• 생물정신의학
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• 제4권1호
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• pp.108-115
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• 1997

The alcoholic neuropathies developed in approximately 34% of chronic alcoholics and the sexual dysfunction had been experienced in 8-54% of male alcoholics(Schiavi 1990). The aims of this study were to identify the prevalence of subclinical polyneuropathies and sexual disorders in alcohol dependence, and to evaluate the association between them. The nerve conduction velocity(NCV), electromyography(EMG), and pudendal somatosensory evoked potentials(SEPs) were tested for the male alcoholics(N=34) and controls(N=17 for NCV & EMG, N=25 for pudendal SEPs). The pudendal SEPs were measured by the following procedures, in which we stimulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity, three times of threshold : stimulus rate, 1-4.7Hz : stimulus duration, 0.1 or 0.2msec), and recorded at the scalp(active electrode, 2cm behind Cz : reference electrode, Fz). The NCV and EMG detected signs of peripheral neuropathies in 79.4% of alcoholics. Among the alcoholics, 64.7% were abnormal on the pudendal SEPs. Among the alcoholics who revealed abnormality on EMG and NCV, 81.4% were abnormal on the pudendal SEPs, in which 51.9% were not responded. The P1 latencies of pudendal SEPs on neuropathic alcoholics were significantly delayed(p<0.05) than non-neuropathic alcoholics. There was a relative correlation between peripheral neuropathies and sexual disorders in the alcoholics. The prevalence of subclinical neuropathies and sexual disorders seemed to be much higher in alcohol dependence than expectation, and these two problems were relatively correlated, and our results suggested that the peripheral polyneuropathies were one of the prerequisites of sexual disorders.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.319-329
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• 1998

The purpose of this study was finding the pain inhibitory effect of acupuncture based on rataining time at LI -4. The pain at dentes incisor was evoked by noxious electric stimulation and digastric electromyogram(dEMG) changes based on time interval were measured. To do this, the opioid antagonist was administered intraperitoneally and four groups were made for convenience. Without naloxone, dEMG was changed by either retaining the needle for 40 minutes (Group I) or by lifting and thrusting the needle (Group II). With naloxone administration, dEMG was changed by either retaining the needle for 40 minutes (Group III) or by lifting and thrusting the needle (Group IV). The results are as following 1. The pain inhibitory effect of acupuncture at LI -4 was expressed best in Group I. 2. The pain inhibitory effect was somewhat expressed in Group II but the effect was smaller than Group I. 3 .In Groups III and IV, the pain inhibitory effect was not expressed. The overall result should be the foundation for the further studies to figure out the underlying mechanism of acupuncture. In addition, it is assumed that the results will be useful for optimal retaining time of acupucture for its maximal effect.

• 대한소아치과학회지
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• 제23권3호
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• pp.717-728
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• 1996

The effects of electro-acupuncture on the pain threshold and the amplitude of dEMG(di-gastric EMG) evoked by the noxious electric stimulation on teeth and gingiva in dogs were studied. Experiments were carried out with 10 dogs weighing 5-8kg. Each animal was anestheticed with Entobar given intraperitoneally in an initial dose of 30mg/kg. Maintenance dose of 5mg/kg/hr was given through a cannula, in the femoral vein, as required to keep up light anesthesia. Bipolar stimulating wire electrodes, 0.1mm in diameter, insulated except for tips, were inserted into the upper canine and palatal gingiva. Rectangular aluminium plate electrodes (15$\times$5mm) were placed on acupuncture points, called Yin-Hsiang, located at both sides of the upper jaw. Rectangular biphasic current pulses of 2Hz, with a $250{\mu}sec$ duration, were delivered for 15 minutes. The dEMG activities were recorded from the anterior belly of the digastric muscle(one of the jaw opening muscles) using bipolar wire electrodes. The magnitude of the jaw opening reflex at different intensties of electro-acupuncture(1volt 4volt and 10volt) was estimated by averaging the 30 superimposed dEMGs recorded on an oscilloscope and audiomonitor. Data were analysed statistically with ANOV A and paired t-test. The obtained results were as follows: 1. Pain thresholds were increased 7.7 %, 15.4 %, 17.3 % in the teeth and 11.1 %, 19.0 %, 25.4 % in the gingiva as the intensities of electro-acupuncture increased incrementally. 2. Amplitudes of dEMG were decreaed 8.3%, 22.4%, 27.4% in the teeth and 9.8%, 36.5%, 42.2 % in the gingiva as the intensities of electro-acupuncture increased incrementally. 3. Inhibition of pain responses by the electroacupuncture was more effective in the gingiva than in the teeth.

• 대한한의학회지
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• 제20권1호
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• pp.106-112
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• 1999

The purpose of this study is to investigate the effects of Bee Venom Herb-Acupuncture on the jaw opening reflex evoked by tooth pulp stimulation. Rats were anesthetized with thiopental sodium given intraperitoneally in an initial dose of 80mg/kg. Maintenance doses of 5mg/kg thiopental sodium were given through a cannular in the femoral vein as required to maintain light anesthesia. To apply noxious stimuli, a pair of enameled wires were inserted into the tooth pulp of the lower incisor. The effects of conditioning stimuli were estimated as an indicator of the degree of suppression of the digastric muscle electromyogram(dEMG) in the jaw opening reflex. Bee Venom Herb- Acupuncture(0.2% solution 0.1ml/rat) was injected to Hapgok(LI4) loci. In addition, Normal Saline (0.1ml/rat) was injected to Hapgok loci so as to compare the degree of suppression elicited from Bee-Venom. By administration of Bee Venom Herb-Acupuncture, the amplitude of dEMG was maximally suppressed to $67.5{\pm}3.38%$ ipsilaterally, 73.33{\pm}8.00%$ contralaterally. Generally, the dEMG activities caused by electrical stimulation were gradually suppressed during the stimulation and maximal suppressive effect showed at 15min after its onset. However the dEMG activities by Be Venom Herb-Acupuncture were immediately suppressed after its onset and the suppressive effect continued for a long time compared to electrical stimulation. In conclusion, Bee Venom Herb-Acupuncture may have a different mechanism of analgesia from that of electro-acupuncture and contribute to the modulation of pain analgesia.

• 대한소아치과학회지
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• 제25권4호
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• pp.788-796
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• 1998

The purpose of this study was to investigate the effect of various electroacupuncture duration induced by acupuncture point-Zusanli ($S_{36}$) electrical stimulation on inhibition of amplitude of digastric electromyogram (dEMG) evoked by noxious electrical stimuli around the mental foramen. intraperitoneal sodium pentobarbital in an initial dose of 50mg/kg and maintenance doses of 4.5mg/kg/h were given through a cannula in the femoral vein using a constant infusion pump. A pair of stimulating electrodes were inserted for noxious stimuli around the mental foramen. An irritant electronic stimuli pulse (0.2 Hz, 0.1 ms duration) was produced with an intensity of about $1.5{\times}2$ times threshold for evoking the dEMG. The anterior belly of the digastric muscle was exposed and a pair of 0.1mm wire electrodes were inserted for dEMG recording. Acupuncture point stimulation on Zusanli (2 Hz, 250 ${\mu}s$, biphasic pulse, 2 V) was delivered by Dental Electronic Anesthesia (3M, U.S.A). For periods of electronic stimulation of 10, 20, and 30min, the amplitudes of dEMG were measured on the oscilloscope and on the monitor connected to the amplifier. The following results were obtained: The dEMG was decreased to 73.4% of that in the control set after 10 min electroacupunture stimulation (Group I); The dEMG was decreased to 77.1% (10min), 54.0.% (20min) of that in the control set after 20minutes of electroacupunture stimulation (Group II). The dEMG was decreased to 73.3% (10min), 61.9% (20min), 76.2% (30min) of that in the control set after 30 min of electroacupunture stimulation (Group III). From these results, it may be that in the electroacupuncture stimulation on the Zusnali resulted in a reduction of amplitude of dEMG and that the most effective electroacupuncture stimulation period was 20min.

• 대한임상검사과학회지
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• 제44권4호
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• pp.184-198
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• 2012

The purpose of intra-operative neurological monitoring (INM) is to minimize surgically induced nerve damage, sensory nerves and motor neurons without affecting the operations to proceed during surgery such as evoked potentials (EP), electromyography (EMG), electroencephalography (EEG), transcranial doppler (TCD), etc. During the course of checking a patient's condition, surveillance of ambulatory patients is a very different thing to check if the test is done under general anesthesia. INM can be possible or impossible depending on the type of drugs used and their concentrations because the monitoring is performed under anesthesia. Therefore, it is emphasized on the necessity of reviewing anesthesia which influences on INM.

• 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 Korean Neurosurgical Society
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• 제29권6호
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• pp.778-785
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• 2000

Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.

• Journal of Acupuncture Research
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• 제17권2호
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• pp.231-246
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• 2000

Acupuncture has been used for treatment of numerous diseases, especially for pain control in the oriental culture. However, the mechanism of pain control by acupuncture was not clear so far. The present study was examined that the effects of electro-acupuncture (EA) applied to the acu-point of extra-segmental area on modulation of formalin induced pain in Sprague - Dawley rats. In order to apply EA to acu-points in the plantar area of right fore paws, a pair of teflon - coated stainless steel wires were implanted in HT 7 (shin-mun) and PC 7 (dae-neong) 5 days before behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\mu}l$) into the lateral plantar region of left hind paw. EA was delivered by a constant current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. The electromyographic activities were recorded in the biceps femoris muscle under chloral hydrate anesthesia. Test stimuli with 1~9mA were applied to the sural nerve territory including the medial portion of the 4th toe and the lateral portion of the 5th toe. Behavioral responses including favoring, flinching and bitting were occured in the biphasic pattern, such as the lst phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited Che behavioral responses. EMG activities of flexor reflex had a latency of 100~300 ms and thresholds of test stimuli for EMG were 4~5 mA in normal rats. Injection of formalin decreased threshold of test stimuli and increased EMG activities for 2hrs after injection. However, EA significantly inhibited EMG activities of flexor reflex increased by formalin and recovered EMG evoked thresholds. These results suggest that contralateral extra-segmental EA inhibits the first and second phases of formalin induced pain but their mechanism be needed to examine additionally.

• Annals of Clinical Neurophysiology
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• 제1권1호
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• pp.1-9
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• 1999

Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.