Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.
The ability of neurotropic alpha herpesviruses to replicate within synaptically linked neurons has made these pathogens valuable tools for transneuronal analysis. Recent studies suggest that unique gene products expressed by genetically engineered strains of virus may permit the use of multiple strains in complex tracing paradigms. In the present study we have examined the invasiveness of two genetically engineered strains of the swine pathogen known as pseudorabies virus(PRV). The two strains were isogenic with the attenuated Bartha strain of PRV; in one strain a lacZ reporter gene was inserted into the gC locus (PRV-BaBlu; $4.75\times10^8pfu/ml$) contrained a PRV envelope glycoprotein gene that was absent in PRV-BaBlu. Simultaneous or temporally separated sequential injection of $4\mu\ell$ of each strain into the ventral wall of the stomach produced a predictale course of retrograde synaptic infection. The results were as follows: 1. PRV-BaBlu and PRV-D infected the dorsal motor nucleus of vagus nerve(DMV) and paraventricular nucleus(PVN). 2. Invasion and replication of PRV-D occured at a faster rate than the parental strain or PRV-BaBlu. 3. PRV-D was much more virulent than PRV-BaBlu or the parental strain. 4. Co-injection of PRV-D and PRV-BaBlu produced an infection that was more virulent than that produced by the parental strain (PRV-Bartha), 5. Neurons in DMV were permissive to co-infection with PRV-D and PRV-BaBlu when they were injected simultaneously into the same site. 6. Replication of PRV-BaBlu was compromised by prior infection of the same circuit with PRV-D. 7. Prior infection of neurons with PRV-D maked them resistant to infection with PRV-BaBlu.
General pharmacological properties of DA-8159, a new pyrazolopyrimidinone derivative were examined in laboratory animals to investigate its safety profile. The oral administration of DA-8159 (1, 5 or 30 mg/kg) in mice and rats had no effect on general behaviors and central nervous system of the animals in test systems, such as hexobarbital-induced sleeping time, motor coordination, normal body temperature, writhing syndromes induced by 0.75% acetic acid solution, chemo-shock produced by pentetrazole solution and rotar rod test. Anesthetized cats treated intravenously with DA-8159 (0.1, 0.3, 1, 3 or 10 mg/kg) showed transient and mild decrease in blood pressure. However, heart rate, respiration rate and tidal volume were not changed by intravenous DA-8159. In the isolated organs including ileum, heart (sinus rate of atria and contractility of papillary muscle), trachea of guinea pigs and phrenic nerve of rats, DA-8159 ($10^{-8}$ ∼$10^{-5}$ mg/L) did not elicit any effect or inhibitory action on the chemically or electrically stimulated contraction. DA-8159 did not influence gastric secretion, pH and total acid output in rats and intestinal propulsion in mice. The administration of DA-8159 in rats had no effect on the platelet aggregation induced by ADP in rabbit plasma, urinary volume and electrolyte ion ($Na^{+}$, $K^{+}$, $Cl^{-}$) excretion in rats. Prothrombin time (PT) of the rats showed a mild but significant increase after administration of DA-8159. Activated partial thromboplastin time (APTT), however, was not affected by DA-8159. These results indicate that DA-8159 does not exert any of serious pharmacological effects.
Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.
Kim, G.H.;Ryu, M.H.;Shin, Y.I.;Kim, H.I.;Kim, N.G.;Yang, Y.S.
Journal of Biomedical Engineering Research
/
v.28
no.1
/
pp.153-161
/
2007
Stroke is the second most significant disease leading to death in Korea. The conventional therapeutic approach is mainly based on physical training, however, it usually provides the limited degree of recovery of the normal brain function. The electric stimulation therapy is a novel and candidate approach with high potential for stroke recovery. The feasibility was validated by preliminary rat experiments in which the motor function was recovered up to 80% of the normal performance level. It is thought to improve the neural plasticity of the nerve tissues around the diseased area in the stroked brain. However, there are not so much research achievements in the electric stimulation for stroke recovery as for the Parkinson's disease or Epilepsy. This study aims at the developments of a wireless variable pulse generator using ZigBee communication for future implantation into human brain. ZigBee is widely used in wireless personal area network (WPAN) and home network applications due to its low power consumption and simplicity. The developed wireless pulse generator controlled by ZigBee can generate various electric stimulations without any distortion. The electric stimulation includes monophasic and biphasic pulse with the variation of shape parameters, which can affect the level of recovery. The developed system can be used for the telerehabilitation of stroke patient by remote control of brain stimulation via ZigBee and internet. Furthermore, the ZigBee connection used in this study provides the potential neural signal transmission method for the Brain-Machine Interface (BMI).
Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Cho, Soo-Ho;Jang, Sung-Ho
Journal of Korean Neurosurgical Society
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v.41
no.1
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pp.22-26
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2007
Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.
Journal of The Korean Society of Clinical Toxicology
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v.4
no.2
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pp.161-165
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2006
Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.
Journal of Dental Rehabilitation and Applied Science
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v.33
no.1
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pp.1-6
/
2017
Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.
Journal of the Korean Academy of Clinical Electrophysiology
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v.9
no.1
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pp.35-39
/
2011
Purpose : The purpose of this study was to determine changes in muscle activity due to elastic taping at the rectus femoris, biceps femoris and tibialis anterior muscles using surface electromyography analysis. Methods : In this study 10 healthy university students in the Department of Taekwondo Studies were screened and individuals with a history of previous injury or surgery to their nerve, muscle, and skeletal systems, such as paresthesia and motor disorder, were excluded. Subjects were taped over the rectus femoris, biceps femoris, and tibialis anterior and their muscle activities were analyzed using the surface electromyography method during maximal voluntary isometric contraction. Results : The results of this study were as follows: muscle activities indicated a significant increase after elastic taping than before at the rectus femoris, biceps femoris, and tibialis anterior muscle. These results lead us to the conclusion that muscle activity were influenced by elastic taping at the rectus femoris, biceps femoris, and tibialis anterior muscles. Conclusion : The results of this study show that muscle activity can be improved by elastic taping at the lower limbs. These results suggest that elastic taping of muscles in the lower extremities has the capability to increase muscle activity in the body.
Journal of the Korean Academy of Clinical Electrophysiology
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v.9
no.2
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pp.19-24
/
2011
Purpose : This study is to examine the effects of transcranial direct current stimulation on the excitability of the central neuron. Methods : This study selected 24 suitable women in their twenties. A positive electrode of transcranial direct current stimulation was placed on the primary motor area (M1) C4 and a negative electrode was placed on the left supraobital. A stimulation of 0.04mA/$cm^2$ was applied for 20 minutes. H-reflex and V wave used diagnostic electromyography. An active electrode was placed at the muscle belly of the medial gastrocnemius muscle at a prone posture. An electrical stimulation was given to the posterior tibial nerve. Measurements were made before and after the stimulation. All data were analyzed with SPSS 12.0 and between each measuring before and after the change of the H-reflex and V wave amplitude. Results : There were no significant differences in all H wave, M wave, and V wave amplitude before and after transcranial direct current stimulation. There were no significant differences in the change of H/M ratio and V/M ratio before and after transcranial direct current stimulation. Conclusion : We know that transcranial direct current stimulation cannot have an influence on a normal grown-up person's central neuron.
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