• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.387-395
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• 2009

Nerve growth factor (NGF) and sensory neuropeptides are involved in the process of nociception at peripheral nerve fibers and wide spread in central nervous system. The aims of this study were to investigate NGF and sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) levels in human plasma and saliva, and the associations between these sensory neuropeptides levels and chronic orofacial pain symptoms. NGF, SP, and CGRP levels in plasma and resting whole saliva samples collected from 67 orofacial pain patients (joint pain, dental or periodontal pain, mucosal pain) and 36 pain free control subjects were measured by enzyme immunoassay. The characteristic pain intensity of each subject was measured using the Graded Chronic Pain Scale and the flow rate of resting whole saliva was measured. Joint pain patients group showed significantly higher plasma NGF level compared to each of dental pain patients (p<0.01), mucosal pain patients (p<0.01), and control group (p<0.01). Plasma NGF level of dental pain patients group was significantly higher than that of control group (p<0.01). Saliva SP level of dental pain patients group (p<0.05) and saliva CGRP level of mucosal pain group (p<0.05) were significantly higher than that of control group. Plasma and saliva SP levels of joint pain patients was significantly associated with pain intensity (plasma: standardized coefficient=0.599, p<0.01, saliva: standardized coefficient=0.504, p=0.05). In dental pain patients group, plasma SP (standardized coefficient=0.559, p<0.01), saliva SP (standardized coefficient=0.520, p<0.01) and saliva CGRP (standardized coefficient=0.599, p<0.01) levels were significantly associated with age. In mucosal pain patients group, plasma SP (standardized coefficient=0.495, p<0.05), saliva SP (standardized coefficient=0.500, p<0.05), and saliva CGRP (standardized coefficient=0.717, p<0.01) levels were significantly associated with age. NGF and neuropeptides may play a role in the maintenance of various orofacial pain symptoms. The examination of those levels in plasma and saliva helps understanding the mechanism of orofacial pain, and furthermore, can be applied to the diagnosis and therapy of orofacial pain.

• Sleep Medicine and Psychophysiology
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• v.13 no.2
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• pp.67-74
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• 2006

Introduction: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. Methods: Twelve narcoleptic patients (7 male, age: $22.9{\pm}2.6\;yrs$) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. Results: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. Discussion: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.365-373
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• 1999

Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.87-106
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• 2005

In order to evaluate the mechanism of transmission as well as processing of sensory information originating from low-threshold mechanoreceptor in oral and maxillofacial region at primary synaptic region of trigeminal nervous system, vibrissa afferent fibers of adult cat were labeled with intra-axonal HRP injection. Serial sections containing labeled boutons were obtained from the piece of trigeminal interpolar nucleus. Under electron microscope, total 30 labeled boutons were observed, and ultrastructural characteristics, frequency of occurence, synaptic organizations of vibrissa afferent terminals were analysed. The results were as follows: 1. Labeled boutons contained clear, spherical synaptic vesicles with diameter of 45$\sim$55nm. They formed asymmetrical synapse with dendrites showing definite postsynaptic density, larger synaptic cleft, multiple synaptic structures at various regions. With unlabeled axon terminals(p-ending) containing polymorphic synaptic vesicles, they formed symmetrical synapse showing indefinite postsynaptic density and narrower synaptic area. 2. Each labeled bouton formed 1 to 15 synapses, the average of 4.77$\pm$3.37 contacts per labeled bouton, with adjacent neuronal profiles. Relatively complex synaptic organization, which formed synapses with more than 5 neuronal profiles, was observed in a large number(46.7%, n=14) of labeled boutons. 3. Axo-somatic synapse was not observed. The number of axo-dendritic synapse was 1.83$\pm$1.37 per labeled bouton. Majority(85.0%) of axo-dendritic synapses were formed with dendritic shafts, nonprimary dendrites(n=47, 1.57$\pm$1.38/1 bouton), however, synapses formed with primary dendrites(n=6, 0.20$\pm$0.41/1 bouton) or dendritic spines(n=2, 0.07$\pm$0.25/1 bouton) were rare. 4. 76.7%(n=23) of labeled boutons formed axo-axonic synapse (2.93$\pm$2.36/1 bouton) with p-endings containing pleomorphic vesicles. Synaptic triad, in which p-endings formed synapses with labeled boutons and dendrites adjacent to the labeled boutons simultaneoulsy, were also observed in 60.0%(n=18) of labeled boutons. From the above results, vibrissa afferent terminals of adult cat showed distinctive synaptic organization in the trigeminal interpolar nucleus, thus, suggests their correlation with the function of the trigeminal interpolaris nucleus, which participates in processing of complex sensory information such as two-point discrimination and motivational-affective action. Further studies on physiologic functions such as quantitative analysis on ultrastructures of afferent terminals and nerve transmitters participating in presynaptic inhibition are required.

• Journal of Life Science
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• v.17 no.11
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• pp.1576-1581
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• 2007

Dopamine reward pathway projecting from ventral tegmental area to nucleus accumbens is well known as playing an important role in alcohol dependence. It is supposed that this dopamine pathway is modulated by $5-HT_3$ nervous system, and it was reported that ondansetron (OND), $5-HT_3$ receptor antagonist, reduced drinking amount and increased abstinence rate in alcohol-dependent patients. The purpose of this study is to investigate the effect of combination of OND and naltrexone (NTX), non-specific opioid receptor antagonist, on alcohol intake in C57BL/6 mice. In 40 C57BL/6 mice in the state of alcohol dependence, vehicle, while OND 0.01 mg/kg, or NTX 1.0 mg/kg administrated respectively, or OND 0.01 mg/kg and NTX 1.0 mg/kg administrated simultaneously for ten days, medication effects on 2-hr alcohol, 22-hr water, 24-hr food intake and body weight were studied. When vehicle group was compared with 3 medication groups respectively, using a repeated measure ANOVA, NTX alone and vehicle groups showed a significant medication by time interaction (p=0.042) in 2-hr alcohol intake, but in the other 2 groups, OND and NTX combination group and OND alone group, there was no significant interaction with vehicle group in 2-hr alcohol intake. From these results, it is suggested that there is no effect on alcohol intake in mice treating with OND, and naltrexone#s suppression effect on alcohol intake in mice is attenuated when treating with OND and NTX simultaneously. It is supposed that a further study looking at the interactions of serotonin, dopamine and opioid nerves systems will be needed.

• The Korean Journal of Physiology
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• v.2 no.2
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• pp.21-31
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• 1968

The appearance rates of antipyrine and urea into cerebrospinal fluid from blood were studied in the rabbits which were in the state of hypotension and of high permeability in the capillary beds following injection of histamine. The alteration in the distribution of electrolytes among various compartments of the brain and the permeability characteristics in the blood-cerebrospinal fluid barrier were also observed. Adult male rabbits, weighing around 2 kg, were used. Twenty four rabbits were divided into 3 groups. Besides the control group, histamine treated rabbits were categorized into 2 groups. $H_1$ consisted of the rabbits showing moderate responses to histamine and ranging from 62 to 80 mmHg in their mean anterial blood pressure. The animals which belong to $H_2-group$ showed severe responses to histamine and the mean anterial blood pressures dropped to 30-50 mmHg. Animals were anesthetized with nembutal, 30mg/kg i.v. The mean arterial blood pressure was read by means of the mercury manometer connected to the femoral artery. The animals, treated with histamine, were kept in hypotensive state at least for 40 minutes before the administration of the test-substances. The test-substances, 300 mg of urea and 200 mg of antipyrine, were dissolved in 3 ml of distilled water and were injected into the ear vein of the rabbit. After 10 minutes elapsed arterial blood sample was taken from the femoral artery and cerebrospinal fluid from the cisterna magna. Brain tissues were also analysed with respect to electrolytes in order to observe the disturbances in the electrolytes balance as well as in the function of the central nervous system. The results obtained were as follow: 1. The ratio of antipyrine concentration in cerebrospinal fluid to that of arterial blood plasma, that was the distribution ratio, was close to unity, revealing a well established equilibrium between the compartments of blood and cerebrospinal fluid in 10 minutes. In other words, there was no diffusion barrier with regard to antipyrine. The ratios over unity which were frequently seen in the histamine treated animals were attributable to the early penetration of the substance into the cerebrospinal fluid. 2. The appearance rates of urea into the cerebrospinal fluid in the histamine treated rabbits were higher in comparison with those of in the control animals. The increasing tendency in the rates was particularly remarkable in the $H_2-group$, showing the enhanced penetration of urea across the boondary. 3. In the htisamine treated $H_2-group$ the concentration of potassium in the blood plasma and cerebrospinal fluid well exceeded the control values and showed 8.5 and 9.0 mEq/l in average, respectively. Simultaneous drops in the brain tissue water were noticed, suggesting the leakage of intracellular potassium. 4. There was a coincidence in the rising pattern of potassium in the blood plasma and in the cerebrospinal fluid of $H_2-group$ and at least partial removal of the blood-cerebrospinal fluid barrier with respect to potassium was suggested in these animals. 5. The concentration of sodium in the blood plasma or in the cerebrospinal fluid showed no significant changes following histamine injection. However, sodium in the brain tissue revealed slight elevation in the histamine treated groups. 6. The ratios of the concentrations of potassium to those of sodium, [K]/[Na] in the brain tissues, were 1.92 in the control 1.82 in the $H_1$ and 1.52 in the $H_2-group$, respectively. The marked drop in the $H_2-group$ might represent neural dysfunction in the extremely hypotensive rabbits.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4346-4353
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• 2010

The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion($2.39^{\circ}$) and extension($38.36^{\circ}$), flexion($54.11^{\circ}$) and extension($69.39^{\circ}$), lateral flexion on left($43.50^{\circ}$) and right($41.28^{\circ}$), rotation on left($66.39^{\circ}$) and right($65.94^{\circ}$) in male and suboccipital flexion($5.14^{\circ}$) and extension($36.47^{\circ}$), flexion($55.92^{\circ}$) and extension($71.22^{\circ}$), lateral flexion on left($43.34^{\circ}$) and right($41.06^{\circ}$), rotation on left($69.38^{\circ}$) and right($68.63^{\circ}$) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

• Journal of Nutrition and Health
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• v.47 no.2
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• pp.113-123
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• 2014

Purpose: Vitamin D has been known to play an important role in the central nervous system and brain functions in the human body, and cumulative evidence has shown that vitamin D deficiency might be linked with various mental health conditions. Epidemiologic studies have shown that vitamin D deficiency may be associated with higher risk of depression in the US and European populations. However, limited information is available regarding the association between vitamin D status and depression in the Korean population. The objective of this study was to examine the associations between vitamin D levels and prevalence of depression. Methods: We conducted a cross-sectional analysis using nationally representative data from the 2008-2010 Korean National Health and Nutrition Examination Survey from which serum 25-hydroxyvitamin D concentrations were available. A total of 18,735 adults who had available demographic, dietary, and lifestyle information were included in our analysis. We defined "depression" with a diagnosis by a physician. "Depressed condition" was defined as having feelings of sadness or depression without diagnosis by a physician. Results: The prevalence of depression was 1.63% and 5.43% in Korean men and women, respectively; 12.5% of men and 26.1% of women were defined as the group having depressed conditions. In multivariate logistic regression models, no significant associations were observed between vitamin D status and prevalence of depression or depressed conditions in Korean men and women. Conclusion: We found no association between vitamin D insufficiency and depression/depressed conditions in Korean adults. Future large prospective studies and randomized controlled trials are needed to confirm this relationship.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.175-183
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• 2019

Cerebral nervous system intervention has been reported frequently due to radiation exposure such as blistering of the skin, hair loss, and erythema due to prolonged procedures. By applying ergonomically manufactured Bismuth (atomic number 83; Bi) shield to endovascular treatment of cerebral aneurysms, we aimed to minimize radiation exposure of scalp and lens from medical radiation exposure. The measurement site was the posterior part of the head, bilateral temporal part, bilateral quadriceps part, nose part, and the measuring part was attached to the optically stimulated Luminescence dosimeter (OSLD) Before and after the use, the entrance surface dose was compared and analyzed. The average entrance surface dose of group A (unshield) was 92.44 mGy, and group B was measured at 67.55 mGy. The average decrease in Group B was 26.92% compared to Group A. The entrance surface dose mean of the occipital region was measured at 146.08 mGy B group at 103.23 mGy and decreased by an average of 29.32% in group B compared to group A. The average entrance surface dose of the bilateral temporal part was measured in group A at 101.90 mGy group B at 72.69 mGy and decreased by an average of 28.67% in group B compared to group A. The average entrance surface dose for bilateral quadriceps part was measured at 27.51 mGy group B at 21.39 mGy and averaged 22.26% less in group B than group A. It is believed that the use of bismuth shields will be an alternative to reducing radiation disturbance due to temporary hair loss and other stochastic effects that may occur after the endovascular treatment of cerebral aneurysms procedure.

• Sleep Medicine and Psychophysiology
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• v.26 no.1
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• pp.44-48
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• 2019

Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.