• 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.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.146-152
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• 2011

Purpose: To describe the recent clinical results and complications of total elbow arthroplasty based on the literature review. Materials and Methods: The indications of total elbow arthroplasty include rheumatoid or inflammatory arthritis, posttraumatic arthritis, anklylosed elbow, tumor resection which cannot recover elbow function by other reconstructive procedures, and comminuted distal humerus fracture in elderly patients. Complications are aspetic loosening, infection, prosthesis fracture, periprosthetic fracture, ulnar neuropathy, ectopic ossification, triceps insufficiency, dislocation, and bushing wear. Results and Conclusion: Mean 10 year survival rate following total elbow arthroplasty has been reported 85% on the basis of revision. The prognosis in patients with an inflammatory arthritis is reported to be best, and loosening rate in patients with a posttraumatic arthritis tends to be high. Complication rate is known to be higher than that of other joint arthroplasty. In particular, deep infection occurs in 3~5% of the patients. Total elbow arthroplasty provide satisfactory results when it is performed properly in selected patients who have an elbow joint with irreversible dysfunction and low level activities.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.404-410
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• 2006

Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.815-818
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• 2010

Purpose: Soft tissue chondroma is a rare benign tumor, found mainly on the palm and sole and grows slowly. Typically, mature hyaline cartilage is the dominant pathological feature. There are reports that assert soft tissue chondromas to be a cause of median nerve entrapment syndrome. However, this is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy. Methods: A 62 year-old woman presented with chief complaints of numbness and hypoesthesia of her right palm for 4 to 5 years, and a palpable mass on her right palm that had been increasing in size slowly for 3 years. Physical examination revealed a firm, mobile, non-tender and about $3{\times}3\;cm^2$ sized mass in the center of the right palm. Electromyography showed entrapment neuropathy of the median and ulnar nerve. Ultrasonography showed an approximately $5.7\;cm^2$ mass below the flexor tendon of ring finger. Upon surgical excision, a $3{\times}3\;cm^2$ mass attached to the flexor digitorum profundus of ring finger and redness and hypertrophy of both the median and ulnar nerve were discovered. Mass excision was performed gently and the specimen was referred for histopathologic study. Mass excision resulted in median and ulnar nerve release. Results: The pathology report confirmed the mass to be a soft tissue chondroma with mature hyaline cartilage. The patient exhibited post-operative improvement of her symptoms and did not show any complications. Conclusion: This is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.335-342
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• 2008

Background: Congenital cystic diseases of the lung are uncommon, and they share similar embryogenic and clinical characteristics. But they are sometimes vary widely in their presentation and severity. Therefore they are often difficult to make different diagnosis each other, and all require surgical treatment. Material and Method: From 1993 to 2006, 38 patients underwent surgical procedures under these diagnostic categories in the Depart. of Thoracic and. Cardiovascular Surgery, Busan-Paik Hospital, College of Medicine, Inje University. And we retrospectively reviewed these patients' charts for clinical presentations, surgical procedures, pathologic findings and postoperative morbidity and mortality. Result: There were 22 males and 16 females, ages ranged from 1 month after birth to 51 years and mean age was 20.8 years. The main symptoms were 19 fever, cough, sputum production due to recurrent infection, 7 dyspnea, 8 chest discomfort, 4 hemoptysis, but eight patients were asymptomatic. Computed tomography was chosen as diagnostic modalities and available for operation plan for all of patients. For all the cases, surgical resection were performed. Lobectomy was performed in 28 patients, simple excision (resection) in 8 patients, segmentectomy or wedge resection in 2 patients. There were 10 pulmonary sequestrations, 15 congenital cystic adenomatoid malformations (CCAM), 11 bronchogenic cysts, and 2 congenital lobar emphysemas. They all were confirmed by pathologic exams. The complications were 6 wound disruption or infection, 2 chylothorax, 1 ulnar neuropathy, but all of them were resolved uneventful. There was no persistent air leakage, respiratory failure, operative mortality and recurrence. Conclusion: We performed immediate surgical removal of congenital cystic lung lesions after diagnosis and obtained good results, so reported them with literature review.