• Title/Summary/Keyword: innervation

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Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy

  • Koh, Jae Chul;Kim, Do Hyeong;Lee, Youn Woo;Choi, Jong Bum;Ha, Dong Hun;An, Ji Won
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.296-303
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    • 2017
  • Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: 'Complete', when twitching was observed at all needles; 'Partial', when twitching was present at 1 or 2 needles; and 'None', when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. Results: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). Conclusions: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.

Detecting of Periodic Fasciculations of Avian Muscles Using Magnetic and Other Multimedia Devices

  • Nakajima, Isao;Tanaka, Sachie;Mitsuhashi, Kokuryo;Hata, Jun-ichi;Nakajima, Tomo
    • Journal of Multimedia Information System
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    • v.6 no.4
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    • pp.293-302
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    • 2019
  • In the past, there was a theory that influenza wasn't transmitted directly from birds but was infected to humans via swains. Recently, molecular level research has progressed, and it was confirmed that the avian influenza virus can directly infected to human lung and intestinal epithelial cells. Three pandemicsin the past 100 years were also infected to humans directly from birds. In view of such scientific background, we are developing a method for screening sick birds by monitoring the physiological characteristics of birds in a contactless manner with sensors. Here, the movement of respiratory muscles and abdominal muscles under autonomic innervation was monitored using a magnet and Hall sensor sewn on the thoracic wall, and other multimedia devices. This paper presents and discusses the results of experiments involving continuous periodic noise discovered during flight experiments with a data logger mounted on a Japanese pheasant from 2012 to 2015. A brief summary is given as the below: 1. Magnet and Hall sensor sewn to the left and right chest walls, bipolar electrocardiograms between the thoracic walls, posterior thoracic air sac pressure, angular velocity sensors sewn on the back and hips, and optical reflection of LEDs (blue and green) from the skin of the hips allow observation of periodic vibrations(fasciculations) in the waves. No such analysis has been reported before. 2. These fasciculations are presumed to be derived from muscle to maintain and control air sac pressure. 3. Since each muscle fiber is spatially Gaussian distributed from the sympathetic nerve, the envelope is assumed to plot a Gaussian curve. 4. Since avian trunk muscles contract periodically at all time, we assume that the sympathetic nerve dominates in their control. 5. The technique of sewing a magnet to the thoracic wall and measuring the strength of the magnetic field with a Hall sensor can be applied to screen for early stage of avian influenza, with a sensor attached to the chicken enclosure.

Intestinal Neuronal Dysplasia in Twins (쌍생아에서 발생한 Intestinal Neuronal Dysplasia)

  • Lim, In-Suk;Chung, Ju-Young;Choi, Myung-Jai;Kim, Sang-Woo;Kim, Hong-Ju;Kim, Jeong-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.202-207
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    • 2003
  • Intestinal neuronal dysplasia (IND) is a disorder of abnormal intestinal innervation resulting in dysfunctional colonic motility. IND shares clinical features with Hirschsprung's disease but differentiated by histological findings such as hyperplasia of submucosal and myenteric plexuses, giant ganglia, ectopic ganglion cell and increased acetylcholinesterase activity in lamina propria. Although IND may exist as an isolated condition, more commonly, it occurs in association with Hirschsprung's disease. We report a case of twins affected with IND. Both children manifested with delayed passage of meconium and severe abdominal distention after birth. Barium enema in both patients showed microcolon. They underwent emergency ileostomy under the impression of total aganglionosis. But surgical biopsy specimens showed hyperganglionosis in submucosa with formation of giant ganglia. Both neonates suffers from several episodes of peudo-obstruction after the repair operation of colostomy.

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The involvement of protein kinase C in the inhibitory effect of methoxamine on the thyrotropin-induced release of thyroxine in mouse thyroid (Mouse 갑상선에서 thyrotropin에 의한 thyroxine 유리에 미치는 methoxamine의 억제효과에 대한 protein kinase C의 관련)

  • Kim, Se-gon;Kim, Jin-sang
    • Korean Journal of Veterinary Research
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    • v.38 no.3
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    • pp.508-517
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    • 1998
  • There is evidence that the sympathetic nervous system exerts a control on thyroid function via an adrenergic innervation of thyroid cells. Although it is clear that the inhibitory effects of catecholamines result from an activation of ${\alpha}_1$-adrenoceptors, the mechanisms involved in ${\alpha}_1$-stimulation are not fully understood. The effects of methoxamine and protein kinase C (PKC) activator on the release of thyroxine ($T_4$) from mouse thyroid were studied to clarify the role of PKC in the regulation of $T_4$ release in vitro. The glands were incubated in the medium, samples of the medium were assayed for $T_4$ by EIA kits. Methoxamine inhibited the TSH-stimulated $T_4$ release. This inhibition was reversed by prazosin, an ${\alpha}_1$-adrenergic antagonist. Futhermore, the inhibitory effect of methoxamine on the $T_4$ release stimulated by TSH was prevented by chloroethylclonidine, an ${\alpha}_{1b}$-adrenoceptor antagonist, but not by WB4101, an ${\alpha}_{1a}$-adrenoceptor antagonist. Also methoxamine inhibited the forskolin-, cAMP- or IBMX-stimulated $T_4$ release. These inhibition were reversed by PKC inhibitors, such as staurosporine and $H_7$. PMA, a PKC activator, completely inhibited the TSH-stimulated $T_4$ release, and its inhibition was reversed by staurosporine and $H_7$, but not by chelerythrine. R59022 (a diacylglycerol kinase inhibitor), like methoxamine, also inhibited the TSH-stimulated $T_4$ release, and its inhibition was also reversed by staurosporine. The present study suggests that methoxamine inhibition of $T_4$ release from mouse thyroid can be induced by activation of the ${\alpha}_{1b}$-adrenoceptors and that it is mediated through the ${\alpha}_1$-adrenoceptor-stimulated PKC formation.

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NITRIC OXIDE AND DENTAL PULP (NITRIC OXIDE와 치수)

  • Kim, Young-Kyung;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.27 no.5
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    • pp.543-551
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    • 2002
  • Nitric oxide (NO) is a small molecule (mol. wt. 30 Da) and oxidative free radical. It is uncharged and can therefore diffuse freely within and between cells across membrane. Such characteristics make it a biologically important messenger in physiologic processes such as neurotransmission and the control of vascular tone. NO is also highly toxic and is known to acts as a mediator of cytotoxicity during host defense. NO is synthesized by nitric oxide synthase (NOS) through L-arginine/nitric oxide pathway which is a dioxygenation process. NO synthesis involves several participants, three co-substrates, five electrons, five co-factors and two prosthetic groups. Under normal condition, low levels of NO are synthesized by type I and III NOS for a short period of time and mediates many physiologic processes. Under condition of oxidant stress, high levels of NO are synthesized by type II NOS and inhibits a variety of metabolic processes and can also cause direct damage to DNA. Such interaction result in cytostasis, energy depletion and ultimately cell death. NO has the potential to interact with a variety of intercellular targets producing diverse array of metabolic effects. It is known that NO is involved in hemodynamic regulation, neurogenic inflammation, re-innervation, management of dentin hypersensitivity on teeth. Under basal condition of pulpal blood flow, NO provides constant vasodilator tone acting against sympathetic vasoconstriction. Substance P, a well known vasodilator, was reported to be mediated partly by NO, while calcitonin-gene related peptide has provided no evidence of its relation with NO. This review describes the roles of NO in dental pulp in addition to the known general roles of it.

Transient Hypoglossal Nerve Palsy after Open Reduction of Zygomatic Complex Fracture (관골복합골절 수술 후 발생한 일시적 설하신경 마비의 증례보고)

  • Kim, Jee Wook;Kim, Woo Seob;Kwon, Nam Ho;Kim, Han Koo;Bae, Tae Hui
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.80-83
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    • 2009
  • Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

Reducing Donor Site Morbidity When Reconstructing the Nipple Using a Composite Nipple Graft

  • Lee, Taik Jong;Noh, Hyung Joo;Kim, Eun Key;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.384-389
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    • 2012
  • Background Numerous procedures are available for nipple reconstruction without a single gold standard. This study presents a method for reducing donor-site morbidity in nipple reconstruction using a composite nipple graft after transverse rectus abdominis musculocutaneous flap breast reconstruction. Methods Thirty-five patients who underwent nipple reconstruction using a composite nipple graft technique between July of 2001 and December of 2009 were enrolled in this study. To reduce the donor site morbidity, the superior or superior-medial half dome harvesting technique was applied preserving the lateral cutaneous branch of the fourth intercostal nerves. The patients were asked to complete a previously validated survey to rate the color and projection of both nipples, along with the sensation and contractility of the donor nipple; and whether, in retrospect, they would undergo the procedure again. To compare projection, we performed a retrospective chart review of all the identifiable patients who underwent nipple reconstruction using the modified top hat flap technique by the same surgeon and during the same period. Results Thirty-five patients were identified who underwent nipple reconstruction using a composite nipple graft. Of those, 29 patients (82.9%) responded to the survey. Overall, we received favorable responses to the donor site morbidity. Projection at postoperative 6 months and 1 year was compared with the immediate postoperative results, as well as with the results of nipples reconstructed using the modified top hat flap. Conclusions The technique used to harvest donor tissue is important. Preserving innervation of the nipple while harvesting can reduce donor site morbidity.

Comparison between C.M.R.T. and acupuncture in the treatment of liver dysfunction (간 기능 이상 치료에 대한 C.M.R.T. 치료 부위(T8 횡돌기)와 경혈과의 비교)

  • Sim Young;Lee Jun-Moo
    • Korean Journal of Acupuncture
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    • v.19 no.2
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    • pp.97-117
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    • 2002
  • Chiropractic is very similar to Oriental Medicine in philosophy on the cause of diseases and in utilization of spinal articulations for diagnosis and treatment. In this paper the spinal area used to treat liver dysfunction in S.O.T. technique, one of chiropractic techniques, was compared to the acupncture points used to cure the same conditions. Because both Oriental medicine and Chiropractic are dealing with autonomic nervous system in regulating abnormal conditions, also the innervation of spinal nerves to those areas was checked. The spinal area that S.O.T. technique utilizes to correct liver dysfunction is transverse processes of T8, which corresponds to B16. Acupncture points from this level down to T12/L1, which are B16, B17, B18, B19, B20, B21, B45, B46, B47, B48, B49, B50, GV6, GV7, GV8 and GV9, all have been applied to control liver function. Apparent discrepency exists in therapeutic areas for liver malfunction between the two natural healing arts. According to the neurology texts, liver is innervated by sympathetic fibers from the 7th-10th thoracic segments and by parasympathetic fibers from vagus nerve. Sympathetic afferent nerves from the liver reach the 7th-12th thoracic spinal cord segments. It can be said all the 7th-12th thoracic spinal cord segments are related to liver function. Therefore the areas used for liver dysfunction in both natural medicine are appropriately selected. However, B16, the Oriental medical equivalent of the main spinal area which is used for lowered liver function in C.M.R.T. Technique, is not utilized as frequent as in Oriental medicine.

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Differences Between Facial Skin Temperature of the Paralyzed Side and Those of the Normal Side in Bell's Palsy Patients (Bell's Palsy 환자의 건측-환측 안면부 피부온도차이에 관한 연구)

  • Nam, Dong-Hyun;Koh, Hyung-Kyun;Park, Young-Bae
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.126-136
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    • 2007
  • Objectives : Bell's palsy in an acute peripheral facial nerve paralysis that usually affects only one side of the face. The seventh cranial nerve carries predominantly motor fibers, but also supplies some autonomic innervation, sensation to park of the ear, and taste to the anterior two thirds of the tongue. The aim of this study is to provide evidence of differences between facial skin temperature of the paralyzed side and normal side in Bell's palsy patients. Methods : the author studied 68 patients with Bell's palsy whose facial nerve function had been documented by the House-Brackmann grading system. We measured skin temperature of the forehead, zygoma, lower lip, temple and lower jaw area of the paralyzed side and those of the normal side. Results : there were significant facial skin temperature differences between the forehead area of paralyzed side and that of normal side of GrII(P<0.05) and III(P<0.05). The result also showed that the facial skin temperature difference according to the aflection period vanished when air temperature was calibrated (F=1.700, P=0.178). Conclusions : Thermography is a useful diagnostic tool in Bell's palsy if the air temperature is low enough to cool the facial skin temperature and the forehead area is evaluated as the sampling zone.

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Pulmonary aspiration during intubation in a high-risk patient: A video clip and clinical implications

  • Koh, Gi-Ho;Kim, Sung-Hoon;Son, Hyo-Jung;Jo, Jun-Young;Choi, Seong-Soo;Park, Se-Ung;Kim, Wook-Jong;Ku, Seung-Woo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.111-114
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    • 2018
  • We report a case of pulmonary aspiration during induction of general anesthesia in a patient who was status post esophagectomy. Sudden, unexpected aspiration occurred even though the patient had fasted adequately (over 13 hours) and received rapid sequence anesthesia induction. Since during esophagectomy, the lower esophageal sphincter is excised, stomach vagal innervation is lost, and the stomach is flaccid, draining only by gravity, the patient becomes vulnerable to aspiration. As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We present a video clip showing pulmonary aspiration and discuss the literature concerning the risk of aspiration and its preventive strategies.