• Journal of Korean Biological Nursing Science
• /
• 제20권2호
• /
• pp.55-66
• /
• 2018

Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

• Journal of Korean Neurosurgical Society
• /
• 제55권3호
• /
• pp.148-151
• /
• 2014

Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

• 대한암한의학회지
• /
• 제25권2호
• /
• pp.23-36
• /
• 2020

Objective: This study was aimed to report the therapeutic effects of herbal medicine on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The prior studies were searched from the databases included PubMed, Cochrane Library, EMBASE, CNKi, CiNii, KISS, NDSL, KMBASE, and OASIS until September 2020. The main search keywords were chemotherapy, peripheral neuropathy, and herbal medicine, and only randomized controlled trials that analyzed the therapeutic efficacy of herbal medicine were included. The Cochrane's Risk of Bias was used for assessment of the risk of bias and the Review Manager 5.3 program was used for meta-analysis. Meta-analyses were grouped by the administration routes of herbal medicines (oral administration or topical use). Results: Nine studies with a total of 563 participants were included. Compared with usual care, the effective rate was higher in oral administrated herbal medicine (RR 1.67, 95% CI 1.25 to 2.23; p<0.001, I2=31%). In addition, topical herbal medicine showed an significantly higher effective rate than placebo (RR 2.20, 95% CI 1.52 to 3.18; p<0.001, I2=0%) and usual care (RR 2.24, 95% CI 1.74 to 2.89; p<0.001, I2=66%). There was no severe adverse effect in all participants. Conclusions: Herbal medicine appears to improve neuropathy caused by chemotherapy in cancer patients more than conventional therapy of CIPN. However, as there is heterogeneity between the included studies and a lack of blinding, further well-designed researches are more needed.

• 여성건강간호학회지
• /
• 제28권4호
• /
• pp.296-306
• /
• 2022

Purpose: This study investigated the effects of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. Methods: The participants included 144 patients with gynecological cancer undergoing anticancer chemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28, 2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. Results: Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), and the most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89) was greater than the midpoint. The regression model analyzing the patients' QoL was statistically significant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001), disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms (β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL. Conclusion: Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their daily life can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care ability of patients and alleviating their limitations in daily life may improve QoL.

• 대한한방내과학회지
• /
• 제45권3호
• /
• pp.358-380
• /
• 2024

Objectives: This study was performed to research Korean medical treatment methods for chemotherapy-induced peripheral neuropathy by summarizing domestic studies. Methods: All domestic research papers on the Korean medical treatment of chemotherapy-induced peripheral neuropathy were selected from the literature published until April 2024 in four domestic databases. In total, 26 domestic papers were selected. Results: Eighteen clinical studies and eight experimental studies were published by April 2024. Most of the studied patients were in their fifties, and 93.4% of the subjects were women. Uchashinki-hwan (牛車腎氣丸) was the most frequently prescribed herbal formula, and Rehmanniae Radix Preparata was the most commonly used herb. All studies showed significant effects of Korean medical treatment, and any adverse events were not reported. Conclusion: This study included all domestic research papers on chemotherapy-induced peripheral neuropathy to identify research trends in the Korean medicine community. Based on this, it is meaningful to confirm areas that need to be supplemented in future research plans. However, large-scale studies are needed.

• 대한핵의학회지
• /
• 제34권1호
• /
• pp.55-61
• /
• 2000

목적: 정상 대조군과 당뇨병성 자율 신경병증의 합병 유무에 따른 $^{99m}Tc$-DISIDA 스캔을 이용한 담낭 배출률의 변화 정도를 37명의 당뇨병 환자와 24명의 정상인을 대상으로 본 연구를 시행하였다. 대상 및 방법: $^{99m}Tc$-DISIDA 스캔은 검사 전날 저녁부터 금식한 상태에서 185 MBq의 $^{99m}Tc$-DISIDA를 정맥주사하고 저에너지 범용 조준기가 장착된 감마카메라(Vertex, ADAC)를 이용하여 주사 후 5분, 10분, 20분, 30분, 60분에 복부 전면상을 1분간 획득하였고 지방식을 먹인 후 30분에 다시 복부 전면상을 1분간 획득하였다. 담낭 배출률을 구하기 위해 60분 및 90분 영상의 담낭에 관심영역을 설정하였으며 배후 방사능 측정을 위해 간우엽에 담도를 피해 같은 화소 크기의 관심영역을 설정하였다. 각 담낭의 방사능 계수치는 배후 영역 방사능치를 제하고 구하였으며 담낭 배출률은 다음의 공식을 이용하여 계산하였다. 담낭 배출률=(60분 담낭 방사능 계수치-90분 담낭 방사능 계수치)${\div}$60분 담낭방사능 계수치${\times}$100 (%). 결과: 당뇨병성 자율 신경병증이 합병된 환자가 20명 이었으며 자율 신경병증이 없는 환자가 17명이었다. 당뇨병성 자율 신경병증이 동반된 환자의 담낭 배출률이 $43.12{\pm}12.3%$로 자율 신경병증이 없는 환자의 $57.5{\pm}13.2%$보다 의미 있게 감소되었으며, 정상인의 $68{\pm}11.6%$보다 두 환자군에서 의미 있게 감소하였다. 두 환자군 간의 혈중 지질 농도, 당화혈색소, 체질량 지수, 공복시 혈당, 지단백(a) 등은 유의한 차이를 보이지 않았다. 수신자판단특성곡선 분석에서 얻은 담낭 배출률 50.2%를 기준으로 한 당뇨병성 자율 신경증의 진단 예민도와 특이도는 각각 80%와 76.5%였으며 곡선 아래 부분의 면적은 0.846이었다. 결론: 이상의 결과에서 보듯이 $^{99m}Tc$-DISIDA 스캔을 이용하여 측정한 담낭 배출률이 정상 대조군에 비해 당뇨병 환자에서 감소되어 있었으며 자율 신경병증이 동반된 환군에서 동반되지 않은 군보다 의미 있게 감소되어 있었다.

• Annals of Clinical Neurophysiology
• /
• 제14권1호
• /
• pp.41-44
• /
• 2012

Thenar motor neuropathy (TMN) is a compressive mononeuropathy of recurrent motor branch of median nerve. It is infrequent and may have different pathogenesis. It may be a unique entity of disease or considered a variant of carpal tunnel syndrome involving the motor branch only. We report a case of TMN induced by vigorous massage that applied strong digital pressure in the region of the base of palm and thenar muscles.

• Annals of Clinical Neurophysiology
• /
• 제4권2호
• /
• pp.98-107
• /
• 2002

Multifocal motor neuropathy (MMN) is a chronic immune-mediated peripheral myelinopathy. The major clinical features include slowly progressive, painless, and asymmetric weakness, usually of distal limb muscle. Early in the course of the disease, weakness is not necessarily associated with muscle atrophy, owing to the initial primary involvement of peripheral myelin. Chronic progressive weakness is often associated with some degree of concurrent axonal loss and subsequent muscle atrophy. Sensory symptoms are usually mild or absent, and involvement of cranial and respiratory muscles is rare. The findings of multifocal motor conduction block, abnormal temporal dispersion, and focal conduction slowing at segments not at risk for common entrapment or compression injury, associated with normal sensory conduction studies along the same segments, are the hallmark electrophysiologic features of MMN. The slow progression and absence of upper motor neuron signs are the major clinical points that separate MMN from amyotrophic lateral sclerosis. The role of GM1 antibodies, found in high titers in 22~84% of MMN patients, remains uncertain. The contention that MMN is an autoimmune disorder is largely based on the often dramatic improvement in symptoms following the administration of intravenuos immunoglobulin or cyclophosphamide.

• Annals of Clinical Neurophysiology
• /
• 제3권1호
• /
• pp.47-49
• /
• 2001

Lateral antabrachial cutaneous neuropathy(LACN) was diagnosed in a 42-year-old woman who developed pain and paresthesia in the left forearm after several days of heavy labor. The symptoms were resolved with conservative treatment, including cessation of heavy labor and a brief course of oral corticosteroids. But the symptoms recurred after 9 months. Those were also resolved with same treatment as the first attack. LACN is important to recognize because the symptoms may mimic the pathology of a cervical root, the brachial plexus, the radial and median nerves at the level of the elbow, and a focal idiopathic inflammatory neuritis.

• Annals of Clinical Neurophysiology
• /
• 제20권2호
• /
• pp.101-104
• /
• 2018

Multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy is a variant of chronic acquired demyelinating polyneuropathy. A 65-year-old women presented with upper arm weakness. A nerve conduction study showed conduction blocks over intermediate segments with sparing of distal compound action potentials. Magnetic resonance imaging revealed asymmetric hypertrophy of the brachial plexus on the affected side. These findings represent important electrophysiological and radiological evidence of MADSAM neuropathy. The condition of the patient began to improve after starting intravenous immunoglobulin administration.