• Animal cells and systems
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• 제16권2호
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• pp.114-120
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• 2012

In echinoderms, the SALMFamide neuropeptides sharing the SxL/FxFamide motif seem widespread throughout the phylum and may be important signalling molecules that mediate various physiological functions. Recent identification of S1 and its analogues, MagS3 and MagS4, along with the S2 analogue, MagS2 from the starfish $Marthasterias$ $glacialis$, indicated that SALMFamides in the class Asteroidea are more diverse than previously thought. Further, isolation of the neuropeptides from the radial nerve cord and studies on pharmacological actions of the neuropeptides on the cardiac stomach warrant studies on the tissue distributions of these peptides in both the nervous and digestive systems. In the present study, antisera raised against an S1 analogue, KYSALMFamide, and an S2 analogue, KYSGLTFamide, were used to localize the distribution patterns of the S1- and S2-like immunoreactivities (S1-IR/S2-IR) in the nervous and digestive systems of the starfish. In the nervous system, cell bodies in the ectoneural part were immunostained for both S1 and S2 peptides, while in the digestive system, the basiepithelial plexus and mucosal cell bodies were immunoreactive. These immunocytochemical data support the notion that the SALMFamides may play a neuroendocrine role in mediating feeding behaviour of the starfish. Further studies including identification of peptide binding sites and differential expression pattern of mRNAs encoding the peptides are required to elucidate their physiological functions.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.499-503
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• 2015

Objective : The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods : Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results : The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. Conclusion : This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.151-163
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• 1989

건강한 성인 83명을 무작위로 선정하여 실시한 신경전도속도 검사에서 다음과 같은 결과를 얻었다. 1) 상지의 정중신경에서는 운동신경의 TL이 3.0-4.2msec 이고, MNCV는 각각 52.1-70.3m/sec(W-E), 44.6-71.0m/sec(E-Ax), 56.6-70.8m/sec(W-E), 50.5-75.1m/sec(E-Ax)이며, CNAP의 진폭은 $6.5-46.1{\mu}V$였다. 2) 척골신경에서는 운동신경의 TL이 2.4-3.4msec이고, MNCV는 각각 54.6-72.8m/sec(W-E), 41.1-64.9m/sec(E-Ax)이며, 진폭은 3.1-12.0mV였다. 척골신경의 MNCV는 각각 31.1-44.7m/sec(F-W)m, 55.9-70.9m/sec(W-E), 46.9-67.1m/sec(E-Ax)이며, CNAP의 진폭은 4.8-42.9${\mu}V$범위였다. 3) 요골신경에서는 운동신경의 TL이 1.9-2.7msec이고, MNCV는 53.1-77.5m/sec(W-E)이며, CMAP의 진폭은 1.1-6.6mV범위였다. 요골신경의 SNCV는 각각 38.5-52.1m/sec(F-V), 53.2-75.2m/sec(W-E) 이며, CNAP의 진폭은 $2.5-9.2{\mu}V$범위였다. 4) 하지의 비골신경에서는 운동신경의 TL이 3.5-5.7msec이며, MNCV는 각각 44.4-58.6m/sec(A-FH), 42.8-65.8m/sec(FH-PF)이며, CMAP의 진폭은 0.6-12.7mV 범위였다. 5) 후경골신경에서는 TL이 4.0-6.2m/sec이며, MNCV는 40.6-60.6m/sec이며, CMAP의 진폭은 3.9-29.2mV범위였다. 6) 비골신경의 SNCV는 37.5-49.5m/sec이며, CNAP의 진폭은 $0.7-17.1{\mu}V$범위였다. 7) H-반사의 평균 잠복기는 28.4msec였다.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.135-141
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• 2024

The use of ultrasound (US)-guided interventions has rapidly increased in Korean medicine (KM) to ensure the safety and accuracy of invasive procedures, such as pharmacopuncture and acupotomy. Although hands-on training is important for the acquisition of skills, it requires considerable time and cost. A detailed guide on the procedure and treatment regions is needed to ensure hygiene and safety during US-guided procedures in KM practice. In this study, we present the overall procedure, target structures, and treatment approaches of US-guided pharmacopuncture and acupotomy for nerve entrapment in the upper extremities of the cubital and radial tunnel, posterior interosseous nerve, carpal tunnel, and Guyon's canal syndrome. We believe that the findings of our study will serve as a foundation for future clinical research, practice, and education on US-guided KM procedures. Further research involving US-guided interventions should specify target structures in three-dimension to delineate the treatment areas.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.51-57
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• 2004

Introduction: To cover the exposed tendons and bones in the foot and hand which need coverage and abundant vascular flow, lateral arm flaps were transferred. Lateral arm flap is a thin and innervated fasciocutaneous flap with a lower lateral cutaneous nerve and posterior radial collateral artery. Materials and methods: From October 1992 through September 2003, we have performed 5 lateral arm flaps for reconstruction of the exposed achilles tendons in 2 cases and the exposed forearm extensors, 2nd to 5th metacarpal bones and scaphoid each 1 case. The causes were traffic accident in 2 cases and machinary injury in 3 cases. Age range was between 31 to 74 (average 50) and all male except 1. Posterior lateral collateral artery and venae comitantes were anastomosed by end to end in 3 cases and vena comitante in 2 cases. Lower lateral cutaneous nerve was anastomosed with a branch of superficial radial nerve in 2 cases. Results: The results were evaluated by survival of the flap, sensory discrimination, cosmesis and comfort in the activities of the daily living. All flaps were survived. Sensory recovery was graded as deep cutaneous pain sensibility in 2 cases. Cosmesis was moderately satisfied and comfort was good except 1 as moderate. Postoperative defatting procedure was done in 1 case and skin abrasion was occurred in 1 case. Conclusion: Lateral arm flap was suitable for coverage of the exposed achilles tendons and exposed forearm extensors, metacarpals and scaphoid in the wrist.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.86-91
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• 2012

Purpose: Mass can compress around tissue and cause deviation of normal anatomical structures. Often, mass grows toward neurovascular pedicle and encircles depending on the nature of mature mass. Neglecting neurovascular involvement of the mass is a serious problem not to be overlooked. Authors have performed microscopic approach regarding mass involving the neurovascular pedicle in the hand. Materials and Methods: From January 2007 through February 2012, retrospective analysis for nine cases of mass involving neurovascular pedicles was done. Patients were evaluated preoperatively by ultrasonography or MRI and checked intraoperative finding. Masses were evaluated by site, preoperative evaluation, involved neurovascular pedicle, histopathologic diagnosis, complication, and recurrence. Results: The site of mass involving neurovascular pedicles was 4 cases on the wrist, 2 cases on the palm, 2 cases on the finger, 1 case on the hand dorsum. Involved neurovascular pedicles were 3 radial arteries and nerves, 3 proper digital arteries and nerves, 1 radial artery, 1 superficial branch of radial nerve, 1 common digital artery and nerve. The histopathologic diagnosis of mass were 3 ganglions, 2 giant cell tumors, 2 epidermal cysts, 1 fibroma, and 1 benign spindle tumor. There were 2 cases of recurrence and secondary excisions were performed. Conclusion: Neurovascular pedicle injury can lead to serious complication like sensory and motor disorders, distal part ischemia, and so on. In case of mass suspected neurovascular invasion, accurate preoperative evaluation such as ultrasonography or MRI is necessary. To prevent any neurovascular related complication during mass excision, delicate surgical technique using a microscope becomes essential.

• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.21-26
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• 2012

The radial artery superficial palmar branch free flap is based on the perforators of the superficial palmar branch of the radial artery and its venae comitantes. This flap can be used as a sensible flap including palmar cutaneous branch of the median nerve. Forty radial artery superficial palmar branch free flaps were performed at Centum Institute during October 2010 to December 2011. There were 32 males and 8 females and their mean age were 48 years (range 30 to 66 years). The thumb injured in 13 patients, the index finger in 16 patients, the middle finger in 4 patients, the ring finger in 2 patients, and the little finger in 5 patients. The mean size of the flap was $2.5{\times}3.5$ cm(range $2{\times}2.5$ to $3{\times}7$ cm). The donor site was always closed primarily. The overall survival rate was 90.2 percent. The flaps showed well-padded tissue with glabrous skin. All patients have touch sensation and showed 12 mm two point discrimination in an average(range 8 to 15 mm). Donor site morbidity was conspicuous. One patient showed unsightly scar. Early postoperative range of motion of the affected thumb showed slightly limited radial and palmar abduction. But it improved after postoperative 2 months, and patients did not complaint limitation of motion. In conclusion, the radial artery superficial palmar branch free flap can be used as an option for soft tissue reconstruction of finger defects where local or island flaps are unsuitable.

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.34-37
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• 2002

Background : The term "mononeuropathy multiplex" means simultaneous or sequential involvement of individual noncontiguous nerve trunks, evolving over days to years. The aim of this study was to delineate the causes, clinical features, and detailed electrophysiological findings in the patients with mononeuropathy multiplex. Methods : We analyzed the medical records of 22 patients with mononeuropathy multiplex confirmed on electrophysiological studies in Inje University Seoul Paik Hospital, Seoul Municipal Boramae Hospital, and Seoul National University Hospital between 1991 to 2000. Results : The number of male and female patients was equal. The mean age was 48 years with a peak incidence in the sixth decade. The etiology could be divided into vasculitis(11 patients) or non-vasculitis group. In vasculitis group, Churg-Strauss syndrome, polyarteritis nodosa, and rheumatoid arthritis were included. The non-vasculitis group included diabetes mellitus, leprosy, and Guillain-Barre syndrome. Ulnar and median nerves were most commonly involved(91%). In descending order of frequency, peroneal, posterior tibial, sural, and radial nerves were also involved. Bilateral involvement occurred most commonly in ulnar nerve. The symptoms and signs of mononeuropathy multiplex were the initial manifestations in 12 patients(55%), which was more frequent in vasculitis group(73%). Nerve conduction abnormalities could be divided into axonal, demyelinating, or mixed type. Most(91%) of the patients in vasculitis group revealed axonal type abnormalities. The location of the nerve lesion was frequently related to potential site of entrapment in demyelinating type. Conclusions : Mononeuropathy multiplex is the presenting features of the etiological disease frequently, especially in vasculitis group. Nerve conduction studies(NCS) reveals not only axonal type but also demyelinating type abnormalities. The etiological diseases were different in each type. Therefore, NCS is very helpful for the early etiological diagnosis and therapeutic implication in the patients with mononeuropathy multiplex.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.81-87
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• 2016

Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. Conclusion: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.