• Title/Summary/Keyword: Vagus nerve

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Seizure Control in Patients with Extratemporal Lobe Epilepsy

  • Park, Seung-Soo;Koh, Eun-Jeong;Oh, Young-Min;Lee, Woo-Jong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.283-290
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    • 2007
  • Objective : This study was designed to analyze seizure outcome and to investigate the prognostic factors for predicting seizure outcome according to the preoperative evaluations, surgical procedures, topectomy sites and histopathological findings in patients with extratemporal lobe epilepsy [ETLE]. Methods : This study comprised 63 patients with ETLE who underwent surgery. Preoperative evaluations included semiologic analysis, chronic video-EEG monitoring, and neuroimaging studies. Surgical procedures consisted of topectomy in 51 patients, corpus callosotomy in 9, functional hemispherectomy in 2, and vagus nerve stimulation [VNS] in 1. Histopathological findings were reviewed. Postoperative seizure outcomes were assessed by Engel's classification at the average follow up period of 66.8 months. Chi-square test was used for statistics. Results : Total postoperative seizure outcomes were class I in 51 [80%] patients, class II in 6 [10%], class III in 6 [10%]. Patients with structural abnormalities on neuroimaging study showed class I in 49 [88%] patients [p<0.05]. Patients with focal and regional ictal EEG onset revealed class I in 47 [90%] patients [p<0.05]. Semiologic findings, surgical procedures, topectomy sites and histopathological findings did not show statistical correlation with seizure outcome [p<0.05]. Conclusion : A good seizure outcome was obtained in patients with ETLE. The factors for favorable seizure outcome are related to the presence of structural abnormalities on neuroimaging study, and focal and regional ictal EEG onset.

Factors for Postoperative Gallstone Occurrence in Patients with Gastric Cancer: a Meta-analysis

  • Chen, Xiang-Jun;Li, Nian;Huang, Ying-De;Ren, Shuang;Liu, Fang;Chen, Lian;Wang, Yong;Chen, Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.877-881
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    • 2014
  • Objective: To evaluate risk factors for gallstones after gastrectomy. Methods: To identify documents published from 1990 to 2011 the Pubmed, Cochrane Library, Springer Link, CBM and WanFang databases were searched and a meta-analysis was performed with RevMan 5.2 software for odds ratios and 95%CIs. Results: Fifteen studies were selected for the meta-analysis. The pooled ORs [95%CIs] were 0.56 [0.43, 0.73], (P<0.0001) for digestive tract reconstruction, 0.80 [0.54, 1.17], (P=0.25) for pylorus preservation, 0.33[0.15, 0.75], (P=0.008) for resection scope of stomach, 0.33 [0.15, 0.75], (P=0.008) for lymphadenectomy, and 0.13 [0.05, 0.33], (P<0.0001) for vagotomy. Conclusions: Digestive tract physical reconstruction and vagus nerve preservation can reduce the morbidity of gallstones after gastrectomy. Total gastrectomy can add to the morbidity of galltones as does increasing the degree of lymph node dissection. There was no significant difference in gallstones with or without pylorus preservation.

Effect of Jichul-hwan on Gastric Motility in Conscious and Gastric Wall Injured Rats (지출환(枳朮丸)의 흰쥐 위(胃) 운동성(運動性)에서 정상 상태 및 위벽 국소손상 후에 대한 효능)

  • Lee, Seung-Woo;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.189-199
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    • 2008
  • Background & Objective : Jichul-hwan(JCH) has been used for the treatment of functional dyspepsia, regarded as a gastric dysmotility disease. We investigated the effects of JCH on gastric motility and its mechanisms of action in rats. Methods : The gastric wall was injured by tracting a part of stomach body in rats. Gastric emptying was measured after administration of normal saline(NS) or JCH in normal rats and gastric wall injured rats. To evaluate the mechanism of JCH under delayed gastric emptying conditions, normal rats were treated with atropine sulfate(1mg/kg, s.c.), quinpirole HCl(0.3mg/kgg, i.p.), $NAME(N^{G}-nitro-L-arginine$ methyl ester, 75mg/kg s.c.) and cisplatin(10mg/kg, i.p.). The gastric slow waves were measured for 30 minutes before and after administration of each solution(NS, JCH). Results : JCH 110.1mg/kg improved gastric emptying for 2 hrs(p=0.014). JCH 110.1mg/kg improved gastric emptying in the gastric wall injured rats(p=0.001). Under the delayed gastric emptying, JCH 110.1mg/kg improved gastric emptying in the group treated with atropine $sulfate(1.83{\pm}0.96$ vs $8.43{\pm}8.46$, p=0.003), but aggravated it with quinpirole $HCl(4.7{\pm}2.9$ vs $1.61{\pm}2.09$, p=0.021). Administration JCH 110.1mg/kg increased EGG power in rats. Conclusions : JCH stimulates gastric motility through the cholinergic pathway, so we expect that it would be effective in the treatment of dysmotility-like functional dyspepsia with low activity of vagus nerve.

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HEN Simulation of a Controlled Fluid Flow-Based Neural Cooling Probe Used for the Treatment of Focal and Spontaneous Epilepsy

  • Mohy-Ud-Din, Zia;Woo, Sang-Hyo;Qun, Wei;Kim, Jee-Hyum;Cho, Jin-Ho
    • Journal of Sensor Science and Technology
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    • v.20 no.1
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    • pp.19-24
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    • 2011
  • Brain disorders such as epilepsy is a condition that affects an estimated 2.7 million Americans, 50,000,000 worldwide, approximately 200,000 new cases of epilepsy are diagnosed each year. Of the major chronic medical conditions, epilepsy is among the least understood. Scientists are conducting research to determine appropriate treatments, such as the use of drugs, vagus nerve stimulation, brain stimulation, and Peltier chip-based focal cooling. However, brain stimulation and Peltier chip-based stimulation processes cannot effectively stop seizures. This paper presents simulation of a novel heat enchanger network(HEN) technique designed to stop seizures by using a neural cooling probe to stop focal and spontaneous seizures by cooling the brain. The designed probe was composed of a U-shaped tube through which cold fluid flowed in order to reduce the temperature of the brain. The simulation results demonstrated that the neural probe could cool a 7 $mm^2$ area of the brain when the fluid was flowing atb a velocity of 0.55 m/s. It also showed that the neural cooling probe required 23 % less energy to produce cooling when compared to the Peltier chip-based cooling system.

Comparison between C.M.R.T. and acupuncture in the treatment of liver dysfunction (간 기능 이상 치료에 대한 C.M.R.T. 치료 부위(T8 횡돌기)와 경혈과의 비교)

  • Sim Young;Lee Jun-Moo
    • Korean Journal of Acupuncture
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    • v.19 no.2
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    • pp.97-117
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    • 2002
  • Chiropractic is very similar to Oriental Medicine in philosophy on the cause of diseases and in utilization of spinal articulations for diagnosis and treatment. In this paper the spinal area used to treat liver dysfunction in S.O.T. technique, one of chiropractic techniques, was compared to the acupncture points used to cure the same conditions. Because both Oriental medicine and Chiropractic are dealing with autonomic nervous system in regulating abnormal conditions, also the innervation of spinal nerves to those areas was checked. The spinal area that S.O.T. technique utilizes to correct liver dysfunction is transverse processes of T8, which corresponds to B16. Acupncture points from this level down to T12/L1, which are B16, B17, B18, B19, B20, B21, B45, B46, B47, B48, B49, B50, GV6, GV7, GV8 and GV9, all have been applied to control liver function. Apparent discrepency exists in therapeutic areas for liver malfunction between the two natural healing arts. According to the neurology texts, liver is innervated by sympathetic fibers from the 7th-10th thoracic segments and by parasympathetic fibers from vagus nerve. Sympathetic afferent nerves from the liver reach the 7th-12th thoracic spinal cord segments. It can be said all the 7th-12th thoracic spinal cord segments are related to liver function. Therefore the areas used for liver dysfunction in both natural medicine are appropriately selected. However, B16, the Oriental medical equivalent of the main spinal area which is used for lowered liver function in C.M.R.T. Technique, is not utilized as frequent as in Oriental medicine.

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Medullary Thyroid Carcinoma in a Maltese Dog (말티즈 개에서 발생한 갑상선수질암)

  • Hyun, Hee-Jin;Jung, Soo-Kyo;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.435-438
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    • 2014
  • An 11-year-old, 2.67 kg female Maltese dog with 3 weeks history of palpable cervical mass near trachea was submitted to a local animal hospital. Radiography and ultrasonography showed radiopaque mass adjacent trachea and vagus nerve. Surgically excised mass was solitary and approximately $3.5{\times}2{\times}0.8cm$ in size. Histopathologically, there were large neoplastic foci admixed with normal thyroid tissues. These neoplastic foci were composed of small to large packets of the neoplastic cells with plasmacytic morphology, and these packets were divided by fine fibrovascular septa. Immunohistochemically, most neoplastic cells in the thyroid mass showed positive reactions for cytokeratin (AE1/AE3), chromogranin A, neuron specific enolase (NSE) and the negative reaction for vimentin. Based on the gross, histopathologic and immunohistochemical characteristics, this dog was diagnosed as medullary thyroid carcinoma.

Pylorus-Preserving Gastrectomy for Gastric Cancer

  • Oh, Seung-Young;Lee, Hyuk-Joon;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.16 no.2
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    • pp.63-71
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    • 2016
  • Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.

Change in Each Vertebral Segment During Smartphone Usage with Both Hands while in the Standing Position

  • Cho, Sung-Hak;Moon, Hyun-Ju
    • PNF and Movement
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    • v.17 no.1
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    • pp.41-46
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    • 2019
  • Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

Anatomical study on The Arm Greater Yang Small Intestine Meridian Muscle in Human (수태양소장경근(手太陽小腸經筋)의 해부학적(解剖學的) 연구(硏究))

  • Park, Kyoung-Sik
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.57-64
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    • 2004
  • This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

Usefullness of Injection Laryngoplasty with Calcium Hydroxyapatite in Unilateral Vocal Cord Paralysis (일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성)

  • Lee, Jae-Hoon;Kim, Sung-Won;Oh, Jung-Ho;Kim, Seung-Tae;Lee, Kang-Dae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.119-125
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    • 2011
  • Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

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