• Journal of Biomedical Engineering Research
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• v.17 no.2
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• pp.221-226
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• 1996

Tendon reflex responses generated from mechanical stimulus had been studied for quantitative analysis of activity of tendon reflex, especially patellar tendon reflex responses are known to be a criterion for diagnosing the L3 or L4 radiculopathy. In this paper, we developed a digital signal processing system for analysis of the tendon reflex response. The system parameter, i.e., $\textit{sampling frequency, pre-amplification gain, input channel and filter bank}$ are selected by Using software switches. From the view points of flexibility, the system hardware is connected to an IBM PC for analyzing the tendon reflex parameters, amplitude, latency duration We applied the proposed system to the analysis of the patellar tendon reflex reponses. In the experiment, we measured latency, duration, amplitude of the reflex action potentials generated from vastus medialis, vastus lateralis and rectus femoris that compose quadriceps, and the measured data are analyzed througll the ANOVA test which has 5% significant level. As a result, we showed that the mean amplitude of reflex action potential at the vastus lateralis is larger than any other muscle and the mean latency of the reflex action potential at the rectus femoris is shorter than any other muscle.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.126-146
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• 1999

In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

• The Korean Journal of Physiology
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• v.21 no.1
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• pp.67-77
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• 1987

Effect of intravenously injected clonidine on the flexion reflex was studied in 15 decerebrated and spinalized cats. The flexion reflex was elicited by electrical stimulation of the tibial nerve or the common peroneal nerve and it was recorded as single unit activity from filaments of the L6 or L7 ventral roots. In order to obtain the late flexion reflex discharges, $A{\delta}$ and C afferent fibers were stimulated with single or train electrical pulses respectively. The flexion reflex, especially the late component, was markedly inhibited after intravenous administration of clonidine. The clonidine-induced inhibition of the flexion reflex was compared before and after treatment of the animals respectively with yohimbine and naloxone. The inhibitory effect on the flexion reflex of clonidine was not altered by naloxone, a ${\mu}-opioid$ receptor blocker, whereas it was completely blocked by yohimbine, an ${\alpha}_2-adrenergic$ antagonist. These results indicate that clonidine inhibits the flexion reflex through excitation of ${\alpha}_2-adrenoceptors$ even at the spinal cord level.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.25-28
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• 2012

Background: Bell's palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell's palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell's palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell's palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex, but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell's palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell's palsy, although it could be normal in patients with mild Bell's palsy.

• Physical Therapy Korea
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• v.8 no.4
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• pp.81-89
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• 2001

There are two independent mechanisms to control the segmental reflex gain in humans during gait. They are presynaptic inhibition and homosynaptic depression. Through the mechanism of the presynaptic inhibition, the muscle spindle afferent feedback can be properly gated during eccentric phase of gait. The modulation of the presynaptic inhibition is reflected in the level of H-reflex at a constant EMG level. During the eccentric muscle activation presynaptic inhibition should increase to account for the lower amplitude level of H-reflex at a constant level of EMG. Homosynaptic depression is another mechanism responsible for regulating the effectiveness of the muscle spindle afferent feedback. Both the presynaptic inhibition and the monosynaptic depression are responsible for modulating reflex gain during gait initiation. Reflex modulation is influenced not only as a passive consequence of the alpha motor neuron excitation level, but also through supraspinal mechanisms. Spastic paretic patients show the impaired soleus H-reflex modulation either during the initial stance phase, or during the swing phase. This abnormal modulatory mechanism can partially and artificially be restored by the application of peripheral stimulus to the sole of the foot, provided that the segmental circuitry remains functional.

• The Korean Journal of Physiology
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• v.15 no.2
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• pp.67-71
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• 1981

Experiments were conducted to test morphine sensitivity of the flexion reflex in the anemic decerebrate cats. Animals were immobilized with gallamine triethiodide(Flxaedil) and were artificially ventilated. The sural nerve was electrically stimulated(20V, 0.5 msec) and the flexion reflex was obtained by recording compound action potentials from the nerve innervated to the semitendinosus muscle. Intravenous injection of morphine $(0.5{\sim}2.0\;mg/kg)$ was found to have following effects on the flexion reflex. 1) Morphine tended to depress the early component of the flexion reflex and the effect was widely variable between animal preparations. 2) Morphine significantly depressed the late component of the flexion reflex, the effect being proportional to the dose of morphine. 3) The morphine effect on the flexion reflex was reversed by a small dose of naloxone hydrochloride$(0.025{\sim}0.1\;mg/kg)$. 4) Naloxone hydrochloride alone did not appear to facilitate the flexion reflex. 5) The main site for the morphine action was found to be the brain stem. From these results and those reported in literatures, we conclude that the late component of the flexion reflex well represents the pain sensation, thus the late component of the flexion reflex can be used as a reasonable subjective index of pain in experimental animals.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.81-92
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• 2006

Objectives: To review recent findings from physiologic research about the nature of proprioceptive spinal reflex, proposed explanation for mechanisms of musculoskeletal problems associated with propriceptive dysfunction and techniques controlling this problem. Methods: MEDLINE databases were searched using various combinatins of the keywords proprioception, spinal reflex, somata-somatic reflex, spinal manipulation, muscle spindle, Golgi-tendon organ, along with searching the related articles and textbooks. Results and Conclusion: Proprioceptors(muscle spindle, Golgi-tendon organs) monitor the position of joints, tension in tendons and ligaments, and the state of muscular contraction. Disturbed activity of proprioceptive spinal reflex can cause chronic state of increased muscle stiffness, pain, deficiencies both in muscle coordination and propioception, and so on. All kinds of techniques that control proprioceptive primary afferent neurons can affect the motor control system and evoke changes in the neuromuscular system.

• Biomedical Science Letters
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• v.18 no.4
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• pp.391-398
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• 2012

The conventional blink reflex has limited clinical application since it displays a wide range of change in the responses. Thus, we studied the blink reflex using the averaging process which is engaged in evoked potential studies in order to measure various responses such as latency, amplitude, and duration, which have been difficult to measure due to their wide ranges of changes. Among the Bell's palsy patient group, 13 patients who had the symptoms of incomplete palsy were examined to assess the results of the blink reflex through the averaging process. The subjects were 54 people in a normal group (108 eyes) and 18 patients (36 eyes) with Bell's palsy. For the study method, the conventional blink reflex and the blink reflex using the averaging process were measured for the people in the normal group, while in the Bell's palsy group, only the blink reflex using the averaging process was analyzed. In the case of the normal group, the blink reflex using the averaging process could measure all of the latency, amplitude, and duration. It was also observed that the latency, amplitude, and duration of R1, ipsilateral R2, and contralateral R2 significantly differed on the affected side of the Bell's palsy patients, compared to the unaffected side. The blink reflex using the averaging process should be more effective than the conventional method since the former can evaluate the latency, amplitude, and duration for Bell's palsy, while the latter can only assess latency.

• The Korean Journal of Nuclear Medicine
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• v.9 no.2
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• pp.29-37
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• 1975

In an attempt to establish the diagnostic value of Achilles tendon reflex and to determine the normal value of Achilles tendon reflex time in normal Korean, the author measured the Achilles tendon reflex time by photomotograph. This study was carried out in 272 cases with various thyroid diseases and 340 normal Korean. 1) The Achilles tendon reflex time in normal Korean was like this, between 11 years old and 20 years old; male (62cases); $250{\pm}27$ msec, female (36 cases); $266{\pm}27$ msec, between 21 years old and 30 years old; male (38 cases); $271{\pm}27$ msec, female (21 cases); $284{\pm}27$ msec, between 31 years old and 40 years old; male (26 cases); $275{\pm}25$ msec, female (29 cases); $291{\pm}27$ msec, between 41 years old and 50 years old; male (20 cases); $286{\pm}35$ msec, female (24 cases); $307{\pm}42$ msec, between 51 years old and 60 years old, male (20 cases); $296{\pm}33$ msec, female (20 cases); $318{\pm}46$ msec, over 61 years; male (24 cases) $301{\pm}33$ msec, female (20 cases); $325{\pm}35$ msec. The Achilles tendon reflex time was delayed with increasing age and delayed in the female. 2) The Achilles tendon reflex time was markedly shortened to $221{\pm}20$msec in untreated hyperthyroidism. 3) The Achilles tendon reflex time was markedly delayed to $435{\pm}59$msec in hypothyroidism. 4) The Achilles tendon reflex time was not changed significantly in.other thyroid diseases with normal thyroid function. 5) The Achilles tendon reflex time showed good,correlationship with ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. 6) Reproducibility of Achilles tendon reflex: time was good, and no significant difference between left and right was noted. 7) Diagnostic accuracy of Achilles tendon reflex time was 71% in hyperthyroidism and 90% in hypothyroidism. 8) The Achilles tendon reflex time showed useful test to evaluate the clinical course of the hyperthyroidism.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.83-87
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• 2003

Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.