• Journal of Gastric Cancer
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• 제19권1호
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• pp.49-61
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• 2019

Purpose: The perigastric vagus nerve may play an important role in preserving function after gastrectomy, and intraoperative neurophysiologic tests might represent a feasible method of evaluating the vagus nerve. The purpose of this study is to assess the feasibility of neurophysiologic evaluations of the function and viability of perigastric vagus nerve branches during gastrectomy. Materials and Methods: Thirteen patients (1 open total gastrectomy, 1 laparoscopic total gastrectomy, and 11 laparoscopic distal gastrectomy) were prospectively enrolled. The hepatic and celiac branches of the vagus nerve were exposed, and grabbing type stimulation electrodes were applied as follows: 10-30 mA intensity, 4 trains, $1,000{\mu}s/train$, and $5{\times}$frequency. Visible myocontractile movement and electrical signals were monitored via needle probes before and after gastrectomy. Gastrointestinal symptoms were evaluated preoperatively and postoperatively at 3 weeks and 3 months, respectively. Results: Responses were observed after stimulating the celiac branch in 10, 9, 10, and 6 patients in the antrum, pylorus, duodenum, and proximal jejunum, respectively. Ten patients responded to hepatic branch stimulation at the duodenum. After vagus-preserving distal gastrectomy, 2 patients lost responses to the celiac branch at the duodenum and jejunum (1 each), and 1 patient lost response to the hepatic branch at the duodenum. Significant procedure-related complications and meaningful postoperative diarrhea were not observed. Conclusions: Intraoperative neurophysiologic testing seems to be a feasible methodology for monitoring the perigastric vagus nerves. Innervation of the duodenum via the celiac branch and postoperative preservation of the function of the vagus nerves were confirmed in most patients.

• 대한한방내과학회지
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• 제44권3호
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• pp.455-465
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• 2023

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

• 대한임상검사과학회지
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• 제39권1호
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• pp.56-62
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• 2007

Lennox-Gastaut syndrome(LGS) is a severe age-specific epilepsy syndrome that causes medication-resistant seizures in childhood. Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the treatment of refractory epilepsy. We treated 9 patients with Lennox-Gastaut syndrome between the ages of 2 and 11 years (mean 5.8 years), by using the vagus nerve stimulation. The mean follow-up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 52% after 6 months (range, 0% to 89%; P<0.011), and 58% after 1 year (range 0% to 89%; P<0.012). Seven patients showed improvements of quality of life (QOL) such as alertness, mood, and language skills. The most common side effects were transient hoarseness (6 patients) and drooling (1 patient). Our results suggest that the vagus nerve stimulation could be an effective and safe adjunct therapy for the treatment of Lennox-Gastaut syndrome.

• The Korean Journal of Physiology
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• 제23권2호
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• pp.401-408
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• 1989

This study was conducted to investigate whether an electrical stimulation of medial amygdaloid nucleus in rats increases pancreatic secretion. And an involvement of vagus nerve or plasma secretin in this process was also studied. In fasting rats anesthetized with urethane, a monopolar stainless steel electrode was stereotaxically inserted into the right medial amygdaloid nucleus. Pancreatic juice was collected for 20 minutes, during which physiological saline or 0.01 N HCI (0.18 ml/min) was perfused into the duodenum with or without bilateral subdiaphragmatic vagotomy. In the medial amygdaloid group, an electrical stimulation was continuously applied to the medial amygdaloid nucleus during the perfusion period. After collection of pancreatic juice, blood was drawn from the abdominal aorta for determination of the plasma secretin level. The results were as follows: 1) The electrical stimulaion of the medial amygdaloid nucleus did not influence the pancreatic secretion in response to intraduodenal saline perfusion. 2) The stimulation of the medial amygdaloid nucleus significantly increased the pancreatic secretory response (volume, bicarbonate output) to the intraduodenal 0.01 N HCI perfusion, and the increases were abolished by vagotomy. 3) The plasma secretin concentration after the intraduodenal 0.01 N HCI perfusion was higher than that after the saline perfusion. However, neither the electrical stimulation of the medial amygdaloid nucleus nor vagotomy affected the plasma secretin concentration during the intraduodenal perfusion with saline or 0.01 N HCI. It is, therefore, suggested that the medial amygdaloid nucleus facilitates the pancreatic secretion (volume, bicarbonate) elicited by intraduodenal HCI perfusion through the vagus nerve.

• Archives of Pharmacal Research
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• 제11권1호
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• pp.65-73
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• 1988

The effects of clonidine on the negative chronotropic response induced by stimulation of vagus nerve were studied in the presence of propranolol in reserpinized and anesthetized rats. When the heart rate was decreased by stimulation of the vagus nerve, clonidine significantly inhibited vagally induced heart rate decrease (negative chronotropic response) in dose dependent manner. This inhibitory effect of clonidine was virtually abolished by phentolamine, ${\alpha}_1-\;and\;{\alpha}_2-adrenoceptor$ antagonist, and partially antagonized by prazosin, ${\alpha}_1-adrenoceptor$ antagonist. On the other hand, when the heart rate was decreased by the infusion of bethanechol, a muscarinic parasympathetic stimulant, clonidine had no effect on the bethanechol-induced heart rate decrease. These results suggest that clonidine inhibits vagally induced negative chronotropic response by activation of presynaptic ${\alpha}-adrenoceptors$ located on the parasympathetic cholinergic nerve terminal in the heart and this effect of clonidine is more related to ${\alpha}_2-adrenoceptors$ than ${\alpha}_1-adrenoceptors$.

• Journal of Acupuncture Research
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• 제20권1호
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• pp.97-103
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• 2003

Objective : Auricular acupuncture is a method of treatment that involves needling the ear in order to produce relief of symptoms. This concept was first developed by P.Nogier, french doctor and referred to as somatotopic representation. Many authors have commented the fact that the vagus nerve supplies the external auditory and the concha. The aim of this randomised, single blind study was to investigate whether auricular acupuncture of the ear produced changes in the pulse rate, an indicator of vagal tone. Methods: 10 healthy man volunteers were divided into normal and epinephrine stimulation group. Then each group was divided into vagus area acupuncture and control area acupuncture group again. Epinephrine stimulation group was injected by epinephrine 0.3cc twice, first. All of them were needled in either the vagus area or control area of the ear, and pulse rate changes were measured by patient monitor over 1 hour. Results : In the epinephrine stimulation group, there was significant differences in the pulse rate change between vagus area acupuncture and control area acupuncture group. After injection of epinephrine, the basal pulse rate was increased 1.3~1.4 times in the control group. However, in the vagus area acupuncture group the basal pulse rate was increased only 1.1~1.2 times.

• 한국감성과학회:학술대회논문집
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• 한국감성과학회 1999년도 춘계학술발표논문집 논문집
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• pp.243-248
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• 1999

There is substantial evidence that anatomical connections and functional interactions exist between vestibular and autonomic systems. Heart rate variability (HRV) including mean, standard deviation, coefficient of variation (CV), power spectrum was analyzed for evaluation of the physiological role of the vestibular system on control of heart rate in rabbits. In anesthetized rabbits, electrical stimulation of the vagus nerve decreased heart rate and decreased LF/HF by increasing HF. On the cervical sympathetic nerve increased heart rate and increased LF/HF by increasing LF. Atropine, cholinergic blocker, increased heart rate and increased LF/HF by reducing HF, and propranolol, ${\beta}$-adrenergic blocker, decreased heart rate and decreased LF/HF by reducing LF> In unanesthetized rabbits, stimulation of the vestibular system induced by rotation or caloric increased heart rate and increased LF/HF by increasing LF> Also electrical stimulation of the vestibular nerve produced the same of effects as rotation or caloric in anesthetized rabbits. These results suggest that Stimulation of the vestibular system increased heart rate not by inhibiting the parasympathetic nerve but by activating the sympathetic nerve.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.196-198
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• 2008

Objective : Vagus nerve stimulation (VNS) has been used in epilepsy patients refractory to standard medical treatments and unsuitable candidates for resective or disconnective surgery. In this study, we investigated the efficacy of VNS to patients who had refractory result to epilepsy surgery and patients with post-traumatic epilepsy. Methods : We analyzed the effect of VNS in 11 patients who had undergone previous epilepsy surgery and patients with intractable post-traumatic epilepsy associated with brain injury. All patients underwent VNS implantation between October 2005 and December 2006. Results : We evaluated seizure frequency before and after implantation of VNS and maximum follow up period was 24 months. In the first 6 months, 11 patients showed an average of 74.3% seizure reduction. After 12 months, 10 patients showed 85.2% seizure reduction. Eighteen months after implantation, 9 patients showed 92.4% seizure reduction and 7 patients showed 97.2% seizure reduction after 24 months. Six patients were seizure-free at this time. Conclusion : We conclude that the VNS is a helpful treatment modality in patients with surgically refractory epilepsy and in patients with post-traumatic epilepsy due to severe brain injury.

• The Korean Journal of Physiology
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• 제9권2호
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• pp.23-31
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• 1975

The effects of ethanol intravenously administered on the mean arterial blood pressure and heart rate responses to electrical stimulation of vagus nerve and the hypothalamus were studied in the cats. Also investigated were the effects of ethanol on the cardiovascular responses to bilateral carotid occlusion and to intravenously injected epinephrine and acetylcholine separately. The results obtained from the present study were as follows; 1. In 1.0 ml/kg and 2.0 ml/kg of ethanol infused groups the mean arterial blood pressure increased gradually and reached plateaus in 10 minutes after ethanol infusion while no marked changes in blood pressure were observed in 0.5 ml/kg of ethanol infused group. 2. The pressor responses elicited by the electrical stimulation of the hypothalamus were depressed directly proportionally to amount of ethanol infused. In 0.5 ml/kg of ethanol infused group the pressor response was reduced to 84.5% of control value and it declined to 17.0% of control in 2.0 ml/kg of ethanol infused group. 3. After ethanol administration the heart rate decreased slightly and also was decreased positive chronotropic effect elicited by hypothalamic stimulation. In several cases even negative chronotropic responses were observed during electrical stimulation in the hypothalamus. 4. Since the pressor responses to bilateral carotid occlusion was reduced by ethanol administration it is suggested that activity of baroreceptor is inhibited by ethanol. 5. No changes were observed in the negative chronotropic effect Produced by electrical stimulation of the vegus nerve of ethanol infused animal. And cardiovascular responses to intravenously injected epinephrine and acetylcholine were not influenced by ethanol either.

• The Korean Journal of Physiology and Pharmacology
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• 제2권1호
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• pp.9-19
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• 1998

The present study was primarily carried out to characterize the properties of the spinomesencephalic tract (SMT) neurons that project from the upper cervical spinal segments to the midbrain. It was also investigated whether these neurons received convergent afferent inputs from other sources in addition to cervical inputs. Extracellular single unit recordings were made from neurons antidromically activated by stimulation of midbrain. Recording sites were located in lamina $I{\sim}VIII\;of\;C1{\sim}C3$ segments of spinal cord. Receptive field (RF) and response properties to mechanical stimulation were studied in 71 SMT neurons. Response profiles were classified into six groups: complex (Comp, n=9), wide dynamic range (WDR, n=16), low threshold (LT, n=5), high threshold (HT, n=6), deep/tap (Deep, n=10), and non- responsive (NR, n=25). Distributions of stimulation and recording sites were not significantly different between SMT groups classified upon their locations and/or response profiles. Mean conduction velocity of SMT neurons was $16.7{\pm}1.28\;m/sec$. Conduction velocities of SMTs recorded in superficial dorsal horn (SDH, n=15) were significantly slower than those of SMTs recorded in deep dorsal horn (DDH, n=18), lateral reticulated area (LRA, n=21), and intermediate zone and ventral horn (IZ/VH, n=15). Somatic RFs for SMTs in LRA and IZ/VH were significantly larger than those in SDH and DDH. Five SMT units (4 Comps and 1 HT) had inhibitory somatic RFs. About half (25/46) of SMT units have their RFs over trigeminal dermatome. Excitabilities of 5/12 cells and 9/13 cells were modulated by stimulation of ipsilateral phrenic nerve and vagus nerve, respectively. These results suggest that upper cervical SMT neurons are heterogenous in their function by showing a wide range of variety in location within the spinal gray matter, in response profile, and in convergent afferent input.