• Title/Summary/Keyword: Nerve function

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Long-Term Results of Surgical Treatment for Sacral Chordoma (천추 척색종의 수술적 치료 후 장기 추시 결과)

  • Chung, Jae-Yoon;Lee, Jae-Joon;Seo, Hyoung-Yeon;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.148-154
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    • 2005
  • Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

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Intraoperative Neurophysiological Monitoring : A Review of Techniques Used for Brain Tumor Surgery in Children

  • Kim, Keewon;Cho, Charles;Bang, Moon-suk;Shin, Hyung-ik;Phi, Ji-Hoon;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.363-375
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    • 2018
  • Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

Development of Healthcare Bathing System for Improving the Multisensory Functions (복합감각 기능증진 개념의 헬스케어 목욕시스템 개발)

  • Kim, Hyung-Ji;Yu, Mi;Jin, Hea-Ryen;Kwon, Tae-Kyu
    • Science of Emotion and Sensibility
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    • v.13 no.2
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    • pp.309-316
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    • 2010
  • This paper proposes healthcare bathing system for improving the multisensory function and not washing. We designed various types of bathtub for developing bathing system. This system consists of whirlpool bathtub for multisensory stimulation, a cover of bathtub with visual-auditory stimulation function, a small size PC for main control, touch panel, digital multimedia broadcasting (DMB), color-changeable LED mood lighting system for improving visual sensibility and speaker. We investigate the effects on autonomic nervous system during bathing with healthcare bathing system for improving the multisensory functions. To analysis physiological parameter, body temperature, blood pressure, intraocular pressure and heart rate variability (HRV) were measured before, during and after bath using healthcare bathing system. Experiments were performed on partial immersion bath and the water temperature was kept $39{\pm}0.5^{\circ}C$. The body temperature and the heart rate variability of the subject were measured every 5 minutes before, during, and after the bath. In analysis of HRV, the parasympathetic nerve increased from starting bath and decreased after 15 minutes. So the subjects felt comfortable at 15 minutes after starting bath. Blood pressure decreased to 16mmHg maximumly however pulse increased. Bath using healthcare bathing system for improving the multisensory functions affects positively the circulation of the blood. From this results, it leaves something to be desired in evaluation of serviceability and physiological analysis using the healthcare bathing system, however, we expect to analyze more clearly the relationship between the serviceability of product, physiological change and sensibility by various physiological parameters.

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A study on Hand Injury in Industrial Complex Workers (공단 근로자의 수부 손상에 관한 연구)

  • Kim, Soo-Min;Gu, Kyung-Sook;Lee, Geun-Hee;Kang, Ho-Hyun;Hyung, In-Han;Sung, Kwang-Jun
    • Journal of Korean Physical Therapy Science
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    • v.6 no.1
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    • pp.905-913
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    • 1999
  • The hand is a part of the body which has various functions and a sophisticated structures bone, Joint, tendon, ligament and logical nerve organ are aggregated densely in the hand of anatomy its functions are delicate. The hand's functions are very important for doing ADL and a worker's As the hand is structure which is used often and commonly it is a site that can be easily damaged by a accident on work. This study was investigated and analyzed by the results from 238 workers who had hand injury and physical therapy from January, 1997 to June, 1998 at Shin-Pung, Jang-Lim industrial complex which is located in Pusan. 1. A hand injury most frequertly happened in worker in their 30's and 20's(66 case, 28%), second was 57 case(24%) their 40's. 2. Among workers suffering from injury, who had one or less than 2 years on the job, a injury most frequently occurred. 3. Scale of workers, A injury most frequently happend in a place where had workers from 10 to 50. 99 workers from that place were 42% of total. 4. Month of occurrence rate in March were the highest compared to other months 40 injury workers in march were 17% of the total. Second was July, and the least was April that injury appeared with 10 workers. (4.2% of the total) 1. Frocture was the most common lesion 82 workers had that lesion(34%) soft tissue rupture was 71 workers who were 30% of total in type of lesion. 2. Of the site of lesion multiple case was the most common in which 57 workers had that lesion it were 24% of the total. The next was the index finger site in which 44 workers were 19% of the total. The index finger was the most common mono-site that can be lesion 36 workers were the middle finger lesion workers who were 15% of the total. Of the joint lesion, PIP was the most in which 76 workers were 44% and in MC 27 workers were 15% of the total. 3. Interval of physical therapy 79 workers from one month to 2 months, was 33% of the total and 174 workers who had therapy below 3 months were 71% 4. Post injury of disablity of the site, phalangeous disability was the most in which 148 workers had that injury and they were 62% of the total of the grade of disability 110 workers who were 46% of the total state from less than 25% disability in hand-function and 59 patients who were 25% had no disability. There were 6 workers (3% of the total) who had over -75%-dibability in the hand-function.

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A Case of Pulmonary Sarcoidosis Combined with Neurosarcoidosis (신경유육종증이 병발한 폐유육종증 1예)

  • Park, Byung Hoon;Park, Seon Cheol;Shin, Sang Yun;Jeon, Han Ho;Jung, Kyung Soo;Chung, Woo Young;Byun, Min Kwang;Moon, Ji Ae;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.549-553
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    • 2007
  • Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

The Effect of Herbal Formula KH-305 on Erectile Dysfunction in Hyperlipidemic Rat (고지혈증 흰쥐에서 발기부전에 대한 생약제제 KH-305의 효과)

  • Lee, Eun-Jeong;Kim, Hee-Seok;Kim, Byoung-Chul;Hwang, Sung-Wan;Hwang, Sung-Yeoun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.5
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    • pp.548-553
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    • 2007
  • This study was designed to investigate effects of KH-305 on erectile dysfunction in hyperlipidemic rat. KH-305 has been evaluated for antihyperlipidemic and antierectile dysfunction effects on experimental hyperlipidemic rats induced by high cholesterol-diet. After oral administration of KH-305 water extract (50, 100, 200, 300 mg/kg) to hyperlipidemic rats for 8 weeks, the variables including body weight, total cholesterol, HDL-, and LDL-cholesterol levels in serum, the expression of eNOS and nNOS in penis were measured. Also, erectile function was determined by the measurements of intracavernosal pressure (ICP) and maximal arterial pressure (MAP) after electrical stimulation of the cavernosal nerve. Oral administration of KH-305 extracts significantly inhibited the increase of serum total cholesterol and LDL-cholesterol levels and the decrease of serum HDL-cholesterol level in hyperlipidemic rats induced by high fat diet. The penile expression level of the two enzymes (eNOS, nNOS) were increased significantly after oral administration of the KH-305 extracts. Erectile function after 10 volts stimulation was significantly decreased in the hyperlipidemic rat compared with the normal rat, but increased in KH-305 group compared with hyperlipidemic group. These results suggest that KH-305 is effective for erectile dysfunction in hyperipidemia.

Study of the possible mode of action of O-ethyl S-methyl ethylphosphonothioate via the formation of S-oxide in chemical and metabolic oxidation systems (화학적, 대사적 산화반응 중 생성되는 S-oxide를 이용한 O-ethyl S-methyl ethylphosphonothioate (1) 의 독성 기작에 관한 연구)

  • Hur, J.H.;Fukuto, T.R.;Han, D.S.
    • Korean Journal of Environmental Agriculture
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    • v.10 no.2
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    • pp.167-177
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    • 1991
  • O-ethyl S-methyl ethylphosphonothioate [$LD_{50}$ (rat, oral) 4.6mg/kg ; $K_i$(bovine erythrocyte acetylcholinesterase) 303 $M^{-1\;min-1}$] was selected as a model compound to study the mode of action of O, S-dialkyl alkylphosphonothioates which have been hypothesized to be toxic via a bioactivation process. Two chemical oxidants, meta-chloroperoxybenzoic acid and monoperoxyphthalic acid, and rat liver microsomal oxidases were used to mimic the action of mixed function oxidases on the model compound. The formation of S-oxide, a very unstable active intermediate, was proposed based on the identification of metabolic products.Furthermore, a trapping experiment with ethanol showed that the unstable intermediate S-oxide had the ability to phosphorylate acetylcholinesterase which is an important enzyme in nerve systems. The S-oxide intermediates are presumed to be responsible for the toxicity of O,S-dialkyl alkylphosphonothioates.

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Evaluation of Autonomic Function in Patients with Head-Hyperhidrosis by Power Spectral Analysis of Heart Rate Variability (심박변이도 측정을 통한 두한증(頭汗證) 환자의 자율신경계 기능 평가)

  • Lee, Kun-Young;Hwang, Joon-Ho;Lee, Sung-Hun;Jeong, Seung-Yeon;Rhee, Hyung-Koo;Jung, Sung-Ki;Jung, Hee-Jae
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.822-826
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    • 2006
  • Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system, especiallythe sympathetic system. This study was designed to investigate the autonomic nerve system in patients with essential hyperhidrosis and healthy controls by the frequency domain analysis of heart rate variability (HRV). Methods : 17 head-hyperhidrosis patients in the ambulatory care were investigated. All were inspected at the first medical examination. using the PSA of HRV. HRV was measured for minutes after 5 minutes bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then we compared the values of patients with means of normal Korean subjects. Results : The values of natural logarithmic measure of HRV (LnTP, LnHF, LnLF, LnVLF) of patients With head-hyperhidrosis we examined were $6.85{\pm}1.61$, $4.93{\pm}$2.00, $5.40{\pm}1.83$, and $6.13{\pm}1.37$, respectively. None of these values were higher than means of normal subjects. Conclusions : This study suggests that the function of the autonomic nervous system does not increase in patients with head-hyperhidrosis.

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Study on maintaining healthy body and changes of human body by circadian rhythm (인체(人體)의 일주리듬에 따른 변화(變化)와 건강법(健康法)에 관한 연구(硏究))

  • Jeong, Sang Jee;Kang, Jung Soo
    • Journal of Haehwa Medicine
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    • v.12 no.1
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    • pp.103-121
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    • 2003
  • Human being can't live without nature, then the changes of nature affect human body. It means that human body has corresponding changes to the KI(vital energy) of nature. There is a stream of changes in human body which circulate mysteriously and punctually by the laws of nature. If this stream of changes fits into human's life style, it would be most effective. It has a certain mode continuously. So if a person has a habit fitting into it, he will get the healthiest body. Then the researcher tries to explain the changes in human body by the time, mainly focused on within 24 hours. it is showing not only the oriental view, but also the western's. The researcher can find the coincidence as followings. At In-Si(3-5 am), the body function and the body temperature get to the bottom, therefore it's good for him to wake up and to run the vital energy. At Sa-Si(9-11 am), the patience on pain anxiety and the psychic concentration get to the top, he'd better start the work. At O-Si(11am-1pm), the heart energy has a vital move, then the blood concentration of Hb(hemoglobin) gets to the top. At Mi-Si(1-3 pm), the muscle strength, the squeeze, and the breathing rate increase. The reflex nerve sensitivity gets to the top. Creativity, observation, and working efficiency go high, so it's time to work hard. At Hae-Si(9pm-1am), the body function falls, sleeping is needed. At Chuck-Si(1-3 am), the cell spontaneity gets to the top, immune lymphocyte moves actively, and the blood concentration of growth hormone gets to the top. These are liver's work. In west, there has been active studies on how to reduce the side effect by using a person's bio-rhythm based on the 'time treatment', and how to reorganize the bio-rhythm by using the machine and the age resistance based on the 'bio-watch'. Though the 'time treatment' means something, the artificial resistance on bio-rhythm seems to give bad effects to human body. If a person lives by regimen of oriental medicine, he will maintain the healthiest body. Regimen is that human body follows the laws of nature, and moves its mysterious, Punctual and periodical changes.

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Respiratory Assist by Use of Electrical Diaphragmatic Pacing (전기자극에 의한 횡격막 조율을 이용한 호흡보조장치)

  • 오중환;김은기;서재정;박일환;김부연;이상헌;이종국;이영희
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.441-446
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    • 2001
  • Background: Electrical breathing pacing has many advantages over mechanical ventilation. However, clinically permanent diaphragmatic pacing has been applied to limited patients and few temporary pacing has been reported. Our purpose is to investigate the feasibility of temporary electrical diaphragm pacing in explothoracotomy canine cases. Methods: Five dogs were studied under the general anesthesia. Left 5th intercostal space was opened. Self designed temporary pacing leads were placed around the left phrenic nerve and connected to the myostimulator. Chest wall was closed after tube insertion with underwater drainage. Millar catheter was introduced to the aorta and right atrium. Swan-Ganz catheter was introduced to the pulmonary artery. When the self respiration was shallow with deep anesthesia, hemodynamic and tidal volume were measured with the stimulator on. Results: Tidal volume increased from 143.3$\pm$51.3 ml to 272.3$\pm$87.4 ml(p=0.004). Right atrial diastolic pressure decreased from 0.7$\pm$4.0 mmHg to -10.5$\pm$4.7 mmHg(p=0.005). Pulmonary arterial diastolic pressure decreased from 6.1+2.5 mmHg to 1.2$\pm$4.8 mmHg(p<0.001). The height of water level in chest tube to show intrathoracic pressure change was from 10.3$\pm$6.7cmH$_{2}$O to 20.0$\pm$5.3 cmH$_{2}$O. Conclusion: Temporary electrical diaphragmatic pacing is a simple method to assist respiration in explothoracotomy canine cases. Self designed pacing lead is implantable and removable. Negative pressure ventilation has favorable effects on the circulatory system. Therefore, clinical application of temporary breathing pacing is feasible in thoracotomy patients to assist cardiorespiratory function.

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