• 정신신체의학
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• 제3권1호
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• The Korean Journal of Pain
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• 제9권1호
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• pp.275-278
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• 1996

The placement of epidural catheter may cause complications such as epidural hematoma, epidural abscess and neural damage. Among the above complications, epidural abscess is a rare but serious complication. This report pertains to a diabetic metlitus patient who developed spinal epidural and subdural abscess after continuous epidural catheterization for management of pain caused by reflex sympathetic dystrophy. The patient experienced urinary incontinence, as a neurologic sign, 8 days after epidural catherization. In was considered that the poor prognosis was due to a combination effects of a delayed visit to the hospital for treatment, rapid progression of abscess and uncontrolled blood sugar level. We therefore recommend aseptic technique and proper control of blood sugar level to prevent infection during and after epidural catheterization for diabetic patients. Early diagnosis of epidural abscess following surgical procedure must be required to avoid sequelae.

• 대한기계학회논문집B
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• 제38권1호
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• pp.57-62
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• 2014

인체 해석모델은 주로 인간이 의식적으로 행하는 운동을 중심으로 발전해 왔다. 의식적 운동과 달리 슬개건 반사는 뇌를 거치지 않고 일어난다. 본 연구는 건강한 성인의 슬개건 반사로 인한 대퇴부의 근력과 근활성도를 해석적으로 예측하고자 하였다. 해석 모델은 시상면에서 평면운동을 하고, 앉은 자세에서 상체와 허벅지를 고정시켜 종아리만 진자 운동이 가능하도록 모델링 하였다. 무릎은 레볼루트 조인트로 모델링 하였고, 발목관절은 고정시켜 종아리와 발을 하나의 강체로 가정하였다. 근력은 Mamizuka 의 실험 결과로부터 얻은 운동학 정보를 이용하여 역동역학 해석을 통해 구하였으며, 근활성도는 Hill-type 근육 모델을 이용하여 예측하였다. 해석 결과는 실험결과를 통해 검증되었다.

• The Journal of Korean Physical Therapy
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• 제22권4호
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• pp.15-20
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• 2010

Purpose: The purpose of this study was to measure changes in the H-reflex and V wave under loading conditions (e.g. prone and standing position) and to investigate whether postural change would affect the H-reflex and V wave in post stroke hemiplegic patients. Methods: Thirty persons with hemiplegia resulting from stroke (20 males, 10 females) participated in this study. Electromyography (EMG) was used to electrically stimulate and record the soleus H-reflexes and V waves under various loading conditions. The normality of the distribution of each variable (H latency, $H_{max}/M_{max}$ ratio, $V_{max}/M_{max}$ ratio) was tested using the Kolmogorov-Smirnov test. The means of normally distributed continuous data were assessed by independent t-test (${\alpha}$=0.05). Results: There were statistically significant differences in $H_{max}/M_{max}$ ratio (p<0.01), $V_{max}/M_{max}$ ratio (p<0.01), H latency (p<0.01) among the prone and standing position. Conclusion: We found that the H-reflex and V wave in standing position was more active to weight bearing load than prone position.

• 대한한방내과학회지
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• 제32권2호
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• pp.259-277
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• 2011

Objectives : The purpose of this study was to investigate two subjects: the diagnostic value of bilateral lowering of electrical activity at point H4,5,6 of Ryodoraku and the mechanism for Ryodoraku phenomena. Methods : Electrical activities of Ryodoraku test and electrogastrography recorded simultaneously and monitored continuously from 16 cases of functional dyspeptic patients were collected and their variations were grouped by the topics of discussion which were peculiarity, stability, lagging, alterability, and anomaly. Ryodoraku recordings obtained from 6 patients with different gastrointestinal diseases and 1 normal healthy person were used as control. The results are discussed with Nakatani's suggestion, theory of sympathetic nerve and Meridian Principle, respectively. Finely, coincidence of stomach arrangement between anatomy and meridian system in Ryodoraku was also evaluated. Results : Time-course variation showed a regular relationship between the typical pattern of Ryodoraku at point H4,5,6 and gastric myoelectrical activity. However, an irregular relationship and atypical pattern of Ryodoraku occasionally appeared. A literature search suggested that electrical response at the Ryodoraku point H4,5,6 may be dependent on an afferent sympathetic spinal reflex transmitted from the stomach. However, there was no evidence for making clear whether bilateral lowering of electrical activity at this point was induced by hypofunction of local sympathetic nerve in the skin itself or of signals transmitted from the gastric sympathetic nerve or not. The coincidence of 19% could not provide a visceral arrangement of the stomach between anatomy and meridian systems. Conclusions : Bilateral lowering of electrical activity at Ryodoraku point H4,5,6 has value as a diagnostic index for gastric dysmotility of functional dyspepsia. This phenomenon is associated with spinal reflex transmitted from the afferent sympathetic nerve in the stomach but not that of meridian function.

• 대한한의학회지
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• 제22권2호
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• pp.31-40
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• 2001

This experimental studies was to investigate location of labeled neurons in CNS following injection of pseudorabies virus(PRV), Bartha strain, into the uterus and Sanyinjiao(Sp6) of rats. After survival times of 4-5 days following the injection of PRV, the rats were perfused, and their brain and spinal cord were frozen sectioned($30\mu\textrm{m}$). These sections were stained by PRV immunohistochemical staining methods, and observed with light microscope. The results were as follows: 1. In the spinal cord, overlap areas of PRV labeled neurons projecting to uterus and Sp6 were observed in lamina VII, IX and X areas of cervical segments. In thoracic segments, overlap areas were observed in lamina IV, VII, X and intermediolateral n.. In lumbar segments, overlap area of PRV labeled neurons were observed in lamina I, V-VII, IX, X and intermediolateral n.. In sacral segments, overlap areas of PRY labeled neurons were observed in lamina N, V, VII, X and sacral parasympathetic n.. 2. In the brain, overlap areas of PR V labeled neurons projecting to the uterus and Sp6 were observed in lateral paragigantocellular n., rostroventrolateral reticular n., raphe obscurus n., raphe pallidus n., raphe magnus n., locus coeruleus n., Barrington's n., A5 cell group, central gray n., paraventricular hypothalamic n. and arcuate n. This results suggest that overlap areas of PRV labeled neurons of the spinal cord projecting to the uterus and Sp6 might be the first-order neurons related to the viscera-somatic sensory and sympathetic preganglionic neurons. PRV labeled neurons of the brain may be the second and third-order neurons response to the movement of smooth muscle of uterus. These PRV labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitoring the internal environment. These overlap areas of spinal cord and brainmay be related to autonomic centers related to regulation of uterus.

• The Journal of Korean Physical Therapy
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• 제19권1호
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• pp.11-22
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• 2007

Purpose: The purpose of this study were to analysis the effect on change of spinal neuron excitability during gait training of hemiplegia patients by the functional electrical stimulation. Methods: Thirty six hemiplegia patients participated in this study. Stimulation conditions of FES were pulse rate 35pps, pulse width $250{\mu}s$, and on-time 0.3 second, treatment hour was 30 min. and treatment period was once a day for five days a week through six weeks. For functional evaluations before and after treatment, Modified Ashworth Scale (MAS), active range of motion (AROM), Hmax threshold, H/Mmax ratio were measured and the following conclusions were obtained. Results: Functional evaluation showed significant changes in experimental group as MAS(p<0.01), AROM(p<0.001), compared to control group. In spinal neuron excitability evaluation, change of Hmax threshold was significantly reduced in both non weight bearing (p<0.001) and bearing condition (p<0.05), H/Mmax ratio was significantly reduced in non weight bearing (p<0.05) and bearing condition (p<0.05). Conclusion: In conclusion, application of FES to hemiplegia patients in recovery stage during gait training improved mitigation of muscular spasticity, balance adjustment and moving ability and it was interpreted that it was caused by mitigation of muscular spasticity by the spinal neuron excitability.

• 대한물리의학회지
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• 제3권1호
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• pp.21-25
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• 2008

Purpose : The objective of this study was conducted to find out the facilitation therapy. Therapeutic exercise concepts are changed from classical therapeutic exercise and neurophysiolosical approach to facilitation therapy. Methods : This is literature study with books and PNF international course books. Results : Facilitation concepts are changed. Complex movements are the result of spinal reflex-mechanism. It was changed the to reflex-reponses are variable and organization of complex movements are determined by the necessity to move. Therefore therapy goals and concepts of spasticity have to change. Conclusion : Facilitation therapy approach by use input systems, which are needed to interact with environmental and task demands. The systems are visual, tactile, propriocepsis, vestibular, acoustical and olfactory. Facilitation therapy need these system all together with shaping.

• The Korean Journal of Pain
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• 제3권2호
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• pp.165-171
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• 1990

The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.73-77
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• 2016

Laryngopharyngeal reflux disease (LPRD) is different with gastroesophageal reflux disease (GERD). The lower esophageal sphincter (LES) possesses an intrinsic nervous plexus that allows the LES to have a considerable degree of independent neural control. Sympathetic control of the LES and stomach stems from cholinergic preganglionic neurons in the intermediolateral column of the thoracic spinal cord (T6 through T9 divisions), which impinge on postganglionic neurons in the celiac ganglion, of which the catecholaminergic neurons provide the LES and stomach with most of its sympathetic supply. Sympathetic regulation of motility primarily involves inhibitory presynaptic modulation of vagal cholinergic input to postganglionic neurons in the enteric plexus. The magnitude of sympathetic inhibition of motility is directly proportional to the level of background vagal efferent input. Recognizing that the LES is under the dual control of the sympathetic and parasympathetic nervous systems, we refer the reader to other comprehensive reviews on the role of the sympathetic and parasympatetic control of LES and gastric function. The present review focuses on the functionally dominant parasympathetic control of the LES and stomach via the dorsal motor nucleus of the vagus.