• Annals of Clinical Neurophysiology
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• v.5 no.1
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• pp.34-38
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• 2003

Backgrounds and Objectives: In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/ulnar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subjects. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 agematched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1.1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polyneuropathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

• The Journal of Korean Medicine
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• v.34 no.3
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• pp.126-142
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• 2013

Objectives: Previous reports have shown that Bogijetong-Tang (BJT) is effective in peripheral neuropathy induced by taxol and crush injury. In this study, we researched the effects of BJT on diabetic neuropathy induced by STZ in the mouse. Methods: We performed both in vitro and in vivo experiments to verify the effects of BJT on diabetic neuropathy induced by STZ in mice. Changes in axonal recovery were observed with immunofluorescence staining using NF-200, Hoechst33258, $S100{\beta}$, caspase 3 and anti-cdc2. Proliferation and degeneration of Schwann cells were investigated by immunofluorescence staining and western blot analyses. Results: BJT showed considerable effects on neurite outgrowth and axonal regeneration in diabetic neuropathy. BJT contributed to the creation of NF-200, GAP-43, Cdc2, phospho-vimentin, ${\beta}1$, active ${\beta}1$, ${\beta}3$ integrin, phospho-Erk1/2 protein. Conclusions: Through this study, we found that BJT is effective for enhanced axonal regeneration via dynamic regulation of regeneration-associated proteins. Therefore, BJT had a pharmaceutical property enhancing recovery of peripheral nerves induced by diabetic neuropathy and could be a candidate for drug development after more research.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.935-940
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• 2005

Objectives : This study it designed to evaluate the effects of an oriental medicine therapy, namely Binsosan-gamibang, on diabetic peripheral polyneuropathy. Methods : The clinical data was analyzed on a patient with diabetic peripheral polyneuropathy due to subyeolongsung(濕熱壅盛), gihyeoloeche(氣血瘀滯) whose main symptoms were pain and numbness in both legs. The patient was admitted at the internal medicine department of Dae-Gu Hanny University Dae-Gu Oriental Medicine Hospital on December 22, 2003, and was treated with herbal medicine(Binsosan-gamibang), acupuncture and physical therapy. Results : After treatment, improvement in pain and numbness in both legs was seen in the subsection of the pain rating score(PRS) and the visual analogue scale(VAS). Conclusions : This study suggests that Binsosan-gamibang is significantly effective in treatment of diabetic peripheral polyneuropathy.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.675-680
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• 2017

A diabetic neuropathy patient was treated with Korean medicine for 2 weeks. In this case report, we report the efficacy of a complex treatment comprising various Korean medicine methods by evaluating the differences in pain scores. The patient reported improvement in both pain score and glucose index. Korean medicine could therefore be effective for the treatment and prevention of diabetic neuropathy.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.243-250
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• 2013

Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

• The Journal of Korean Medicine
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• v.30 no.5
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• pp.127-136
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• 2009

Objective: This study aimed to analyze the current status of treatments and patients with diabetic peripheral neuropathy, and then map out of a strategy for development of generalized-treatments for diabetic peripheral neuropathy in Traditional Korean Medicine. Methods: We selected research materials from various databases such as PubMed, Google, KStudy, KoreanTK, OIM, KOMS and books. Also, to understand current tendencies of medical examination and treatment related with diabetic peripheral neuropathy, we requested Health Insurance Review and Assessment Service clinical data from 2003 to 2007. Results: It is reported that the incidence of diabetic peripheral neuropathy is increasing in an aging society. The medical fees of National Health Insurance related with diabetic peripheral neuropathy show a year-on-year increase. There are no particularly effective therapies for diabetic peripheral neuropathy in Western medicine, and in some papers, it was reported that treatment of diabetic peripheral neuropathy using Traditional Korean Medicine was effective. However, patients usually visit on Western medical center rather than seek Traditional Korean Medicine. To take charge of clinical fields related with diabetic peripheral neuropathy by Traditional Korean Medicine, we need more studies and experiments of diabetic peripheral neuropathy using Traditional Korean Medicine and should make a standardized protocol. Conclusion: Various studies related with diabetic peripheral neuropathy using Traditional Korean Medicine will have to be undertaken hereafter. We expect that Traditional Korean Medicine will play a vital role in treating of diabetic peripheral neuropathy.

• Physical Therapy Korea
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• v.5 no.3
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• pp.11-20
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• 1998

The purposes of this study were to determine the effect of different degrees of severity of diabetic neuropathy on balance function, and to evaluate dynamic balance and functional performance in diabetes patients. Twenty-four subjects with diabetes mellitus were divided into three groups according to results of sensory nerve conduction study. All subjects were evaluated for dynamic balance which was measured using computerized dynamic posturography, and functional performance which was measured using the Berg balance scale. One-way analysis of variance was used to determine whether there were any statistically differences of dynamic balance function and functional performance among the three groups. The Spearrnan's rank correlation was used to determine statistical significance between dynamic balance and age. The results were as follows: 1. Dynamic balance measured using computerized dynamic posturography was significantly lower in the no response group than in the normal amplitude group (p<0.05). 2. Functional performance tested by the Berg balance scale was not statistically different among the three groups (p>0.05). 3. an inverse relationship was found between dynamic balance measured using computerized dynamic posturography and age (r=-0.68, p<0.05). These results suggest that patients with severe diabetic neuropathy have loss of dynamic balance function. Therefore, patients with severe diabetic neuropathy need to have their balance evaluated and receive appropriate education.

• Annals of Clinical Neurophysiology
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• v.5 no.2
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• pp.181-186
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• 2003

Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.232-236
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• 2016

Objective: Diabetic neuropathy is a common complication of diabetes mellitus. Patients with this disease suffer from various peripheral sensory symptoms that are not easily alleviated. We report on a case of a patient with diabetic neuropathy whose symptoms were alleviated after traditional Korean medical treatment.Methods: A patient with hand and foot numbness and coldness diagnosed with diabetic neuropathy was treated with Palmijihwang-tang (Bai Wei Di Huang Wa, 八味地黃湯) three times a day. The progress was evaluated with the numerical rating scale (NRS), neuropathy disability score (NDS), and neuropathy symptom score (NSS).Results: The improvement of symptoms appeared to be faster and more effective than that of conventional treatment. The improvement was observed from the second day of the treatment.Conclusions: This case study shows that Palmijihwang-tang may be an effective treatment for diabetic neuropathy.

• Korean Journal of Acupuncture
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• v.30 no.4
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• pp.289-297
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• 2013

Objectives : Diabetic peripheral neuropathy(DPN), generally considered to be the most symptomatically distressing complication of diabetes, affects more than 50% of people with diabetes. However, no consistently effective treatment for DPN is available and patients are forced to struggle with medications that provide only partial relief. In this pilot study, we evaluated the clinical effects of Saam acupuncture for the treatment of painful DPN. Methods : A total of 10 patients with painful DPN were included in the study; 6 subjects with Saam acupuncture treatment and 4 subjects without it. Subjects were defined as having painful DPN if they had at least 2 points using total symptom score(TSS). Treatments were delivered three times a week for 4 weeks. Vitamin $B_{12}$ was orally administrated in the all subjects. At initial(0 week) and follow-up after 4 weeks and 8 weeks, all subjects underwent TSS, Michigan Neuropathy Screening Instrument(MNSI), and nerve conduction test. Results : After initial(0 week) and follow-up(8 weeks), TSS and MNSI were not significantly different between the two groups(p=0.400 and p=0.830, respectively). However, in both two groups, according to time, there was a significant difference in TSS as well as MNSI(p=0.001 and p=0.004, respectively). Conclusions : Saam acupuncture may be considered as the effective treatment for the patients of DPN although the changes of the symptoms were of limited significance in this study. Further investigations are required to elucidate the role of Saam acupuncture for the pain control of DPN.