• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.367-375
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• 2019

Hemifacial spasm (HFS) is due to the vascular compression of the facial nerve at its root exit zone (REZ). Microvascular decompression (MVD) of the facial nerve near the REZ is an effective treatment for HFS. In MVD for HFS, intraoperative neurophysiological monitoring (INM) has two purposes. The first purpose is to prevent injury to neural structures such as the vestibulocochlear nerve and facial nerve during MVD surgery, which is possible through INM of brainstem auditory evoked potential and facial nerve electromyography (EMG). The second purpose is the unique feature of MVD for HFS, which is to assess and optimize the effectiveness of the vascular decompression. The purpose is achieved mainly through monitoring of abnormal facial nerve EMG that is called as lateral spread response (LSR) and is also partially possible through Z-L response, facial F-wave, and facial motor evoked potentials. Based on the information regarding INM mentioned above, MVD for HFS can be considered as a more safe and effective treatment.

• The Korean Journal of Physiology and Pharmacology
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• 제7권1호
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• pp.47-52
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• 2003

The prostate gland contains numerous neuroendocrine cells that are believed to influence the function of the prostate gland. Our recent study demonstrated the expression of both ${\alpha}1$- and ${\alpha}2$-ARs, signaling the release of stored $Ca^{2+}$ and the inhibition of N-type $Ca^{2+}$ channels, respectively, in rat prostate neuroendocrine cells (RPNECs). In this study, the effects of NA on the resting membrane potential (RMP) of RPNECs were investigated using a whole-cell patch clamp method. Fresh RPNECs were dissociated from the ventral lobe of rat prostate and identified from its characteristic shape; round or oval shape with dark cytoplasm. Under zero-current clamp conditions with KCl pipette solution, the resting membrane potential (RMP) of RPNECs was between -35 mV and -85 mV. In those RPNECs with relatively hyperpolarized RMP (＜-60 mV), the application of noradrenaline (NA, $1{\mu}M$) depolarized the membrane to around -40 mV. In contrast, the RPNECs with relatively depolarized RMP (＞-45 mV) showed a transient hyperpolarization and subsequent fluctuation at around -40 mV on application of NA. Under voltage clamp conditions (holding voltage, -40 mV) with CsCl pipette solution, NA evoked a slight inward current (＜-20 pA). NA induced a sharp increase of cytosolic $Ca^{2+}$ concentration ($[Ca^{2+}]_c$), measured by the fura-2 fluorescence, and the voltage clamp study showed the presence of charybdotoxin-sensitive $Ca^{2+}$-activated $K^+$ currents. In summary, adrenergic stimulation induced either depolarization or hyperpolarization of RPNECs, depending on the initial level of RMP. The inward current evoked by NA and the $Ca^{2+}$-activated $K^+$ current might partly explain the depolarization and hyperpolarization, respectively.

• The Korean Journal of Physiology and Pharmacology
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• 제3권1호
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• pp.101-117
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• 1999

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease of unknown etiology in which the upper and lower motor neurons are progressively destroyed. Recent evidences support the role of autoimmune mechanisms in the pathogenesis of ALS. This study investigated the effects of sera from ALS patients on neuromuscular transmission in phrenic nerve-hemidiaphragm preparations and on calcium currents of single isolated dorsal root ganglion (DRG) cells in mice. Mice were injected with either control sera from healthy adults or ALS sera from 18 patients with ALS of sporadic form, for three days. Miniature end plate potential (MEPP) and nerve-evoked end plate potential (EPP) were measured using intracellular recording technique and the quantal content was determined. Single isolated DRG cells were voltage-clamped with the whole-cell configuration and membrane currents were recorded. Sera from 14 of 18 ALS patients caused a significant increase in MEPP frequency in normal Ringer's solution $(4.62{\pm}0.14\;Hz)$ compared with the control $(2.18{\pm}0.15\;Hz).$ In a high $Mg^{2+}/low\;Ca^{2+}$ solution, sera from 13 of 18 ALS patients caused a significant increase in MEPP frequency, from $2.18{\pm}0.31$ Hz to $6.09{\pm}0.38$ Hz. Sera from 11 of 18 patients produced a significant increase of nerve-evoked EPP amplitude, from $0.92{\pm}0.05$ mV to $1.30{\pm}0.04$ mV, while the other seven ALS sera did not alter EPP amplitude. In the ALS group, EPP quantal content was also elevated by the sera of 14 patients (from $1.49{\pm}0.07$ to $2.35{\pm}0.07).$ MEPP frequency and amplitude in wobbler mouse were $4.03{\pm}0.53$ Hz and $1.37{\pm}0.18$ mV, respectively, which were significantly higher than those of wobbler controls (wobblers without the symptoms of wobbler). Sera from ALS patients significantly reduced HVA calcium currents of DRG cells to 42.7% at -10 mV. Furthermore, the inactivation curve shifted to more negative potentials with its half-inactivation potential changed by 6.98 mV. There were, however, significant changes neither in the reversal potential of $I_{Ca}$ nor in the I-V curve. From these results it was concluded that: 1) The serum factors of sporadic ALS patients increase neuromuscular transmission and can alter motor nerve terminal presynaptic function. This suggests that ALS serum factors may play an important role in the early stage of ALS, and 2) Calcium currents in DRG cells were reduced and rapidly inactivated by ALS sera, suggesting that in these cells, ALS serum factors may exert interaction with the calcium channel.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.652-672
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• 1996

Dysfunction of the inferior alveolar nerve may result from trauma, diseases or iatrogenic injury. The development and refinement of an objective method to evaluate this clinical problem is highly desirable and needed, especially concerning for an increasing medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nerve pathways. The purpose of this study was to characterize the Sensory Evoked Potentials(SEPs) and Somatosensory Evoked Potentials(SSEPs) elicited by electrical stimulation of mental nerve. SEPs and SSEPs were measured and analyzed statistically before and after needle injury on the inferior alveolar nerve of Sprague-Dawalye rats. Measuring SEPs was more sensitive in evaluation of the recovery of sensory function from inferior alveolar nerve injury then measuring SSEPs but we measured SSEPs in the hope of providing a safe, simple and objective test to check oral and facial sensibility, which is acceptable to the patient. We stimulated mental nerve after needle injury on the inferior alveolar nerve and SEPS on the level of mandibular foramen and SSEPs on the level of cerebral cortex were recorded. Threshold, amplitude, and latency of both of SEPs and SSEPs were analyzed. The results were as follows ; 1. Threshold of SEPs and SSEPs were $184{\pm}14{\mu}A$ and $164{\pm}14{\mu}A$ respectively. 2 SEPs were composed of 2 waves, i.e., N1 N2 in which N1 was conducted by II fibers and N2 was conducted by III fibers. 3. SSEPS were composed of 5 waves, of which N1 and N2 shower statistically significant changes(p<0.01, unpaired t-test). 4. SEPs and SSEPs were observed to be abolished immediately after local anesthesia and recovered 30 minutes later. 5. SEPs were abolished immediately after injury. N1 of SSEPs was abolished immediately and amplitued of N2 was decreased($20.7{\pm}12.2%$) immediately after 23G needle injury, but N3, N4 and N5 did not change significantly. Recovery of waveform delayed 30 minutes in SEPs and 45 minutes in SSEPs. 6. The degree of decrease in amplitude of SEPs and SSEPs, after 30G needle injury was smaller than those with 23G. SEPs recorded on the level of mandibular foramen were though to be reliable and useful in the assessment of the function of the inferior alveolar nerve after injury. Amplitude of SSEPs reflected the function and integrity of nerve and measuring them provided a safe, simple and abjective test to check oral and facial sensibility. These results suggest that measuring SEPs and SSEPs are meaningful methods for objective assessment in the diagnosis of nerve injury. N1 and N2 of SSEPs can be useful parameters for the evaluation of the nerve function following a needle injury.

• Asian Spine Journal
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• 제12권6호
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• pp.998-1009
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• 2018

Study Design: Olfactory ensheathing cells (OECs) from rat olfactory mucosa were cultured, characterized, and transplanted into a rat model of spinal cord injury (SCI). Purpose: To evaluate different doses of OECs in a rat model of SCI. Overview of Literature: SCI causes permanent functional deficit because the central nervous system lacks the ability to perform spontaneous repair. Cell therapy strategies are being explored globally. The clinical use of human embryonic stem cell is hampered by ethical controversies. Alternatively, OECs are a promising cell source for neurotransplantation. This study aimed to evaluate the efficacy of different doses of allogenic OEC transplantation in a rat model of SCI. Methods: OECs were cultured from the olfactory mucosa of Albino Wistar rats; these cells were characterized using immunohistochemistry and flow cytometry. Rats were divided into five groups (n=6 rats each). In each group, different dosage ($2{\times}10^5$, $5{\times}10^5$, $10{\times}10^5$, and >$10{\times}10^5$) of cultured cells were transplanted into experimentally injured spinal cords of rat models. However, in the SCI group, only DMEM (Dulbecco's modified Eagle's medium) was injected. Rats were followed up upto 8 weeks post-transplantation. The outcome of transplantation was assessed using the Basso, Beattie, Bresnahan (BBB) scale; motor-evoked potential studies; and histological examination. Results: Cultured cells expressed 41% of p75NTR, a marker for OEC, and 35% of anti-fibronectin, a marker for olfactory nerve fibroblast. These cells also expressed $S100{\beta}$ and glial fibrillary acid protein of approximately 75% and 83%, respectively. All the transplanted groups showed promising BBB scores for hind-limb motor recovery compared with the SCI group (p<0.05). A motor-evoked potential study showed increased amplitude in all the treated groups compared with the SCI. Green fluorescent protein-labeled cells survived in the injured cord, suggesting their role in the transplantation-mediated repair. Transplantation of $5{\times}10^5$ cells showed the best motor outcomes among all the doses. Conclusions: OECs demonstrated a therapeutic effect in rat models with the potential for future clinical applications.

• 대한물리치료과학회지
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• 제15권1호
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• pp.11-20
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• 2008

This study was designed to test the effects of comprehensive rehabilitation management on functional recovery after attack of cerebrovascular disease. 16 cerebrovascular disease patients applied comprehensive rehabilitation management of physical therapy at department of physical Therapy, C medical center in Gwang－ju. The collection of the data had been executed for 4months(April 15, 2007${\sim}$July 15, 2007). For evaluating, Functional Independence measure(FIM) and Somatosensory Evoked Potential(SSEP) were used to assess functional recovery. The results of this study were as follows: 1. In the comparison of latency of median nerve SSEP before and after treatment, the lat. N20 and P25 increased, the ampl. P25/N20 was decreased. In the comparison difference data of median nerve SSEP, however there was no significant difference in the group(p>0.05). 2. In the comparison of latency of Post Tibial nerve SSEP before and after treatment, the lat. P40, P50, P60 increased, the ampl. P40 was decreased. In the comparison difference data of post tibial nerve SSEP, however there was no significant difference in the group(p>0.05). 3. In the comparison of FIM scores of Self－care, Sphincter Control, Mobility: Transfer, Locomotion before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was significant difference(p<0.05). 4. In the comparison of FIM scores of Communication, Social Cognition before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was no significant difference in the group(p>0.05). Based on these results, it is concluded that the comprehensive rehabilitation management for cerebrovascular disease case was not significant difference in the SSEP, was significant difference in the motor part of FIM. Further study should be done to analyze the effect of intervention duration of treatment, optimal time to apply the treatment in more long period.

• 감성과학
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• 제18권1호
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• pp.15-26
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• 2015

본 논문에서는 경험적 모드 분해 방법을 이용하여 시각자극 출현에 따른 과제 수행 시 발생하는 뇌 유발전위의 ${\theta}$와 ${\alpha}$대역에 대한 진폭과 위상변화를 확인하였다. 과제수행에 대한 뇌 유발전위를 구성 주파수 대역 별로 분해하기 위하여 경험적 모드 분해 방법을 적용하였고, 분해된 각 내재모드함수에 힐버트 변환을 적용하여 뇌 유발전위의 ${\theta}$와 ${\alpha}$대역의 순간 진폭과 위상 변화를 확인하였다. 과제 수행 시 뇌 유발전위의 P2, N2과 P3지점에서 ${\theta}$와 ${\alpha}$대역의 진폭이 크게 관찰되었으며, N1, P2부근에서 순간 위상의 변화가 최대가 되었다. 시각 자극 출현에 따른 응시 상태에서는 두 대역 모두 관련된 위상 변화시점이 확인되지 않았다. 대역통과필터 방법 적용 시, 경험적 모드 분해 방법에 비해 시간과 주파수 해상도가 떨어졌으며, 필터의 파라미터에 따라 위상 변화 시점의 결과에 차이가 발생하였다. 연구를 통해 ${\theta}$와 ${\alpha}$대역이 시각 자극 출현에 따른 과제 수행에 대한 뇌 유발전위의 주요성분인 ${\theta}$와 ${\alpha}$대역의 위상변화와 뇌 유발전위의 생성을 위상 변화와 연관 지어 해석하였다.

• 대한임상검사과학회지
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• 제38권3호
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• pp.224-230
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• 2006

Up to now, there have been rare clinical studies on leaders and aerobics athletes. To get the useful data for protecting from auditory disorder, we selected 15 female aerobics leaders (experimental group) and 15 females (control group) unexperienced in aerobics and a without neurological and octolaryngological disorder. The average age was $34.87{\pm}8.80$ (experimental group) and $34.07{\pm}8.45$ (control group) years, and the average career of an aerobics leader (experimental group) was $8.33{\pm}4.73$ years. We measured the auditory evoked potential (AEP) of the two groups treated with 70, 75 and 85 dB intensity from January 2006 to May 2006 and analyzed the absolute latency (AL) and interpeak latency (IPL) by the SPSS/pc+ 12.0 program. In the comparison of the AL between the experimental group and the control group according to intensity, both ears treated with 70 and 75 dB had a significant difference (p<0.05) in the I, III, V wave and in the I, V wave respectively, and the experimental group treated with 85 dB showed a difference in the I, III, V wave (left ear) and in the I wave (right ear) respectively. The IPL of the two groups treated with various intensities had no prolongation. In the comparison of the AL between the experimental group and the control group according to ages, the experimental group in their 20s treated with 70 dB showed a significant difference (p<0.05) in the V wave (left ear) and in the I, III, V wave (right ear), and the experimental group in their 20s treated with 75 dB in the I, III wave (left ear) and in I, III, V wave (right ear), and experimental group in their 20s treated with 85 dB in the V wave (left ear) and in the III, V wave (right ear). The experimental group in their 30s treated with 70 dB had a significant difference (p<0.05) only in the V wave (right ear). Only in the IPL of subjects in their 20s treated with 85 dB, III-V and I-V of both ears was extended. In the comparison of the AL and IPL according to career, there was no significant difference between the two groups. From this results, we concluded that the lower sound intensity (70 dB) showed a more significant difference in the experimental group than the control group. We concluded that the leader of aerobics exposed to louder sounds than normal people are affected by auditory neurological and octolaryngological disorders. So we think that the leaders of aerobics need to control the noise level for protecting themselves against a disease.

• 대한임상검사과학회지
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• 제50권4호
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• pp.470-476
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• 2018

다중펄스경두개전기자극(mpTES)을 이용한 안면운동유발전위(FMEP)는 자유 진행 근전도와 직접적인 안면 신경 자극법의 한계점을 보완하고 소뇌교각 종양 수술 중에 안면 신경의 기능적인 완전성을 예측할 수 있다. 본 논문의 목적은 이 검사의 표준화된 검사방법과 안면 신경의 기능예측인자로서의 유용성을 알아보고 수술 후 중대한 후유증인 안면마비 발생률을 최소화하는 것이다. Mz (음극)-M3, M4 (양극) 전극으로 경두개전기자극을 주고 안면운동유발전위의 단일펄스반응(SPR)의 부재와 10 ms이상의 잠복기를 확인해서 직접적인 두개 외 말초 안면 근육 자극을 배제하고 구륜근(orbicularis oris)과 턱근(mentalis)에서 동시에 측정하면 구륜근에서만 측정했을 때보다 안면운동유발전위의 정확도와 성공률을 높일 수 있다. 본 논문에서는 안면운동유발전위의 50% 진폭감소를 경고기준으로 해서 수술 직후 안면 신경의 결과를 효과적으로 예측할 수 있었다. 결론적으로, 소뇌교각 종양 수술 중에 FMEP는 자유 진행 근전도와 직접적인 안면 신경 자극법과 더불어서 수술 후 중대한 후유증인 안면 마비 발생률을 최소화 할 수 있는 유용한 검사방법이다.

• Korean Journal of Radiology
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• 제24권6호
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• pp.553-563
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• 2023

Objective: Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging-derived tractography (DTI-t) contribute to the localization of language areas, but their accuracy remains controversial. This study aimed to investigate the diagnostic performance of preoperative fMRI and DTI-t obtained with a simultaneous multi-slice technique using intraoperative direct cortical stimulation (DCS) or corticocortical evoked potential (CCEP) as reference standards. Materials and Methods: This prospective study included 26 patients (23-74 years; male:female, 13:13) with tumors in the vicinity of Broca's area who underwent preoperative fMRI and DTI-t. A site-by-site comparison between preoperative (fMRI and DTI-t) and intraoperative language mapping (DCS or CCEP) was performed for 226 cortical sites to calculate the sensitivity and specificity of fMRI and DTI-t for mapping Broca's areas. For sites with positive signals on fMRI or DTI-t, the true-positive rate (TPR) was calculated based on the concordance and discordance between fMRI and DTI-t. Results: Among 226 cortical sites, DCS was performed in 100 sites and CCEP was performed in 166 sites. The specificities of fMRI and DTI-t ranged from 72.4% (63/87) to 96.8% (122/126), respectively. The sensitivities of fMRI (except for verb generation) and DTI-t were 69.2% (9/13) to 92.3% (12/13) with DCS as the reference standard, and 40.0% (16/40) or lower with CCEP as the reference standard. For sites with preoperative fMRI or DTI-t positivity (n = 82), the TPR was high when fMRI and DTI-t were concordant (81.2% and 100% using DCS and CCEP, respectively, as the reference standards) and low when fMRI and DTI-t were discordant (≤ 24.2%). Conclusion: fMRI and DTI-t are sensitive and specific for mapping Broca's area compared with DCS and specific but insensitive compared with CCEP. A site with a positive signal on both fMRI and DTI-t represents a high probability of being an essential language area.