• Annals of Clinical Neurophysiology
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• 제9권1호
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• pp.5-10
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• 2007

Background: Bell's palsy (BP) is a self-limited rapid onset facial palsy that is non-life-threatening and has a generally favorable prognosis. Facial paralysis can be caused by numerous conditions, all of which should be excluded before the diagnosis of BP is reached. The etiopathogenesis and clinical course of BP are uncertain. So we analyzed the epidemiology and clinical course of BP patients. Methods: The subjects include 100 cases of BP examined during the period of 18 months. Careful clinical history, neurologic examinations, laboratory tests, electrophysiologic studies, and brain imaging were performed. Follow-up examinations were done once a week during the first month and subsequently once a month until normal function was restored or for up to 3 months. Facial nerve function was assessed by House-Brackman (HB) facial nerve grading scale and electrophysiologic studies. Results: Except 13 recurrent BP patients, we analyzed 87 BP patients. Forty-four (50.6%) were men and 43(49.4%) were women and the mean age was 51.0(${\pm}16.6$) years. Three (3.4%) patients showed a familial tendency. The initial examination within 1 week after attack revealed 35.2% was below HB grade 4 and 64.8% was above grade 3. The associated symptoms are as follows; postauricular pain, increase tear flow, taste change, hyperacusis and drooling. The initial facial nerve conduction study and blink reflex within 1 week after attack showed abnormal findings in 12.6% and 100%, respectively. Brain MRI was performed in 59(67.8%) patients and showed abnormal enhancement of affected nerve in 57(96.6%). Follow-up examination showed that 78.2% of the patients partially improved within 4 weeks and completely improved within 3 months. Finally 80.5% of the total patients obtained normal function in 3 months. Conclusions: We report epidemiologic, clinical, electrophysiologic and radiologic characteristics of BP patients.

• Restorative Dentistry and Endodontics
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• 제21권2호
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• pp.505-516
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• 1996

The effects of application of dentin desensitizer containing glutaraldehyde (Gluma Desensitizer) and dentin adhesive system (All Bond 2) to the exposed dentin on the intradental nerve activity (INA) and the occluding aspects of dentinal tubules were investigated in cat canine teeth. Single pulp nerve units were dissected from the inferior alveolar nerve and indentified as $A{\delta}$-fiber units. The INAs elicited by 4M NaCl before and after the application of each experimental agent were compared. The morphological changes of exposed dentin surfaces and dentinal tubules in the dentin specimens used to record INAs were observed by SEM. The results obtained were as follows. 1. Eight $A{\delta}$-fiber units (conduction velocity: $8.0{\pm}4.0m$/sec) were identified. 4M NaCl evoked an irregular burst of action potentials which ceased immediately after washing. 2. In 4 $A{\delta}$-fiber units, the change of INA after the application of Gluma Desensitizer was $133.9{\pm}80.7%$ when it was compared with the INA before the application of the same agent. 3. In 4 $A{\delta}$-fiber units, application of All Bond 2 completely abolished the INA induced by 4M NaCl. 4. In specimens applied with Gluma Desensitizer, the formation of hybrid layer as well as the identification of resin penetration and reaction products with proteins in dentinal tubules were not clearly observed in interface between dentin and adhesive resin. In specimens applied with All Bond 2, the gap width of 2-$3{\mu}m$ was formed between exposed dentin and adhesive resin, and the hybrid layer and resin tags were not clearly formed either.

• 감성과학
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• 제19권4호
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• pp.111-118
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• 2016

당뇨병 환자들은 말초신경 손상의 합병증으로서 이상감각과 통증을 느낄 수 있는데 이는 날카로운 느낌, 차갑고 시린 느낌, 무딘 느낌, 살갗이 벗겨진 듯한 예민한 느낌, 화끈거리는 느낌, 따끔하고 가려운 느낌 등 다양하게 나타날 수 있다. 이를 진단하기 위해서 여러 선별검사와 전기생리학적 검사를 활용할 수 있다. 본 연구에서는 신경병통증척도와 미시간 신경병증 선별도구 및 신경전도검사를 통해 이상감감/통증을 호소하는 당뇨병 환자 11명과 호소하지 않는 당뇨병 환자 10명 간에 차이점 및 특징을 분석하였고, 세부 감각양상과 신경전도검사 지표간 상관성을 분석하였다. 그 결과 이상감각/통증을 호소하는 환자군에서 신경병통증척도와 미시간 신경병증 선별검사의 점수가 통계적으로 유의하게 높았고 신경전도검사에서는 주로 정중신경 운동신경과 비골신경이 의미 있는 기능 변화를 보였다. 세부 감각양상에 따른 신경전도검사 지표는 주로 정중신경 운동신경, 후경골신경, 장딴지신경에서 유의한 변화를 보였다. 이러한 결과들은 감각이상과 통증이 실제 말초신경 이상과 관련이 있음을 시사한다. 향후 많은 수의 대상자를 포함한 추가적인 연구가 필요하다.

• The Korean Journal of Pain
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• 제29권4호
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• pp.270-273
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• 2016

Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated $5^{th}$ lumbar and $1^{st}$ sacral polyradiculopathy. Integrating all the results, the diagnosis was neurogenic muscle hypertrophy. Neurogenic muscle hypertrophy is very rare, but we recommend that clinicians consider this problem when a patient complains of lower limb hypertrophy and pain.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.404-410
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• 2006

Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.130-134
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• 2018

A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.375-395
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• 2006

Purpose: Lingual nerve (LN) damage may be caused by either tumor resection or injury such as wisdom tooth extraction, Although autologous nerve graft is sometimes used to repair the damaged nerve, it has the disadvantage of necessity of another operation for nerve harvesting. Moreover, the results of nerve grafting is not satisfactory. The nerve growth factor (NGF) is well-known to play a critical role in peripheral nerve regeneration and its local delivery to the injured nerve has been continuously tried to enhance nerve regeneration. However, its application has limitations like repeated administration due to short half life of 30 minutes and an in vivo delivery model must allow for direct and local delivery. The aim of this study was to construct a well-functioning $rhNGF-{\beta}$ adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with enhanced and extended secretion of hNGF from the injured nerve by injecting $rhNGF-{\beta}$ gene directly into crush-injured LN in rat model. Materials and Methods: $hNGF-{\beta}$ gene was prepared from fetal brain cDNA library and cloned into E1/E3 deleted adenoviral vector which contains green fluorescence protein (GFP) gene as a reporter. After large scale production and purification of $rhNGF-{\beta}$ adenovirus, transfection efficiency and its expression at various cells (primary cultured Schwann cells, HEK293 cells, Schwann cell lines, NIH3T3 and CRH cells) were evaluated by fluorescent microscopy, RT-PCR, ELISA, immunocytochemistry. Furthermore, the function of rhNGF-beta, which was secreted from various cells infected with $rhNGF-{\beta}$ adenovirus, was evaluated using neuritogenesis of PC-12 cells. For in vivo evaluation of efficacy of $rhNGF-{\beta}$ adenovirus, the LNs of 8-week old rats were exposed and crush-injured with a small hemostat for 10 seconds. After the injury, $rhNGF-{\beta}$ adenovirus($2{\mu}l,\;1.5{\times}10^{11}pfu$) or saline was administered into the crushed site in the experimental (n=24) and the control group (n=24), respectively. Sham operation of another group of rats (n=9) was performed without administration of either saline or adenovirus. The taste recovery and the change of fungiform papilla were studied at 1, 2, 3 and 4 weeks. Each of the 6 animals was tested with different solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) by two-bottle test paradigm and the number of papilla was counted using SEM picture of tongue dorsum. LN was explored at the same interval as taste study and evaluated electro-physiologically (peak voltage and nerve conduction velocity) and histomorphometrically (axon count, myelin thickness). Results: The recombinant adenovirus vector carrying $rhNGF-{\beta}$ was constructed and confirmed by restriction endonuclease analysis and DNA sequence analysis. GFP expression was observed in 90% of $rhNGF-{\beta}$ adenovirus infected cells compared with uninfected cells. Total mRNA isolated from $rhNGF-{\beta}$ adenovirus infected cells showed strong RT-PCR band, however uninfected or LacZ recombinant adenovirus infected cells did not. NGF quantification by ELISA showed a maximal release of $18865.4{\pm}310.9pg/ml$ NGF at the 4th day and stably continued till 14 days by $rhNGF-{\beta}$ adenovirus infected Schwann cells. PC-12 cells exposed to media with $rhNGF-{\beta}$ adenovirus infected Schwann cell revealed at the same level of neurite-extension as the commercial NGF did. $rhNGF-{\beta}$ adenovirus injected experimental groups in comparison to the control group exhibited different taste preference ratio. Salty, sweet and sour taste preference ratio were significantly different after 2 weeks from the beginning of the experiment, which were similar to the sham group, but not to the control group.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.11-15
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• 2010

Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle's tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.

• Journal of Multimedia Information System
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• 제5권2호
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• pp.121-130
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• 2018

We developed multimedia esophageal catheters for use with birds to measure and record ECG and angular velocity while anesthesized, at rest, and in flight. These catheters enable estimates of blood pressure based on readings given by an angular velocity sensor and by RR intervals of ECG affected by EMG. In our experiments, the catheters had the following characteristics: 1. Esophageal catheters offer a topological advantage with 8-dB SNR improvement due to elimination of electromyography (EMG). 2. We observed a very strong correlation between blood pressure and the angular velocity of esophageal catheter axial rotation. 3. The impulse conduction pathway (Purkinje fibers) of the cardiac ventricle has a direction opposite to that of the mammalian pathway. 4. Sympathetic nerves predominate in flight, and RR interval variations are strongly suppressed. The electrophysiological data obtained by this study provided especially the state of the avian autonomic nervous system activity, so we can suspect individual's health condition. If the change of the RR interval was small, we can perform an isolation or screening from the group that prevent the pandemics of avian influenza. This catheter shall be useful to analysis an avian autonomic system, to perform a screening, and to make a positive policy against the massive infected avian influenza.