• Journal of Preventive Medicine and Public Health
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• 제26권2호
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• pp.282-292
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• 1993

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by cliniical neurologists and neurotoxicologists to evaluate neurotoxicity in working populations is a necessity fur the occupational physician. To investigate the effects of carbon disulfide($CS_2$) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of $CS_2$-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between $CS_2$-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.656-662
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• 2022

The median nerve can be compressed due to a tumor along the course of the median nerve, causing typical compression symptoms or even persistence or recurrence after an operation. The aim of this review is to provide a comprehensive overview of rare tumors described in recent publications that cause median nerve compression and to evaluate treatment options. The PubMed, Embase, and Web of Science databases were searched for studies describing median nerve compression due to a tumor in adults, published from the year 2000 and written in English. From 94 studies, information of approximately 100 patients have been obtained. Results The rare tumors causing compression were in 32 patients located at the carpal tunnel, in 21 cases in the palm of the hand, and 28 proximal from the carpal tunnel. In the other cases the compression site extended over a longer trajectory. There were 37 different histological types of lesions. Complete resection of the tumor was possible in 58 cases. A total of 8 patients presented for the second time after receiving initial therapy. During follow-up, three cases of recurrence were reported with a mean follow-up period of 11 months. The most common published cause of median nerve compression is the lipofibromatous hamartoma. Besides the typical sensory and motor symptoms of median nerve compression, a thorough physical examination of the complete upper extremity is necessary to find any swelling or triggering that might raise suspicion of the presence of a tumor.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• The Korean Journal of Pain
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• 제8권2호
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• pp.390-393
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• 1995

Although spinal anesthesia has long been considered a safe technique, it is not without risk or side effect. Cauda equina syndrome is a rare but serious complication of spinal anesthesia. We have experience a case of cauda equina syndrome after spinal anesthesia. A twenty year old healthy male patient complained of pain, numbness, tingling sensation and motor weakness on his right lower extremity 8 hours after subarachnoid blockade. On the following day, the patient was noted to have a right L1 to S2 radiculopathy. Magnetic Resonance Imaging results were unremarkable. The patient sprained his ankle while trying to move down from the bed, so short leg splint was applied. Then he had additional right common peroneal nerve injury from the splint. His neurologic symptoms improved gradually thereafter, and three months postoperatively his electromyogram revealed improving stage from right common peroneal nerve palsy.

• Journal of Acupuncture Research
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• 제21권6호
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• pp.249-257
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• 2004

Objective : Radial nerve palsy is characterized by palsy or paralysis of extensors of the wrist and digits, as well as the forearm supinators. Very proximal lesions also may affect the triceps. Numbness occurs on the dorsoradial aspect of the hand and the dorsal aspect of the radial 3 and 1/2 digits. We observed 7 patients with radial nerve palsy, the results are as follows. Methods & Results : All patients were treated by the same method and treatment was performed by acupuncture and Neuromuscular Electrical Stimulation. the electrode were placed unilaterally on the motor points of forearm. As the result, symptoms are improved remarkably. Conclusions : Patients were treated for 5.4 weeks, 14.7 times(average). The grade was that 6 cases were good and 1 case was excellent.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.125-134
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• 2006

Among the various physiological factors that affect nerve conduction velocity (NCV), temperature is the most important. Because the influence of temperature is the most important source of error. It is known from animal experiments that conduction is eventually completely blocked at low temperatures, the myelinated A fibers being the first affected and the thin fibers of group C the last. Many studies showed that the NCV decreases linearly with lowering temperature within the physiological range. The distal motor latency increased by $0.2msec/^{\circ}C$ drop in temperature between $25^{\circ}C$and $35^{\circ}C$ in the median, ulnar and peroneal nerves. The temperature affect the neuromuscular transmission; The miniature endplate potential (MEPP) and endplate potential (EPP) are increase with increasing temperature. In myasthenia gravis, the reduction in the decremental response is observed following cooling. The lowering temperature make increase the amplitude of sensory compound action potential; make enlarge the surface area of compound muscle action potential with very little increase in amplitude; make diminish the fibrillation potential and increase the myotonia in needle electromyography (EMG). Because of these findings mentioned above, the skin temperature should be routinely monitored and controlled during nerve conduction tests and needle EMG and should be taken into account when interpreting the findings.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.156-159
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• 2001

Miller Fisher syndrome(MFS) has been the focus of conflicting opinions regarding the peripheral versus the central nature of the site of major neural injury. We present our electrophysiological findings in one case of MFS to help clarify the pattern of peripheral nerve injury in this syndrome. A 45-year-old man visited our hospital due to sudden diplopia. Initial examination revealed internuclear opthalmoplegia. The next day, his symptoms rapidly aggravated to complete external ophthalmoplegia, ataxia, and areflexia with hand and foot numbness. Serial electrophysiological studies were performed. The results of brainstem evoked potential(BAEP) and blink reflex were normal in the serial studies. Motor and sensory nerve conduction study(NCS) were normal findings in second hospital day, but ulnar sensory nerve shows no sensory nerve action potential(SNAP) and sural sensory conduction velocity was delayed in 7th hospital day. Our patient's clinical presentation began to improve on 15th hospital day, and his electrophysiologic study showed improvement on 29th hospital day. We believe that all the manifestations of MFS can be explained by the involvement of peripheral nerves without brainstem or cerebellar lesion with the serial electrophysiological studies.

• The Journal of Korean Physical Therapy
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• 제19권2호
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• pp.41-55
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• 2007

Purpose: This study aimed to compare the effect on nerve regeneration of ultrasound irradiation in rats with peripheral nerve injury. Methods: To investigate alterations of the NCAM immunoreactivity in non-crushed part and crushed part of the spinal cord, the unilateral sciatic nerve of the rats were crushed. The expression of NCAM was used as the marked of peripheral nerve regeneration, and also plays an important role in developing nerve system. Experimental animals were sacrificed by perfusion fixation at post-injury 1, 3, 7, 14 days after ultrasound irradiation. The pulsed US was applied at a frequency of 1MHz and a spatial average-temporal average Intensity of 0.5W/of (20% pulse ratio) for 1 mins. The Luxol fast blue-cresyl violet stain were also done to observe the morphological changes. Results: Alteration of NCAM immunoreactivity in the crushed part and the non-crushed part of lower lumbar spinal cord were observed. NCAM-immunoreactivity cells were some increased in the dorsal horn lamina I, III and cell ventral horn at 1 day after unilateral sciatic nerve injury. However, there was not significant difference in the relationship between crushed part and non-crushed part. NCAM-inmmunoreactivity was remarkably increased at 3 days after unilateral sciatic nerve injuryin the gray matter and white matter. NCAM-immunoreactivity was increased in the ventral horn and post horn of experimental crushed part. Also, NCAM-immunoreactivity in large motor neurons in ventral horns lamina VIII, IX were increased at 7 days after unilateral sciatic nerve injury. At 14 days after sciatic nerve crushed injury, there was no significant difference. All group were decreased for 14 days. In the time course of NCAM expression, all groups showed a significant difference at 3day groups(p<0.05). Whereas, CC group was noted a significant difference between 3day and 7 day group respectively. In NCAM expression, there were significantly increased in all group. In the relationship between CNC group and ENC group, significant difference was detected among 3, 7, 14 day group(p<0.05). The difference between CC group and ENC group were noted in all groups(p<0.05). Conclusion: It is consequently suggested that the effects of the ultrasound irradiation may increase the NCAM immunoreactive neurons and glial cell in the spinal cord after unilateral sciatic nerve crushed injury. Therefore, the increased NCAM immunoreactivity in the spinal cord may reflect the neuronal damage and healing process induced by a ultrasound irradiation after peripheral nerve injury in rat.

• The Korean Journal of Pain
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• 제14권1호
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• pp.83-92
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• 2001

Background: This study was undertaken to observe the functional changes of the hind limb and histopathological changes in the sciatic nerve after an injection of alcohol or phenol, which are commonly used neurolytic agents, highlighting the time of recovery. Methods: Forty-eight Sprague-Dawley rats weighing 200-300 g were used for the experiment. Histopathological changes under the electron microscope, were observed in the distal part of the sciatic nerve, into which 0.1 ml of alcohol or phenol was injected. This was severed in 3 rats of each group at 10 minutes, 1 hour, 24 hours, 3 days, 1, 2, 4 and 6 weeks later. The functional changes in the hind limbs were observed for 6 weeks by noting their walking pattern. Results: Following the injection of alcohol or phenol into the right sciatic nerve, the right hind limb showed a severe pronounced motor weakness and obvious gait changes. About 2 weeks later, gradual improvement of gait changes began, and after 6 weeks, the motor weakness and gait changes were no longer perceptible in both groups. The findings of any histopathological change were similar in both alcohol or phenol groups. At 10 minutes after injection, destructive lesions were confined to the unmyelinated fibers and the myelin sheath of small the myelinated fibers. On the 3rd day and at 1 week, pathologic changes in axonal fibers and Schwann cells were in being phagocytized in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared at the same time a myelin disintegration and axonolysis. At 6 weeks, neural regeneration was similar to that of the contralateral control group. Conclusions: These results suggest that functional and histopathological changes, after injection of neurolytics into the peripheral nerves, are quite similar in both alcohol and phenol groups. The progression of functional and histopathological changes become more obvious according to the time interval following the injection. Consequently, side effects that develop following the use of alcohol or phenol may begin to improve around the time that nerve regeneration occurs, i.e., two to four weeks later.

• 생명과학회지
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• 제15권3호
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• pp.486-491
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• 2005

Growth-associated protein (GAP-43)은 손상된 신경 재생 시 axonal growth를 확인할 수 있는 가장 널리 알려진 단백질이다. 본 연구의 목적은 좌골신경 손상을 준 쥐에 저강도 운동 수행 후 좌골신경에서 발현되는 GAP-43 단백질의 양을 정량적으로 분석하고, 손상된 부분으로부터 신경섬유의 재생 정도를 조직학적으로 분석함으로써 운동이 말초신경 손상을 가한 쥐에 미치는 영향을 분석하는 것이다. CAP-43의 정량적인 분석은 western blotting을 통해 확인하였고, 좌골신경의 조직학적인 분석은 immunofluorescence staining과 anterograde로 DiI 주입, 척수 내의 motor neuron은 retrograde로 DiI를 주입 한 후 형광현미경에서 관찰하였다. 본 연구에서는 좌골신경이 손상된 쥐에게 운동을 수행시킴으로써 CAP피3단백질이 비운동 그룹보다 더 많은 양이 발현되고, 손상된 부위에서 재생하는 신경섬유의 길이와 양이 더 많은 것을 확인할 수 있었다. 또한 운동을 수행한 그룹에서 DiI에 염색된 motor neuron의 수가 더 많이 증가하는 것을 관찰하였다. 따라서 이러한 결과들은 운동이 좌골신경이 손상된 쥐의 재생을 촉진시킬 것으로 생각된다.