운동이 좌골신경 손상 F344쥐의 Neurotrophins, BDNF, NT-3, GAP-43 단백질 발현과 축삭재생에 미치는 영향

윤진환,서태범,Yoon Jin-Hwan,Seo Tae-Beom 한국생명과학회 2006 생명과학회지 Vol.16 No.3

본 연구에서는 흰쥐의 좌골신경을 손상시킨 후 트레드밀 운동을 적용하여 신경돌기 성장과 좌골신경의 축삭 재생 및 신경성장 인자 발현 그리고 신경기능지수의 변화를 연구했다. 본 연구결과 좌골손상 후 트레드밀 운동을 실시한 그룹이 비운동군에 비해 축삭재생이 촉진되었고, 원위부의 좌골신경에서도 NGF, BDNF단백질 발현이 상당히 증가된 것으로 나타났다. 또한 좌골신경지수를 검사한 결과에서도 운동을 실시한 흰쥐가 비운동 흰쥐에 비해 기능적 회복이 상당히 빠른 것으로 나타났다. 이러한 결과는 좌골손상 후 운동의 실시가 좌골신경의 축삭재생 촉진과 신경영양인자의 발현증가를 통해 기능적 회복에 도움이 될 수 있음을 보여주는 것이다. Peripheral nerve injuries are a commonly encountered clinical problem and often result in severe functional deficits. In the present study, the effects of treadmill exercise on neurotrophin expressions and functional recovery following sciatic crushed nerve injury were investigated. Animals were randomly assigned into four groups: the sciatic nerve injury group, the sciatic nerve injury and 3-day-exercise, the sciatic nerve injury and 7-days-exercise, and the sciatic nerve injury and 14-days-exercise groups. Sciatic nerve injury was caused by crushing the right sciatic nerve for 30 s using a surgical clip. A the light-exercise was applied to each of the exercise group over the respective number of days. In the present results, we identified enhanced axonal re-growth in the distal stump of the sciatic nerve 3-14 days after crush injury with treadmill training. Dorsal root ganglion (DRG) neuron when cultured from animals with nerve injury and treadmill training showed more enhanced neurite outgrowth than that of sedentary animals. Nerve growth factor (NGF) protein levels in low-intensity treadmill training group were highly induced in the injured sciatic nerves 3, 7 and 14 days after injury compared with sedentary group, and brain-derived neurotrophin factor (BDNF) protein levels in treadmill exercise group were highly induced in the injured sciatic nerve 3 days after injury compared with sedentary group. Then, treadmill exercise increased neurotrophic factors induced in the regenerating nerves. We further demonstrate that motor functional recovery after sciatic nerve injury was promoted by treadmill exercise. Thus, the present data provide a new evidence that treadmill exercise enhanced neurotrophins expression and axonal regeneration after sciatic nerve injury in rats.

Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

Tojyo, Itaru,Nakanishi, Takashi,Shintani, Yukari,Okamoto, Kenjiro,Hiraishi, Yukihiro,Fujita, Shigeyuki Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-

Background: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

우슬 추출물이 흰쥐 좌골신경 손상 후 좌골신경의 기능회복에 미치는 영향

이마성 ( Ma Seong Lee ),송윤경 ( Yun Kyung Song ),임형호 ( Hyung Ho Lim ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: Peripheral nerve injuries are commonly encountered clinical problem and often result in severe functional deficits. The aim of this study is to evaluate the effects of aqueous extract of Achyranthes japonica(AJ) on functional recovery in sciatic nerve after crushed sciatic nerve injury. Methods: In the present study, the animals in the AJ-treated groups received the aqueous extract of AJ at the respective doses orally for 13 consecutive days. In order to assess the effects of the aqueous extract of AJ on function recovery in crushed sciatic nerve injury, sciatic functional index(SFI) was performed. c-Fos expression in the paraventricular nucleus(PVN) and ventrolateral periaqueductal gray(vlPAG), and neurofilament, and the expressions of brain-derived neurotrophic factor(BDNF), nerve growth factor(NGF) following crushed sciatic nerve injury in rats were investigated. For this, immunohistochemistry and western blot were performed. Results: In the present study, crushed sciatic nerve injury showed characteristic gait changes showing decrease of SFI value and treatment with the aqueous extract of AJ significantly enhanced the SFI value. Neurofilament expression in the sciatic nerve was decreased by crushed sciatic nerve injury and treatment with the AJ increased neurofilament expression. The expressions of BDNF and NGF in the sciatic nerve were increased following crushed sciatic nerve injury and treatment with the AJ significantly controlled the sciatic nerve injury-induced increment of BDNF and NGF expressions. c-Fos expressions in the PVN and vlPAG were increased following crushed sciatic nerve injury and treatment with the AJ significantly suppressed the sciatic nerve injury-induced increment of c-Fos expressions. Conclusions: These results suggest that AJ treatment after crushed sciatic nerve injury is effective in the functional recovery by enhancing axonal regeneration and suppressing of pain.

해인탕 추출물이 흰쥐 좌골신경 손상 모델에서 기능회복과 뇌의 c-Fos 발현에 미치는 영향

은영준 ( Young Joon Eun ),송윤경 ( Yun Kyung Song ),임형호 ( Hyung Ho Lim ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. The purpose of this study was to evaluate the effects of Haein-tang(Hairen-tang) extract on functional recovery and pain release in the sciatic nerve after crushed sciatic nerve injury in rats. Methods: 1. Sciatic functional index(SFI) were performed on functional recovery. 2. c-Fos immunohistochemistry were performed on c-Fos expressions in the paraventricular nucleus(PVN) and ventrolateral periaqueductal gray(vlPAG). 3. Neurofilament immunohistochemistry were performed on neurofilament regeneration. 4. Western blot were performed on brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) expression. Results: 1. Haein-tang(Hairen-tang) extract significantly enhanced the SFI value in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. 2. Haein-tang(Hairen-tang) extract significantly suppressed the sciatic nerve injury-induced increment of c-Fos expressions in the PVN and vlPAG in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. 3. Haein-tang(Hairen-tang) extract significantly increased neurofilament expression in the sciatic nerve injury and 50 mg/kg, 100 mg/kg, 200 mg/kg Haein-tang (Hairen-tang)-treated group. 4. Haein-tang(Hairen-tang) extract significantly controled the sciatic nerve injury-induced increment of BDNF and NGF expressions in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. Conclusions: These results suggest that Haein-tang(Hairen-tang) treatment after sciatic nerve injury is effective for the functional recovery by enhancing of axonal regeneration and suppressing of pain.

The Effects of Aqueous Extracts of Aconiti ciliare tuber on Functional Recovery after Sciatic Crushed Nerve Injury in Rats

조태영,송윤경,임형호 대한한의학회 2009 대한한의학회지 Vol.30 No.3

Objective:The aim of this study was to evaluate the effects of Aconiti ciliare tuber on the descending pain and the recovery of locomotor function that results from sciatic crushed nerve injury in rats. Method:In order to assess the effects of the aqueous extract of Aconiti ciliare tuber on the recovery rate of locomotor function, we investigated the walking track analysis, and for the effects on the pain control we investigated brain-derived neurotrophic factor (BDNF) and inducible nitric oxide synthase (iNOS) expression in the sciatic nerve and on the expressions of c-Fos in the ventrolateral periaqueductal gray (vlPAG) region resulting from the sciatic crushed nerve injury in rats. Result:Treatment with Aconiti ciliare tuber significantly enhanced the SFIvalue, enhanced BDNF expression, decreased iNOS expression, and suppressed c-Fos expression. The present results showed that Aconiti ciliare tuber facilitated functional recovery following sciatic crushed nerve injury in rats. The recovery mechanisms of SFI by Aconiti ciliare tuber might be ascribed to the increase of BDNF expression for nerve regeneration and reinnervation and to the suppression of iNOS expression for inhibiting nerve inflammation. Conclusion:In this process it has been shown that Aconiti ciliare tuber can be used for pain control and functional recovery from peripheral nerve injury. Objective:The aim of this study was to evaluate the effects of Aconiti ciliare tuber on the descending pain and the recovery of locomotor function that results from sciatic crushed nerve injury in rats. Method:In order to assess the effects of the aqueous extract of Aconiti ciliare tuber on the recovery rate of locomotor function, we investigated the walking track analysis, and for the effects on the pain control we investigated brain-derived neurotrophic factor (BDNF) and inducible nitric oxide synthase (iNOS) expression in the sciatic nerve and on the expressions of c-Fos in the ventrolateral periaqueductal gray (vlPAG) region resulting from the sciatic crushed nerve injury in rats. Result:Treatment with Aconiti ciliare tuber significantly enhanced the SFIvalue, enhanced BDNF expression, decreased iNOS expression, and suppressed c-Fos expression. The present results showed that Aconiti ciliare tuber facilitated functional recovery following sciatic crushed nerve injury in rats. The recovery mechanisms of SFI by Aconiti ciliare tuber might be ascribed to the increase of BDNF expression for nerve regeneration and reinnervation and to the suppression of iNOS expression for inhibiting nerve inflammation. Conclusion:In this process it has been shown that Aconiti ciliare tuber can be used for pain control and functional recovery from peripheral nerve injury.

Nerve injury after elbow arthroscopy during the surgeon’s learning curve

Gu Min Jeong,Seong Cheol Park,Han Hoon Kim,Tae Kang Lim 대한정형외과 스포츠의학회 2022 Arthroscopy and Orthopedic Sports Medicine Vol.9 No.1

Background: A major concern among elbow surgeons regarding the use of elbow arthroscopy is the risk of nerve injury. This study reports the incidence and risk factors of nerve injury after elbow arthroscopies performed by a single elbow surgeon during the learning curve. Methods: This retrospective study reviewed consecutive series of 110 elbow arthroscopic surgeries performed by one beginner elbow surgeon between 2011 and 2018. Surgical procedures included extensor carpi radialis brevis tendon release, osteocapsular arthroplasty, fracture reduction and fixation, the lateral collateral ligament repair, and septic joint irrigation and debridement. The incidence involving nerves and their outcomes were recorded. Clinical outcomes were assessed using the visual analog scale for pain, Mayo Performance Elbow score, Disabilities of the Arm, Shoulder, and Hand, and SF-36 score. Results: Nerve injury was observed in eight patients (7.3%) that included the superficial radial nerve (2 patients), the ulnar nerve (2 patients), lateral antebrachial cutaneous nerve (2 patients), median nerve (1 patient), and medial antebrachial cutaneous nerve (1 patient). All injuries were localized to sensory deficit and transient, except one patient with superficial radial nerve injury showing a permanent sensory deficit that was not resolving until 30 months postoperatively. Surgical procedures related to nerve injury included six osteocapsular arthroplasties, which included one release of extensor carpi radialis brevis tendon, and one fixation of the radial head fracture. Notably, most nerve injuries occurred in the latter half-period of the learning curve (six cases in between serial numbers 56 and 110) without statistically significant difference (P = 0.097). Conclusion: A nerve injury occurred with an incidence rate of 7.3% during the surgeon’s learning curve, although most injuries involved only the sensory branch and were transient.

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

Yiu Yan Leung 대한구강악안면외과학회 2019 대한구강악안면외과학회지 Vol.45 No.5

Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

Facial Nerve Repair following Acute Nerve Injury

Ehud Fliss,Ravit Yanko,Arik Zaretski,Roei Tulchinsky,Ehud Arad,Daniel J. Kedar,Dan M. Fliss,Eyal Gur 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.4

Background Acute facial nerve iatrogenic or traumatic injury warrants rapid management with the goal of reestablishing nerve continuity within 72 hours. However, reconstructive efforts should be performed up to 12 months from the time of injury since facial musculature may still be viable and thus facial tone and function may be salvaged. Methods Data of all patients who underwent facial nerve repair following iatrogenic or traumatic injury were retrospectively collected and assessed. Paralysis etiology, demographics, operative data, postoperative course, and outcome were examined. Results Twenty patients underwent facial nerve repair during the years 2004 to 2019. Data were available for 16 of them. Iatrogenic injury was the common category (n¼13, 81%) with parotidectomy due to primary parotid gland malignancy being the common surgery (n¼7, 44%). Nerve repair was most commonly performed during the first 72 hours of injury (n¼12, 75%) and most of the patients underwent nerve graft repair (n¼15, 94%). Outcome was available for 12 patients, all of which remained with some degree of facial paresis. Six patients suffered fromcomplete facial paralysis (50%) and three underwent secondary facial reanimation (25%). There were no major operative or postoperative complications. Conclusion Iatrogenic and traumatic facial nerve injuries are common etiologies of acquired facial paralysis. In such cases, immediate repair should be performed. For patients presenting with facial paralysis following previous surgery or trauma, nerve repair should be considered up to at least 6 months of injury. Longstanding paralysis is best treated with standard facial reanimation procedures.

The effect of FK506 (tacrolimus) loaded with collagen membrane and fibrin glue on promotion of nerve regeneration in a rat sciatic nerve traction injury model

Jin-Hong Kim,Young-Jin Choi,Han-Ick Park,Kang-Min Ahn 대한악안면성형재건외과학회 2022 Maxillofacial Plastic Reconstructive Surgery Vol.44 No.-

Background: Peripheral nerve injury is one of the most common injuries that might occur in oral and maxillofacialsurgery. The purpose of this study was to determine the effect of FK506 loaded with collagen membrane and fibringlue on the promotion of nerve regeneration after traction nerve injury in a rat model. Methods: Thirty male Sprague-Dawley rats were divided into three groups: group A (n = 10), a sham group whosesciatic nerve was exposed without any injury; and groups B (n = 10) and C (n = 10), which underwent tractionnerve injury using 200 g of traction force for 1 min. The injured nerve in group C was covered with a collagenmembrane soaked with FK506 (0.5 mg/0.1 mL) and fibrin glue. Functional analysis and microscopic evaluation wereperformed at 2 and 4 weeks after injury. Results: The sciatic function index was ? 5.78 ± 3.07 for group A, ? 20.69 ± 5.22 for group B, and ? 12.01 ± 4.20for group C at 2 weeks after injury. However, at 4 weeks, the sciatic function index was ? 5.58 ± 2.45 for group A, ?19.69 ± 4.81 for group B, and ? 11.95 ± 1.94 for group C. In both periods, statistically significant differences werefound among the groups (p<0.017). Histomorphometric evaluation revealed improved nerve regeneration in groupC compared to that in group B. However, no statistical differences in axonal density were found among the threegroups (p < 0.017). Conclusion: Localized FK506 with collagen membrane and fibrin glue could promote axonal regeneration in a ratmodel of traction nerve injury.

안면신경 손상 후 안면신경 원위부에서 톨 유사 수용체(Toll-Like Receptor) Messenger Ribonucleic Acid의 발현 양상

민혜규,여승근,이재민,정준양,김영일,김상훈 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.8

Background and Objectives This study aimed to evaluate whether Toll-like receptors(TLRs) messenger ribonucleic acid (mRNA) were expressed in the facial nerve after incurringa crush or an injury of the facial nerve. Materials and Method An adult Sprague-Dawley underwent a crush or injury of the unilateralfacial nerve. The crush or injury was incurred by a cutting at the midpoint between thefacial nerve trunk and its branch. The whisker movement of vibrissae muscle was examined 4and 14 days after injury. Real-time polymerase chain reaction was performed for the normalfacial nerve taken from the left side and the damaged nerve taken from the right side. Results On the 4th day of injury, the expression of TLR 9, 13 mRNA was significantly lowerin the crush and injured groups than in the control group (p<0.05). On the 14th day of injury,the expression of TLR 2 mRNA was significantly higher in the injured group than in thecontrol group (p<0.05). Conclusion The expressions of TLR 9, 13 mRNA in the distal facial nerve after injury inthe crush and injured groups were significantly lower than that in the control group, but theexpression of TLR 2 mRNA in the injured group was significantly higher. Therefore, TLRsmay be involved in facial nerve damage and regeneration.