• Title/Summary/Keyword: 신경자극

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Pain Control by Spinal Cord Stimulation in the Reflex Sympathetic Dystrophy -A case report- (반사성 교감신경성 위축증 환자에서 척수 자극기를 이용한 통증관리 -증례 보고-)

  • Lee, Sang-Chul;Kim, Jin-Hee;Hwang, Jung-Won;Han, Mi-Ae;Kim, Seong-Deok;Kim, Kye-Min;Lee, Byeong-Geon
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.86-88
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    • 1997
  • Regional sympathetic blockade is the most effective treatment for reflex sympathetic dystrophy (RSD). Radiofrequency thermocoagulation provides longer duration of pain relief than local anesthetics and less complication than chemical neurolytic agents for lumbar sympathectomy. Spinal cord stimulation (SCS) is thought to be an effective modality yieding good results in treating intractable neuropathic pain. Therefore RSD might be a good indication for SCS. We treated a patient with RSD who responded well to lumbar sympathetic blockade (LSB) with radiofrequency thermocoagulation and SCS. The patient had a left ankle sprain requiring a case for the lower leg for 2 weeks. The patient suffered increasing pain and swelling on the lower part of that leg. We thought to block the lumbar sympathetic chain utillzing radiofrequency thermocoagulation 2 days after LSB with local anesthetics. The results provided accepatable pain relief (VAS $8{\rightarrow}15$) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS $5{\rightarrow}13$) and patient could walk without assistance.

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Fos Protein Expression in Trigeminal Nociceptive Central Pathway of the Rat Brain by Cisternal Capsaicin Injection (흰쥐에서 Capsaicin 대조(Cisterna Magna) 내 주입 후 삼차신경 유해자극수용전달로에서의 Fos 단백의 발현)

  • Chung, Sung-Woo;Kim, Yeong-In;Kim, Sung-Nyeun
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.143-148
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    • 2000
  • Background: Trigeminovascular system is implicated in the pathophysiology of the headache in migraine. This study was designed to evaluate the pattern of Fos protein expression in trigeminal nociceptive central pathway after meningeal stimulation of rats by capsaicin. Methods: The expression of Fos protein was examined by immunohistochemistry in thalamus, brainstem and upper cervical cord (at three levels corresponding to obex, 0.8 mm and 2 mm below obex) 2 hours after intracisternal injection of either diluted capsaicin solution (0.1 ml, $61{\mu}g/ml$) or normal saline (0.1 ml) through a catheter placed in the cisterna magna, or following epidural instillation of diluted capsaicin solution in urethane-anesthetized Sprague-Dawley rats. Results: Fos immunoreactivity was strongly expressed within lamina I, II of bilateral trigeminal nucleus caudalis (TNC) after cisternal capsaicin injection and magnitude of expression was greatest at level 2.0 mm below obex. Epidural capsaicin caused much less labelling than cisternal capsaicin. Fos positive cells were also observed in area postrema, nucleus of the solitary tract, medullary reticular nucleus and midline nuclear groups of the thalamus with similar intensity between capsaicin and control group. Conclusions: These results indicate that the injection of capsaicin into the cisterna magna is an effective stimulus for the induction of Fos protein within TNC through activation of trigeminovascular afferents and this animal model can be useful for the evaluation of the pathophysiology and drug development in migraine and related headache.

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Identification of M-1, S-1 Cortex Using Combined Intraoperative SEP and Cortical Stimulation - A Case Report - (수술중 체성감각 유발전위 및 대뇌피질 자극을 이용한 일차 운동피질영역과 일차 감각피질영역의 확인 - 증례보고 -)

  • Lee, Jae-Uhn;Son, Byung-Chul;Kim, Moon-Chan;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.954-958
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    • 2000
  • In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

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Development of functional lighting fixture and Experiment of to the Biological effects (기능성 반사판 조명기구 개발 및 효능 실험)

  • Kim, Chang-Hwan;Kim, Hyeon-Soo;Chee, Chol-Kon
    • Proceedings of the Korean Institute of IIIuminating and Electrical Installation Engineers Conference
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    • 2004.11a
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    • pp.203-208
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    • 2004
  • We are living now under the bad air pollition contained the many plus(+)ion produed by the exhaust gases from automobil and Industrial plant. To be refreshe those air pollution. We developed the funtional lighting fixture which emit the lighting, negative(-)ion and Infraredray. The negative(-)ion and Infraredray refresh the air pollition and will arise nature healing power lot the human body and activate the body cell, and makes the good blood circulation and then we had the experiment to the Biological effect by the funtional lighting fixture.

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Effect of 8 Direction Incline and Rotation Exercise on Pain and Dynamic Balance in the Patients with Chronic Low Back Pain (8방향 경사와 회전 운동이 만성요통환자의 통증과 동적균형에 미치는 영향)

  • Goo, Bong-Oh;Park, Min-Chull;Song, Yoo-Yik;Cho, Ye-Rim
    • The Journal of the Korea Contents Association
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    • v.10 no.9
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    • pp.285-292
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    • 2010
  • The purpose of this study is to investigate the effect of 8 direction incline and rotation exercise on pain and dynamic balance in the patients with chronic low back pain(CLBP). 20 patients who were diagnosed with CLBP were included for the study. 10 patients(experimental group) were treated by modality{Hot Pack(H/P), Transcutaneous Electric Nerve Stimulation(TENS), Ultra Sound(U/S)} and then performed 8 direction incline and rotation exercise. The other 10 patients(control group) were only treated by modality. The therapeutic intervention was taken three times a week for 6 weeks. Dynamic balance was assessed by Star Excursion Balance Test(SEBT) and pain was assessed by Visual Analog Scale(VAS). VAS scores of both groups were decreased. However, the experimental group was more significantly decreased than the control group. The dynamic balance of both groups was significantly increased in anterior, posterior, medial, lateral direction. But experimental group was more significantly increased than the control group. In conclusion, 8 direction incline and rotation exercise was effective on pain and dynamic balance in CLPB.

Effect of Acupuncture-like Transcutaneous Electrical Nerve Stimulation on Plasma $\beta-endorphin$ and ACTH, Serum Cortisol and Urinary 17-OHCS Levels (저빈도-고강도 경피신경전기자극이 혈장 $\beta-endorphin$ 과 ACTH, 혈청 Cortisol 및 요중 17-OHCS 농도에 미치는 영향)

  • Park Chun-Seo;Lee Jae-Hyoung
    • The Journal of Korean Physical Therapy
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    • v.6 no.1
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    • pp.5-15
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    • 1994
  • The purpose of this study was to examine the effect of electroanalgeia and $\beta-endorphin$ action by acupuncture-like (Lof/Hil) transcutaneous electrical nerve stimulation (TENS) applied to acupuncture points. Twelve healthy adult male aged between 19 ann 25 were randomly assigned to TENS group (n=6) and naloxone group (n=6). Subjects of both groups were strongly stimulated TENS with 4 pps and $200{\mu}s$ for 30 minutes on the LI 3 and LI 10 meridian points of dominant am. Naloxone group was injected naloxone hydrochloride before TENS application. The experimental pain threshold was measured by chronaxie meter CX-2 on the distal end of radius just before and after TENS application. The levels of plasma $\beta-endorphin$ and ACTH. serum cortisol and urinary 17-OHCS were analyzed by radioimmunoassay (RIA) kits before and after TENS application. In TENS group, there was a significant increase of experimental pain threshold (p<0.01), plasma $\beta-endorphin$ level (p<0.05), serum cortisol level (p<0,001) and urinary 17-OHCS levels (p<0.05) after TENS application. The plasma ACTH level was not significantly increased, but it showed an increasing tendency. In naloxone group, although there was a decreasing trend, ACTH and cortisol level did not show a significant change, but $\beta-endorphin$ and 17-OHCS level were significantly decreased (p<0.01). The result of this study stewed that acupuncture-like TENS induced analgesic effect, such that the levels of plasma $\beta-endorphin$, plasma ACTH, serum cortisol and urinary 17-OHCS were concomitantly increased with experimental pain threshold. It is suggested that the analgesic mechanism of the acupuncture-like TENS probably related to endogenous opioid component such as $\beta-endorphin$.

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Analysis of Surface EMG Power Spectrum and Muscle Fatigue Depending on the Variable of Neuromuscular Electrical Stimulation (표면근전도를 이용한 신경근 전기자극 치료변수에 따른 근피로도 분석)

  • Kim, Gi-Won;Kim, Junesun
    • The Journal of Korean Physical Therapy
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    • v.26 no.5
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    • pp.280-289
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    • 2014
  • Purpose: This study was conducted in order to determine the stimulation variables which should be considered when neuromuscular electrical stimulation (NMES) is applied for a muscle under the normal innervation to minimize muscle fatigue and increase force-generating ability. Methods: A total of 23 healthy men participated in the study and all subjects were randomly assigned to the 1:1 group, 1:3 group, 1:5 group, and control group with on-off ratio of NMES. The subjects performed a fatigue task, consisting of 10 times of isometric contraction sustained by NMES. NMES using Russian current stimulation was applied to muscle fatigue and divided into three sessions by pulse frequency (10 bps, 30 bps, 90 bps). The EMG was recorded using an MP 100 system from the quadriceps femoris muscle in four groups. Results: The differences of delta MdF and delta MF of between on-off ratio groups of 10 bps, 30 bps, and 90 bps pulse frequencies were very significant (p<0.05). According to the results of post hoc of 10, 90 bps, it was greater in the 1:1 group and the 1:3 group compared with the 1:5 group, and no fatigue was observed in the control group. In 30 bps, it was greater in the 1:1 group compared with 1:3, 1:5, and control group (p<.05). Conclusion: Among NMES variables to minimize muscle fatigue, the larger on-off ratio by pulse frequency showed the lower muscle fatigue. Therefore, on-off ratio needs to be great enough, and will be more efficient with the frequency 30 bps rather than of 10 bps and 90 bps.

Immediate effects of High-Frequency Transcutaneous Electrical Nerve Stimulation on the Lower Limb Spasticity and the Balance in the Stroke Patient (고빈도 경피신경전기자극이 편마비 환자의 하지 경직과 균형에 미치는 즉각적 효과)

  • Cho, Hwi-Young;In, Tae-Sung;Lee, Soon-Hyun;Lee, Gyu-Chang;Shin, Won-Seob;Lee, Yong-Woo;Song, Chang-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.487-498
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    • 2010
  • Purpose : To investigate the immediate effects of transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in the stroke patients. Methods : 26 subjects with spasticity over lower limbs were allocated randomly into two groups : (1) TENS group, (2) placebo-TENS group. TENS was applied on the both gastrocnemius for 60 minutes(100 Hz, 0.25 ms, 2 times sensory threshold). The modified Ashworth Scale(MAS) and Manual Muscle Tester were used to assess the spasticity of the ankle plantar flexors. Static balance under three conditions was measured by force-plate; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Results : When compared with the pre and post TENS application, TENS showed significant reduction of ankle spasticity in MAS and MMT measurement. Also, Application of high-frequency TENS improved the balance under three conditions. Conclusion : A single session of TENS to stroke patients could reduce spasticity and improve the balance.

Effects of Ipsilateral and Contalateral Stimulation of Peripheral Nerve on Flexion Reflex in Cats (동측(ipsilateral) 및 대측(contralateral) 말초신경자극이 굴근반사에 미치는 영향의 비교연구)

  • Nam, Taick-Sang;Paik, Kwang-Se;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.169-176
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    • 1983
  • It is well known that the acupuncture has been used effectively for the relief of certain types of pain. Although the precise mechanism of action of acupuncture analgesia is unknown, it is generally accepted that their analgesic properties are related to the activation of endogenous opiate system in central nervous system. And it is suggested that pain-relieving properties of acupunture may be related to a stimulation of peripheral nerve underlying the acupuncture point on the skin. However, the efficacy of acupuncture has no relationship between the site of pain and the acupuncture point. Consequently, the present study was undertaken to investigate electroacupuncture analgesia in relation to the site of peripheral nerve stimulation. Cats were decerebrated ischemically and the flexion reflex as an index of pain was elicited by stimulating the sural nerve (20V, 0.5 msec duration) and recored as a compound action potential from the nerve innervated to the posterior biceps femoris muscle in the ipsilateral hindlimb. Bilateral common peroneal nerve and contralateral superficial radial nerve were selected as the site of peripheral nerve stimulation. For the stimulation of peripheral nerve, a stimulus of 20 V intensity, 2 msec-duration and 2 Hz-frequency was applied for 60 min respectively. The results obtained are summarized as follows: 1) Both stimulation of contralateral common peronal nerve and contralateral superficial radial nerve did not change the flexion reflex and there were no significant differences between them. 2) Stimulation of ipsilateral common peroneal nerve markedly depress the flexion reflex, the effect being reversed by naloxone application. These results suggest that stimulation of ipsilateral common peroneal nerve has the analgesic effect but both stimulation of contralteral common peroneal nerve and contralateral superficial radial nerve to the pain site where flexion reflex was elicited have no analgesic effect.

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Effects of Ethanol on the Cardiovascular Respones to Electrical Stimulation of Vagus Nerve and the Hypothalamus (Ethanol이 시상하부 및 미주신경의 전기자극에 의한 심맥관계반응에 미치는 영향)

  • Shin, Hong-Kee;Kim, Kee-Soon
    • The Korean Journal of Physiology
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    • v.9 no.2
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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.

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