• Title/Summary/Keyword: Functional neurology

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Spinal cord stimulation in chronic pain: technical advances

  • Isagulyan, Emil;Slavin, Konstantin;Konovalov, Nikolay;Dorochov, Eugeny;Tomsky, Alexey;Dekopov, Andrey;Makashova, Elizaveta;Isagulyan, David;Genov, Pavel
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.99-107
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    • 2020
  • Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

An Estimation of the Efficiency and Satisfaction for EEG Practice Using the Training 10-20 Electrode System: A Questionnaire Survey (연습용 10-20 Electrode System을 이용한 뇌파검사 실습의 효율성과 만족도 평가)

  • Lee, Chang Hee;Kim, Dae Jin;Choi, Jeong Su;Lee, Jong-Woo;Lee, Min Woo;Cho, Jae Wook;Kim, Suhng Wook
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.300-307
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    • 2017
  • Electroencephalography (EEG) is distinct from other medical imaging tests in that it is a functional test that helps to diagnosis disorders related to the brain, such as epilepsy. The most important abilities for a medical technologist when performing an EEG are knowing the exact location of the electrode and recording the EEG wave clearly, except for artifacts. Although theoretical education and practical training are both included in the curriculum for improving these abilities, sufficient practical training has been lacking due to problems like expensive equipment and insufficient practical training time. We try to solve these issues by manufacturing the training 10-20 electrode system and by estimating the efficiency and satisfaction of the training 10-20 electrode system through a questionnaire. The time required for practical training using this system was $43.58{\pm}9.647min$, which proved to be efficient. The satisfaction score of participants who experienced curriculum practical training was improved from $7.21{\pm}2.285$ to $9.46{\pm}1.166$. Based on these findings, it is considered that practical training via the use of the training 10-20 electrode system will solve the problems, such as lack of equipment and insufficient practical training time. Nonetheless, to further improve the training 10-20 electrode system, it must overcome the limitations of developing a device capable of checking the actual brain waves and validating the exact location of electrode attachment.

Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( II ): Mapping of Human Working Memory ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(II): 작업 기억의 지도 작성)

  • Lee, Jae-Sung;Lee, Dong-Soo;Lee, Sang-Kun;Nam, Hyun-Woo;Kim, Seok-Ki;Park, Kwang-Suk;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.238-249
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    • 1998
  • Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

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Neuronal injury in AIDS dementia: Potential treatment with NMDA open-channel blockers and nitric oxide-related species

  • Lipton, Stuart A.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.19-29
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    • 1996
  • The neurological manifestations of AIDS include dementia, encountered even in the absence of opportunistic superinfection or malignancy. The AIDS Dementia Complex appears to be associated with several neuropathological abnormalities, including astrogliosis and neuronal injury or loss. How can HIV-1 result in neuronal damage if neurons themselves are only rarely, if ever, infected by the vitus\ulcorner In vitro experiments from several different laboratiories have lent support to the existence of HIV- and immune-related toxins. In one recently defined pathway to neuronal injury, HIV-infected macrophages/microglia as well as macrophages activated by HIV-1 envelope protein gp120 appear to secrete excitants/neurotoxins. These substances may include arachidonic acid, platelet-activating factor, free radicals (NO - and O$_2$), glutamate, quinolinate, cysteine, cytokines (TNF-${\alpha}$, IL1-B, IL-6), and as yet unidentified factors emanating from stimulated macrophages and possibly reactive astrocytes. A final common pathway for newonal suscepubility appears to be operative, similar to that observed in stroke, trauma, epilepsy, and several neurodegenerative diseases, including Huntington's disease, Parkinson's disease, and amyotrophic lateral sclerosis. This mechanism involves excessive activation of N-methyl-D-aspartate (NMDA) receptor-operated channels, with resultant excessive influx of Ca$\^$2+/ leading to neuronal damage, and thus offers hope for future pharmacological intervention. This chapter reviews two clinically-tolerated NMDA antagonists, memantine and nitroglycerin; (ⅰ) Memantine is an open-channel blocker of the NMDA-associated ion channel and a close congener of the anti-viral and anti-parkinsonian drug amantadine. Memantine blocks the effects of escalating levels of excitotoxins to a greater degree than lower (piysiological) levels of these excitatory amino acids, thus sparing to some extent normal neuronal function. (ⅱ) Niuoglycerin acts at a redox modulatory site of the NMDA receptor/complex to downregulate its activity. The neuroprotective action of nitroglycerin at this site is mediated by n chemical species related to nitric oxide, but in a higher oxidation state, resulting in transfer of an NO group to a critical cysteine on the NMDA receptor. Because of the clinical safety of these drugs, they have the potential for trials in humans. As the structural basis for redox modulation is further elucidated, it may become possible to design even better redox reactive reagents of chinical value. To this end, redox modulatory sites of NMDA receptors have begun to be characterized at a molecular level using site-directed mutagenesis of recombinant subunits (NMDAR1, NMDAR2A-D). Two types of redox modulation can be distinguished. The first type gives rise to a persistent change in the functional activity of the receptor, and we have identified two cysteine residues on the NMDARI subunit (#744 and #798) that are responsible for this action. A second site, presumably also a cysteine(s) because <1 mM N-ethylmaleimide can block its effect in native neurons, underlies the other, more transient redox action. It appears to be at this, as yet unidentified, site on the NMDA receptor that the NO group acts, at least in recombinant receptors.

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Electrophysiological Analysis in Diabetic Patients with Abnormal Sensation and Pain (이상감각과 통증을 호소하는 당뇨병 환자의 전기생리학적 특징 분석)

  • Yang, Jiwon;Lee, Yeong-Bae
    • Science of Emotion and Sensibility
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    • v.19 no.4
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    • pp.111-118
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    • 2016
  • Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

Acupuncture Analgesia : A Sensory Stimulus Induced Analgesia Observed by functional Magnetic Resonance Imaging (침의 진통효과: 체성감각신경자극으로 유도된 진통작용에 대한 기능성자기공명영상장치를 이용한 연구)

  • Cho, Zang-hee;Hwang, Seon-chool;Son, Young-don;Kang, Chang-ki;Wong, Edward K.;Bai, Sun-joon;Lee, Un-jung;Sung, Kang-kyung;Park, Tae-seok;Kim, Young-bo;Min, Hoon-ki;Oleson, Terry
    • Journal of Acupuncture Research
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    • v.21 no.2
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    • pp.57-71
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    • 2004
  • Objective : Physiological evidence regarding acupuncture's effect in human patients is not yet well established, despite considerable evidence for its therapeutic efficacy. Besides target or disease specificity of acupuncture, acupuncture analgesia (AA) appears to be another large subclass that poses many questions, such as whether there is point specificity with respect to which acupoint is most effective for a particular condition. Methods : We observed brain activation with functional magnetic resonance imaging (fMRI) using a set of stimuli that consist of pain, pain following Meridian acupuncture, and pain following Sham acupuncture. Results : Among the new observations, the most interesting fact is that data sets of both Meridian acupuncture and Sham acupuncture show decreased activation of the same brain areas related to the pain processing signals. Present functional MRI study demonstrate two important biological observations that could elucidate AA mechanism in human participants: the effects of acupuncture occur through mediation of the higher brain areas. Sham acupuncture stimulation appears to be almost as effective as traditional Meridian acupoint stimulation, suggesting that acupuncture is not entirely point specific. Decreased activation in the limbic paleo cortical areas appears to be the probable neurological manifestation of AA and strongly implies that acupuncture stimulation inhibits the transmission of ascending pain signals to the higher cortical areas by the previously known descending pain inhibitory circuit. Conclusion : We, therefore, a hypothesized that this pain inhibitory circuit is initiated and mediated via the broad sense Hypothalamus Pituitary Adrenal (BS HPA) axis in conjunction to the "sensory stimulation."

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Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging for Language Mapping in Brain Tumor Surgery: Validation With Direct Cortical Stimulation and Cortico-Cortical Evoked Potential

  • Koung Mi Kang;Kyung Min Kim;In Seong Kim;Joo Hyun Kim;Ho Kang;So Young Ji;Yun-Sik Dho;Hyongmin Oh;Hee-Pyoung Park;Han Gil Seo;Sung-Min Kim;Seung Hong Choi;Chul-Kee Park
    • Korean Journal of Radiology
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    • v.24 no.6
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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.

Down-regulation of Long Non-coding RNA TUG1 Inhibits Osteosarcoma Cell Proliferation and Promotes Apoptosis

  • Zhang, Qiang;Geng, Pei-Liang;Yin, Pei;Wang, Xiao-Lin;Jia, Jin-Peng;Yao, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2311-2315
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    • 2013
  • Objective: To investigate the expression level of TUG1 and one of its transcript variants (n377360) in osteosarcoma cells and assess the role of TUG1 in proliferation and apoptosis in the U2OS cell line. Methods: TUG1 and n377360 expression levels in patients with osteosarcomas and the U2OS human osteosarcoma cell line were evaluated using real-time quantitative PCR. U2OS cells were transected with TUG1 and n377360 siRNA or non-targeting siRNA. MTS was performed to assess the cell proliferation and flow cytometry was applied to analyze apoptosis. Results: We found significantly higher TUG1 and n377360 expression levels in osteosarcoma tissues compared with matched non-tumorous tissues. In line with this, suppression of TUG1 and n377360 expression by siRNA significantly impaired the cell proliferation potential of osteosarcoma cells. Furthermore, inhibition of TUG1 expression significantly promoted osteosarcoma cell apoptosis. Conclusions: The overexpression of TUG1 and n377360 in osteosarcoma specimens and the functional role of TUG1 and n377360 regarding cell proliferation and apoptosis in an osteosarcoma cell line provided evidence that the use of TUG1 or n377360 may be a viable but an as yet unexplored therapeutic strategy in tumors that over express these factors.

18FDG Synthesis and Supply: a Journey from Existing Centralized to Future Decentralized Models

  • uz Zaman, Maseeh;Fatima, Nosheen;Sajjad, Zafar;Zaman, Unaiza;Tahseen, Rabia;Zaman, Areeba
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10057-10059
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    • 2015
  • Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. $^{18}$Flourodeoxyglucose ($^{18}FDG$) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of $^{18}F$ (110 minutes) have paved the path of a centralized model in which $^{18}FDG$ is produced by commercial PET radiopharmacies and the finished product (multi-dose vial with tungsten shielding) is dispensed to customers having only PET scanners. This indeed reduced the cost but has limitations of dependence upon timely arrival of daily shipments as delay caused by any reason results in cancellation or rescheduling of the PET procedures. In recent years, industry and academia have taken a step forward by producing low energy, table top cyclotrons with compact and automated radiochemistry units (Lab-on-Chip). This decentralized strategy enables the users to produce on-demand doses of PET probe themselves at reasonably low cost using an automated and user-friendly technology. This technological development would indeed provide a real impetus to the availability of complete set up of PET based molecular imaging at an affordable cost to the developing countries.

Animals Physical Therapy (동물물리치료)

  • Kim, Jin-Ung;Bae, Soo-Chan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.8 no.2
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    • pp.45-55
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    • 2002
  • This article review the animals physical therapy. It is so called veterinary physical therapy. The animals physical therapist is working to physical therapy for animals in veterinary clinical field. The veterinary medicine has not veterinary rehabilitation medicine or physical therapy for animals, also physical therapy field in Korea. So, This research will explain about animals physical therapy of Korea and other countries' by journals and internet information and suggest the future of the animals physical therapist. Finally, The veterinary physical therapy is not used to veterinary clinical field in now. But, The veterinary physical therapy will desire to the view of medical serve and economy by the host of animals and clinical veterinarian the future. Animal physical therapy is a new and rapidly developing field of health care for animals. The benefits of physical therapy have long been recognized in humans. More recently, work in the veterinary field has shown the same benefits of physical therapy to be true for animal patients. Performing orthopaedic or neurological surgery, or fitting a human patient with a cast or splint, and then discharging the patient is an outdated approach. In such cases, physical therapy is clearly warranted. Similarly, recent research has shown that post-surgical rehabilitation and therapy after injuries significantly improves the functional outcomes for animals. Physical Therapy is a healthcare profession directed at evaluating, restoring and maintaining physical function and movement. Working with the owner, veterinarian and often other healthcare professionals, a physiotherapist helps your animal to achieve and maintain optimal health and well-being. Equipped with a specialized university Bacheloriate education and intensively educated in Anatomy, Physiology, Biomechanics, Histology, Neurology, and Pathology, PT's are able to assess, diagnose and treat movement and function. Physical Therapy, Sports Medicine and Rehabilitation are recognized sciences applied to both humans and animals. The goals of physiotherapy are to relieve pain, restore range of motion/movement, improve function, prevent injuries and expand the physical potential of the patient. Once in the field, physical therapists actively continue their education to keep up to date on the latest treatments and technologies. Via continuing education courses, physiotherapists can learn how to apply their unique and specialized knowledge to other animal species.

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