• Title/Summary/Keyword: Nerve stimulation

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Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Cho, Soo-Ho;Jang, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.22-26
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    • 2007
  • Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

Inhibitory Modulation of 5-Hydroxytryptamine on Corticostriatal Synaptic Transmission in Rat Brain Slice

  • Choi, Se-Joon;Chung, Won-Soon;Kim, Ki-Jung;Sung, Ki-Wug
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.6
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    • pp.295-301
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    • 2003
  • Striatum plays a crucial role in the movement control and habitual learning. It receives an information from wide area of cerebral cortex as well as an extensive serotonergic (5-hydroxytryptamine, 5-HT) input from raphe nuclei. In the present study, the effects of 5-HT to modulate synaptic transmission were studied in the rat corticostriatal brain slice using in vitro extracellular recording technique. Synaptic responses were evoked by stimulation of cortical glutamatergic inputs on the corpus callosum and recorded in the dorsal striatum. 5-HT reversibly inhibited coticostriatal glutamatergic synaptic transmission in a dose-dependent fashion (5, 10, 50, and $10{\mu}M$), maximally reducing in the corticostriatal population spike (PS) amplitude to $40.1{\pm}5.0$% at a concentration of $50{\mu}M$ 5-HT. PSs mediated by non-NMDA glutamate receptors, which were isolated by bath application of the NMDA receptor antagonist, d,l-2-amino-5-phospohonovaleric acid (AP-V), were decreased by application of $50{\mu}M$ 5-HT. However, PSs mediated by NMDA receptors, that were activated by application of zero $Mg^{2+}$ aCSF, were not significantly affected by $50{\mu}M$ 5-HT. To test whether the corticostriatal synaptic inhibitions by 5-HT might involve a change in the probability of neurotransmitter release from presynaptic nerve terminals, we measured the paired-pulse ratio (PPR) evoked by 2 identical pulses (50 ms interpulse interval), and found that PPR was increased ($33.4{\pm}5.2$%) by 5-HT, reflecting decreased neurotransmitter releasing probability. These results suggest that 5-HT may decrease neurotransmitter release probability of glutamatergic corticostriatal synapse and may be able to selectively decrease non-NMDA glutamate receptor-mediated synaptic transmission.

Seizure Control in Patients with Extratemporal Lobe Epilepsy

  • Park, Seung-Soo;Koh, Eun-Jeong;Oh, Young-Min;Lee, Woo-Jong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.283-290
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    • 2007
  • Objective : This study was designed to analyze seizure outcome and to investigate the prognostic factors for predicting seizure outcome according to the preoperative evaluations, surgical procedures, topectomy sites and histopathological findings in patients with extratemporal lobe epilepsy [ETLE]. Methods : This study comprised 63 patients with ETLE who underwent surgery. Preoperative evaluations included semiologic analysis, chronic video-EEG monitoring, and neuroimaging studies. Surgical procedures consisted of topectomy in 51 patients, corpus callosotomy in 9, functional hemispherectomy in 2, and vagus nerve stimulation [VNS] in 1. Histopathological findings were reviewed. Postoperative seizure outcomes were assessed by Engel's classification at the average follow up period of 66.8 months. Chi-square test was used for statistics. Results : Total postoperative seizure outcomes were class I in 51 [80%] patients, class II in 6 [10%], class III in 6 [10%]. Patients with structural abnormalities on neuroimaging study showed class I in 49 [88%] patients [p<0.05]. Patients with focal and regional ictal EEG onset revealed class I in 47 [90%] patients [p<0.05]. Semiologic findings, surgical procedures, topectomy sites and histopathological findings did not show statistical correlation with seizure outcome [p<0.05]. Conclusion : A good seizure outcome was obtained in patients with ETLE. The factors for favorable seizure outcome are related to the presence of structural abnormalities on neuroimaging study, and focal and regional ictal EEG onset.

Suppression of Peripheral Sympathetic Activity Underlies Protease-Activated Receptor 2-Mediated Hypotension

  • Kim, Young-Hwan;Ahn, Duck-Sun;Joeng, Ji-Hyun;Chung, Seungsoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.489-495
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    • 2014
  • Protease-activated receptor (PAR)-2 is expressed in endothelial cells and vascular smooth muscle cells. It plays a crucial role in regulating blood pressure via the modulation of peripheral vascular tone. Although some reports have suggested involvement of a neurogenic mechanism in PAR-2-induced hypotension, the accurate mechanism remains to be elucidated. To examine this possibility, we investigated the effect of PAR-2 activation on smooth muscle contraction evoked by electrical field stimulation (EFS) in the superior mesenteric artery. In the present study, PAR-2 agonists suppressed neurogenic contractions evoked by EFS in endothelium-denuded superior mesenteric arterial strips but did not affect contraction elicited by the external application of noradrenaline (NA). However, thrombin, a potent PAR-1 agonist, had no effect on EFS-evoked contraction. Additionally, ${\omega}$-conotoxin GVIA (CgTx), a selective N-type $Ca^{2+}$ channel ($I_{Ca-N}$) blocker, significantly inhibited EFS-evoked contraction, and this blockade almost completely occluded the suppression of EFS-evoked contraction by PAR-2 agonists. Finally, PAR-2 agonists suppressed the EFS-evoked overflow of NA in endothelium-denuded rat superior mesenteric arterial strips and this suppression was nearly completely occluded by ${\omega}$-CgTx. These results suggest that activation of PAR-2 may suppress peripheral sympathetic outflow by modulating activity of $I_{Ca-N}$ which are located in peripheral sympathetic nerve terminals, which results in PAR-2-induced hypotension.

Restoration of Blink Function in the Paralyzed Rabbit Using Electroactive Polymer (안면신경마비 동물모델에서 전기활성고분자를 이용한 눈 깜박임 기능의 회복)

  • Kwon, Seong-Keun;Sung, Myung-Whun;Kim, Kwang-Hyun;Kim, Hee-Chan
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.19-25
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    • 2006
  • There have been numerous modalities to recover blink function of orbicularis oculi muscle in patients with facial paralysis. However, there is still no optimal method for reanimation of eyelid. In this study, we tried to recover blink function of paralyzed rabbit's eyelid with the ion polymer metal composite (IPMC) which is one of the electroactive polymers that is spotlighted as artificial muscle. We manufactured IPMC by plating the platinum over perfluorosulphonic acid polymer ($Nafion^{(R)}$). IPMC was coated by Norland optical adhesive for the purpose of insulation and keeping it from dry. IPMC modifications by roughening the surface of Nafion, repetitive plating (maximum 4 times) with platinum, and lengthening the width of IPMC were done. The facial paralysis was induced in the rabbit by sectioning of facial nerve at the main trunk. After minimum period of 4 weeks, IPMC was inserted in the paralyzed rabbit's eyelid. By modification, the force generated by IPMC was enhanced. Restoration of blink function in paralyzed rabbit was achieved on electrical stimulation of the IPMC by 5 voltage direct current. IPMC can be promising option for facial reanimation, but further studies are needed to enhance the efficiency of IPMC.

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CsA Affects the Rat Submandibular Glands via Regulating the CypA Expression

  • Lee, Eun-Joo;Hong, Young-Gil;Yoo, Hong-Il;Yang, So-Young;Kang, Jee-Hae;Kim, Min-Seok;Kim, Sun-Hun
    • International Journal of Oral Biology
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    • v.37 no.4
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    • pp.153-159
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    • 2012
  • The effects of the an immunosuppressive drug cyclosporine A (CsA), on the salivary gland are largely unknown, even though clinical trials for the stimulation of salivation using CsA have been attempted. Cyclophilin A (CypA) is known to be a binding protein for CsA. CypA has cell proliferation and tissue matrix change activities. In our present study, the presence of CypA in the gland and effects of CsA on CypA expression were investigated by immunohistochemistry, immunoblotting and RT-PCR analyses. CypA was immunohistochemically detected in various kinds of ducts in the submandibular glands of Sprague Dawley rats. The CypA mRNA level was highest at postnatal day 1 and gradually decreased in a time-dependent manner up to adulthood. The expression of CypA increased after a 10 day subcutaneous administration of CsA in postnatal day 1 rats. Surgical sections of the chorda-lingual nerve with impaired salivation showed no changes in CypA expression. A cell proliferation assay using PCNA anti-serum showed increased cell division following CsA treatment. These results suggest that CsA and CypA may act on ductal cells to regulate saliva composition rather than salivation levels.

The Effect of Joint Mobilization with Electrotherapy interventions on External Rotation and Pain in Mastectomy Patients (유방암 절제술 환자의 관절가동술과 전기자극을 융합한 중재가 어깨 가쪽돌림과 통증에 미치는 영향)

  • Kim, Tae-Hyun;Cho, Kyun-Hee;Park, Shin-Jun
    • Journal of Convergence for Information Technology
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    • v.10 no.5
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    • pp.188-197
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    • 2020
  • This study was to investigate the effects of joint mobilization with two different electrotherapy methods on shoulder external rotation range of motion and pain in mastectomy patients. Thirty mastectomy patients were divided into STMG (joint mobilization+pain scrambler therapy, n=15) and TENMG (joint mobilization+transcutaneous electrical nerve stimulation, n=15). The measurements were performed shoulder external rotation range of motion (ROM), pain (VAS). In both groups, there was a significant difference in the shoulder external rotation ROM, pain after intervention (p <.05). STMG was more decrease in VAS score than TENMG (p <.05). There was no significant difference in shoulder external rotation ROM between the two groups. In order to decrease the pain of mastectomy patients, it was confirmed that STMG was more effective than TENMG.. It is thought that a control group is added to confirm various differences, and more subjects are needed.

An Immunohistochemical Study of Effects of Therapeutic Ultrasound on the Expression of VEGF and Substance-P in Muscle Contusion Injury (근타박상시 치료용 초음파가 혈관내피성장인자와 Substance-P 발현에 미치는 효과에 대한 면역조직화학적 연구)

  • Kim Yong-Su;Oh Jae-Young;Kim Souk-Boum
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.46-64
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    • 2003
  • Therapeutic angiogenesis is the controlled induction or stimulation of new blood vessel formation to reduce unfavourable tissue effects caused by local hypoxia and to enhance tissue repair. Therapeutic ultrasound can be considered as a physical agent to deliver therapeutic angiogenesis. The purpose of this study was to evaluate the effect of therapeutic ultrasound after muscle contusion injury by observed immunoreactivity of vascular endothelial growth factor(VEGF) that plays an important role in angiogenesis and substance-P in pain transmission. Ultrasound irradiation(1MHz, $1W/cm^2$, continuous mode, treatment time 5 min) was applied through water submersion technique to 1 limb daily by kept off 5cm from muscle belly of gastrocnemius. The result of this study were as follows. 1. In morphological observation, there were no significant changes excepts of 7 days. At 7 days, granular tissue viewed abundantly in control group. In other groups, general feature were increased interspace of muscle fiber; centronucleated muscle fiber; collapsed of muscle and nerve tissue; appeared inflammatory cell. 2. The VEGF was expressed in interspace of muscle fiber. Especially, at 7 days in experimental group, VEGF was showed in connective tissue surrounding gastrocnemius muscle. 3. The VEGF was higher expressed in experimental group at 2 and 3 days, but in control group at 7 days. These data suggest therapeutic ultrasound enhanced production of VEGF in the early day relatively, therefore stimulated angiogenesis in the skeletal muscle induced contusion injury. Also therapeutic ultrasound may stimulate pain relief by diminish of substance-P in dorsal horn of spinal cord.

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Alternative Input Lower Weight Information Method Error to Reduce Specific Absorption Rate in MRI (자기공명영상 검사 시 환자정보의 체중을 낮게 입력하여 전자파흡수율을 감소시키는 대안의 오류)

  • Choi, Kwan-Woo
    • The Journal of the Korea Contents Association
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    • v.20 no.2
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    • pp.472-477
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    • 2020
  • The purpose of this study is to correct the error of lower weight input method as an alternative to reduce the specific absorption rate(SAR) in MRI. In order to prove that the SAR values not change according to the weight entered into the patient information, the 50kg phantom is placed in the coil and the input weight is changed from 10 to 100 in 10kg units to compare the SAR values. As a result, T1-weighted images had a SAR rate of 0.2W/kg and T2-weighted images had an average of 0.4W/kg. In conclusions, the SAR does not change according to the weight input by the technician before the scan, a lower weight when inputting patient information cannot be an alternative to reduce the SAR.

The Effects of Electroacupuncture on Mechanical Allodynia and Its Involvement with the Sympathetic Nervous System (Tail model의 기계적 이질통에 대한 전침 자극의 효과 및 교감신경계의 관여기전)

  • Lee, Hyung-suk;Min, Byung-il;Hwang, Byung-gil;Park, Dong-suk;Lee, Soon-geul
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.177-190
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    • 2003
  • Objective : This study was intended to investigate the analgesic effects of electroacupuncture(EA) on mechanical allodynia according to the frequency and intensity of EA. Also to know if mechanical allodynia and the analgesic effects of EA is related to the sympathetci nervous system and/or the purinergic system. Methods : mechanical allodynia-induced rats were produced by resecting S1-S2 nerve. The zusanli(ST36) was used for acupoint and the rats were divided into 4 groups. Each group was given different stimuli[low frequency low intensity-EA(LFLI-EA), low frequency high intensity-EA(LFHI-EA), high frequency low intensity-EA(LFHI-EA), high frequency high intensity-EA(HFHI-EA)]. Futhermore, to make sympathectomy6-OHDA and phentolamine were administered intraperitonially and the concentration of norepinephrine(NE) were measured. As a ATP blocker, suramin was applied for this study. Results : Comparing to control group, each of the 4 groups(LFLI-EA, LFHI-EA, HFLI-EA, HFHI-EA) showed a significant reduction of response frequency of mechanical allodynia. LFHI-EA was more effective than that of LFLI-EA. The LFHI-EA group also had longer lasting effects from the stimulation than the other groups. Sympathectomy didn't show any reduction of response frequency of mechanical allodynia.(Each n=6, n=4). Nor did both sympathectomy and ATP block. The response frequency wasn't reduced by sympathectomy or by sympathectomy and ATP block, but was significantly reduced with LFHI-EA Conclusions : These results suggest that EA has a significant analgesic effect on mechanical allodynia which has no connection with NE and/or ATP.

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