This study was performed to investigate the morphometric and ultrastructural change in the adult and aged rat small intestine. The myenteric and submucous plexuses were stained by NADH-TR in the ileum of adult Sprague-Dawley rats (3 mo., 300~350 gm) and aged rats (24 mo., 500~550 gm). The neurons of myenteric and sumucous plexuses were divided into 3 groups depending on their cell body morphology. Type 1 cells were polygonal or round with abundant cytoplasm. Type 2 cells were spindle shaped and type 3 cells were small and round with scanty cytoplasm. The nerve cell numbers and sizes were measured using an image analyzer (VIDAS, Carl Zeiss, Co., Ltd.). Ultrastructural changes were observed by JEM-1200 EXII (JEOL Co., Ltd.) electron microscope. The result obtained are as followed: 1. In adult rats, majority of neuron population were type 3 and neuron density (total numbers/1 mm2) was more higher in submucous plexus than in the myenteric plexus. 2. Statistically significant loss of type 1 and type 2 neurons were in myenteric and submucous plexus of aged rat small intestine. 3. All types of neuron sizes were increased in aged myenteric and submucous plexuses. 4. Lipofusin granules were prominent in the cytoplasm of aged rat. Cell organelles were not shown degenerative change. These results suggest that type 1 and type 2 nerve cells which is originated from autonomic nerves were lost in aged rat small intestine. Ultrastructurally lipofusin granules were prominent in the cytoplasm of aged rat and the cell organelles were not degenerated.
Adult* ; Aging ; Animals ; Autonomic Pathways ; Cytoplasm ; Enteric Nervous System* ; Humans ; Ileum ; Intestine, Small* ; Myenteric Plexus ; Neurons ; Organelles ; Rats* ; Rats, Sprague-Dawley ; Submucous Plexus

The paracolpium or paravaginal tissue is surrounded by the vaginal wall, the pubocervical fascia and the rectovaginal septum (Denonvilliers' fascia). To clarify the configuration of nerves and fasciae in and around the paracolpium, we examined histological sections of 10 elderly cadavers. The paracolpium contained the distal part of the pelvic autonomic nerve plexus and its branches: the cavernous nerve, the nerves to the urethra and the nerves to the internal anal sphincter (NIAS). The NIAS ran postero-inferiorly along the superior fascia of the levator ani muscle to reach the longitudinal muscle layer of the rectum. In two nulliparous and one multiparous women, the pubocervical fascia and the rectovaginal septum were distinct and connected with the superior fascia of the levator at the tendinous arch of the pelvic fasciae. In these three cadavers, the pelvic plexus and its distal branches were distributed almost evenly in the paracolpium and sandwiched by the pubocervical and Denonvilliers' fasciae. By contrast, in five multiparous women, these nerves were divided into the anterosuperior group (bladder detrusor nerves) and the postero-inferior group (NIAS, cavernous and urethral nerves) by the well-developed venous plexus in combination with the fragmented or unclear fasciae. Although the small number of specimens was a major limitation of this study, we hypothesized that, in combination with destruction of the basic fascial architecture due to vaginal delivery and aging, the pelvic plexus is likely to change from a sheet-like configuration to several bundles.
Aged* ; Aging ; Anal Canal ; Autonomic Pathways ; Cadaver* ; Fascia* ; Female ; Humans ; Hypogastric Plexus ; Muscles ; Rectum ; Urethra

Herpes zoster oticus is caused by herpetic viruses including varicella zoster and most commonly affects cranial nerves (CN) VII and VIII. With a review of literature, we report a case of herpes zoster oticus with selective involvement of CN VIII, IX and X. Interestingly, the motor fibers of CN VII were spared while ipsilateral recurrent laryngeal nerve involvement was evident. The patient was treated with antiviral medication and systemic steroids and symptoms were improved.
Chickenpox ; Cranial Nerves ; Facial Nerve ; Herpes Zoster ; Herpes Zoster Oticus ; Humans ; Polyneuropathies ; Recurrent Laryngeal Nerve ; Steroids ; Vocal Cord Paralysis

Optimal goals of rectal cancer surgical treatment should include appropriate local control, higher survival rates, scrupulous operation procedures and good quality of life with maintained sexual and voiding function through the conservation of anal sphincter. Complete surgical removal of rectal cancer mass and adjacent lymph nodes in en-bloc package decreases the risk of local recurrence. Furthermore heightened awareness of better surgical techniques has created much interest in the anatomy involved in total mesorectal excision (TME), with particular focus on the fascial planes, nerve plexuses and their relationship to the surgical planes of excision. Total mesorectal excision focuses on several technical components and the quality of operated specimen. Sharp anatomic pelvic dissection along the visceral pelvic fascia must avoid any breach from the mesorectum haboring metastatic tumor deposits and lymph nodes. Also any coning down or blunt dissection should not be allowed. The rectal cancer mass and its surrounding mesorectum must be removed as one complete unit. Circumferential and distal resection margin must be also adequately obtained. Such sharp pelvic dissection instead of blunt dissection requires precised knowledge of the pelvic anatomy. Studying the hemisected cadevaric pelvis shows a clear relationship between the fascia and rectum. Also pelvic autonomic nerves can be saved to preserve the patient's sexual and voiding functions. Therefore the clincial importances of anatomical structures must be emphasized at each step of surgery. Upon such understanding of techniques, TME was performed in rectal cancer patients routinely and was able to obtain fair oncologic results and improved quality of life regarding sexual and voiding functions.
Anal Canal ; Autonomic Pathways* ; Fascia ; Humans ; Hypogastric Plexus ; Lymph Nodes ; Pelvis ; Quality of Life ; Rectal Neoplasms* ; Rectum ; Recurrence ; Survival Rate

The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle is connected directly to the conjoined longitudinal muscle at the top of the external anal sphincter. Preserving the rectourethralis muscle without damage to the carvernous nerve or veins passing through it when the abdominoperineal resection is implemented is important. The mesorectal fascia is a multi-layered membrane that surrounds the mesorectum. Because the autonomic nerves also pass between the mesorectal fascia and the parietal fascia, a sharp pelvic dissection must be made along the anatomic fascial plane. With the development of pelvic structure anatomy, we can understand better how we can remove the tumor and the surrounding metastatic lymph nodes without damaging the neural structure. However, because the anorectal anatomy is not yet fully understood, we hope that additional studies of anatomy will enable anorectal surgery to be performed based on complete anatomical knowledge.
Anal Canal ; Autonomic Pathways ; Fascia ; Hope ; Hypogastric Plexus ; Lymph Nodes ; Membranes ; Muscle, Smooth ; Rabeprazole ; Rectum ; Surgeons* ; Veins

It is well known that M. leprae involves peripheral nerves, but it is a few known that M. leprae involves craninal nerves. I experienced one case of relapsed leprosy accompanied by multiple cranial nerve palsies. Revealed symptoms are to involve trigeminal nerve (V). facial nerve (VII), vestibular nerve (VIII), glossopharyngeal nerve (IX), vagus nerve (X). It is not effect to treat with corticosteroid, but is good effect to treat with MDT(multiple drug therapy)
Cranial Nerve Diseases* ; Cranial Nerves* ; Dystroglycans ; Facial Nerve ; Glossopharyngeal Nerve ; Leprosy* ; Peripheral Nerves ; Trigeminal Nerve ; Vagus Nerve ; Vestibular Nerve

PURPOSE: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. METHODS: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. RESULTS: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. CONCLUSION: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.
Blepharoptosis ; Facial Bones ; Muscles ; Oculomotor Nerve ; Orbit

No abstract available.
Deglutition Disorders ; Facial Nerve ; Glossopharyngeal Nerve ; Herpes Zoster ; Herpes Zoster Oticus ; Paralysis

Bell's palsy is acute idiopathic peripheral facial nerve palsy which is diagnosed after all the possible causes are ruled out. Several symptoms and signs of polyneuropathy, such as hypesthesia of cranial nerve IX or V, vagal motor weakness, retroauricular pain, and hearing impairment were frequently accompanied with Bell's palsy. However, association of vertigo has been rarely reported, and moreover, associated vestibulopathy was not characterized in detail in those cases. We report a 35 year-old male patient with Bell's palsy accompanying acute peripheral vestibular loss, which eventually evolved to benign paroxysmal positional vertigo.
Adult ; Bell Palsy* ; Facial Nerve ; Glossopharyngeal Nerve ; Hearing Loss ; Humans ; Hypesthesia ; Male ; Paralysis ; Polyneuropathies ; Vertigo

PURPOSE: To assess the radiologic response and cranial nerve morbidity in intracranial schwannoma patients treated with stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). MATERIALS AND METHODS: Twenty-six patients with intracranial schwannoma were treated with linear accelerator- based SRS or FSRT between February 1995 and October 1999. The origin of schwannoma was acoustic nerve in twenty-one patients, facial nerve in two, trigeminal nerve in two, and glossopharyngeal nerve in one. SRS were performed with the median peripheral dose of 14 Gy (range 12-16), and FSRT were done with the median peripheral dose of 25 2 Gy (range 50-60). RESULTS: With a median follow-up period of 33 months (range 12-67), the local control rate was 100%. Tumorregression was noted in eleven patients, and tumor stabilization was found in the remaining fifteen. Useful hearing preservation was achieved in two of three patients. Facial nerve neuropathy was shown in two patients and one patients developed trigeminal nerve neuropathy. CONCLUSION: Stereotactic radiotherapy including SRS and FSRT provided excellent local control in intracranial schwannoma. It shows the possibility of a high rate of hearing preservation and an acceptable neurotoxicity, although the number of patients are small and follow-up is relatively short.
Cochlear Nerve ; Cranial Nerves ; Facial Nerve ; Follow-Up Studies ; Glossopharyngeal Nerve ; Hearing ; Humans ; Neurilemmoma* ; Radiosurgery* ; Radiotherapy* ; Trigeminal Nerve