• 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.

• Journal of Acupuncture Research
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• 제41권1호
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• pp.69-73
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• 2024

This study evaluated a case of trigeminal nerve stimulation during acupotomy at a site 5 pun left of GV16. The study participant was a 52-year-old male suffering from upper neck pain and numbness, which was managed by acupotomy at a site 5 pun left of GV16. During acupotomy, the patient experienced unexpected numbness and stiffness of the left zygomatic bone. This area corresponds to the distribution of the maxillary nerve, which is the second branch of the trigeminal nerve. After approximately one month, symptoms of numbness and stiffness disappeared without rendering medical treatment. These side effects are presumed to be associated with the trigeminocervical complex and stimulation of the trigeminal nucleus within the spinal cord. Thus, during the acupotomy of the upper neck, especially at GV16, the needles should be inserted slowly, and the patient's response should also be monitored.

• The Korean Journal of Physiology and Pharmacology
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• 제9권3호
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• pp.143-147
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• 2005

Following peripheral nerve injury, excessive nociceptive inputs result in diverse physiological alterations in the spinal cord substantia gelatinosa (SG), lamina II of the dorsal horn. Here, I report the alterations of excitatory or inhibitory transmission in the SG of a rat model for neuropathic pain ('spared nerve injury'). Results from whole-cell recordings of SG neurons show that the number of distinct primary afferent fibers, identified by graded intensity of stimulation, is increased at 2 weeks after spared nerve injury. In addition, short-term depression, recognized by paired-pulse ratio of excitatory postsynaptic currents, is significantly increased, indicating the increase of glutamate release probability at primary afferent terminals. The peripheral nerve injury also increases the amplitude, but not the frequency, of spontaneous inhibitory postsynaptic currents. These data support the hypothesis that peripheral nerve injury modifies spinal pain conduction and modulation systems to develop neuropathic pain.

• Journal of Chest Surgery
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• 제23권5호
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• pp.833-843
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• 1990

Vasomotor areas were identified by stimulating various sites of the medulla electrically in adult cats anesthetized with a-chloralose and their correlation with somatosympathetic pressor or depressor responses was investigated. Followings are the results obtained: 1. Pressor areas were found in the rostral ventrolateral, the caudal ventrolateral and the rostral dorsolateral medulla. 2. Separate depressor areas were found dorsal and ventral to the rostral ventrolateral pressor area. 3. Some areas showed biphasic responses: depressor responses to low frequency[1 \ulcorner2 Hz] and pressor responses to high frequency[20 \ulcorner100 Hz] stimulation 4. Lesions on the rostral ventrolateral pressor areas abolished the somatosympathetic pressor responses to the stimulation of peripheral afferent nerves, while the depressor responses remained. Lesions on the caudal ventrolateral pressor area affected neither the pressor nor depressor responses to the peripheral nerve stimulation. 5. Lesions on the depressor areas resulted in decreased depressor responses to the peripheral nerve stimulation, but to a lesser degree than that resulted from lesions on the pressor areas. 6. A microinjection of glutamate solution to the pressor area resulted in a prolonged pressor response, while glutamate injection to the depressor areas did not elicit depressor responses. From the above results, it is concluded that there are separate pressor and depressor areas in the rostral medulla of cats and each area plays a role in somatosympathetic pressor and depressor responses, respectively.

• Journal of Gastric Cancer
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• 제19권1호
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• pp.49-61
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• 2019

Purpose: The perigastric vagus nerve may play an important role in preserving function after gastrectomy, and intraoperative neurophysiologic tests might represent a feasible method of evaluating the vagus nerve. The purpose of this study is to assess the feasibility of neurophysiologic evaluations of the function and viability of perigastric vagus nerve branches during gastrectomy. Materials and Methods: Thirteen patients (1 open total gastrectomy, 1 laparoscopic total gastrectomy, and 11 laparoscopic distal gastrectomy) were prospectively enrolled. The hepatic and celiac branches of the vagus nerve were exposed, and grabbing type stimulation electrodes were applied as follows: 10-30 mA intensity, 4 trains, $1,000{\mu}s/train$, and $5{\times}$frequency. Visible myocontractile movement and electrical signals were monitored via needle probes before and after gastrectomy. Gastrointestinal symptoms were evaluated preoperatively and postoperatively at 3 weeks and 3 months, respectively. Results: Responses were observed after stimulating the celiac branch in 10, 9, 10, and 6 patients in the antrum, pylorus, duodenum, and proximal jejunum, respectively. Ten patients responded to hepatic branch stimulation at the duodenum. After vagus-preserving distal gastrectomy, 2 patients lost responses to the celiac branch at the duodenum and jejunum (1 each), and 1 patient lost response to the hepatic branch at the duodenum. Significant procedure-related complications and meaningful postoperative diarrhea were not observed. Conclusions: Intraoperative neurophysiologic testing seems to be a feasible methodology for monitoring the perigastric vagus nerves. Innervation of the duodenum via the celiac branch and postoperative preservation of the function of the vagus nerves were confirmed in most patients.

• The Korean Journal of Pain
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• 제14권1호
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• pp.123-125
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• 2001

A 50-year-old female patient developed severe right neck and upper extremity pain, hyperesthesia and allodynia during cervical epidural block. Her pain was diagnosed as neuropathic nature. She was treated with repeated stellate ganglion block (SGB) and electrical stimulation (EST). After 3 weeks of treatment, symptomatic relief was achieved, but a mild degree of hyperesthesia and motor weakness was remained. However, she refused all treatment. So treatment was stopped. In a follow-up done, 15 weeks after the nerve injury, she had recovered without complications.

• The Korean Journal of Pain
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• 제6권2호
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• pp.224-230
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• 1993

Most patients who have suffered from pain and muscle weakness on femoral nerve distributing area show no definite pathologic finding on X-ray or laboratory examinations. Therefore proper diagnosis is difficult to determine for the proper treatment of the symptoms. Based on my clinical experiences and anatomical studies, I have found most of these symptoms are a result of femoral nerve compression on trigger point of psoas major muscle. Accordingly, releasing the compression of femoral nerve by Laser stimulation and local anesthetic injection to the identified trigger point of psoas major muscle was found to be an effective treatment for femoral neuralgic pain.

• Medical Lasers
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• 제10권4호
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• pp.195-200
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• 2021

Evidence shows that nerve injury triggers mitochondrial dysfunction during axonal degeneration. Mitochondria play a pivotal role in axonal regeneration. Therefore, normalizing mitochondrial energy metabolism may represent an elective therapeutic strategy contributing to nerve recovery after damage. Photobiomodulation (PBM) induces a photobiological effect by stimulating mitochondrial activity. An increasing body of evidence demonstrates that PBM improves ATP generation and modulates many of the secondary mediators [reactive oxygen species (ROS), nitric oxide (NO), cyclic adenosine monophosphate (cAMP), and calcium ions (Ca²⁺)], which in turn activate multiple pathways involved in axonal regeneration.

• The Korean Journal of Pain
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• 제19권1호
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• pp.33-44
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• 2006

Background: Peripheral nerve injury leads to neuropathic pain, including mechanical hyperalgesia (MH). Nerve discharges produced by an injury to the primary afferents cause the release of glutamate from both central and peripheral terminals. While the role of centrally released glutamate in MH has been well studied, relatively little is known about its peripheral role. This study was carried out to determine if the peripherally conducting nerve impulses and peripheral glutamate receptors contribute to the generation of neuropathic pain. Methods: Rats that had previously received a left L5 dorsal rhizotomy were subjected to a spinal nerve lesion (SNL) or brief electrical stimulation (ES, 4 Hz pulses for 5 min) of the left L5 spinal nerve. The paw withdrawal threshold (PWT) to von Frey filaments was measured. The effects of an intraplantar (i.pl.) injection of a glutamate receptor (GluR) antagonist or agonist on the changes in the SNL- or ES-produced PWT was investigated. Results: SNL produced MH, as evidenced by decrease in the PWT, which lasted for more than 42 days. ES also produced MH lasting for 7 days. MK-801 (NMDAR antagonist), DL-AP3 (group-I mGluR antagonist), and APDC (group-II mGluR agonist) delayed the onset of MH when an i.pl. injection was given before SNL. The same application blocked the onset of ES-induced MH. NBQX (AMPA receptor antagonist) had no effect on either the SNL- or ES-induced onset of MH. When drugs were given after SNL or ES, MK-801 reversed the MH, whereas NBQX, DL-AP3, and APDC had no effect. Conclusions: Peripherally conducting impulses play an important role in the generation of neuropathic pain, which is mediated by the peripheral glutamate receptors.

• 한국산학기술학회논문지
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• 제16권3호
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• pp.2029-2037
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• 2015

본 연구의 목적은 척수분절레벨에 적용한 간섭전류의 자극수준에 따른 정상성인의 자율신경계에 미치는 영향을 알아보고자 하였다. 간섭전류는 T1-T4 분절에 접착식 패드전극을 2극 배치 후 20분간 전기자극하여, 전기자극 전과 후, 30분 후의 변화를 확인하였다. 연구대상은 광주시에 소재한 N대학교에 다니는 건강한 성인남녀 45명을 대상으로 감각자극수준은 100 bps, 10~12 mA, 운동자극수준은 5 bps, 45~50 mA, 유해자극수준은 100 bps, 80~90 mA으로 각각 15명씩 무작위 배치하여 연구를 수행하였으며 연구 결과는 다음과 같다. 각 집단의 교감신경활성도의 변화는 시간과 집단 간의 상호작용에 유의한 차이가 없었으나, 시간에 따라 유의한 변화를 보여주었다(p<.05). 사후 분석결과 전기자극 직후와 전기자극 후 30분에서 유의한 차이를 보여주었다(p<.05). 각 집단의 부교감신경활성도의 변화는 시간과 집단 간의 상호작용에 유의한 차이가 없었으나, 시간에 따라 유의한 변화를 보여주었다(p<.05). 사후 분석결과 전기자극 직후와 전기자극 후 30분에서 유의한 차이를 보여주었다(p<.05). 이상의 결과로 전기자극 수준은 특정목적과 상황에 따라 다양하게 적용되어야 할 것으로 생각된다.