• 한국의학물리학회지:의학물리
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• 제9권1호
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• pp.23-28
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• 1998

최근에 당뇨병이 말초혈관 혈류흐름에 치명적인 영향을 준다는 의학보고에 따라 기존의 혈액체취를 통한 혈액 속의 당치를 측정하는 방식 대신에 고분해능을 가진 LDF(Laser Dopller Flowmeter)를 이용하여 말초혈관 혈류를 측정하여 정상인과 당뇨병환자와의 차이점에 대하여 연구하였다. 여러 가지 분석 방법중, 본 연구에서는 주파수영역에서의 ASD방법을 통하여 그 차이를 분석하였다. 실험대상은 음성 신경병증, 양성 신경병증, 갑상선 기능 항진증, 갑상선 기능 저하증 등 4개의 당뇨병환자군과 당뇨병에 대한 정상군에 대하여 LDF를 측정하였다. 그 결과 모든 당뇨환자군은 정상인에 대하여 모든 진동수영역에서 낮은 ASD를 가져 당뇨병이 말초혈관 혈류운동에 손실을 가져옴을 확인하였고, 신경병증을 가진 환자와 갑상선기능저항증 당뇨환자군은 거의 모든 진동수 영역에서 낮은 ASD를 가졌다.

• 대한한방내과학회지
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• 제28권3호
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• pp.434-441
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• 2007

Objectives : Peripheral neurodegeneration occurs in diabetes mellitus (DM), both sensory and motor nerve. but we don't know exactly if DM affects central nerve pathway for all studies. Electrophysiologic study is one of the most important diagnostic tools for diabetic neuropathy. Electroneurography and electromyography are usually used. but evoked potentials (EP) is more sensitive to small nerve fiber damages and useful for central nerve evaluation in addition to peripheral nerves. Most diabetic neuropathy studies by EP have been performed with somatosensory evoked potentials (SSEP). In contrast, the objective of this study is to investigate if DM targets central motor neurons by assessing the relation between fasting blood sugar (FBS) and motor evoked potentials (MEP) latency. Methods : We inspected the medical records of 34 patients who had MEP tests during admitting days. The latency from cervical portion to abductor pollicis brevis was used as peripheral motor conduction time (PMCT). and the latency from vertex to cervical portion was used as central motor conduction time (CMCT). Then, they were correlated to FBS using correlation analysis. Results : There was a significant linear relation between FBS and PMCT (Pearson's correlation coefficient r=0.487, p<0.01), but a poor linear relation between FBS and CMCT (Pearson's correlation coefficient r=-0.l97. p>0.05). Conclusions : This study suggests that prolonged latencies of MEP in DM may be due to peripheral neuropathy rather than dysfunction of central motor pathway. therefore the clinical use of MEP to diabetic neuropathy has to be divided segmentally.

• 디지털콘텐츠학회 논문지
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• 제19권4호
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• pp.615-620
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• 2018

당뇨병성 다발성 신경병증 환자들을 진단하는 전류지각 역치 시험과 진동 감각 지각 역치의 임상학적 유용성에 대한 평가는 당뇨병성 다발성 신경병증에 대한 진단방법 중의 하나이다. 현재까지 당뇨병성 다발성 신경병증 환자들에 대해 몇 가지 방법들이 사용되어 왔는데, 예를 들면, 하지 신경병증 장애 시험, 신경전도 시험, 냉각감지 역치 시험, 열-고통 역치 시험 등을 들 수 있다. 그러나, 이들 대부분의 시험은 고가이거나 시험하는데 많은 시간을 필요로 한다. 본 논문에서는 진동 감지 능력을 평가하는 새로운 기구가 소개되고, 이를 위해 환자의 말초 신경을 자극하는 보이스 코일 모터(voice coil motor)와 전류 증폭기를 제작하였다. 또한, 당뇨병성 다발성 신경병증 환자들의 정량적 진동 감지 수준을 측정하기 위하여 진동 감지 역치 시험을 센싱하고 구동하는 소프트웨어가 개발되었다.

• 여성건강간호학회지
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• 제19권4호
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• pp.201-210
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• 2013

Purpose: The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. Methods: This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). Results: The neuropathy score was $14.3{\pm}7.9$. The quality of life score was $64.8{\pm}16.4$. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. Conclusion: Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.

• 대한족부족관절학회지
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• 제8권1호
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• pp.52-57
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• 2004

Purpose: We evaluated the effect of nerve decompression for restoration of plantar sweating and sensation in diabetic neuropathic feet, and we selected diabetic neuropathic patients with the possibility of overlying entrapmental neuropathy. Materials and Methods: From June 2002 to May 2003, we have investigated and follow-up examed 10 patients with diabetic neuropathic feet, with decreased sensation in their lower limb, who underwent peripheral nerve decompression. The surgical procedure was multiple neurolysis of the common peroneal nerve, posterior tibial nerve and its three branches of one limb. We compared the operated limb with the opposite, unoperated limb. We performed history taking, physical examination, sweat secretion test, touch sensory test using Semmes-Weinstein monofilaments and electrodiagnostic study, pre-operatively and post-operatively. Results: On 6 months after the operation, the post-operative tests showed that there were noticeable improvements to sensation, statistically (P<0.05), but there was no change in the sweat secretion test. According to the Cseuz criteria, 7 patients out of the 10 patients who received the multiple neurolysis showed excellent or good results. Conclusion: We observed that the peripheral nerve neurolysis could be benefit for improving sensation and alleviating pain of the diabetic neuropathic feet with nerve entrapmental symptoms, but there was no change in the sweat secretion on short-term follow-up. To identify whether the effect will be continued or not, additional follow-up will be required.

• International journal of advanced smart convergence
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• 제9권1호
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• pp.37-46
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• 2020

Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.

• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• Journal of Acupuncture Research
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• 제32권4호
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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.

• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.25-28
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• 2008

Diabetic polyneuropathy (DPN) is the most frequently encountered form of neuropathy in diabetic patients, and it either relentlessly progresses or remains relatively stable for many years, not showing any trend towards improvement. From this point of view, early detection of DPN is very important to prevent the irreversible change of the peripheral nerve from diabetic insults. Although a number of clinical symptoms and/or deficit scales have been developed for clinical or research purposes, nerve conduction study (NCS) has been known one of the most objective and sensitive tools to detect peripheral nerve dysfunctions in diabetic patients. NCS, however, also have several shortcomings. The next two consecutive articles will focus on debates about diagnostic usefulness of NCS and on recent updates of other diagnostic tests including quantitative sensory testings and skin biopsy in the field of diabetic polyneuropathy.

• 한국전문물리치료학회지
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• 제5권2호
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• pp.98-105
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• 1998

The purposes of this article are to review the pathogenesis, prevention, and management of amputation due to diabetes mel1itus complications, and to report one case who had lost his toes due to diabetes mellitus. A primary cause for hospital admission of the patient was foot ulcer. Since many amputations in diabetic patients are precipitated by such ulcers, a program for active prevention and optimal treatment of diabetic foot lesions might decrease the risk of amputation. Diabetic foot ulcers and, ultimately, amputation can stem from a variety of pathways. The combination of peripheral neuropathy, peripheral vascular disease and infections is the harbinger of the final cataclysmic events of gangrene and amputation. As the physical therapist is often involved in the treatment of diabetic patients, the therapist should be aware of the followings: the patient's type of diabetes and the severity of the diabetes, the complications of the disease, the effects of exercise, the importance of wearing proper shoes and education to patients about appropriate diabetic foot care.