• The Korean Journal of Pain
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• 제32권1호
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• pp.47-50
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• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 1992년도 한국자동제어학술회의논문집(국내학술편); KOEX, Seoul; 19-21 Oct. 1992
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• pp.90-94
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• 1992

A portable multichannel functional electrical stimulation(FES) system for the fine control of the paralyzed extremities in spinal cord injury patients is described. This system is composed of a stimulation data creating system, a serial communication device, a 16-bit microprocessor, D/A converter of 32 channels and a display device. Stimulation patterns are created from analytical results of integrated EMGs during motion in normal subjects and are stored in the stimulation data creating system as data files. And then the stimulation patterns are sent to the memory in the portable multichannel FES system through serial communication interfacing device. Sophisticated fine control of paralyzed extrimities was realized by transmitting multichannel stimulation patterns to percutaneous intramuscular electrodes, which stimulate the motor function of paralyzed muscle simultaneously. Advantages of this system are as follws: 1) It is possible to modify stimulation patterns in accordance with the patient's situation. 2) This system is small and light.

• 한국산학기술학회논문지
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• 제12권7호
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• pp.3109-3116
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• 2011

본 연구는 뇌병변으로 상지경직이 관찰되는 환자를 대상으로 자극방식에 따른 진동자극이 경직에 미치는 영향에 대하여 알아보고자 하였다. 뇌병변으로 인해 상지경직이 있는 21명의 환자가 연구에 참여하였고, 실험군 I: 길항근(상완삼두근)자극, 실험군II: 주동근(상완이두근)자극, 실험군III: 동시(상완삼두근 및 상완이두근)자극에 각 7명씩을 배정하여 진동자극을 실시하였다. 척수운동신경원 흥분성을 알아보기 위해 Neuro-EMG_Micro를 이용한 F파를 자극전, 자극 직후, 자극 10분 후, 자극 20분 후에 측정하였고, 임상적 평가로는 MAS(Modified Ashworth Scale)와 MFT(Manual Function Test)를 자극 전, 자극 20분 후에 평가하였다. 본 연구의 결과, MAS는 세군 모두 유의한 감소를 나타냈고, F파 진폭 및 F/M비에서는 세군 모두에서 자극 직후에서부터 유의한 감소를 나타냈으며, 실험군III에서 시간 경과상 변화량이 가장 크게 나타났다. MFT에서는 실험군II와 III에서 유의한 증가를 나타냈으며 특히, 실험군III에서 기능적 변화량이 가장 크게 나타났다. 이러한 결과는 경직근에 대한 진동자극시 경직 주동근이나 길항근에 대한 단일 자극 방식보다는 동시자극 방식이 척수운동신경원의 흥분성 감소 및 상지 운동 기능 향상에 더 효과적임을 확인할 수 있었다.

• The Korean Journal of Pain
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• 제31권4호
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• pp.235-243
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• 2018

Postherpetic neuralgia (PHN) is the most troublesome side effect of Herpes Zoster (HZ), which mainly affects the elderly and immunocompromised populations. Despite the current advancement of treatments, PHN persists in many individuals influencing their daily activities and reducing their quality of life. Anticonvulsants, antidepressants, topical therapies including lidocaine and capsaicin, and opioids, are the most widely used therapies for the treatment of PHN. These medications come with their adverse effects, so they should be used carefully with the elderly or with patients with significant comorbidities. Other measures like botulinum toxin, nerve blocks, spinal cord stimulation, and radiofrequency have also contributed significantly to the management of PHN. However, the efficacy, safety, and tolerability of these invasive methods need to be carefully monitored when administering them. Early diagnosis and early initiation of treatment can reduce the burden associated with PHN. The zoster vaccine has effectively reduced the incidence of HZ and PHN. In this article, we discuss the treatment options available for the management of PHN, mainly focusing on the efficacy and safety of different therapeutic modalities.

• The Journal of Korean Physical Therapy
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• 제22권2호
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• pp.47-53
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• 2010

Purpose: This study investigated the effect of electroacupuncture stimulation on changes in blood biochemistry in spinal cord injury (SCI) rats whose cords were damaged by 6-hydroxydopamine (6-OHDA). Methods: Twenty-one Sprague-Dawley adult male rats were assigned to one of three groups: normal (n=7), control (n=7) and experimental group (n=7). The experimental group received electroacupuncture (Es-160, ITO, Japan) for 15 minutes in the form of low frequency (2 Hz) stimulation to the zusanli point. After treatment, we observed motor behavior recovery using the inclined plane test. We also measured serum and CNS concentrations and activities of enzymes including creatine kinase (CK), alkaline phosphatase (ALP), and Immunoglobulin G (IgG). Statistical analysis was done using one-way analysis of variance (ANOVA). Results: Concentrations of CK, ALP and IgG were lower in the experimental group than in the control group. Functional recovery was evaluated by the maximal angle of the inclined board on which rats could maintain their initial position. This allowed us to monitor progressive locomotor recovery. The maximal angles of the inclined plane test were higher in the experimental group than in the control group (p<0.05). Conclusion: The results of this study showed that electroacupuncture to the zusanli point has a therapeutic effect on functional recovery after SCI.

• 대한물리의학회지
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• 제5권2호
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• pp.265-272
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• 2010

Purpose : This study was investigated the effect of electroacupuncture stimulation on the change of blood biochemical components in the rat spinal cord injury(SCI) damaged by the 6-hydroxydopamine. Methods : SCI model rats were damaged in L1-L2 injected with 6-hydroxydopamine. The thirty Sprague-Dawley adult male rats were randomly divided into normal group, control group and electroacupuncture group. Experimental groups were applied as electroacupuncture(Es-160, ITO, Japan) for 15minutes during the low frequency(2 Hz) stimulation to zusanli. The enzyme concentration levels analysis of the hematological changes were measured of Glutamate Oxaloacetate Transaminase(GOT), Glutamate Pyruvate Transaminase(GPT), Lactate dehydrogenase(LDH) and motor function recovery change was evaluated by the rota-rod test. Results : This study were as follow : The concentration of GOT, LDH in experimental group was lower than control group(p<.05). The experimental group showed increase of motor function recovery more in compared to control group(p<.05). Conclusion : The results of this study showed that electroacupuncture to zusanli point have an effect on functional recovery after the 6-hydroxydopamine induced SCI in rats.

• 재활치료과학
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• 제7권1호
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• pp.63-77
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• 2018

목적 : 본 연구는 기능적 전기 자극을 병행한 과제 지향적 훈련이 불완전 경수 손상 환자의 손 기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 대상자는 불완전 경수 손상 진단을 받은 성인 3명으로, ABA 설계를 사용하였으며, 연구기간 동안 기초선(A1) 5회기, 중재기(B) 20회기, 재기초선(A2) 5회기로 총 30회기 실시하였다. 중재기(B) 동안 기능적 전기 자극을 병행한 과제 지향적 훈련이 제공되었고, 모든 회기에는 손 기능을 평가하기 위해 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 측정하였으며, 기초선(A1) 전, 재기초선(A2) 후로 Canadian Occupational Performance Measure(COPM), Jebsen-Taylor Hand Function Test(JTHFT)와 Wolf Motor Function Test(WMFT)를 실시하여 중재 효과를 살펴보았다. 결과 : 모든 대상자는 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 통해 기초선(A1)보다 중재기(B)에서 우세 손 기능이 향상되었고, 재기초선(A2)에서 그 효과가 유지되었다. 재기초선(A2) 후 COPM, JTHFT와 WMFT의 결과, 우세 손 기능의 향상과 과제 수행도와 만족도의 향상을 보였다. 결론 : 기능적 전기 자극을 병행한 과제 지향적 훈련은 경수 손상 환자의 손 기능뿐만 아니라, 대상자가 선택한 훈련 과제의 과제 수행도와 만족도 향상에 효과적이다.

• 한국콘텐츠학회논문지
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• 제9권6호
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• pp.187-195
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• 2009

본 연구는 흰쥐를 대상으로 좌골신경 압좌 손상 유발 후 경피신경전기자극과 전침자극을 적용하고 진통효과와 기능회복에 미치는 영향을 알아보았다. 실험동물은 경피신경전기자극군을 적용한 TENS군, 전침자극군을 적용한 EA군과 대조군으로 구분하였고, 각각의 군은 전기자극 적용기간에 따라 1일군, 7일군 및 14일군으로 나누었다. 경피신경자극과 전침자극을 적용한 결과, 실험군에서 대조군에 비하여 통각신경활성의 지표로 이용되는 c-fos 발현의 감소, 발도피지연시의 증가, 좌골신경기능지수의 증가를 통해 전기자극이 말초신경 손상에서 통증억제와 기능회복을 증가시키는 것으로 나타났다. 하지만 경피신경전기자극군과 전침자극군간의 유의한 차이는 관찰되지 않았다.

• The Korean Journal of Physiology
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• 제27권2호
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• pp.185-197
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• 1993

The rostral ventrolateral medulla (RVLM) includes vasopressor neurons, which transmit activation signals to the intermediolateral nucleus (IML) of the spinal cord, where the preganglionic sympathetic nucleus is located, to raise arterial blood pressure (BP). However, controversy exists as to the possible depressor area in the RVLM and the pathway involved. The present study persued evidence far the location of depressor neurons and the pathway by simultaneously observing changes in BP and the firing rate (FR) of cardiovascular neurons (CVNs) in the RVLM during the somatosympathetic reflex (SSR) elicited by peripheral nerve stimulation, since CVNs are known to contribute to the generation of the sympathetic nerve discharge. In 42 cats, anaesthetized with $\alpha-chloralose$, single unit recording was performed, using carbon filament electrodes inserted into the RVLM, enabling estimation of the post R wave unit histogram (PR-UNlT) and the spike triggered average of sympathetic nerve discharge (STA-SND), allowing identification of CVNs. Antidromic stimulation of spinal $T_2$ segment was followed to determine whether the identified CVN projects axonal endings to the spinal cord (reticulospinal neuron). The sciatic nerve was electrically stimulated at $A\delta-intensity$ (1 mA, 0.1 ms), 1 Hz and C-intensity (10 mA, 0.5 ms), 20 Hz to elicit the depressor, and pressor responses of the SSR, respectively. Simultaneous measurement of CVN firing rate was made. Experimental results are summarized as follows. 1) 20 out of 98 CVNs had axonal projections to the spinal cord and 17 out of 98 CVNs showed FR changes during SSR. 2) Response patterns of FR and BP during SSR were classified into 8 types. 3) These 8 different response patterns could be further classified into those from pressor and depressor neurons. These results demonstrate that some CVNs were identifiable as reticulospinal neurons responding to anti-dromic stimulation and that CVNs operating as depressor neurons as well as pressor neurons exist in the RVLM, both of which are involved with SSR mediation. Therefore, evidence was found that an independent depressor pathway might be involved in the mediation of SSR.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.29-35
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• 2006

Background: Transcranial magnetic stimulation (TMS) is a non-invasive diagnostic method particularly suited to investigation the long motor tracts. The clinical value of TMS in most spinal cord diseases has still to be made. Diagnostic value of magnetic motor evoked potential (MEP) parameters in intramedullary spinal cord lesions was investigated. Methods: MEP elicited by TMS was recorded in 57 patients with clinically and radiologically defined intramedullary myelopathy. Twenty five patients with cervical myelopathy (CM) and 32 thoracic myelopathy (TM) were included. Recordings were performed during resting and minimal voluntary contraction at both abductor pollicis brevis (APB) and tibialis anterior (TA) muscles. Stimulation threshold(ST), amplitude, and central motor conduction time (CCT) were measured at resting and facilitated conditions. CCT was calculated by two means; central motor latency (CML)-M using magnetic transcranial and root stimulation, and CML-F using electrical F-wave study. The results were compared between patient groups and 10 normal control group. Results: Facilitated mean ST recorded at TA was elevated in both CM and TM compared with control group. Resting mean CML-M at TA was significantly prolonged in both CM and TM, and CML-M was absent or delayed in 37.1% of CM and 8% of TM at APB with facilitation. Facilitated mean MEP amplitude at ABP was lower in CM than in TM, while MEP/M ratios were not different significantly between groups. Conclusions: Magnetic motor evoked potential has diagnostic value in intramedullary myelopathy and localizing value in differentiating between CM and TM by recording at APB and TA. It is a noninvasive way to investigate the functional status of motor tracts of spinal cord.