• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.131-136
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• 2001

Purpose : The sensory radial forearm flap is used to recover the soft tissue defect of hand and foot. The aim of this study is to evaluate the results after sensory reconstruction using sensate radial forearm flaps. Materials and Methods : There were 9 cases of 8 patients (6 males and 2 females). The 7 cases of 6 patients were donated to foot, the 2 cases of 2 patients to hand. At operation, the ages of them ranged from 18 to 63 years (mean: 37.9 years). Sensory evaluation was performed using percentage(%) of responding area to the pinprick test and the static and moving two-point discrimination test (s-2PD and m-2PD). Results : The mean percentage of responding area to the pin prick test was 48.5%. The mean s-2PD and m-2PD of recipient hands were 37.2 mm and 28.8 mm. The mean s-2PD and m-2PD of recipient feet were 46.7 mm and 45.0 mm. The mean s-2PD and m-2PD of controls were 23.5 mm and 19.7 mm. Conclusion : All the recipients were less sensitive than the control, but the recipient hands more sensitive than the recipient feet. Although the small numbers were studied, the results suggested that the recovery of sensation in the innervated flaps was influenced by the recipient nerve. So the donor nerve seems to be selected as more sensitive and more distal nerve of donor site for better outcome.

• 대한약침학회지
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• 제14권4호
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• pp.63-69
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• 2011

Objectives: This study was to investigate the clinical effect of additional Jungsongouhyul Pharmacopuncture on radial nerve palsy patients. Methods & Results: The patients were hospitalized or outpatients in Department of traditional korean medical hospital, Dongshin University from 28th, Oct. 2009 to 25th, Aug, 2010. All patients were treated by additional Jungsongouhyul Pharmacopuncture. To evaluate the wrist drop and numbness of fingers, coding result, Verbal numerical scale (VNS) were used. As the result, symptoms are improved remarkably according to improvement of coding result, VNS score. Conclusions: Patients were treated during 3.5 weeks in average. All cases were excellent results by additional Jungsongouhyul Pharmacopuncture. But further studies are required to investigate exact effects.

• The Korean Journal of Physiology
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• 제23권2호
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• pp.409-420
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• 1989

Extracellular recordings were made from the spinal neurons in the lumbar enlargement of 16 cats before and during electrical stimulation of the radial nerve ipsilaterally and contralaterally. Only neurons activated by remote nerve stimulation (RNS) were included in sample. All the cell classes of spinal neurons which received afferents message from the skin and/or muscles were activated by RNS except LT cells. Approximately three quaters of cells activated by RNS had an inhibitory receptive field (RF) on the ipsilateral hindlimb and two thirds of RNS-activated neurons showed spontaneous activity. The most of these RNS-activated cells seemed to be in deep dorsal horn and in ventral horn as well. Stimulation of contralateral radial nerve produced activation of spinal neurons almost same degree as by ipsilateral nerve stimulation. The optimal stimulation parameters of radial nerve for activation of spinal cells were 5Hz-0.5 msec-2V while threshold stimulus for activation was approximately 0.18 V. Following close intra-arterial injection of $K^+$ ion excitability of RNS-activated neuron was increased in 4 of 8 cells whereas it was decreased in 2 of 8 cells. The results indicate that there are some spinal neurons in the lumbar enlargement of cats that can be activated by forelimb afferent $(A{\beta}\;&\;A{\delta})$ inputs.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.377-380
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• 2011

Objective : The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Methods : Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. Results : The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). Conclusion : It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.

• 혜화의학회지
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• 제13권1호
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• pp.303-309
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• 2004

After treating a patient suffering from metacarpophalangeal joint extension disturbance which is caused by posterior interosseous nerve palsy, some results are gained as follows. The symptom of posterior interosseous nerve palsy is simillar to the it of radial nerve palsy. But posterior interosseous nerve palsy isn't accompany with wrist drop. posterior interosseous nerve palsy is accompany with metacarpophalangeal joint extension disturbance. This symptom is caused by posterior interosseous nerve palsy. Posterior interosseous nerve palsy is correspond to MAMOKBULIN(麻木不仁), SUTONG(手痛), SUGI(手氣) in oriental medicine. The cause of this case on oriental medicine is Deficiency of qi and blood. Treatment which based on cause of oriental medicine-herb medication, acupuncture treatment- have a good effect to patient.

• 대한치과의사협회지
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• 제52권10호
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• pp.615-622
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• 2014

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

• 국제물리치료학회지
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• 제9권2호
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• pp.1447-1454
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• 2018

The objective of this study was to investigate the dynamic neural mobilization program on the changes in muscle activity and nerve conduction velocity (NVC) in stroke patients. The participants were sampled and randomly divided into experimental group I (n=12) who underwent arm neural mobilization and experimental group II (n=13) who underwent arm dynamic neural mobilization. As the pretest, peripheral NVC of the radial, median, and ulnar nerves were measured using the Viking Quest; the biceps brachii, brachioradialis, flexor carpi radialis, and extensor carpi radialis activities were measured with sEMG. Each intervention program consisted of 10 trials per set and three sets per session. The intervention programs were performed once daily for four weeks (four days/week). Posttest measurements were taken equally as the pretest measurements. Significant differences in peripheral NVC in all sections of the radial and median nerves and wristbelow elbow and below elbow-above elbow areas of the ulnar nerve, as well as in muscle activity of all muscles except the biceps brachii. These findings indicate that dynamic neural mobilization was effective in increasing peripheral NVC and altering the muscle activity.

• Archives of Plastic Surgery
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• 제47권5호
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• pp.435-443
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• 2020

Background The innervated radial artery superficial palmar branch (iRASP) flap was designed to provide consistent innervation by the palmar cutaneous branch of the median nerve (PCMN) to a glabrous skin flap. The iRASP flap is used to achieve coverage of diverse volar defects of digits. However, unexpected anatomical variations can affect flap survival and outcomes. Methods Cases in which patients received iRASP flaps since April 1, 2014 were retrospectively investigated by reviewing the operation notes and intraoperative photographs. The injury type, flap dimensions, arterial and neural anatomy, secondary procedures, and complications were evaluated. Results Twenty-eight cases were reviewed, and no flap failures were observed. The observed anatomical variations were the absence of a direct skin perforator, large-diameter radial artery superficial palmar branch (RASP), and the PCMN not being a single branch. Debulking procedures were performed in 16 cases (57.1%) due to flap bulkiness. Conclusions In some cases, an excessively large RASP artery was observed, even when there was no direct skin perforator from the RASP or variation in the PCMN. These findings should facilitate application of the iRASP flap, as well as any surgical procedures that involve potential damage to the PCMN in the inter-thenar crease region. Additional clinical cases will provide further clarification regarding potential anatomical variations.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.120-126
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• 2000

저자들은 1992년 7월부터 수부에서 연부 조직이 손상되어 결손된 부위를 신경감각 유리 피부판을 이용하여 재건하여 평균 5년 11개월 추시하였다. 수부에서 적절한 신경감각 유리 피부판은, 절개와 문합시 미세 수술이 가능하도록 충분한 직경과 길이를 가진 혈관이 존재하여야 하며, 피부판에 존재하는 신경은 임계 감수성이 가장 중요하며, 때로는 방어 감수성을 향상시키기 위하여 선택되어져야 한다. 포장 주위 유리 피부판은, 족부의 제 1 협부-공간 피부판과 족지-수질 피부판과 함께 임계 감수성을 향상시키기 위한 중요한 피부판이지만, 수부에서 결손 부위, 그리고 결손 부위의 특수한 상황과 결손 부위가 넓은 경우에는, 2차적으로 방어 감수성의 향상을 위하여 족 배유리 피부판이나 외 상완 피부판 등이 선택되어 질수 있다. 저자들이 치험한 수부 무지의 재건에 이용한 포장 주위 피부판 4례는 임계 감수성이 우수하고, 2점 감별 검사에서 양호한 결과를 보였다.

• The Korean Journal of Pain
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• 제28권4호
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• pp.287-289
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• 2015

Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim$^{(R)}$.