• Title/Summary/Keyword: Electrophysiological study

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Loss of Facilitation in H-reflex: Implication as an Initial Abnormality and an Evidence of Central Nervous Involvement in Guillian-Bare Syndrome (H-반사 촉진의 소실: 길랑-바레 증후군의 초기 이상과 중추신경 침범의 증거로써의 의미)

  • Sung, Jung-Joon;Lee, Yoon-Jeong;Hong, Yoon-Ho;Chung, Young-Min;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.119-124
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    • 2002
  • Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is a neurologically emergent condition, leading to respiratory insufficiency without an early and appropriate treatment. Thus, the treatment of GBS requires early diagnosis but it is difficult due to the low sensitivity of laboratory tools in the initial stage. Hoffman reflex (H-reflex) and its facilitation by Jendrassik maneuver (JM) are sensitive tools evaluating the central circuit of motor system on the spinal cord level. The aim of this study is to test whether the change of H-reflex and F-wave under the JM is able to detect the early stage of GBS and whether GBS involves the central nervous system (CNS). Material and Methods : All 7 GBS patients who showed normal or nearly normal nerve conduction study were included. The facilitation of H-reflex and changes of F-wave were calculated by measuring the percent difference of H-reflex or F-wave amplitude under JM compared to basal H-reflex of F-wave amplitude. The changes of F-wave and H-reflex in the GBS patients were compared with them of 8 healthy controls. Results : The F-wave amplitudes of both healthy controls and GBS patients did not changed under the influence of JM ($102.4{\pm}24.9%$, $108.7{\pm}29.0%$ respectively). However, the facilitation of H-wave by JM in the GBS patients was absent ($98.8{\pm}5.8%$), even though the H-reflex amplitude I the healthy controls increased under the influence of JM ($124.8{\pm}12.1%$). Conclusions : The loss of H-reflex facilitation in GBS implies that this phenomenon might be the most early change detected in the electrophysiological study and support the early diagnosis, and that GBS might include lesion in the spinal motor CNS.

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Correlation of acoustic features and electrophysiological outcomes of stimuli at the level of auditory brainstem (자극음의 음향적 특성과 청각 뇌간에서의 전기생리학적 반응의 상관성)

  • Chun, Hyungi;Han, Woojae
    • The Journal of the Acoustical Society of Korea
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    • v.35 no.1
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    • pp.63-73
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    • 2016
  • It is widely acknowledged that the human auditory system is organized tonotopically and people generally listen to sounds as a function of frequency distribution through the auditory system. However, it is still unclear how acoustic features of speech sounds are indicated to the human brain in terms of speech perception. Thus, the purpose of this study is to investigate whether two sounds with similar high-frequency characteristics in the acoustic analysis show similar results at the level of auditory brainstem. Thirty three young adults with normal hearing participated in the study. As stimuli, two Korean monosyllables (i.e., /ja/ and /cha/) and four frequencies of toneburst (i.e., 500, 1000, 2000, and 4000 Hz) were used to elicit the auditory brainstem response (ABR). Measures of monosyllable and toneburst were highly replicable and the wave V of waveform was detectable in all subjects. In the results of Pearson correlation analysis, the /ja/ syllable had a high correlation with 4000 Hz of toneburst which means that its acoustic characteristics (i.e., 3671~5384 Hz) showed the same results in the brainstem. However, the /cha/ syllable had a high correlation with 1000 and 2000 Hz of toneburst although it has acoustical distribution of 3362~5412 Hz. We concluded that there was disagreement between acoustic features and physiology outcomes at the auditory brainstem level. This finding suggests that an acoustical-perceptual mapping study is needed to scrutinize human speech perception.

Nerve Regeneration Using a Vein Graft Conduit filled with Hyaluronic Acid in a Rat Model (흰쥐 모델에서 하이알루론산을 채운 정맥도관의 신경재생에 관한 연구)

  • Suh, Bo Ik;Kim, Sang Woo;Chung, Ho Yun;Kim, Il Hwan;Yang, Jung Dug;Park, Jae Woo;Cho, Byoung Chae
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.279-284
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    • 2007
  • Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

Effects of Human Mesenchymal Stem Cell Transplantation Combined with Polymer on Functional Recovery Following Spinal Cord Hemisection in Rats

  • Choi, Ji Soo;Leem, Joong Woo;Lee, Kyung Hee;Kim, Sung-Soo;SuhKim, Haeyoung;Jung, Se Jung;Kim, Un Jeng;Lee, Bae Hwan
    • The Korean Journal of Physiology and Pharmacology
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    • v.16 no.6
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    • pp.405-411
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    • 2012
  • The spontaneous axon regeneration of damaged neurons is limited after spinal cord injury (SCI). Recently, mesenchymal stem cell (MSC) transplantation was proposed as a potential approach for enhancing nerve regeneration that avoids the ethical issues associated with embryonic stem cell transplantation. As SCI is a complex pathological entity, the treatment of SCI requires a multipronged approach. The purpose of the present study was to investigate the functional recovery and therapeutic potential of human MSCs (hMSCs) and polymer in a spinal cord hemisection injury model. Rats were subjected to hemisection injuries and then divided into three groups. Two groups of rats underwent partial thoracic hemisection injury followed by implantation of either polymer only or polymer with hMSCs. Another hemisection-only group was used as a control. Behavioral, electrophysiological and immunohistochemical studies were performed on all rats. The functional recovery was significantly improved in the polymer with hMSC-transplanted group as compared with control at five weeks after transplantation. The results of electrophysiologic study demonstrated that the latency of somatosensory-evoked potentials (SSEPs) in the polymer with hMSC-transplanted group was significantly shorter than in the hemisection-only control group. In the results of immunohistochemical study, ${\beta}$-gal-positive cells were observed in the injured and adjacent sites after hMSC transplantation. Surviving hMSCs differentiated into various cell types such as neurons, astrocytes and oligodendrocytes. These data suggest that hMSC transplantation with polymer may play an important role in functional recovery and axonal regeneration after SCI, and may be a potential therapeutic strategy for SCI.

Sural nerve involvement accompanying peroneal nerve palsy (비골신경 마비에 따른 비복신경 손상의 정도)

  • Yoon, Won-Tae;Lee, Taek-Jun;Shin, Kyung-Jin;Kim, Byoung-Joon
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.31-34
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    • 2004
  • Backgrounds: The pathway of the sural nerve (SN) is variable, but usually divided into medial and lateral sural branches joining the posterior tibial nerve (PTN) and the peroneal nerve (PN). The sural nerve may be affected by PN palsy. The frequency or the severity of SN involvement in peroneal palsy is not known. The purpose of the study is to investigate the frequency and the severity of the SN involvement by the peroneal nerve palsy. Methods: Total 85 patients were included with peroneal palsy. Amplitudes of distal peroneal, sural, and superficial peroneal nerves (SPN) were compared between normal and paralyzed sides. The frequency and severity of SN involvement by peroneal palsy were investigated. Results: Mean age was $48.4{\pm}17.4$ years old at the time of the test. Peroneal palsy was right side in 32, left in 38, and bilateral in 15 patients. Mean amplitudes of affected distal PN, SPN, and SN were $1.51{\pm}1.64mV$, $3.50{\pm}4.86{\mu}V$, and $10.42{\pm}6.59{\mu}V$ in right side, and $1.19{\pm}1.57mV$, $4.38{\pm}5.67{\mu}V$, and $11.06{\pm}6.87{\mu}V$ in left side, respectively. Sensory nerve action potential (SNAP) amplitude of the SN in the affected side was average $73.7{\pm}33.1%$ of normal, which was significantly lower than that in the normal side(p<0.01). The decrease of the sural SNAP amplitude was more than 15% in 39 out of 70 patients with unilateral peroneal palsy. Peroneal compound muscle action potential (CMAP) amplitude was not correlated with the amplitude of the sural SNAP. By complete peroneal palsy, SN SNAP amplitude was decreased to 4% of SNAP and $57.7{\pm}31.8%$ of that in normal side. Conclusions: PN injury without PTN involvement may induce reduction of sural SNAP amplitude. Because of the anatomic variation of SN, the electrophysiological findings are variable. It should be considered to interpret the location of the PN lesion.

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Motor Evoked Potential Study with Magnetic Stimulation in Ischemic Stroke Patients (허혈성 뇌졸중 환자에서 Magnetic Stimulation에 의한 운동유발전위 반응)

  • Kim, Seong-Min;Suh, Sang-Dug;Lee, Jun;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.248-261
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    • 1994
  • This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 ischemic stroke patients. The central motor conduction time (CMCT) was represented by the difference of latency to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.

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Quantitative Analysis of Neurotransmitters in the Endings Presynaptic to Vibrissa Afferent Terminals in the Cat Trigeminal Caudal Nucleus (고양이 삼차신경꼬리핵에서 저역치기계자극수용기 유래 들신경종말의 연접이전종말이 함유하는 신경전달물질에 대한 정량적 분석)

  • Kim, Yun-Sook;Mun, Cheol-Ju;Cho, Jin-Hyun;Bae, Jin-Young;Na, Yeon-Kyung;Bok, Hye-Jeong;Bae, Yong-Chul;Paik, Sang-Kyoo
    • Applied Microscopy
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    • v.42 no.1
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    • pp.9-16
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    • 2012
  • The goal of this study was to identify neurotransmitters in endings (p-endings) presynaptic to low-threshold mechanoreceptive vibrissa afferents in the laminae III/IV of cat trigeminal caudal nucleus (Vc). Rapidly-adapting vibrissa afferents were intra-axonally labeled after electrophysiological identification, and postembedding immunogold staining with antisera against ${\gamma}$-aminobutyric acid (GABA) and glycine was performed, followed by quantitative ultrastructural analysis of p-endings presynaptic to the labeled vibrissa afferent terminals. Sixteen p-endings, which are presynaptic to the HRP-labeled vibrissa afferent terminals, were analyzed in this study: Eight p-endings (50%, 8/16) were immunopositive to GABA but immunonegative to glycine (GABA+ p-ending), and remaining 8 p-endings (50%, 8/16) exhibited immunoreactivity to both GABA and glycine. Bouton volume of the p-endings was not significantly different between the two groups. However, the p-endings differed from each other in relative content of GABA and glycine. These findings suggest that low-threshold mechanoreceptive information conveyed through vibrissa afferent at Vc is presynaptically modulated by GABA and/or glycine, and that degree of presynaptic modulation may differ among each vibrissa afferent terminal.

Pituitary Adenylate Cyclase-activating Polypeptide Inhibits Pacemaker Activity of Colonic Interstitial Cells of Cajal

  • Wu, Mei Jin;Kee, Keun Hong;Na, Jisun;Kim, Seok Won;Bae, Youin;Shin, Dong Hoon;Choi, Seok;Jun, Jae Yeoul;Jeong, Han-Seong;Park, Jong-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.435-440
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    • 2015
  • This study aimed to investigate the effect of pituitary adenylate cyclase-activating peptide (PACAP) on the pacemaker activity of interstitial cells of Cajal (ICC) in mouse colon and to identify the underlying mechanisms of PACAP action. Spontaneous pacemaker activity of colonic ICC and the effects of PACAP were studied using electrophysiological recordings. Exogenously applied PACAP induced hyperpolarization of the cell membrane and inhibited pacemaker frequency in a dose-dependent manner (from 0.1 nM to 100 nM). To investigate cyclic AMP (cAMP) involvement in the effects of PACAP on ICC, SQ-22536 (an inhibitor of adenylate cyclase) and cell-permeable 8-bromo-cAMP were used. SQ-22536 decreased the frequency of pacemaker potentials, and cell-permeable 8-bromo-cAMP increased the frequency of pacemaker potentials. The effects of SQ-22536 on pacemaker potential frequency and membrane hyperpolarization were rescued by co-treatment with glibenclamide (an ATP-sensitive $K^+$ channel blocker). However, neither $N^G$-nitro-L-arginine methyl ester (L-NAME, a competitive inhibitor of NO synthase) nor 1H-[1,2,4]oxadiazolo[4,3-${\alpha}$]quinoxalin-1-one (ODQ, an inhibitor of guanylate cyclase) had any effect on PACAP-induced activity. In conclusion, this study describes the effects of PACAP on ICC in the mouse colon. PACAP inhibited the pacemaker activity of ICC by acting through ATP-sensitive $K^+$ channels. These results provide evidence of a physiological role for PACAP in regulating gastrointestinal (GI) motility through the modulation of ICC activity.

Microsurgical DREZotomy for Deafferentation Pain (구심로 차단 동통에서의 미세 후근 진입부 절제술)

  • Kim, Seong-Rim;Lee, Kyung Jin;Cho, Jeong Gi;Rha, Hyung Kyun;Park, Hae Kwan;Kang, Joon Ki;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.85-90
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    • 2001
  • Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

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Effects of Herbal medicines in Pacemaker Potential of Colonic Intestinal Interstitial cells of Cajal in mice (생쥐 대장 카할세포의 자발적 탈분극에서 한약의 효과에 관한 비교연구)

  • Na Ri, Choi;Haejeong, Jeong;Woo-gyun, Choi;Byung Joo, Kim
    • Herbal Formula Science
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    • v.31 no.1
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    • pp.11-19
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    • 2023
  • Objectives : The purpose of this study was to examine the effects of herbal medicines on pacemaker potentials of large intestinal interstitial Cells of Cajal (ICC) in mice. Methods : We made the ICC culture in large intestine in mice and used the electrophysiological method to record pacemaker potentials. Also we used MTT assay to check cell viability and examined the ICC protein expression by western blot. Results : 1.Glycyrrhiza uralensis Fischer (GF) (50-150 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 58.95 ㎍/ml. Angelica gigas (AG) (50-200 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 77.22 ㎍/ml. Poncirus fructus (PF) (10-100 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 13.39 ㎍/ml. Citrus unshiu S. Marcov. (CU) (10-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 139.80 ㎍/ml. Gardenia jasminoides J. Ellis (GJ) (100-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 78.70 ㎍/ml. Coptis chinensis (CC) (100-1000 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 138.10 ㎍/ml. Scutellaria baicalensis (SB) (10-100 ㎍/ml) had no effects on pacemaker potentials and decreased frequency with concentration-dependent manners. IC50 is 18.34 ㎍/ml. Atractylodes macrocephala koidzumi (AM) (10-100 ㎍/ml) induced pacemaker hyperpolarizations and decreased frequency with concentration-dependent manners. IC50 is 18.54 ㎍/ml. 2. PF, SB and AM had no effects on cell death in large ICC. 3. PF increased the ANO1 and c-kit protein expression and SB and AM increased the c-kit protein expression in large ICC. Conclusions : These results suggest that PF, SB, and AM are likely to be the optimal combination of herbal medicines that can be used to treat diseases such as gastrointestinal motility disorders such as irritable bowel syndrome.