• Title/Summary/Keyword: 신경 해부학

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Suggestion on Locating Method for ST36 Acupoint Based on Neuroanatomical Features (족삼리 취혈방식 제안: 신경해부학적 특성을 기반으로)

  • Heeyoung Moon;Da-Eun Yoon;Yeonhee Ryu;In-Seon Lee;Dody Chang;Poney Chiang;Younbyoung Chae
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.128-133
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    • 2023
  • Objectives : There are many variations in the ST36 acupoint location. The purpose of this article is to suggest a method of locating the ST36 acupoint. Methods : Based on the available research and the neuroanatomical characteristics of the underlying acupoint, we summarized the proper procedure for finding the ST36 acupoint. Results : ST36 is 3 B-cun inferior to ST35 and is vertically situated on the line that connects ST35 and ST41. The ST36 acupoint corresponds to the deep peroneal nerve, which is situated in the tibialis anterior muscle's back. The neurovascular bundles that are located on the interosseous membrane between the interosseous crests of the tibia and fibula include the deep peroneal nerve, anterior tibial artery, and anterior tibial vein. According to both classical and modern literature, this acupoint can be found horizontally between the two muscles, tibialis anterior and extensor digitorum longus. Conclusions : Based on a review of the literature and neuroanatomical features, we suggest that ST36 can be positioned horizontally between tibialis anterior and extensor digitorum longus. Additional imaging studies and clinical proof are required to determine ST36 acupoint.

Ultrasound-Guided Injections in the Lumbar and Sacral Spine (요추 및 천추부에 대한 초음파 유도하 중재 시술)

  • Ko, Kwang Pyo;Song, Jae Hwang;Kim, Whoan Jeang;Kim, Sang Bum;Min, Young Ki
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.185-195
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    • 2018
  • Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

Anatomy of the Sural Nerve in the Foot and Ankle and Its Surgical Implications (족부 및 족관절 부위에서 비복 신경의 해부학 및 수술시의 의미)

  • Lee, Woo-Chun;Park, Hyun-Soo;Han, Young-Kil;Chang, Byeong-Chun;Rim, Jang-Woon;Rha, Jong-Deuk
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.2
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    • pp.88-92
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    • 1998
  • The course of the sural nerve in the calf has been well documented, but there is a general lack of information concerning the distal course of the nerve. The purpose of this study was to describe the distal course of the sural nerve and its surgical implications. Seven fresh amputated specimens were dissected to show the anatomy of the sural nerve in the foot and ankle. At the level of about 10cm proximal to the plantar surface, the sural nerve coursed anteriorly and inferiorly away from the Achilles tendon. 2 to 4 lateral calcaneal branches arose. The first branch of the lateral calcaneal branches coursed along the lateral border of the Achilles tendon, and it arose at 8cm proximal to the plantar surface in 2 specimens, 12cm proximal to the plantar surface in 4 specimens, and at 12cm proximal to the plantar surface in one specimen. The main nerve trunk continued distally plantar to the peroneal tendons and divided into two terminal branches and crossed peroneus longus tendon at the level of the inferior border of the calcaneo-cuboid joint, at about 3cm(range, $2.5\sim3.0$)cm from the plantar surface. In conclusion, a longitudinal incision lateral to the Achilles tendon would cross the path of the sural nerve at about 10cm proximal to the plantar surface. When the first branch of them arise more than 10cm above the plantar surface, a logitudinal incision lateral to the Achilles tendon may be made without damage. The other lateral calcaneal branches will be cut when we make transverse incision paralled to the plantar surface. The terminal branch also may be in danger by the same transverse incision.

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Comparison of Brain Activation Images Associated with Sexual Arousal Induced by Visual Stimulation and SP6 Acupuncture : fMRI at 3 Tesla (시각자극과 삼음교 자침으로 유발된 성적 흥분의 대뇌 활성화 영상의 비교 : 3 테슬라 기능적 자기공명영상법)

  • Choi, Nam-Gil;Han, Jae-Bok;Jang, Seong-Joo
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.183-194
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    • 2009
  • Purpose : This study was performed not only to compare the brain activation regions associated with sexual arousal induced by visual stimulation and SP6 acupuncture, but also to evaluate its differential neuro-anatomical mechanism in healthy women using functional magnetic resonance imaging (fMRI) at 3 Tesla (T). Subjects and methods : A total of 21 healthy right-handed female volunteers (mean age 22 years, range 19 to 32) underwent fMRI on a 3T MR scanner. The stimulation paradigm for sexual arousal consisted of two alternating periods of rest and activation. It began with a 1-minute rest period, 3 minutes of stimulation with either of an erotic video film or SP6 acupuncture, followed by 1-minute rest. In addition, a comparative study on the brain activation patterns between an acupoint and a shampoint nearby GB37 was performed. The fMRI data were obtained from 20 slices parallel to the AC-PC line on an axial plane, giving a total of 2,000 images. The mean activation maps were constructed and analyzed by using the statistical parametric mapping (SPM99) software. Results : As comparison with the shampoint, the acupoint showed 5 times and 2 times higher activities in the neocortex and limbic system, respectively. Note that brain activation in response to stimulation with the shampoint was not observed in the regions including the HTHL in the diencephalon, GLO and AMYG in the basal ganglia, and SMG in the parietal lobe. In the comparative study of visual stimulation vs. SP6 acupuncture, the mean activation ratio of stimulus was not significantly different to each other in both the neocortex and the limbic system (p < 0.05). The mean activities induced by both stimuli were not significantly different in the neocortex, whereas the acupunctural stimulation showed higher activity in the limbic system (p < 0.05). Conclusions : This study compared the differential brain activation patterns and the neural mechanisms for sexual arousal, which were induced by visual stimulation and SP6 acupuncture by using 3T fMRI. These findings will be useful to understand the theory of traditional acupuncture and acupoint channel in scientific point of view.

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A Clinical Study on Tumors of the Parapharyngeal Space (부인두강 종양의 임상적 고찰)

  • Kim Young-Min;Rho Young-Soo;Park Young-Min;Lim Hyun-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.38-45
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    • 1994
  • 부인두강(Parapharyngeal space)는 비인두강과 구인두강에 인접하여 위로는 두개저, 아래로는 설골사이에 위치하는 해부학적 잠재공간으로 이곳에 발생하는 종양은 매우 드무나 다양한 병리조직학적 소견을 보이며 인접한 중요장기들로 인한 수술적 어려움으로 두경부 외과의사의 관심이 되어 왔다. 최근 CT나 MRI의 도입으로 이학적 검사가 어려웠던 이부위의 진단에 많은 도움을 얻게 되었고, 발달된 수술방법의 사용으로 크기가 매우 큰 종양도 절제가 가능하게 되었다. 저자들은 1990년 9월부터 1993년 8월까지 한림대학교 이비인후과학교실에서 술전 CT나 MRI를 시행한 후 조직검사로 확진된 부인두강 종물 22례의 후향적 임상분석을 시행하여 다음의 결과를 얻었다. 1) 양성종양이 11례(30.0%), 악성종양이 11례(50.0%)로 빈도에 차이는 없었다. 2) 종양의 조직학적 기원은 타액선종양이 10례(45.5%)로 가장 많았으며 신경종양이 4례(18.2%)였고 기타 종양이 8례(36.4%)로 다양하였다. 3) 방사선학적 진단방법으로는 18례(81.8%)에서 CT를 시행하였고 필요한 경우에 MRI를 5례(22.7%), 혈관조영술을 3례(13.6%)에서 시행하였다. 4) 치료방법으로는 악성종양은 수술 및 방사선치료 또는 항암약물요법을 병리조직검사 결과에 따라 단독 또는 병합하여 시행하였고, 양성종양의 경우에는 모두 수술을 시행하였는데 수술방법은 경이하선 접근법이 가장 많이 사용되었다. 5) 추적조사는 평균 20개월로 양성종양의 경우는 모두 종양의 재발이 없이 치료되었으나 악성종양 중 전이암 1례와 악성 임파종 1례가 사망하였다.

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A Neuroanatomical and Neurophsiolgical basic Study on the Mechanism of Acupuncture in central nervous system (침자기전(鍼刺機轉)의 중추신경계(中樞神經系)에서의 신경해부(神經解剖).생리학적(生理學的) 기초연구(基礎硏究))

  • Kim, Jeong-Heon
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.514-550
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    • 1996
  • There are many theory in acupuncture mechanism, so we must know the detail contents. and then we can use the acupuncture as we know. the follow article will be helpful in this part. 1. Spinal cord are role in intermediate part in somatosensorypathway also in acupuncture stumulating tract 2. Acute pain pathway started in laminae I, V of gray colmn, next are the spinothalamic tract(trigeminal spinothalamic tract in above neck part) and then go to the specific thalamic nucleus. but chronic pain in laminae II, III, VI, VII, next are spinoreticular tract(trigeminal spinoreticular tract in the neck part) and finally to the nonspecific thalamic nucleus. 3. Thalamus is very important area in somatosensory stimuation including acupuncture stumulating sensory also as a pain control center. but except this, there are Hypothalamus, Limbic system Cerebral cortex and Cerebellum as intermediator. as we Know hypothalamus is related to the emotional analgesic system with a limbic system. 4. A ${\delta$ fiber has relationship in Acute, sharp and initial pain, contrary this C fiber is related with Chronic, dull and last pain. 5. In Acupuncture mechanism of pain analgesia, there are two theory, one is gate control theory as large fiber another is stimuation produced analgesia as small diameter fier. 6. In DNIC, the stimulation sources are mechanical, thermal, heating, pain and acupuncture stimulation etc. we call these as a Heterotopic Noxious Stimulation. 7. In DNIC, SRD(Subnucleus reticularis dorsalis)is core nucleus in pain imtermediated analgesic mechanism. 8. Takeshige insisted nonacupuncture point dependent analgesic mechanism and acupuncture point dependent analgesic mechanism. and protested that Stimulation acupuncture piing evoke blocking nomacupuncture point analgesic pathway.

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Motor Imagery Brain Signal Analysis for EEG-based Mouse Control (뇌전도 기반 마우스 제어를 위한 동작 상상 뇌 신호 분석)

  • Lee, Kyeong-Yeon;Lee, Tae-Hoon;Lee, Sang-Yoon
    • Korean Journal of Cognitive Science
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    • v.21 no.2
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    • pp.309-338
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    • 2010
  • In this paper, we studied the brain-computer interface (BCI). BCIs help severely disabled people to control external devices by analyzing their brain signals evoked from motor imageries. The findings in the field of neurophysiology revealed that the power of $\beta$(14-26 Hz) and $\mu$(8-12 Hz) rhythms decreases or increases in synchrony of the underlying neuronal populations in the sensorymotor cortex when people imagine the movement of their body parts. These are called Event-Related Desynchronization / Synchronization (ERD/ERS), respectively. We implemented a BCI-based mouse interface system which enabled subjects to control a computer mouse cursor into four different directions (e.g., up, down, left, and right) by analyzing brain signal patterns online. Tongue, foot, left-hand, and right-hand motor imageries were utilized to stimulate a human brain. We used a non-invasive EEG which records brain's spontaneous electrical activity over a short period of time by placing electrodes on the scalp. Because of the nature of the EEG signals, i.e., low amplitude and vulnerability to artifacts and noise, it is hard to analyze and classify brain signals measured by EEG directly. In order to overcome these obstacles, we applied statistical machine-learning techniques. We could achieve high performance in the classification of four motor imageries by employing Common Spatial Pattern (CSP) and Linear Discriminant Analysis (LDA) which transformed input EEG signals into a new coordinate system making the variances among different motor imagery signals maximized for easy classification. From the inspection of the topographies of the results, we could also confirm ERD/ERS appeared at different brain areas for different motor imageries showing the correspondence with the anatomical and neurophysiological knowledge.

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Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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Development of Flipped Learning Class Design Model in Basic Medicine using Edutech : RECIPE Model (에듀테크를 활용한 기초의학 분야 플립드 러닝 수업 설계 모형 개발 : RECIPE 모델)

  • Lee, Mun-Young;Lee, Hyo-Rim
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.255-267
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    • 2021
  • The purpose of this study is to present basic data for systematic and effective basic medical education by developing a flipped learning class design model using smart tools and verifying its validity. To this end, in this study, a model proposal was developed based on literature review, and its validity was verified through expert review and field application. In this study, as a flipped learning class design model using smart tools, RECIPE(R: Ready, E: Establish a Plan, C: Create and Connect Media, I: Into the Classroom, P: Process-focused Assessment, E: Evaluation) model was developed. This model is a model that enhances the learning effect by applying an appropriate smart tool at each stage of designing flipped learning. As a result of applying this model to the development of'Anatomy'and'Neuroscience'lectures in the first semester of 2019, students' interest and satisfaction are high, and it is proposed as a specialized model in the field of basic medicine. Therefore, the RECIPE model developed in this study can be applied to various basic medicine-related classes, and it is expected that students will be able to understand basic medicine through the design of the flipped learning class based on this.

Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results (외상에 노출된 소방관들의 뇌 구조 및 휴식기 뇌기능 변화: 예비 결과)

  • Yae Won Park;Suhnyoung Jun;Juwhan Noh;Seok Jong Chung;Sanghoon Han;Phil Hyu Lee;Changsoo Kim;Seung-Koo Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.676-687
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    • 2020
  • Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.