endodontics
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    • v.26 no.5
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    • pp.436-442
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    • 2001
  • Neuropeptide such as calcitonin gene-related peptide and substance P may mediate neurogenic inflammation, but little is known about the regulation of neuropeptide release from rat spinal cord. Eugenol has been reported to reduce odontogenic pain and is known to have a structure similar to capsaicin, a potent stimulant of certain nociceptors. This study was done to examine the effect of capsaicin and eugenol on immunoreactive calcitonin gene-related peptide (iCGRP) release from rat spinal cord and whether eugenol regulates capsaicin-sensitive release of iCCRP or it evokes capsaicin-sensitive release of iCGRP. The dor-sal half of rat lumbar spinal cord was chopped into 200$\mu$m slices. They were superfused (500$\mu$l/min) in vitro with an oxygenated Kreb's buffer. The EC$_{50}$ of capsaicin on iCGRP release was measured. Eugenol (600$\mu$M and 1.2mM) and vehicle (0.02% 2-hydroxyl-$\beta$-cyclodextrin) were administered prior to stimulation of rat lumbar spinal cord with capsaicin. The amount of iCGRP release from rat lumbar spinal cord was measured by radioimmunoassay. The results were as follows : 1. iCGRP release from rat lumbar spinal cord was dependent on concentration of capsaicin. The EC$_{50}$ of capsaicin on iCGRP release was 3$\mu$M. 2. In the vehicle treated group, capsaicin (3$\mu$M) evoked a 14-fold increase over basal iCGRP level. 3. Administration of 600$\mu$M and 1.2mM eugenol evoked a 2.2-fold increase and a 2.3-fold increase over basal iCGRP level respectively. 4. Administration of 600$\mu$M and 1.2mM eugenol increased capsaicin evoked release of iCGRP by more than 50%. These results indicate that eugenol evoke CGRP release from central nervous system and potentiate the pain-inducing action of capsaicin on it.

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Clinical Review of Primary Mediastinal Tumors & Cysts (원발성 종격동 종양 및 낭종의 임상적 고찰)

  • 정종화
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.325-332
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    • 1990
  • Complications of the mediastinal tumors and cysts are malignant change, infection, bleeding, local invasion and mass effect to heart, lung and other mediastinal structures. But early surgical excision and proper treatments bring patients to good clinical course and results. Therefore mediastinal tumors and cysts are surgically interesting diseases We report the analysis of the 58 cases of mediastinal tumors and cysts, experienced in the Department of Cardiothoracic Surgery of the Kosin Medical College from July 1979 to June 1989. The results were as follows ; Sex ratio of male to female to female was 1.3: 1. Range of age was from 11 to 64 years and mean age was 34.3 years. The thymomas were 14 cases[24%], the teratomas were 19 cases[33%o], the neurogenic tumors were 10 cases[17%], the cysts were 9 cases[15%], the carcinomas were 3 cases[5%], the thyroid tumor was 1 case[2%], the Castleman’s disease was 1 case[2%] and unclassified tumor was 1 case[2%]. Malignant tumors were 12 cases [21%] of the 58 cases. Most frequent symptom was chest pain and discomfort and relationship of symptom and malignancy was significant. Complete removal of tumor was performed on the 47 cases[92%] and partial excision was 3 cases[6%]. Inoperable cases were treated with anticancer chemotherapy and radiotherapy. Postoperative complications were wound infection, Homer’s syndrome, phrenic nerve palsy, mediastinal hematoma and pleurisy. There was no case of postoperative mortality and good clinical course in surgically completely resected cases.

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