• Annals of Clinical Neurophysiology
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• 제16권1호
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.130-135
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• 2009

Objective: The purpose of this study was to determine the normal morphometric landmarks of the uniting and dividing points of the brachial plexus (BP) in the periclavicular region to provide useful guidance in surgery of BP injuries. Methods: A total of 20 brachial plexuses were obtained from 10 adult, formalin-fixed cadavers. Distances were measured on the basis of the Chassaignac tubercle (CT), and the most lateral margin of the BP (LMBP) crossing the superior and inferior edge of the clavicle. Results: LMBP was located within 25 mm medially from the midpoint in all subjects. In the supraclavicular region, the upper trunk uniting at 21$\pm$7 mm from the CT, separating into divisions at 42$\pm$5 mm from the CT, and dividing at 19$\pm$4 mm from the LMBP crossing the superior edge of the clavicle. In the infraclavicular region, the distance from the inferior edge of the clavicle to the musculocutaneous nerve (MCN) origin was 49$\pm$12 mm, to the median nerve origin 57$\pm$7 mm, and the ulnar nerve origin 48$\pm$6 mm. From the lateral margin of the pectoralis minor to the MCN origin the distance averaged 3.3$\pm$10 mm. Mean diameter of the MCN was 4.3$\pm$1.1 mm (range, 2.5-6.0) in males (n = 6), and 3.1$\pm$1.5 mm (range, 1.6-4.0) in females (n = 4). Conclusion: We hope these data will aid in understanding the anatomy of the BP and in planning surgical treatment in BP injuries.

• Clinical Pain
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• 제20권2호
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• pp.135-140
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• 2021

MiraDry^®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry^®. Of the few reported MiraDry^®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry^® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry^® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry^®.

• 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.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.171-171
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• 2008

발음성 삼두근 증후군은 주관절을 굴곡하거나 신전할 때 삼두근 말단부 일부와 척골 신경이 내상과 전방으로 탈구되는 드문 질환이다. 이학적 검사 만으로는 다른 질환으로 오진되는 경우가 많아 정확한 진단이 필수적이며 확진을 위하여는 척골 신경 및 삼두근의 비정상적인 움직임을 관찰할 수 있는 영상 검사가 필요하다. 초음파 검사는 자기 공명 영상 촬영 등 다른 검사에 비해 간편하고 효과적으로 연부 조직의 동적 검사를 시행할 수 있는 장점이 있다. 저자들은 발음성 삼두근 증후군 환자를 동적 초음파 검사를 사용하여 진단하고 척골 신경 전방 전위술 및 삼두근 내두의 이전술을 시행하여 치유하였기에 문헌 고찰과 함께 초음파 검사의 유용성을 보고하고자 한다.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.102-105
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• 2006

We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.

• Journal of Korean Neurosurgical Society
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• 제43권2호
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• pp.109-110
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• 2008

A 62-year-old female patient suffered from numbness and resting pain in the right ring and little fingers for 3 years. We confirmed cubital tunnel syndrome with electrodiagnostic study and performed the operation. We found seven firm consistent nodules, compressing the overlying the ulnar nerve, proximal to the medial epicondyle in the operation field. Histological finding showed synovial chondromatosis. We report a rare case of a patient with cubital tunnel syndrome caused by synovial chondromatosis.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.252-256
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• 2018

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

• 한국임상수의학회지
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• 제34권4호
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• pp.287-290
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• 2017

A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

• 동의생리병리학회지
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• 제25권2호
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• pp.217-226
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• 2011

The aim of this study is to identify central neural pathway of neurons following the projection to the large intestine and Hapgok(LI4) which is Won acupoint of the large intestine meridian of hand-yangmyeong. In this experiment, Bartha's strain of pseudorabies virus was used to trace central localization of neurons related with large intestine and acupoint(LI4) which has been known to be able to regulate intestinal function. The animals were divided into 3 groups: group 1, injected into the large intestine; group 2, injected into the acupoint(LI4); group 3, injected into the acupoint(LI4) after severing the radial, ulnar, median nerve. After four days survival of rats, PRV labeled neurons were identified in the spinal cord and brain by immunohistochemical method. First-order PRV labeled neurons following the projection to large intestine, acupoint(LI4) and acupoint(LI4) after cutting nerve were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in lamina V- X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the arcuate nucleus and median eminence. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of large intestine-related organs and it was revealed by tracing PRV labeled neurons projecting large intestine and related acupoint(LI4).