• 대한임상검사과학회지
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• 제45권4호
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• pp.170-179
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• 2013

There is a correct way to avoid any sequale in the central motor area during neurosurgery procedures. A clear way to find the circumference of the central sulcus, central motor, and sensory areas by giving cortical electrical stimulation to the central motor area immediate after surgery is proposed. Looking at patients who underwent brain surgery September 2009 to July 2013, the central sulcus and speech areas around the central area of the brain was investigated, using the practices of either a localized brain map check or a direct cortical electrical stimulation test. Brain maps localized around the surgical site through functional movement or speech areas were identified. Accurate tests done during surgery without damage to motor neurons or after surgery were conducted smoothly. Although successful brain map test localization can be accomplished, there are some factors that can interfere. The following phenomena can reverse the phase: (1) the first sensory / motor in the case of patients severe nerve damage; (2) placement of the electrode on top of the vessel; (3) presence of a brain tumor near the brain cortex; (4) use of anesthesia if patient cooperation is difficult; and (5) location of the electrode position and stimulus is inappropriate.

• The Korean Journal of Physiology and Pharmacology
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• 제20권1호
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• pp.1-8
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• 2016

Damage in the periphery or spinal cord induces maladaptive plastic changes along the somatosensory nervous system from the periphery to the cortex, often leading to chronic pain. Although the role of neural circuit remodeling and structural synaptic plasticity in the 'pain matrix' cortices in chronic pain has been thought as a secondary epiphenomenon to altered nociceptive signaling in the spinal cord, progress in whole brain imaging studies on human patients and animal models has suggested a possibility that plastic changes in cortical neural circuits may actively contribute to chronic pain symptoms. Furthermore, recent development in two-photon microscopy and fluorescence labeling techniques have enabled us to longitudinally trace the structural and functional changes in local circuits, single neurons and even individual synapses in the brain of living animals. These technical advances has started to reveal that cortical structural remodeling following tissue or nerve damage could rapidly occur within days, which are temporally correlated with functional plasticity of cortical circuits as well as the development and maintenance of chronic pain behavior, thereby modifying the previous concept that it takes much longer periods (e.g. months or years). In this review, we discuss the relation of neural circuit plasticity in the 'pain matrix' cortices, such as the anterior cingulate cortex, prefrontal cortex and primary somatosensory cortex, with chronic pain. We also introduce how to apply long-term in vivo two-photon imaging approaches for the study of pathophysiological mechanisms of chronic pain.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1998년도 Advances in Ginseng Research - Proceedings of the 7th International Symposium on Ginseng -
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• pp.47-56
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• 1998

In the present study, we assayed a number of compounds isolated from Panax ginseng C. A. Meyer (Araliaceae) for an ability to protect rat cortical cell cultures from the deleterious effects of the neurotoxicant, glutamate. We found that ginsenosides Rbl and Rg3 significantly attenuated glutamate-induced neurotoxicity. Brief exposure of cultures to excess glutamate caused extensive neuronal death. Glutamate-induced neuronal cell damage was significantly reduced by pretreatment with Rbl and Rgl. Ginsenosides Rbl and Rg3 inhibited the overproduction of nitric oxide which routinely follows glutamate neurotoxicity and preserved the level of superoxide dismutase in glutamate-treated cells. Furthermore, in cultures treated with glutamate, these ginsenosides inhibited the formation of malondialdehyde, a compound produced during lipid peroxidation, and diminished the influx of calcium. These results show that ginsenosides Rbl and Rg1 exerted significant neuroprotective effects on cultured cortical cells. As such, these compounds may be efficacious in protecting neurons from oxidative damage produced by exposure to excess glutamate.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.27.1-27.9
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• 2020

Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

• Journal of Korean Dental Science
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• 제3권2호
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• pp.4-11
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• 2010

Purpose: This study aimed at examining the thickness of lateral cortical bone in the mandibular posterior body and the location of the inferior alveolar nerve canal as well as investigating the clinically viable bone grafting site(s) and proper thickness of the bone grafts. Subjects and Methods: The study enrolled a total of 49 patients who visited the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital to have their lower third molar extracted and received cone beam computed tomography (CBCT) examinations. Their CBCT data were used for the study. The thickness of lateral cortical bone and the location of inferior alveolar nerve canal were each measured from the buccal midpoint of the patients' lower first molar to the mandibular ramus area in the occlusal plane of the molar area. Results: Except in the external oblique ridge and alveolar ridge, all measured areas exhibited the greatest cortical bone thickness near the lower second molar area and the smallest cortical bone thickness in the retromolar area. The inferior alveolar nerve canal was found to be located in the innermost site near the lower second molar area compared to other areas. In addition, the greatest thickness of the trabecular bone was found between the inferior alveolar nerve canal and the lateral cortical bone. Conclusions: In actual clinical settings involving bone harvesting in the posterior mandibular body, clinicians are advised to avoid locating the osteotomy line in the retromolar area to help protect the inferior alveolar nerve canal from damage. Harvesting the bone near the lower second molar area is judged to be the proper way of securing cortical bone with the greatest thickness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권4호
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• pp.167-173
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• 2018

Objectives: Classification of the degree of postoperative nerve damage according to contact with the mandibular canal and buccal cortical bone has been studied, but there is a lack of research on the difference in postoperative courses according to contact with buccal cortical bone. In this study, we divided patients into groups according to contact between the mandibular canal and the buccal cortical bone, and we compared the position of the mandibular canal in the second and first molar areas. Materials and Methods: Class III patients who visited the Dankook University Dental Hospital were included in this study. The following measurements were made at the second and first molar positions: (1) length between the outer margin of the mandibular canal and the buccal cortical margin (a); (2) mandibular thickness at the same level (b); (3) Buccolingual $ratio=(a)/(b){\times}100$; and (4) length between the inferior margin of the mandibular canal and the inferior cortical margin. Results: The distances from the canal to the buccal bone and from the canal to the inferior bone and mandibular thickness were significantly larger in Group II than in Group I. The buccolingual ratio of the canal was larger in Group II in the second molar region. Conclusion: If mandibular canal is in contact with the buccal cortical bone, the canal will run closer to the buccal bone and the inferior border of the mandible in the second and first molar regions.

• 대한한의학회지
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• 제22권1호
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• pp.63-77
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• 2001

Objectives : In acute stage of CVA, many patients experience Bugibultong as a symptom. Daesiho-tang is one of the most useful prescriptions for constipated stroke patients. This study investigated the effects of Daesiho-tang extracts on hypoxic E18 cortical neuroblast. Methods : To evaluate the effect of Daesiho-tang extracts on enuronal death caused by hypocia the neuronal viability and protein expressions of NMDA receptor subunits, ${\alpha}CaMK$ II PDE2 PSD95 densin-180, $eEF-l{\alpha}$ and GFAP were investigated. Results : We guessed that Daesiho-tang extracts worked to protect against cell damage through effecting on the protein expression of PSD(post synatpic density), especially increase of ${\alpha}CaMK$ II, $eEF-l{\alpha}$ PDE2, PSD95 and densin-180 Conclusions : According to the above results, it is supposed that Daesiho-tang is clinically applicable to stroke patients in the acute stage.

• 대한한방내과학회지
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• 제22권2호
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• pp.263-269
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• 2001

Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.

• 대한두개안면성형외과학회지
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• 제23권3호
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• pp.103-110
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• 2022

Background: The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex. Methods: We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed. Results: The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age. Conclusion: Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.

• Investigative Magnetic Resonance Imaging
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• 제10권1호
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• pp.8-15
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• 2006

목적 : 저산소성 뇌손상의 자기공명영상(MR) 소견을 유병기간 및 예후와 연관 지어 알아보고자 하였다. 대상 및 방법 : 임상적으로 저산소성 뇌손상으로 진단된 환자 18명의 19예의 MR을 대상으로 분석하였다. MR은 저산소증 발생 후 1일에서 20일(평균 8.6일)사이에 시행되었으며, 대상환자의 T1 및 T2 강조영상에서 비정상 고신호강도 병변의 위치, 뇌부종의 동반 유무 및 시간경과와 예후에 따른 병변의 양상을 분석하였다. 결과 : 전체 19예의 MR영상에서, T2 강조영상에서의 고신호강도 병변은 기저핵(15예, 78.9%), 뇌피질(13예, 68.4%), 뇌백질(9예, 47.4%), 시상(6예, 31.6%), 소뇌(4예, 21.1%), 뇌간(1예, 5.3%)의 순으로 관찰되었다. 뇌피질의 병변은 모든 경우 심부회색질에도 이상소견을 동반 하였으며 양측성, 미만성의 병변을 보였고, 뇌피질 대부분 또는 두정 후두엽에 국한되어 나타났다. 뇌피질 및 심부회색질의 T2 강조영상에서의 고신호는 급성기(6일이내)부터 아급성기(6일이후)에 걸쳐 1예를 제외한 전 예에서 다양한 정도로 있었다. 뇌간이나 소뇌의 침범은 비교적 드물었고 모두 뇌피질의 병변이 동반되어 관찰되었다. 뇌백질의 병변도 대부분 아급성기에 뇌피질과 심부회색질의 병변이 있을 때 발생했지만 양측성 분수경계역 뇌경색의 소견으로 단독 침범한 경우도 1예 있었다. T1 강조영상에서의 고신호강도 병변은 뇌피질 및 심부회색질에 주로 아급성기에 관찰되었으나, 급성기에도 일부 관찰되었다. 뇌부종은 11예에서 급성기, 아급성기에 걸쳐 관찰되었다. 의식이 회복된 환자의 MR에서 뇌피질의 침범이나 뇌부종의 빈도가 적었다. 결론 : 저산소성 뇌손상의 MR소견은 다양하지만, 거의 대부분 뇌피질과 심부 뇌회색질을 침범하는 양측성 미만성의 병변으로 나타났다. 뇌백질의 병변은 아급성기 이후에 주로 나타나나 급성기의 혹은 단독의 병변으로도 나타날 수 있다. 뇌피질의 침범정도가 경미하거나 뇌부종이 미약한 경우 예후가 좋았다.