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AN EXPERIMENTAL STUDY OF ELECTROPHYSIOLOGICAL AND HISTOLOGICAL ASSESSMENT ON THE INJURY TYPES IN RABBIT INFERIOR ALVEOLAR NERVE (가토의 하치조 신경 손상 형태에 따른 전기생리학적 및 조직학적 변화에 관한 실험적 연구)

  • Lee, Jae-Eun;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.679-700
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    • 1996
  • Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

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Updates on the Inferior Alveolar Nerve Block Anesthesia (하치조신경전달마취의 최신지견)

  • Paeng, Jun-Young
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.3-10
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    • 2014
  • The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for restorative and surgical procedures. However, The IAN block does not always result in successful anesthesia, especially pulpal anesthesia. Lidocaine is used as a "standard" local anesthetic for the inferior alveolar nerve. Articaine recently joined Korean market as a form of dental cartridge. It has an advantage of superior diffusion through bony tissue. A variety of trial was performed to improve the success rate of inferior alveolar nerve block. In this review, the recent update related with inferior alveolar nerve block anesthesia will be discussed on the anatomical consideration, anesthetic agent, technique, and complications.

Eye Movements Produced by the Inferior Oblique Muscle in the Rabbits (가토(家兎)에 있어서 하사근(下斜筋)의 작용(作用)으로 초래(招來)되는 안구운동(眼球運動))

  • Kim, Jae-Hyub
    • The Korean Journal of Physiology
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    • v.11 no.2
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    • pp.73-78
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    • 1977
  • In urethane anaesthetized rabbits, reflex contraction of the inferior oblique muscle of a unilateral rye was evoked by the stimulation of a relevant vestibular canal nerve. Eye movement evoked by the inferior oblique muscle contracion was carefully observed with naked eyes, and recorded by means of the electrooculographic and electronystagmographic methods. The following results were obtained. 1) Contraction of the inferior oblique muscle evoked by a canal nerve excitation produced excycloduction of the eyeball associated with depression (downward rotation) instead of elevation. 2) Such depression of the eyeball was demonstrated even after the resection of the inferior oblique muscle. These experimental evidences indicate that tile rotatory action (secondary action of the muscle) of the inferior oblique muscle in the rabbits is apparently different in its direction from those already reported in the binocular animals such as cat, dog and monkey.

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The Inferior Orbital Wall Reconstruction by Titanium Micro-mesh Remodeling (Titanium Micro-mesh의 개형을 통한 하벽부 안와골절의 재건)

  • Kim, Han Koo;Choi, Min Seok;Kim, Woo Seob;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.81-85
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    • 2009
  • Purpose: The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall. Methods: Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated. Results: All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos (2 mm), but no further surgical correction was required. Conclusion: The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.

STUDY ON THE RELATIONSHIP OF THE INFERIOR ALVEOLAR NERVE POSITION BETWEEN BUCCAL AND LINGUAL SIDE USING CT AND ORTHPANTOMOGRAM (컴퓨터단층촬영과 파노라마상을 이용한 한국인 하치조관의 하악에서의 협, 설측 위치 관계에 대한 연구)

  • Shin, Hong-Soo;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.1-6
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    • 2002
  • When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

Anterior inferior reconstruction plate on acute midshaft clavicle fvacture (쇄골 간부골절의 전하방 부착 재구성 금속판을 이용한 치료)

  • Kang, Jae-Do;Kim, Kwang-Ryul;Kim, Hyung-Chun;Lim, Moon-Sup;Kim, Seong-Hoon;Kweon, Jun-Hyung
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.44-49
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    • 2003
  • Purpose: Many different operative technique of mid-shaft clavicle fracture have been reported. The aim of this prospective study was to compare the results of anterior or anterior-inferior plating with superior plating on the acute mid-shaft fracture of clavicle Materials and Methods: From February1997 to February 2002, thirty-eight consecutive open reduction and internal fixation with reconstruction plates were performed in thirty-eight patients. from August 1999, anterior or anterior-inferior plating was mainly used, prospectively. The duration of follow-up averaged 17 months (range,23 to 43 months). The mean age was 38 years old (range,21 to 57 years old) on anterior or anterior-inferior plating group and 35 years old (range,24 to 55 years old) on superior plating group. The physician progress note, VAS patient complement score, Roentgenogram and ASES score was evaluated. Results: Four patients were lost to follow-up. There was no statistical difference on mean radiological bone union time (8.7 weeks vs. 8.6 weeks) and ASES score (92 vs 94) at inferior and superior plating groups (P > 0.05). VAS patient complement score was very good or excellent on anterior or anterior-inferior group, average score was 1.1 (ranger,0 to 2) compare with superior plating group (P < 0.05). There were two cases of infection, 1 case of failed fixation on superior plating group and 1 case of delayed union on anterior inferior plating group. Conclusion: Anterior inferior plating on acute clavicle midshaft fracture results in excellent patient complement score compare with conventional superior reconstruction plate.

Reduction Mammaplasty by the Inferior Dermal Flap (Modified Mckissock Method) (Inferior Dermal Flap (modified Mckissock 법)을 이용한 유방축소술)

  • Woo, Sang-Hyun;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.51-58
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    • 1987
  • The goal of reduction mammaplasty is a breast with natural contour and volume, aesthetically situated scars, and a well-placed, sensate nipple and areola. The most successful techniques achieve this through the excision of tissue from the lower part of the breast based on some variation. However, the Mckissock's vertical bipedicle technique is the popular method for reduction mammaplasty. As an alternative modified Mckissock's method, we have found the use of only an inferior dermal flap with a keyhole pattern to be a simple and safe method for obtaining satisfactory aesthetic results. We have used inferior dermal flap for 4 patients recently and obtained the advantages as below compare to the Mckissock's method. 1. Rich blood supply to the broad based inferior flap. 2. More easy transposition of the nipple and areola. 3. More good operation field for resection of breast tissue. 4. Short operation time. 5. Can applied to the gigantomastia.

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Inferior Capsular Shift for Multidirectional Shoulder Instability in Contact Sports Athletes (접촉성 운동 선수에서 견관절 다방향 불안정성에 대한 하방 관절막 이동술)

  • Choi Chong-Hyuk;Yun Kyung-Hwan;DJ Ogilvie-Hanis
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.10-19
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    • 2000
  • The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

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A New Technique for Inferior Hypogastric Plexus Block: A Coccygeal Transverse Approach -A Case Report-

  • Choi, Hong-Seok;Kim, Young-Hoon;Han, Jung-Woo;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.38-42
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    • 2012
  • Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.

Differences in Reactions to Sales Promotions: Superior or Inferior to Your Product?

  • Kim, Chang Soo;Jo, Myung-Soo
    • Asia Marketing Journal
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    • v.15 no.2
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    • pp.99-116
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    • 2013
  • This study examines whether product promotions are influenced by the market standing of promoted products, using social comparison theory (upward versus downward comparisons). It is hypothesized that people in possession of a product that is inferior to the one on promotion express less discomfort about the promotion and use the information more than do people in possession of a superior product. People in possession of an inferior product may also exhibit more positive attitudes toward the product on promotion, but may show poorer attitudes toward their own possessed product than do people with a superior product. This is because people in an inferior socioeconomic position show a strong motivation to improve themselves through upward social comparison, whereas people in a superior socioeconomic position maintain a strong sense of superiority in downward social comparison, which suggests strong endowment effects. The findings mainly support the hypotheses, and suggest that sales promotions are more effective for people who currently own an inferior product, but not for people with a superior product, who have a strong motivation to maintain their sense of superiority. The findings also imply that, in order to attract consumers in the superior market, managers for inferior products need to turn to methods other than sales promotions, which may include introducing a new brand or sub-brand, or emphasizing luxury and modern features. In contrast, managers for superior products may emphasize product functions and attributes of superior products in their promotions, as people with inferior products may consider such information as benefits of the superior products.

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