Objective: We report a case of a 73-year-old Korean male with vertigo and nausea, both of which were brought about by head repositioning. The condition was diagnosed as benign paroxysmal positional vertigo (BPPV).Method: The patient was treated with acupuncture, electroacupuncture, cupping, transcutaneous electrical nerve stimulation (TENS), and herbal medicine (Bosimsahwacheonggan-tang [補心瀉火淸肝湯]). We conducted the vertigo symptoms scale (VSS) and the dizziness handicap inventory (DHI) to evaluate the degree of the patient’s symptoms.Results: Vertigo and nausea started to improve after the administration of Bosimsahwacheonggan-tang, but although the patient took the anti-vertigo medication and a tranquilizer after the symptoms became aggravated, no prominent improvements could be observed.Conclusion: These results suggest that traditional Korean medical treatment may be effective in treating peripheral vertigo due to BPPV.
It is well established that neurons in ventrolateral medulla play a key role in determining the vasomotor tone. The purpose of present study is to identify sympathetic related, medullospinal tract neurons in ventrolateral medulla and to show that these mediate somato-sympathetic reflex. Medullospinal tract cells were identified by antidromic stimulation to intermediolateral nucleus (IML) of the second thoracic ($T_2$) spinal cord in anesthetized cats. Peripheral nerves were stimulated for orthodromic activation of these cells and peripheral receptive fields were determined. Post R wave histogram of unit and spike triggered averaging of sympathetic nerve discharge (SND) were used to define sympathetic related cell. A total of 113 neurons was recorded in ventrolateral medulla that had the axonal projections to $T_2$ spinal cord. Thirty four of these medullospinal cells showed spontaneous discharges and the others not. Between these two groups, rostro-caudal coordinate of the distribution from obex [$4.7{\pm}0.2\;$ (mean S.E.) mm, 4.1 0.1 mm], depth from dorsal surface ($5.5{\pm}0.2mm,\;4.9{\pm}0.1mm$ and conduction velocity ($9.9{\pm}1.7m/sec,\;16.7{\pm}1.9\;m/sec$) were significantly different (p<0.05). In spontaneously discharging group, characteristics of rostral and caudal groups were significantly different and we demonstrated that cells in rostral group mediate somatosympathetic reflex. From these results, we conclude that a certain portion of spontaneously discharging medullospinal tract cells in rostral ventrolateral medulla comprise the efferent outputs of somatosympathetic reflex to sympathetic preganglion neurons.
Explant culture condition of dorsal root ganglion have been used to investigate the pathophysiology of peripheral nerve injury, while applying for the various clinical symptom such as trauma, pressure, and stretch. However, explant culture is usually contaminated by mitotic cells, which may observed as a newly divided cells including fibroblast or glia. The mitotic cells could be able to interrupt and change the cell signaling that make it difficult to avoid detrimental effects during the experiments. To eliminate mitotic cells, anti-mitotic reagents like mixture of uridine and 5-fluorodeoxyuridine or cytosine arabinoside were added to the cultures on the following day, but there is no research that investigate viability of anti-mitotic reagent in dorsal root ganglion explant culture. In this study, we investigate inhibition effect of cytosine arabinoside to mitotic cells in dorsal root ganglion explant culture. Also we visualized and analyzed anti-mitotic effect and toxicity of cytosine arabinoside in various concentration condition. This dorsal root ganglion explant culture condition can be applied to research that effect and mechanism of various stimulation and chemical application which affect peripheral nerve regeneration.
Kim, Sang-Jeong;Lim, Won-Il;Park, Myoung-Kyu;Lee, Jin;Kim, Jun
The Korean Journal of Physiology
/
v.28
no.2
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pp.133-141
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1994
The discharge patterns and peripheral nerve inputs to cardiovascular neurons were investigated in rostral ventrolateral medulla (RVLM) and raphe nucleus of cats. The data from the two were compared to determine their roles in cardiovascular regulation and the endogenous analgesic system. Animals were anesthetized with ${\alpha}-chloralose$ and single cell activities were recorded by carbon-filament microelectrode and their relationships with cardiovascular activity were analyzed. In RVLM area, a total of thirty-three cells were identified as cardiovascular neurons. During one cardiac cycle, the mean discharge rate of the neurons was $1.96{\pm}0.29$ and the peak activity was observed 45 ms after the systolic peak of arterial blood pressure. Thirteen cells could be activated antidromically by stimulation of the the $T_2$ intermediolateral nucleus. Forty-three raphe neurons were identified as cardiovascular neurons whose mean discharge rate during one cardiac cycle was $1.02{\pm}0.12$. None of these cells could be activated antidromically. Study of the interval time histogram of RVLM neurons revealed that the time to the first peak was $128{\pm}20.0\;ms$, being shorter than the period of a cardiac cycle. The same parameter found from the raphe neurons was $481{\pm}67.2\;ms$, which was much longer than the cardiac cycle length. Of seventeen RVLM neurons examined ten received only the peripheral $A{\delta}-afferent$ inputs, whereas six RVLM neurons received both $A{\delta}-$ and C-inputs; the remaining one cell received an inhibitory peripheral C-input. In contrast, nine of eleven raphe neurons were found to receive $A{\delta}-inputs$ only. We conclude that the main output of cardiovascular regulatory influences are mediated through the RVLM neurons. The cardiovascular neurons in the raphe nucleus appear to serve as interneurons transferring cardiovascular afferent information to the raphespinal neurons mediating the endogenous analgesic mechanisms.
This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.
After fifteen years of development, Magnetic Resonance (MR) technology for human imaging and spectroscopy is reaching a refined state with FDA approved 3T clinical products from Siemens, GE, and Philips. Broker has cleared CE approval with a 4T system. Varian supports a 4T system platform as well. Shielded magnets are standard at 3T from GE, Oxford, Magnex, and IGC. A shielded 4T whole body magnet is available from Oxford. Stronger switched gradients and dynamic shim coils, desired at any field, areespecially useful at higher static magnetic fields B0. In addition to the higher currents required for higher resolution slice or volume selection afforded by higher SNR, whole body gradient coils will be driven at increasing slew rates to meet the needs of new cardiac applications and other requirements. For example 3T and 4T systems are now being equipped with 2kV, 500A gradient coils and amplifiers capable of generating 4G/cm in 200msec, over a 67+/-cm bore diameter. High field EPI applications require oscillation rates at 1 kHz and higher. To achieve a benchmark 0.2 ppm shim over a 30cm sphere in a high field magnet, at least four stages of shimming need to be considered. 1) A good high field magnet will be built to a homogeneity spec. falling in the range of 100 to 150 ppm over this 30cm spherical "sweet spot" 2) Most modern high field magnets will also have superconducting shim coils capable of finding 1.5 ppm by their adjustment during system installation. 3) Passive ferro-magnetic shimming combined with 4) active, high order room temperature shim coils (as many as five orders are now being recommended) will accomplish 0.2 ppm over the 30cm sphere, and 0.1 ppm over a human brain in even the highest field magnets for human studies. Safety concerns for strong, fast gradients at any B0 field include acoustic noise and peripheral nerve stimulation. One or more of the mechanical decoupling methods may lead to quieter gradients. Patient positioning relative to asymmetric or short gradient coils may limit peripheral nerve stimulation at higher slew rates. Gradient designs combining a short coil for local speed and strength with a longer coil for coverage are being developed for 3T systems. Local gradients give another approach to maximizing performance over a limited region while keeping within the physiologically imposed dB0/dt performance limits.
Objcetive : Neuropathic pain sometimes arises from a partial peripheral nerve injury. This kind of pain is usually accompanied by spontaneous burning pain, allodynia and hyperalgesia. It has been well known that acupuncture is effective to the pain control from ancient time in Asia. However, it is not clear whether acupuncture can control neuropathic pain. The aim of the present study is to examine if acupuncture stimulation may be effective to the mechanical allodynia in a rat model of neuropathic pain. Methods : To produce neuropathic pain, under sodium pentobarbital anesthesia, the right superior caudal trunk was resected between the S3 and S4 spinal nerves. After the neuropathic surgery, we examined if the animals exhibited the behavioral signs of mechanical allodynia. The mechanical allodynia was assessed by stimulating the tail with von Frey hair (bending force : 2.0g). three or 6 weeks after the neuropathic surgery, acupuncture stimulation was delivered to Houxi (SI 3) as the following parameters (2HZ frequency, 0.07mA intensity and 3msec duration) for 30 minutes. Results : The stimulation of Houxi (SI 3) acupoint relieved the behavioral signs of mechanical allodynia. Conclusion : Our results suggest that acupuncture can control the mechanical allodynia of neuropathic pain.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.12
no.1
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pp.46-54
/
2001
Background and Objectives : Nitric oxide(NO) is a short-lived molecule with messenger and cytotoxic functions in nervous, cardiovascular, and immune systems. Among the three distinct NOS isoforms, the neuronal isoform is expressed in small, discrete neuronal populations of CNS and PNS. Axonal injury in adult animals results in a dramatic NOS up-regulation in many types of central and peripheral neurons which normally lack the enzyme or express it only at very low levels. In previous study, we confirmed the efficacy of PEMS on the early functional recovery in rats with surgically transected and reanastomosed recurrent laryngeal nerve. Therefore, after we obtained functionally recovered rats using PEMS in this study, we studied to evaluate the expression of nNOS through the analysis of the difference between functional recovery group and non-recovery group in the recurrent laryngeal nerve. Materials and Method : Using 84 healthy male Sprague-Dawley rats, transections and primary anastomosis were performed on their left recurrent laryngeal nerves. Rats were then randomly assigned to 2 groups. The rats in group A(n=42) received PEMS by placing them in custom cages equipped with Helm-holz coils(3 hr/day, 5 days/wk, for 12 wk). The rats in group B(n=42) were handled the same way as the group A, except that they did not receive PEMS. Laryngovideoendoscopy was performed before and after surgery and followed up weekly. Laryngeal EMG was obtained in both PCA and TA muscles. Immunohistochemisty staining using monoclonal anti-neuronal nitric oxide synthase(nNOS) antibody was performed to detect nNOS in recurrent laryngeal nerve and nodose ganglion. Results : 20 rats(63%) in group A and 5 rats(17%) in the group B showed recovery of vocal fo1d motion. The number of NOS-positive cells was increased in functionally-recovered rats. NOS-staining intensity was reduced 12 weeks after nerve injury. The difference between PEMS group and non-stimulated group was not found. Conclusion : This study shows that nNOS may exert a beneficial effect on nerve regeneration and functional repair.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.1
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pp.445-452
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2015
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.
The pain is common among individuals with physical disabilities. It can interfere with therapy since patients with pain can become uncooperative and reluctant to move. This paper reviews the natural physiological mechanisms that can reduce pain perception, and considers physiological mechanisms which contribute to clinical pain by describing how the pain system changes its sensitivity depending upon the body's needs. The peripheral and central mechanisms contributing to sensitised nociceptive system are described with reference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous 'on-going'-projected and referred pain. It is suggested that in some chronic pain the nociceptive system maintains a state of sensitivity despite the absence of on-going tissue damage and under such circumstances the nociceptive system itself may have become dysfunctional. Such situations are often initiated by damage to nervous tissue which results in changes in the activity and organization of neuronal circuits within the central nervous system. The ability of the nociceptive system to operate in a suppressed state is also discussed with reference to pain modulation. The physical therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.
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