• Title/Summary/Keyword: 당뇨병성 신경병증

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Ankle Arthrodesis using Cannulated Screws & Hybrid Type Rigid External Fixation in Diabetic Charcot Neuroarthropathy (유관 나사 및 Hybrid형 외고정술을 이용한 당뇨병성 샤르코 족관절 신경관절병증의 관절 유합술)

  • Han, Kyeung-Jin;Roh, Hyong-Rae;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.140-145
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    • 2010
  • Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

Vasodilatation effect of Kirenol isolated from Sigesbeckia pubescens (털진득찰에서 분리한 Kirenol의 혈관 이완효과)

  • Nam, Jung Hwan
    • Korean Journal of Plant Resources
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    • v.33 no.5
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    • pp.467-475
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    • 2020
  • The purpose of this study is to investigate the vasodilatation effect of kirenol isolated from Sigesbeckia pubescens on the rabbit basilar artery. In this study, to determine the vasodilatation effect of kirenol on the rabbit basilar artery, arterial rings with intact or damaged endothelium were used for the experiment. And used an organ bath and force transducer were contracted by endothelin. Kirenol, major active constituents of S. pubescens, showed a moderate vasodilatation effect on the basilar arteries of rabbits. Therefore, treatment with kirenol may selectively accelerate cerebral blood flow through dilatation of the basilar artery. This result suggests a potential role of kirenol isolated from S. pubescens as a source of vasodilatation agent.

Quantitative Sensory Test: Normal Range in Korean Adults and Application to Diabetic Polyneuropathy (정량적 감각 검사: 한국인에서의 연령별 정상 범위 및 당뇨병성 다발신경병증에서의 유용성 평가)

  • Kim, Su-Hyun;Kim, Sung-Min;Ahn, Suk-Won;Hong, Yoon-Ho;Park, Kyung-Seok;Sung, Jung-Joon;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.21-26
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    • 2010
  • Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

Case Report: Lower Extremity Paresthesia and Pain with Diabetic Polyneuropathy Combated with Complex Korean Medical Treatment (하지 감각이상 및 통증을 호소하는 당뇨병성 다발신경병증 환자에 대한 복합 한의치험 1례)

  • Seong-Hoon Jeong;Young-Seon Lee;Si-Yun Sung;Han-Gyul Lee;Ki-Ho Cho;Sang-Kwan Moon;Woo-Sang Jung;Seungwon Kwon
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.231-243
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    • 2023
  • Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

A Study on the Correlation between Pain Intensity and HbA1c for Diabetic Peripheral Neuropathy Patients (당뇨병성 말초신경병증 환자에서 통증 정도와 당화혈색소 간의 상관성 연구)

  • Jung, Se Ho;Sung, Hee Jin;Lim, Su Ji;Lee, Cham Kyul;Jo, Na Young;Roh, Jeong Du;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.17-27
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    • 2015
  • Objectives : The purpose of this study is to evaluate the correlation between HbA1c and pain intensity in diabetic peripheral neuropathy patients, and to compare the difference between two groups divided by the risk of complications. Methods : The participants were 46 men and women suffering from neuropathic pain diagnosed with diabetes mellitus who visited the Hospital of Traditional Korean Medicine, Semyung University from June, 2014 to August, 2015. Age, duration of diabetes mellitus, numeric rating scale(NRS), and Michigan neuropathy screening instrument(MNSI) were used as evaluation tools. Results : 1. In all 46 cases, there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 2. Among 23 cases with a high risk of complications (more than 7.0 % of HbA1c, group A), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 3. Among 23 cases with a low risk of complications(less than 7.0 % of HbA1c, group B), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 4. Means of duration of diabetes mellitus, NRS, MNSIQ, and MNSIE were higher in group A than group B, but there were no significant correlations in statistics. Conclusions : This study could not find statistically significant correlations between pain intensity and HbA1c in diabetic peripheral neuropathy patients, so more studies are required in the future.