• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.896-902
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• 2008

Yukmijihwang-tang(YM) is used in Oriental medicine for treatments of diverse systemic symptoms including neurological dosorders. The present study was performed to examine potential effects of YM on growth-promoting activity of injured sciatic nerve axons. YM treatment in the injured sciatic nerve induced enhanced distal elongation of injured axons when measured 3 and 7 days after injury. Retrograde tracing of sciatic nerve axons showed YM-mediated increases in the number of DiI-labeled dorsal root ganglion (DRG) sensory neurons and spinal cord motor neurons at 3 days after injury. Hoechst nuclear staining showed that non-neuronal cell population was largely elevated by YM treatment in distal nerve area undergoing axonal regeneration. Furthermore, phospho-Erk1/2 protein levels were upregulated by YM treatment in the injured nerve area. These data suggest that YM may play a role in facilitated axonal regeneration in injured peripheral nerves. Further investigations of individual herbal components would be useful to explore effective molecular components and develop therapeutic strategies.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.217-228
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• 2016

The musculoskeletal system is mainly composed of the bones, muscles, tendons, and ligaments, in addition to nerves and blood vessels. The greatest difficulty in an ultrasonographic freeze-frame created by the examiner is recognition of the targeted structures without indicators, since an elephant's trunk may not be easily distinguished from its leg. It is not difficult to find descriptive ultrasonographic terms used for educational purposes, which help in distinguishing features of these structures either in a normal or abnormal anatomic condition. However, the terms sometimes create confusion when describing common objects, for example, in Western countries, pears have a triangular shape, but in Asia they are round. Skilled experts in musculoskeletal ultrasound have tried to express certain distinguishing features of anatomic landmarks using terms taken from everyday objects which may be reminiscent of that particular feature. This pictorial review introduces known signature patterns of distinguishing features in musculoskeletal ultrasound in a normal or abnormal condition, and may stir the beginners' interest to play a treasure-hunt game among unfamiliar images within a boundless ocean.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.61.1-61.8
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• 2019

Background: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. Methods: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. Results: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. Conclusion: Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.203-216
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• 1991

Nerve allografts as a bridge of regeneration is useful in the repair of peripheral nerve defect resulting from trauma, and leprosy. But immunological rejection and complicated scar formation is an unavoidable problem in the application of allogeneic nerves. This article is intended to study of the regeneration of allogeneic nerve grafts in rats with histopathologically, scanning electron microscopically. 24 adult male Sprague-Dawley rats were used as the experimental animals. A 2cm skin incision was made on the lateral aspects of limb, parallel to femur. Segments of sciatic nerve trunk taken from rats, 10mm was resected at the middle of the thigh, nerve graft was inserted between the ends of gaps with perineural and epineural suture method with 10-0 prolene. Obsrevation was made simultaneously at 3 day, 1, 2, 3, 4, 5, 6, 8 weeks after surgery. The results were as follows. 1. In light and electronic microscopic studies, marked degenerative change of the graft nerves were observed at 2 weeks after surgery. 2. After surgery, blood clot fromation was observed at 3 day, granualtion tissue formation was observed at 2 week, and fibrous tissue proliferation was observed at 3 week. 3. In change of nerve fiber, there were Wallerian degeneration at early stage, decrease in degeneration at 4 week but degeneration of myeline was continuded at 8 week. 4. At 4 week, schwann cells proliferate at its cut ends to join with the distal and proximal stump of the damaged nerve. 5. Fibrous scar tissues are formed at 2 weeks and increased progressively in 8 weeks, which was interrupted the regeneration of grafted nerve.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.2 no.1
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• pp.59-67
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• 2007

Objective : Poly neuropathy is disease that reveals musle relaxation or sensory disorder, and Myopathy is disease that reveals musle weakness, wasting, pain. These diseases occur in the lower or upper limbs. This is the clinical report about Poly neuropathy or Myopathy estimated patients. Method : Patients were treated by acupuncture, herb medicine, bee venom herbal-acupuncture, moxibustion. We evaluated the improvement of symptoms with ROM(Range of Motion) and MCR(Medical Research Council) standard. Result : Symptoms that patients have at admission improved and disappered gradually with oriental medicine therapy. Observing the change of ROM and MCR standard, they indicated us improvement of disease. Conclusion : We achived a desirable result from treatment of peripheral neuropathy or myopathy estimated patients. However, further studies are required to prove the effect of oriental medicine treatment.

• The Journal of Korean Medicine
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• v.29 no.5
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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.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.417-423
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• 2017

Objective : Repair of sensorial nerve defect is an important issue on peripheric nerve surgery. The aim of the present study was to determine the effects of sensory-motor nerve bridging on the denervated dermatomal area, in rats with sensory nerve defects, using a neural cell adhesion molecule (NCAM). Methods : We compared the efficacy of end-to-side (ETS) coaptation of the tibial nerve for sural nerve defect repair, in 32 Sprague-Dawley rats. Rats were assigned to 1 of 4 groups : group A was the sham operated group, group B rats had sural nerves sectioned and buried in neighboring muscles, group C experienced nerve sectioning and end-to-end (ETE) anastomosis, and group D had sural nerves sectioned and ETS anastomosis was performed using atibial nerve bridge. Neurological evaluation included the skin pinch test and histological evaluation was performed by assessing NCAM expression in nerve terminals. Results : Rats in the denervated group yielded negative results for the skin pinch tests, while animals in the surgical intervention groups (group C and D) demonstrated positive results. As predicted, there were no positively stained skin specimens in the denervated group (group B); however, the surgery groups demonstrated significant staining. NCAM expression was also significantly higher in the surgery groups. However, the mean NCAM values were not significantly different between group C and group D. Conclusion : Previous research indicates that ETE nerve repair is the gold standard for peripheral nerve defect repair. However, ETS repair is an effective alternative method in cases of sensorial nerve defect when ETE repair is not possible.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.51-58
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• 2024

Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.63-70
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• 2006

Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.