• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.498-500
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• 2011

Purpose: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. Methods: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a $1{\times}1cm$ sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a $1{\times}0.5cm$ sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. Results: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. Conclusion: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.

• Journal of Acupuncture Research
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• 제18권6호
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• pp.59-69
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• 2001

Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

• Annals of Clinical Neurophysiology
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• 제5권1호
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• pp.11-15
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• 2003

Backgrounds: Kennedy disease is a X-linked recessive disease characterized by bulbar symptoms, proximal muscle weakness, and gynecomastia. Methods: We analyzed clinical symptoms and performed electrodiagnostic studies on 6 patients. Results: We found following features: 1) proximal muscle weakness 2) bulbar symptoms, as dysarthria, facial and tongue atrophy 3) hyporeflexia or areflexia 4) fasciculations, predominantly on face, and proximal upper extremities 5) decreased sensory nerve action potentials(SNAPs) 6) chronic neurogenic changes in needle EMG. Conclusions: Kennedy disease is characterized by degenerative process of anterior horn cell and dorsal root ganglion without upper motor neuron dysfunction. Increased triple nucleotide CAG repeats(>38) in androgen receptor gene of Xp21 will confirm early stage of this disease.

• 한국융합학회논문지
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• 제7권2호
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• pp.61-67
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• 2016

후각기관은 주변 환경의 다양한 화학물질을 감지하는 기관으로 생존, 종족번식에서 감정에 이르기까지 다양하고 중요한 역할을 하고 있다. 유전적, 환경적 등 다양한 요소에 의해 후각장애가 발생할 수 있으며, 일시적인 경우에는 약물치료 등으로 회복될 수 있지만, 신경세포에 문제가 생긴 영구적인 손상의 경우는 치료가 어렵다. 따라서, 신경세포의 사멸을 억제하거나 재생을 유도하는 치료제의 개발이 필요하다. 본 연구에서는 후각신경세포 특이적으로 GFP 형광단백질을 발현하는 형질전환동물을 제작하여 생체 내 후각신경세포를 관찰하고자 하였다. 또한, 다양한 화학물질을 처리하여 후각신경세포 손상을 인위적으로 유도할 수 있는 방법을 고안하였고, 후각신경세포의 손상 및 재생 과정을 실시간으로 모니터링하였다. 본 연구를 통해 확립된 후각신경세포의 손상 및 재생 모니터링 시스템은 향후 후각신경세포 재생 메커니즘 연구 및 치료제 개발에 유용하게 사용될 것으로 기대된다.

• 대한한방내과학회지
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• 제28권3호
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• pp.434-441
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• 2007

Objectives : Peripheral neurodegeneration occurs in diabetes mellitus (DM), both sensory and motor nerve. but we don't know exactly if DM affects central nerve pathway for all studies. Electrophysiologic study is one of the most important diagnostic tools for diabetic neuropathy. Electroneurography and electromyography are usually used. but evoked potentials (EP) is more sensitive to small nerve fiber damages and useful for central nerve evaluation in addition to peripheral nerves. Most diabetic neuropathy studies by EP have been performed with somatosensory evoked potentials (SSEP). In contrast, the objective of this study is to investigate if DM targets central motor neurons by assessing the relation between fasting blood sugar (FBS) and motor evoked potentials (MEP) latency. Methods : We inspected the medical records of 34 patients who had MEP tests during admitting days. The latency from cervical portion to abductor pollicis brevis was used as peripheral motor conduction time (PMCT). and the latency from vertex to cervical portion was used as central motor conduction time (CMCT). Then, they were correlated to FBS using correlation analysis. Results : There was a significant linear relation between FBS and PMCT (Pearson's correlation coefficient r=0.487, p<0.01), but a poor linear relation between FBS and CMCT (Pearson's correlation coefficient r=-0.l97. p>0.05). Conclusions : This study suggests that prolonged latencies of MEP in DM may be due to peripheral neuropathy rather than dysfunction of central motor pathway. therefore the clinical use of MEP to diabetic neuropathy has to be divided segmentally.

• Annals of Clinical Neurophysiology
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• 제15권1호
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• pp.13-18
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• 2013

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.

• Journal of Oral Medicine and Pain
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• 제45권2호
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• pp.34-38
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• 2020

Multiple myeloma is malignant neoplasm of plasma cells. Mandible lesions are rarely the first symptoms of multiple myeloma. While sensory dysfunction and pain are the main symptoms of traumatic trigeminal neuropathy, the same oral symptoms can appear in cases of multiple myeloma with developed mandible lesions. In addition, if the radiological osteoporosis or lytic lesion is seen in older patients, further examination is required to find the cause of the symptoms. In this paper, we present a case that was tentatively diagnosed as traumatic trigeminal neuropathy after left third molar extraction, but later confirmed as multiple myeloma.

• 대한족부족관절학회지
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• 제25권3호
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• pp.145-148
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• 2021

A checkrein deformity can occur after a distal tibiofibular fracture. Usually, a checkrein deformity due to a dysfunction of the extensor hallucis longus muscle is rarer than that of the flexor hallucis longus. Only a few related studies have been reported. The authors encountered an extensor hallucis longus checkrein deformity due to extensor retinaculum syndrome while managing a triplane fracture. In magnetic resonance imaging, an increase in the heterogeneous signal was observed on the T2-weighted images suggesting muscle necrosis or ischemic changes in a part of the extensor hallucis muscle. Postoperative great toe motor weakness, unintentional movement, sensory changes, and weakness improved spontaneously during the follow-up.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권1호
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• pp.41-48
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• 2020

Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). Results: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). Conclusion: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.