• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.143-150
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• 2021

Spinal dysraphism often causes neurological impairment from direct involvement of lesions or from cord tethering. The conus medullaris and lumbosacral roots are most vulnerable. Surgical intervention such as untethering surgery is indicated to minimize or prevent further neurological deficits. Because untethering surgery itself imposes risk of neural injury, intraoperative neurophysiological monitoring (IONM) is indicated to help surgeons to be guided during surgery and to improve functional outcome. Monitoring of electromyography (EMG), motor evoked potential, and bulbocavernosus reflex (BCR) is essential modalities in IONM for untethering. Sensory evoked potential can be also employed to further interpretation. In specific, free-running EMG and triggered EMG is of most utility to identify lumbosacral roots within the field of surgery and filum terminale or non-functioning cord can be also confirmed by absence of responses at higher intensity of stimulation. The sacral nervous system should be vigilantly monitored as pathophysiology of tethered cord syndrome affects the sacral function most and earliest. BCR monitoring can be readily applicable for sacral monitoring and has been shown to be useful for prediction of postoperative sacral dysfunction. Further research is guaranteed because current IONM methodology in spinal dysraphism is still deficient of quantitative and objective evaluation and fails to directly measure the sacral autonomic nervous system.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.124-131
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• 2021

Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

• Korean Journal of Audiology
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• v.24 no.1
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• pp.48-52
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• 2020

Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

• Journal of Audiology & Otology
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• v.24 no.1
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• pp.48-52
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• 2020

Lateralization for central auditory processing (CAP) with dichotic digits recognition (DDR) test is believed expression of hemispheric dominance. Multiple sclerosis (MS) is considered an inflammatory and autoimmune alteration of central nervous system (CNS). Hearing alterations in MS and their role in CAP has not been well studied. A patient with MS and new kind of alteration in lateralization of CAP with DDR test is presented. A 53 year of age female with MS of 16 years of evolution, nine of them remained asymptomatic. She has a persistent advantage of the right ear for DDR test; but other monaural tests showed predominance of the left afferent pathway. Brainstem auditory evoked potentials (BAEPs) and long latency auditory evoked potentials (LLAEPs) showed adequate right response with deficits in organization of left response in BAEP, and N2 wave. In the contrary direction of previous publication, we disclosed advantage for DDR test, BAEP, and LLAEP in the right ear. We observed no left ear suppression; with predominance of correct left percentages in monaural psychoacoustics tests. We must keep on searching to find pathophysiological meaning of predominant of right or left auditory laterality as a CAP disorder in patients with MS.

• Journal of Korean Medical Ki-Gong Academy
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• v.22 no.1
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• pp.1-27
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• 2023

Objective : This paper provides a narrative review of the research literature on the neurophysiological and neurochemical mechanisms of local vibration while studying the treatment principles and mechanisms of Whidam's vibrator Sugi therapy. Methods : Searches related to vibration therapy research were conducted in PUBMED using "Vibration", "Whole Body Vibration", "Localized Vibration", and "Focal Vibration". The Conditions were limited to review and systematic review. Results : Roberto Casale's paper was selected as an inquiry task and reviewed critically and narratively by referring to other papers. The stimulation process of local vibration (LV) was broadly classified into receptor transmission (pain reception phase), ascending sensory pathway to the spinal cord (segmental phase), and action of the cortex and subcortical structures (systemic control phase) according to the pain pathway. In addition, the role of C-tactile mechanoreceptors, changes in neurotransmitters and neurohormones, LV stimulation below perception threshold (lower threshold), pain control and kinesiologic illusions were specially addressed. In addition, the expression and function of Piezo Channels were added to supplement the human pain and tactile sensing mechanism. Conclusions : LV exerts pain control mechanisms through different interactions that can interfere with pain transmission and pain perception. Since LV provides sufficient neurophysiological reasons for clinical application, it is necessary to expand the use of Whidam's vibrator Sugi therapy to a wider range of clinical applications.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.316-321
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• 2023

Developmental venous anomalies (DVAs) are composed of mature venous vessels that lack malformed or neoplastic elements. Although the hemorrhage risk is considered negligible, some patients may have neurological symptoms attributable to acute infarction or intracranial hemorrhage secondary to thrombosis, in the absence of a coexisting cavernous malformation. We report the case of a 42-year-old patient who presented with acute left-hand paresis secondary to a subcortical hemorrhage. This bleeding originated from a DVA in the corticospinal tract area and was surgically drained through an awake craniotomy. To accomplish this, we used a trans-precentral sulcus approach. After the complete removal of the coagulum, small venous channels appeared, which were coagulated. No associated cavernoma was found. Although the main DVA trunk was left patent, no signs of ischemia or venous infarction were observed after coagulating the small venous channels found inside the hematoma cavity. Two weeks after the procedure, the patient's hand function improved, and he was able to resume desktop work. DVA-associated hemorrhage within the cortico-spinal tract could be safely removed with modern awake mapping techniques. This technique allowed the patient to rapidly improve his hand function.

• Journal of Korean Dental Science
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• v.5 no.2
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• pp.68-76
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• 2012

Purpose: The headache is a symptom that various somatic or non-somatic disorders gives an effect to head and neck system. The neck and the shoulder pain is a common muscle pain that can not control and bothers the patient after chronic state. The headache and the neck and the shoulder muscle pain are treated with various conventional treatment methods. But, there are cases that symptoms did not resolve or increased in some clinical cases. And generally, the result of temporomandibular disorders (TMD) treatment is good. But, despite of a normal treatment was performed for TMD, there are cases that TMD symptoms did not resolved in clinical cases. In template clinic of Soonchunhyang University Bucheon Hospital, co-operative neurophysiologic treatment of Department of Neurosurgery and Dentistry are done for patients, who had head and neck pain or atypical symptoms that did not treated with various conventional treatment method such as surgery or medication etc. Materials and Methods: Four hundred fifty one patients who have treated in the template clinic, Soonchunhyang University Bucheon Hospital, from January of 2006 to December of 2008 were subjected in this study. Result: Overall average age was 31.9 years old. Ratio of numbers is 74.3% in female and 25.7% in male. The success rate of treatment in TMD symptom was 89.9%, in headache was 88.8%, in muscle pain was 81.6%. Statistically significance of differences visual analogue scale evaluation between before and after had been treated patients who have over average grade headache was calculated by paired t-test. P<0.05 was considered significant. Conclusion: We suggest the template appliance can be attempted for cases whose headache, the neck and the shoulder muscle pain and TMD are not resolved with various conventional treatment methods.

• International Journal of Advanced Culture Technology
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• v.6 no.2
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• pp.100-106
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• 2018

Sometimes, literary therapy is to create an abscission layer at the mind and remove the signifier of love, by the abscission layer. The purpose of this study is to reveal the mechanism of literary therapy by mutation in human-created sentences and to activate literary therapy. In Gosijo, the abscission layer of Seo Gyeongdok's mind is present in the layer of the "falling leaf" of the his Sijo's last sentence, and the abscission layer of Hwang Jin-yi's mind exists in the layer of the "falling leaf" of the her Sijo's last sentence. The "falling leaf" created by the abscission layer of Seo Gyeongdok's sentence acts as an action potential to the nervous system of Hwang Jin-yi. In Hwang Jin-yi's Sijo, the abscission layer is also activated, forming a "leaf". Hwang Jin-yi's Sijo constructs a new sensory layer that is extended and mutated more than the meaning of space between lines of Seo Gyeongdok's Sijo. In her Sijo, Hwang Jin-yi twists and twists Seo Gyeongdok's sentences to squeeze the sound. She accepts the Seo Gyeongdok's sentences and twists in the first sentence and twists out of the second sentence once more to produce the mutation in the last sentence. As a result of her sentence twist, Seo Kyung-duk's visual sense of "falling leaf" is mutated into a "falling leaf's sound" of auditory sense. This mutation process works as a healing mechanism in the human body. If this study will continue in the future, it will be possible to activate literary therapy by Sijo.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.6
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• pp.1832-1842
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• 2004

The present study was performed to examine the possible anti-inflammatory effects of a herbal drug ASCH in RAW264.7 cell line. Inflammation was induced by LPS toxin treatment to RAW264.7 macrophage cell line. Increases in cytokine production such as IL-1β, IL-6. and IL-18, COX-2, NOS-Ⅱ (iNOS), and TNF-alpha were observed at mRNA level in the LPS-treated RAW264.7 cells. Measurement of IL-6, nitric oxide and the reactive oxygen species (ROS) showed increased production of these inflammation mediators. Treatment of ASCH effectively decreased IL-1β protein in a dose-dependent manner, and IL-6 and IL-18 were reduced at 100㎍/㎖ of ASCH concentration. NO production was also decreased by ASCH treatment. A slight inhibition for TNF-alpha in terms of protein, but not mRNA level was obtained by 100㎍/㎖ of ASCH treatment. ASCH treatment to normal RAW264.7 cells did not produce any cytotoxicity, indicting that the action of ASCH was selective to inflammatory cells. Thus, the present data suggest that ASCH may act as an important regulator to alleviate the inflammatory symptoms.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.896-902
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• 2008

Yukmijihwang-tang(YM) is used in Oriental medicine for treatments of diverse systemic symptoms including neurological dosorders. The present study was performed to examine potential effects of YM on growth-promoting activity of injured sciatic nerve axons. YM treatment in the injured sciatic nerve induced enhanced distal elongation of injured axons when measured 3 and 7 days after injury. Retrograde tracing of sciatic nerve axons showed YM-mediated increases in the number of DiI-labeled dorsal root ganglion (DRG) sensory neurons and spinal cord motor neurons at 3 days after injury. Hoechst nuclear staining showed that non-neuronal cell population was largely elevated by YM treatment in distal nerve area undergoing axonal regeneration. Furthermore, phospho-Erk1/2 protein levels were upregulated by YM treatment in the injured nerve area. These data suggest that YM may play a role in facilitated axonal regeneration in injured peripheral nerves. Further investigations of individual herbal components would be useful to explore effective molecular components and develop therapeutic strategies.