• The Journal of the Korea Contents Association
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• v.10 no.10
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• pp.237-245
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• 2010

Nerve conduction studies (NCS) are the most objective measure of nerve function and essential for the diagnosis of sub-clinical neuropathy in diabetes mellitus and diabetic polyneuropathy (DPN). This study evaluates the characteristic of electrophysiological abnormalities in DPN. Electrodiagnostic data from 120 patients with diabetic polyneuropathies and 77 control subjects were reviewed. Motor nerve conduction velocities (MNCV), distal motor latencies (DML), compound muscle action potential (CMAP) amplitudes, No potential frequency and conduction block were analyzed. Data were normalized based on normative reference values, and the proportion of nerves with abnormal values in the lower and upper limbs were evaluated. DPN was systemic demyelinating peripheral polyneuropathy and more severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in peroneal nerve. It was no statistically significant difference of conduction block in control and DPN group. Our findings suggest that DPN had more common and severe peroneal nerve involvement in the motor nerve conduction studies (MNCS). These findings have important implications for the electrophysiological evaluation of DPN.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.1-6
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• 2002

When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

• Biomedical Science Letters
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• v.26 no.3
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• pp.186-191
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• 2020

This study was designed to investigate the median nerve cross-sectional area of the upper extremity which is the main cause of CTS in the 20s and 30s. The median nerve cross-sectional area (MNC-area) of each part of the upper limb was measured in healthy 20s and 30s females and males without neurological diseases or other diseases. This MNC-area was compared with the hand, wrist, finger, and other body indexes. The research group was divided into 20s female and male groups, and the 30s were also divided into female and male groups. In the comparison between the ages, the hand, and wrist configurations in the 30s were significantly higher than those of the 20s. The mean median nerve cross-sectional area was significantly larger in the male group than in the female group in both 20s and 30s, and it was larger in both men and women than in the 20s. Hand and wrist configurations were also positively correlated with the median nerve cross-sectional area in both 20s and 30s. The median values of hand ratio and wrist ratio were 2.26 and 0.65, respectively. This median value of hand ratio was inversely correlated with the median nerve cross-sectional area. The median nerve cross-area of the 20s was 6.88~7.38 ㎟ in the male group and 5.69~6.99 ㎟ in the female group, respectively. The median nerve cross-area of the 30s was 6.32~8.89 ㎟ in the male group and 6.15~7.17 ㎟ in the female group, respectively. The mean median nerve cross-sectional area was positively correlated with body mass index in both groups. Most of the variables were higher in their 30s than in their 20s.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.81-84
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• 2011

Purpose: Nerve injury is one of the complication which can develop after brow lift. Peripheral nerve ending which is stretched from supraorbital nerve and supratrochlear nerve can be injured and symptoms such as pain, dysesthesia may appear. Usually, developed pain disappeared spontaneously and does not go on chronic way. We experienced a case that a patient complained chronic pain after brow lift which was not controlled by conservative management such as medications, local nerve block and report a successful surgical treatment of chronic pain after brow lift. Methods: A 24-year-old male who received brow lift with hairline incision at local hospital was admitted for chronic pain at the right forehead. The pain was continued for 3 months even though fixed thread was removed. Local nerve block at trigger point with mixed 1 mL 2% lidocaine and 1 mL Triamcinolone acetonide was done and oral medications, Gabapentine and carbamazepine, were also applied but there was no difference in the degree of pain. Therefore the operation was performed so that careful dissection was carried out at right supraorbital neurovascular bundle and adhered supraorbital nerve was released from surrounding tissues and covered with silastic sheet to prevent adhesion. Results: The pain was gradually relieved for a week. The patient was discharged without complications. No evidence of recurrence has been observed for 2 years. Conclusion: The pain developed after brow lift was engaged with nerve injury and sometimes remains chronically. Many kinds of conservative management to treat this complication such as medications, local nerve block have been reported and usually been used. But there are some chronic cases that conservative treatment do not work. In sum, we report 1 case of successful surgical treatment for relief of intractable pain developed after brow lift surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7457-7461
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• 2015

Some thyroid cancer patients undergone insufficient tumor removal in the primary surgery in China. our aim is to evaluate the impact of dissection of the recurrent laryngeal nerve during a salvage thyroid cancer operation in these patients to prevent nerve injury. Clinical data of 49 enrolled patients who received a salvage thyroid operation were retrospectively reviewed. Primary pathology was thyroid papillary cancer. The initial procedure performed included nodulectomy (20 patients), partial thyroidectomy (19 patients) and subtotal thyroidectomy (10 patients). The effect of dissection and protection of the recurrent laryngeal nerve and the mechanism of nerve injury were studied. The cervical courses of the recurrent laryngeal nerves were successfully dissected in all cases. Nerves were adherent to or involved by scars in 22 cases. Three were ligated near the place where the nerve entered the larynx, while another three were cut near the intersection of inferior thyroid artery with the recurrent laryngeal nerve. Light hoarseness occurred to four patients without a preoperative voice change. In conclusion, accurate primary diagnosis allows for a sufficient primary operation to be performed, avoiding insufficient tumor removal that requires a secondary surgery. The most important cause of nerve damage resulted from not identifying the recurrent laryngeal nerve during first surgery, and meticulous dissection during salvage surgery was the most efficient method to avoid nerve damage.

• YAKHAK HOEJI
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• v.36 no.3
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• pp.269-277
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• 1992

The effects of ginseng saponins on the distribution of nerve cells in cerebral cortex of carbon monoxide (CO)-intoxicated mice were studied in the young ($5{\sim}8$ weeks) and aged ($43{\sim}52$ weeks) mice. Mice were exposed to 5000 ppm of CO for 40 minutes (72% HbCO). After that, nerve cells in motor(area 4), somatosensory(area 3) and visual(area 17) area of cerebral cortex was observed. In young mice, the number of nerve cells in each area was significantly decreased on 1st, 7th and 14th day after CO intoxication. In aged mice, that was also decreased after CO intoxication. Especially the number of the nerve cells in motor and somatosensory area was significantly decreased on 1st and 7th day, while that in visual area was decreased only on 1st day. The number of nerve cells in young mice pretreated with ginseng saponins were significantly decreased less on 7th and 14th day than that of untreated mice. The number of nerve cells in each area of normal aged mice was larger than that of normal young mice. The results suggest that CO exposure causes local degeneration or disturbance of nerve cells and delayed neurologic sequelae, while ginseng saponins might play a role of protective action on the nerve cells which were damaged by CO.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.39-44
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• 1992

Benign peripheral nerve tumors, although infrequent, must be considered as a possible cause of pain and disability in the extremities. There are three varieties of these tumors that are of clinical importance: neurilemmomas, neurofibromas, and post-traumatic neuroma. Neurilemmomas are the most common primary solitary tumor of the peripheral nerve trunks, and are almost always benign, Neurofibromas may occur as a solitary nerve tumor, but can present as multiple lesions as in von Recklinghausen's disease. Clinically, this tumor may presents as a solitary mass in the subcutaneous tissue which is centrally located with the nerve fibers travelling through the tumor mass. Traumatic neuroma is the proliferation of nerve elements with connective tissue during the process of regeneration from severed nerves undergoing Wallerian degeration, and is therefore not a true neoplasm. A neuroma-in-countinuity is the result of partial severance of a nerve, or of a crushing or traction injury in which all or part of the epineurium and perineurium is intact. We experienced each of the three varieties. With magnification, the neurilemmoma was removed by meticulous dissection from the parent nerve preserving the normal fascicles to which it was attached. The neurofibroma was excised and the nerve was reconstructed with interposed vein graft and the neuroma-in-continuity was excised and reconstructed with sural nerve graft. We report histologic characteristics of each tumors and the methods to repair the nerve defects after tumor excision with brief discussion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.250-257
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• 2001

Sensory dysfunction following the injury of the inferior alveolar nerve requires objective examination to get a reproducible data and to provide necessary treatment. This study was designed to evaluate if the SEP(somatosensory evoked potentials) of the mental nerve can be used as an objective method for the diagnosis of nerve injury and sensory disturbances. The subjects were nineteen patients ($37.4{\pm}11.3$ years old) who had been suffered from sensory disturbance of the unilateral lower lip and mental region for over 6 months after the inferior alveolar nerve injuries confirmed by the microsurgical explorations. The clinical neurosensory tests as SLTD(static light touch discrimination), MDD(moving direction discrimination), 2PD(two point discrimination), PPN(pin prick nociception) and accompanied pain were preceded to electro-physiologic examinations as SEP. The score of sensory dysfunction (sum score of all sensory tests) ranged from 0 to 8 were compared to the latency differences of the mental nerve SEPs. The correlation between clinical sensory scores and SEPs were tested by Spearman nonparametric rank correlation analysis, the differences in SEP latency by Kruskal-Wallis test and the latency differences according to PPN and accompanied pain by Mann-Whitney U test. This study resulted that the difference of the latencies between normal side and affected side was $2.22{\pm}2.46$ msec and correlated significantly with the neurosensory dysfunction scores (p=0.0001). Conclusively, the somatosensory evoked potentials of the mental nerve can be a useful diagnostic method to evaluate the inferior alveolar nerve injuries and the change of sensory dysfunction to be reproduced as an objective assessment.

• Annals of Clinical Neurophysiology
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• v.19 no.1
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• pp.28-33
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• 2017

Background: Previous studies of radial nerve conduction study (NCS) did not present how to measure the length of the radial nerve across the elbow, and did not even mention how to manage the spiral course of the nerve. This study aimed to applicate the most reliable method to measure the length of the radial nerve during NCS. Methods: Three points (A, B, and C) were determined along the relatively straight course of the radial nerve. The distance was measured using three different methods: L1) straight distance corresponding to the A-C distance, L2) sum of the distances corresponding to the A-B-C distance, L3) based on the L2, but the elbow is flexed at a $45^{\circ}$ angle. We compared the three methods of distance measurement and the calculated nerve conduction velocities (V1, V2, and V3) in normal healthy subjects. Results: 19 normal participants were enrolled. The mean value for method L1, L2 and L3 were $22.5{\pm}1.8cm$, $24.0{\pm}2.1cm$, and $23.2{\pm}2.1cm$ (p < 0.001). Calculated conduction velocities using those distance measurement methods as follows (p < 0.001): V1 ($60.9{\pm}2.7m/s$), V2 ($64.6{\pm}3.3m/s$), and V3 ($63.4{\pm}3.9m/s$). V2 was significantly greater than V1 and V3 (p < 0.001, p = 0.010, respectively). Conclusions: The distance measurement using a stopover point near the lateral epicondyle between two stimulus points in position of a fully extended elbow with forearm pronation is the most appropriate posture for radial motor NCS.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.