• Title/Summary/Keyword: Median Nerve

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Usefulness of infrared thermography in diagnosing and evaluating severity of carpal tunnel syndrome

  • Yang, Jiwon;Lee, Yeong-Bae;Sung, Young-Hee;Shin, Dong-Jin;Kim, Yong-Jin;Park, Hyeon-Mi
    • Annals of Clinical Neurophysiology
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    • v.23 no.2
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    • pp.99-107
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    • 2021
  • Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

Sucrose solution for alleviating needle pain during inferior alveolar nerve block in children aged 7-10 years: a randomized clinical trial

  • Supriya Thambireddy;Nirmala SVSG;Sivakumar Nuvvula
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.5
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    • pp.273-280
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    • 2023
  • Background: Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers. Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. Methods: A total of 42 healthy children aged 7-10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants' demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min. The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann-Whitney U test. Results: The median pain score and range for the intervention and control groups were 4 (2 - 6) and 6 (4 - 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group. Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. Conclusion: Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

Clinical Differences and Outcomes of Continuous Renal Replacement Therapy between Critically Ill Neonates and Children (신생아와 소아의 지속적 신대체요법(CRRT) 적용 특성 및 결과)

  • Choi, Aeng Ja;Choi, Su Jung;Choi, Hee Jung;You, Mi Young
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.40-50
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    • 2016
  • Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

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Immunocytochemistry of serotonin and galanin in the hypothalamus of the Japanese quail

  • Haida, Yuka;Oishi, Tadashi;Tsutsui, Kazuyoshi;Tamotsu, Satoshi
    • Journal of Photoscience
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    • v.9 no.2
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    • pp.258-260
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    • 2002
  • We investigated the interaction of serotonin and galanin (GA) by a double immunostaining method in the Japanese quail. Serotonin-immunoreactive (IR) cells were located in the paraventricular organ (PVO) and infundibular nucleus (IF). The number of the cells under short-day photoperiod (SD) was less in the dark phase than in the light phase. GA-IR cells were found in the PVO, IF and median eminence. The number of GA-IR cells in SD was significantly greater than that in long-day photoperiod (LD). Numerous GA- IR varicose fibers ran along serotonin- IR cell bodies and nerve fibers in the PVO and IF of the same sections. Very few serotonin-IR fibers ran along GA-IR cell bodies and GA-IR nerve fibers in the ventral part of the IF. The present results suggest that the possibility of functional interaction takes place between serotonin- and GA- IR neurons in the PVO and IF.

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Open carpal release using local anesthesia without a tourniquet: Does bleeding tendency affect the outcome?

  • Lee, Seongwon;Oh, Sangho;Son, Daegu
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.597-603
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    • 2020
  • Background The aim of this study was to analyze the clinical results of minimal single palmar-incision carpal tunnel release without a tourniquet. Methods We reviewed the medical records of 75 patients (90 cases of carpal tunnel syndrome) who underwent minimal single-palmar incision carpal tunnel release without a tourniquet from June 2010 to January 2018. Ten patients had a bleeding tendency. We compared the preoperative and postoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. We also analyzed outcomes and complications according to the presence of a bleeding tendency. Results In all cases, there was a complete disappearance or marked improvement in symptoms within 6 months, with no recurrence. The postoperative BCTQ score showed a significant improvement compared to the preoperative score, and no statistically significant difference in BCTQ scores was detected according to the presence of a bleeding tendency. Conclusions Carpal tunnel release without a tourniquet using a minimal single palmar incision is effective and reliable. This technique prevents unnecessary pain associated with the tourniquet and is especially helpful in patients with a bleeding tendency or those treated with hemodialysis.

The Effect of Irradiation During Resistance Exercise Using a Diagonal Pattern on the Excitability of Nerves (대각선 패턴에서 저항운동 시 발생한 방산의 효과가 신경의 흥분성에 미치는 영향)

  • Rhee, Min-Hyung;Choi, Su-Hong;Ha, Kyung-Jin;Lee, Sang-Yeol
    • PNF and Movement
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    • v.19 no.1
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    • pp.97-104
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    • 2021
  • Purpose: The human body can experience a variety of injuries. As a result, it may be difficult to directly treat the damaged area. In such a case, indirect treatment is required. Indirect treatment is typically PNF treatment. Morphological changes in muscle have been confirmed through several previous studies; however, few studies have analyzed neurological changes. Therefore, the purpose of this study was to determine how irradiation during resistance exercise using a diagonal pattern effects neurological excitability. Methods: Electromyography was performed on 13 healthy adults. A compound muscle action potential (CMAP) was obtained through a median motor nerve conduction velocity test, which was conducted before and after performing the irradiation exercise and general exercise. Results: Compared to baseline measurements, there was no significant difference in the latency of the irradiation exercise and general exercise. The amplitude of the CMAP measured after the irradiation exercise was significantly higher than after general exercise. Conclusion: Neurological excitability was high in irradiation during resistance exercise using a diagonal pattern. When clinically direct treatment is difficult, it is thought that irradiation can be used indirectly as a technique to induce nerve excitability.

Real-Time Decoding of Multi-Channel Peripheral Nerve Activity (다채널 말초 신경신호의 실시간 디코딩)

  • Jee, In-Hyeog;Lee, Yun-Jung;Chu, Jun-Uk
    • Journal of IKEEE
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    • v.24 no.4
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    • pp.1039-1049
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    • 2020
  • Neural decoding is important to recognize the user's intention for controlling a neuro-prosthetic hand. This paper proposes a real-time decoding method for multi-channel peripheral neural activity. Peripheral nerve signals were measured from the median and radial nerves, and motion artifacts were removed based on locally fitted polynomials. Action potentials were then classified using a k-means algorithm. The firing rate of action potentials was extracted as a feature vector and its dimensionality was reduced by a self-organizing feature map. Finally, a multi-layer perceptron was used to classify hand motions. In monkey experiments, all processes were completed within a real-time constrain, and the hand motions were recognized with a high success rate.

Ultrasound Findings and Treatment of Wrist and Hand Diseases (완관절과 수부 질환의 초음파 소견과 치료)

  • Lee, Jong Hwa
    • Clinical Pain
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    • v.20 no.1
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    • pp.15-19
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    • 2021
  • There are many wrist and hand diseases in which ultrasound can help in the diagnosis and treatment. Because many small structures are located, identifying anatomical locations and pathways is especially important. In De Quervain's syndrome, it is necessary to find tendon lesions located in the first compartment of the wrist. If injection therapy is required, administer the regimen accurately within the tendon sheath through ultrasound. In carpal tunnel syndrome, there are several methods to diagnose a disease by measuring cross-sectional area of the median nerve. Ultrasound has the advantage of administering injection therapy without damaging the nerve. Intersection syndrome can be diagnosed by observing swelling and hypoechoic appearances at the point where the tendons of the first compartment cross over the second compartment of the wrist. Ultrasound-guided injection is also safe and efficient. If there is a trigger finger lesion, the most representative findings is to observe a nodular hypoechoic thickening of the involved A1 pulley. When injection therapy is performed, it is effective to administer medication between pulley and flexor tendons as much as possible to reduce pressure on the attached structures.

Clinical Outcomes of the Surgical Excision of the Ganglion Cyst Causing Compressive Neuropathy - A Review of Twelve Collected Cases - (압박 신경병증을 일으킨 결절종의 수술적 절제의 임상적 결과)

  • Jung, Sung-Taek;Cho, Seong-Beom;Moon, Eun-Sun;Lee, Jae-Joon;Kim, Ki-Hyeoung;Yang, Hyun-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.63-70
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    • 2006
  • Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

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The Effect of Phrenic Nerve Paralysis After Pediatric Cardiac Surgery on Postoperative Respiratory Care (소아 심혈관 수술 후 발생한 횡격신경마비가 술후 호흡관리에 미치는 영향)

  • 윤태진;이정렬
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1118-1122
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    • 1996
  • From January 1990 through December 1995, 43 patients underwent diaphragmatic plication for the management of phrenic nerve palsy .complicating various pediatric cardiovascular surgery. Their mean age at plication was 11.1 months and sex ratio was 31 males to 12 females. In order of decreasing incidence, the primary cardiovascular procedures included modified Blalock-Taussig shunt (7), total correction for the Tetralogy of Falloff (7), arterial switch operation (6), unifocalization for the pulmonary atresia with VSD (3), modified Fontan operation (3), VSD patch closure (3) and others. The involved sides of diaphragm were right in 17, left in 2) and bilateral in 3. Extensive pericardial resection with electocauterization of resected margin was thought to be the most common cause of phrenic nerve palsy (20). The interval between primary operation and plication ranged from the day of operation to 98 days (median 11 days). The methods of plication were central pleating technique(plication with phrenic nerve branch preservation) in 41, and other technique In 2. 10 patients died after plication (7: early, 3; late), and the causes of death were thought to be unrelated to plication itself. Among the 36 early survivors, extubation or cessation of positive pressure ventilation could be accomplished between 1 and 24 days postoperatively(mean : 4.5). Cumulative follow-up was 92 patient years without major complications. Postoperative follow-up fluoroscopy was performed in 6 patients, and the location and movement of plicated diaphragms were satisfactory in 5 patients. We concluded that diaphragmatic plication with preservation of phrenic n rve branch could lead to cessation of positive pressure ventilation and complete recovery of diaphragmatic function in the long term, unless the phrenic nerve was irreversibly damaged.

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