• Title/Summary/Keyword: Peripheral Nervous System

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A Study on the Functional Electrical Stimulation (기능적 전기 자극에 대한 고찰)

  • Lim, Jong-Soo;Kim, Soon-Hee;Song, Young-Wha
    • Journal of Korean Physical Therapy Science
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    • v.6 no.4
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    • pp.187-199
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    • 1999
  • Functional Electrical Stimulation (FES) is used for muscle reeducation, reduction of spasticity, delay of atrophy, and muscle strengthening. FES stronger stimulation than other forms of electrical stimulation. The efficacy of FES in improving function has been substantiated in the literature. Treatment programs employing FES - activation of muscular tissue through the intact peripheral nervous system - can be broken into five major categories, according to the goal of treatment. These broad areas would include the use of FES to: (1) a direct excitation onto the alpha motoneuron, through peripheral stimulation of the Ia myotatic sensory system and ascending afferent information, which will be integrated at conscious and subconscious level of the CNS. (2) The quality of a stimulated muscle contraction is determined by combination of many parameters, including stimulus amplitude, pulse duration, stimulus frequency, and duty cycle. (3) A unit that has a pulse duration between 200 and $400{\mu}sec$ will be more than adequate for FES applications. (4) The neuromuscular plasticity is critically important to return of function using muscle re-education and facilitation applications. (5) Prior to using FES as an electrical orthosis, the patient should build up endurance in the muscles to be stimu1ated during the gait cycle.

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Involvement of Selective Alpha-2 Adrenoreceptor in Sympathetically Maintained Pain

  • Park, Chan-Hong;Yong, An;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.420-423
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    • 2010
  • Objective : Peripheral nerve injury often leads to neuropathic pain, which is characterized by burning pain, allodynia, and hyperalgesia. The role of the sympathetic nervous system in neuropathic pain is a complex and controversial issue. It is generally accepted that the alpha adrenoreceptor (AR) in sympathetic nerve system plays a significant role in the maintenance of pain. Among alpha adrenoreceptor, alpha-1 receptors play a major role in the sympathetic mediated pain. The primary goal of this study is to test the hypothesis that sympathetically maintained pain involves peripheral alpha-2 receptors in human. Methods : The study was a randomized, prospective, double-blinded, crossover study involving twenty patients. The treatments were : Yohimbine (30 mg mixed in 500 mL normal saline), and Phentolamine (1 mg/kg in 500 mL normal saline) in 500 mL normal saline at 70 mL/hr initially then titrated. The patients underwent infusions on three different appointments, at least one month apart. Thus, all patients received all 2 treatments. Pain measurement was by visual analogue scale, neuropathic pain questionnaire, and McGill pain questionnaire. Results : There were significant decreases in the visual analogue scale, neuropathic score, McGill pain score of yohimnine, and phentolamine. Conclusion : We conclude that alpha-2 adrenoreceptor, along with alpha-2 adrenoreceptor, may be play role in sympathetically maintained pain in human.

Sciatic nerve neurolymphomatosis as the initial presentation of primary diffuse large B-cell lymphoma: a rare cause of leg weakness

  • Kim, Kyoung Tae;Kim, Se Il;Do, Young Rok;Jung, Hye Ra;Cho, Jang Hyuk
    • Journal of Yeungnam Medical Science
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    • v.38 no.3
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    • pp.258-263
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    • 2021
  • Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.

Clinical Study of Oriental Medical Treatment on a Patient with Alcoholic Polyneuropathy (알코올성 다발성 신경병증의 한방치료 효과)

  • Yeom, Seung Ryong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.797-802
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    • 2012
  • Alcoholic polyneuropathy is a disorder of the peripheral nervous system that interferes with sensory, motor, and autonomic nerve function. This study was to report the effect of Oriental medical treatment on a patient with alcoholic polyneuropathy. Conservative Oriental medical treatment was done to a man of 84 years who was diagnosed as a alcoholic polyneuropathy and suffered from both distal dominant leg weakness & symmetrical paresthesia and ataxic gait. The changes of symptoms, reflexes and sensory test were checked by Toronto Clinical Neuropathy Scoring System(TCNSS). Reflexes, motor and sensory impairments were improved after the Oriental medical treatment. I reported good effects of Oriental medical treatment on alcoholic polyneuropathy. Oriental medical treatment can be helpful to improve the symptoms of alcoholic polyneuropathy.

Analysis and 3D Reconstruction of a Cerebral Vascular Network Using Image Threshold Techniques in High-resolution Images of the Mouse Brain (쥐 뇌의 고해상도 이미지에서 임계화 기법을 활용한 뇌혈관 네트워크 분석 및 3D 재현)

  • Lee, Junseok
    • Journal of Korea Multimedia Society
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    • v.22 no.9
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    • pp.992-999
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    • 2019
  • In this paper, I lay the foundation for creating a multiscale atlas that characterizes cerebrovasculature structural changes across the entire brain of a mouse in the Knife-Edge Scanning Microscopy dataset. The geometric reconstruction of the vascular filaments embedded in the volume imaging dataset provides the ability to distinguish cerebral vessels by diameter and other morphological properties across the whole mouse brain. This paper presents a means for studying local variations in the small vascular morphology that have a significant impact on the peripheral nervous system in other cerebral areas, as well as the robust and vulnerable side of the cerebrovasculature system across the large blood vessels. I expect that this foundation will prove invaluable towards data-driven, quantitative investigations into the system-level architectural layout of the cerebrovasculature and surrounding cerebral microstructures.

Properties of the Measures to Assess Oxaliplatin-induced Peripheral Neuropathy: A Literature Review (옥살리플라틴 유도 말초신경독성 측정도구의 고찰)

  • Chu, Sang Hui;Lee, Yoon Ju;Lee, Young Joo;Cleeland, Charles S.
    • Journal of Korean Academy of Nursing
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    • v.45 no.6
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    • pp.783-801
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    • 2015
  • Purpose: The purpose of this study is to provide a comprehensive overview of the various measures available for assessment of oxaliplatin-induced peripheral neuropathy (OXLIPN) and to evaluate the measurement properties of each assessment tool. Methods: A systematic review was conducted to identify existing measures for OXLIPN found in the databases of PubMed, Cochrane Library, Embase, RISS and KoreaMed. The quality of the 24 identified tools was evaluated based on their properties of measurement including content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor-ceiling effects and interpretability. Results: Ten (41.7%) of the 24 tools were identified as specific measures for assessing OXLIPN and the most popular type of measures were clinical grading systems by clinicians (58.3%) and only 29.2% of measures were identified as patient reported outcomes. The most frequently used tool was National Cancer Institute-Common Toxicity Criteria (NCI-CTC), but the validity of NCI-CTC has not been reported appropriately. Overall, the Neuropathic Pain Symptom Inventory (NPSI) received the best psychometric scores, and the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-neurotoxicity-12 (FACT/GOG-Ntx-12) followed NPSI. Conclusion: To select appropriate measure, evidences should be accumulated through the clinical use of tools. Therefore, practitioner and researchers are urged to report relevant statistics required for the validation of the currently used measures for assessment of OXLIPN.

Clinical Observation on Heart Rate Variability and Peripheral Blood Flow by Doppler Ultrasound in Healthy Subjects Stimulated by Cold Stress (정상인의 한냉자극에 대한 심박변이도 및 도플러 초음파 혈류계를 이용한 말초 혈류관찰)

  • Lim, Sung-Keun;Lee, Sang-Hoon;Bae, Young-Min
    • The Journal of Korean Medicine
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    • v.31 no.2
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    • pp.114-123
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    • 2010
  • Objectives: This study was performed to investigate the effect of cold stress on heart rate variability and peripheral blood flow by Doppler ultrasound in healthy subjects. Methods: We classified the subjects by their Yin or Yang tendency using a Yin-Yang questionnaire. Cold stress was taken on the left hand of subjects for 10 seconds. Heart rate variability and peripheral blood flow were measured on the right radial artery before and after cold stress. Results: The Yang tendency group showed a significant decrease of heart rate after cold stress which was not seen in the Yin tendency group. The Yang tendency group showed a decrease of LF, total power, and increase of HF after cold stress, while the Yin tendency group showed the opposite. However, there were no statistically significant differences of heart rate variability analysis between the results of the two groups before and after cold stress. Recovery time of blood flow velocity by ultrasound Doppler was significantly different between the Yin and Yang tendency groups after cold stress. Conclusion: These results suggest that people with Yin or Yang tendency may show different responses in the autonomic nervous system. Further modified studies may include the responses to various manipulation techniques in acupuncture treatment and the individual responses according to pattern identification in traditional Korean medicine.

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

Effect of Electrical Stimulation of Peripheral Nerve on Pain Reaction (말초신경자극이 동통반응에 미치는 영향)

  • Paik, Kwang-Se;Chung, Jin-Mo;Nam, Taick-Sang;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.15 no.2
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    • pp.73-81
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    • 1981
  • Experiments were conducted in ischemic decerebrate cats to study the effects of electroacupuncture and electrical stimulation of peripheral nerve on pain reaction. Flexion reflex was used as an index of pain. The reflex was elicited by stimulating the sural nerve(20 V, 0.5 msec duration) and recorded as a compound action potential from the nerve innervated to the semitendinosus muscle. Electroacupuncture was performed, using a 23-gauge hyperdermic needle, on the tsusanli point in the lateral upper tibia of the ipsilateral hindlimb. The common peroneal nerve was selected as a peripheral nerve which may be associated with electroacupuncture action, as it runs through the tissue portion under the tsusanli point. Both for electroacupuncture and the stimulation of common peroneal nerve a stimulus of 20 V-intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min. The results are summerized as follows: 1) The electroacupuncture markedly depressed the flexion reflex; this effect was eliminated by systemic application of naloxone $(0.02{\sim}0.12\;mg/kg)$, a specific narcotic antagonist. 2) Similarly, the electrical stimulation of the common peroneal nerve significantly depressed the flexion reflex, the effect being reversed by naloxone. 3) When most of the afferent nerves excluding sural nerve in the ipsilateral hindlimb were cut, the effect of electroacupuncture on the flexion reflex was not observed. Whereas direct stimulation of the common peroneal nerve at the proximal end from the cut resulted in a significant reduction of the flexion reflex, again the effect was reversible by naloxone application. 4) Transection of the spinal cord at the thoracic 12 did not eliminate the effect of peripheral nerve stimulation on the flexion reflex and its reversal by naloxone, although the effect was significantly less than that in the animal with spinal cord intact. These results suggest that: 1) the analgesic effect of an electroacupuncture is directly mediated by the nervous system and involves morphine-like substances in CNS, 2) the site of analgesic action of electroacupuncture resides mainly in the brainstem and in part in the spinal cord.

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The Therapeutic Efficacy of Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 유발 말초신경병증에 대한 침치료의 효과 : 체계적 문헌고찰 및 메타 분석)

  • Kim, Eun Hye;Yoon, Jee-Hyun;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.350-361
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    • 2020
  • Objective: This study aimed to report the therapeutic effect of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The articles were sourced from databases including PubMed, EMBASE, Cochrane Library, CNKI, CiNii, WHO ICTRP, JSOM, KMBASE, KISS, NDSL, and OASIS as of July 2019. The main search keywords were peripheral neuropathy and acupuncture, and only randomized controlled trials using acupuncture for therapeutic purposes were included. Cochrane's risk of bias was used to assess the risk of bias, and the Review Manager 5.3 program was used for meta-analysis. Results: Six studies with a total 394 participants were included. When combined treatment of acupuncture and usual care was compared with usual care alone, quality of life improved more significantly in the combination treatment group (SMD=-2.71, 95% CI: -5.01 to -0.41, P=0.02, I2=97%). The CIPN pain score was lower among the combination treatment group, but not to a significant degree (SMD=-2.55, 95% CI: -5.14 to 0.04, P<0.05, I2=98%). There were no severe side effects in any studies. Conclusion: Acupuncture combined with usual care may be considered to safely relieve CIPN pain and improve quality of life for cancer patients. However, as there are few randomized controlled trials studying the effect of acupuncture on CIPN, further well-designed research is needed.