두뇌 손상 환자의 뇌간청각 및 체감각 유발전위 반응소견

이장철,김동원,이정교,임만빈,박영춘,김인홍 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.1

There were 84 cases of brainstem auditory evoked potential(BAEP) and 90 cases of somatosensory evoked potential(SSEP) from the 124 cases of head injury. The studies were performed within the first three days after head injury in most cases and after ten days in emergency operative cases. The results of BAEP and SSEP studies recorded from 67 normal volunteers were used as a control group. The latency, amplitude and wave pattern of the pattern of the evoked potential were examined and a peak or interpeak latency were considered abnormal when it exceeded the corresponding mean ±25D found in the control group. The wave patterns were arranged in BAEP as grade Ⅰ : all waves were normal ; grade Ⅱ : waves Ⅰ, Ⅱ, Ⅲ were abnormal ; grade Ⅲ : waves Ⅳ, Ⅴ, Ⅵ were abnormal ; grade Ⅳ ; all waves were abnormal. In SSEP as grade Ⅰ : all waves were normal ; grade Ⅱ : N_(13) wave was abnormal ; grade Ⅲ : N_(19) wave was abnormal ; grade Ⅳ : all waves were abnormal. The abnormal findings by percentage were : 47.6% in latency of BAEP, 68.9% in latency of SSEP, 49.4% in wave pattern of BAEP and 87.8% in wave pattern of SSEP. The BAEP was superior to SSEP in correlation to clinical parameters including GCS, duration of coma, basal cisterns in initial brain CT scan and Glasgow outcome scale(GOS). As a BAEP criterion, the wave Ⅴ latency and the BCT(Ⅲ-Ⅴ interpeak latency) and as a SSEP criterion, the central conduction time (N_(19)-N_(13))were more correlated to duration of coma and GOS. The appearance of the basal cisterns on initial brain CT is significantly correlated with wave Ⅴ and BCT of BAEP only. Grade Ⅰand Ⅱ were reliable predictors of a good prognosis. Therefore, we concluded that BAEP and SSEP are adjunctively diagnostic tests for determining the outcome of head injuried patients.

뇌혈관 질환자의 기능 회복과 체성감각 유발전위의 변화

김윤환,김찬규,박종항,이승엽,최원제,Kim, Yoon-Hwan,Kim, Chan-Kyu,Park, Jong-Hang,Lee, Seung-Yub,Choi, Won-Jye 대한물리치료과학회 2008 대한물리치료과학회지 Vol.15 No.1

This study was designed to test the effects of comprehensive rehabilitation management on functional recovery after attack of cerebrovascular disease. 16 cerebrovascular disease patients applied comprehensive rehabilitation management of physical therapy at department of physical Therapy, C medical center in Gwang-ju. The collection of the data had been executed for 4months(April 15, 2007${\sim}$July 15, 2007). For evaluating, Functional Independence measure(FIM) and Somatosensory Evoked Potential(SSEP) were used to assess functional recovery. The results of this study were as follows: 1. In the comparison of latency of median nerve SSEP before and after treatment, the lat. N20 and P25 increased, the ampl. P25/N20 was decreased. In the comparison difference data of median nerve SSEP, however there was no significant difference in the group(p>0.05). 2. In the comparison of latency of Post Tibial nerve SSEP before and after treatment, the lat. P40, P50, P60 increased, the ampl. P40 was decreased. In the comparison difference data of post tibial nerve SSEP, however there was no significant difference in the group(p>0.05). 3. In the comparison of FIM scores of Self-care, Sphincter Control, Mobility: Transfer, Locomotion before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was significant difference(p<0.05). 4. In the comparison of FIM scores of Communication, Social Cognition before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was no significant difference in the group(p>0.05). Based on these results, it is concluded that the comprehensive rehabilitation management for cerebrovascular disease case was not significant difference in the SSEP, was significant difference in the motor part of FIM. Further study should be done to analyze the effect of intervention duration of treatment, optimal time to apply the treatment in more long period.

뇌동맥류 수술시 체성감각유발전위의 모니터링

염기훈,김국기,이기택,박종태,임영진,김태성,이봉암,임언 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4

뇌허혈시 시간에 따른 상시상동 정맥혈 산소포화도와 뇌피질 체성감각 유발전위에 관한 연구

우영철,장성호 고려대학교 의과대학 1996 고려대 의대 잡지 Vol.33 No.2

Measuring jugular bulb venous oxygen saturation (SjvO_(2) for cerebral oxygen balance is reported to be a effective monitoring. But it is questioned that reduction in SjvO_(2), can explain or predict brain injury. In this study, the author evaluated superior sagittal sinus oxygen saturation and the cortical somatosensory evoked potential(SSEP) in 21 cats with induced brain ischemia. The cats were randomly divided into 3 groups in group Ⅰ (n=7), brain ischemia was induced for 5 minutes, in group Ⅱ (n=7) for 15 minutes and in group Ⅲ (n=7) for 30 minutes. Ischemia was induced by the intrathoracic occlusion of the innominate, the left subclavian and both mammarian arteries, and additionally the mean arterial blood pressure was maintained around 60 mmHg. Arterial blood pressure, heart rate, central venous pressure, arterial blood gases and superior sagittal sinus blood gases were evaluated before, during ischemia and 90 minutes after reperfusion. Cortical SSEP was recorded also before ischemia and 90 minutes after reperfusion. The results were as follows : 1. Six of 7 cats in group Ⅰ , four of 7 cats in group Ⅱ and none in group Ⅲ showed return of SSEP after 90 minutes of reperfusion. The amplitude was 43.1±7.7% and 15.7±5.9% of preischemia level in group Ⅰ and Ⅱ, respectively and there was significant difference between two groups (p<0.05). 2. During ischemia, superior sagittal sinus PCO, was abruptly increased to 102.5±31.6, 121.8±26.4, 116.6±48.5 mmHg in group Ⅰ , Ⅱ and Ⅲ respectively(p(0.05). pH was decreased to 6.99±0.13, 6.8320.09, 6.83±0.14 in group Ⅰ, Ⅱ and Ⅲ respectively (p<0.05). 3. During ischemia, superior sagittal sinus oxygen saturation was decreased to 42. I±11.1, 21.8±12.5, 26.5±9.2 % in group Ⅰ, Ⅱ and Ⅲ respectively (p<0.05) and there was significant difference between group Ⅱ and group Ⅱ (p<0.05). The above results suggest that measuring the superior sagittal sinus oxygen saturation can be a useful monitoring method for prediction of neural injury in cats with brain ischemia. But further study for cerebral venous blood sampling is needed.

척수 외상의 자기공명영상 및 신경학적 소견 : Delayed MR Image and Correlated Neurology

박용규,정진명,김은상,김재일,송해룡,한종우,신형진 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11

19 patients with traumatic spinal cord injuries and associated neurological deficit were examined by delayed(> 1 month) magnetic resonance imaging(MRI), the result of which were correlated with neurologic and somatosensory evoked potential(SSEP) findings. 5 different MRI patterns were observed in these patients : (1) normal signal intensity(SI) on T1-and T2-weighted images(WI)(pattern N/N, n=6), (2) normal SI on T1-WI and high SI on T2-WI(pattern N/Hi, n=3). (3) low SI on T1-WI and high SI on T2-WI(pattern Lo/Hi, n=6), (4) syrinx(n=2), and (5) cord transection(n=2). The neurologic state was determined using Frankel's classification at admission and MRI time. Pattern N/Hi had best neurologic state except pattern N/N, and pattern Lo/Hi showed worst prognosis except pattern transection. SSEP findings relatively well correlated with neurologic findings, but did not exactly. The cause is probably that SSEP shows predominantly the function of ascending sensory systems of the cord, do not reveal motor pathways, directly or indirectly.

감각과 운동 신경의 재생을 동반한 중안모 동종이식 모델

유명수,김성민,서미현,명훈,이종호,최진영 대한구순구개열학회 2011 대한구순구개열학회지 Vol.14 No.1·2

Face transplantation has been reported over the last six years, and it started in 2004 with the announcement of Cleveland Clinic granting the world s first IRB approval to proceed with human face transplantation. Composite tissue allografts (CTAs) in the facial region are considered to be more immunogenic than other solid organ transplants, so these kinds of animal experiments were also considered as challengeable activities to the facial reconstructive surgeons. For the better understanding of CTAs in the oral and maxillofacial fields, we reviewed several recent articles about facial composite transplantation animal model, and summarized some knowledges of composite midface allotransplantation model with sensory and motor reinnervation in this review article.