• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.16-20
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• 2010

Background: The medial plantar nerve (MPN) is a distal branch of the posterior tibial nerve, and various methods of nerve conduction study for MPN have been introduced so far. Hemmi et al described a new method (Hemmi's method) for recording medial plantar sensory nerve action potentials (SNAPs), which is considered as a simple and reliable method for measuring medial plantar SNAPs. This study was aimed to establish the normal values for the MPN conduction study among Koreans and to compare the sensitivities of three different methods for MPN conduction study (Hemmi, Oh, and Saeed's method) in detecting evidence of peripheral neuropathy among diabetic patients. Methods: In 27 healthy subjects, MPN conduction study using Hemmi's method was performed and normal values were calculated. In 54 diabetic patients who showed normal routine nerve conduction studies, three different methods for MPN conduction study were performed and diagnostic sensitivity of each method were compared. Results: In normal subjects, the mean medial plantar SNAP amplitude and conduction velocities measured by Hemmi's method were $4.3{\pm}1.0$ uV and $38.3{\pm}6.8$ m/s respectively. Among 54 patients with diabetes who showed normal routine nerve conduction studies, medial plantar SNAP was not obtainable in 28, 31, and 6 patients by Hemmi, Oh and Saeed's method respectively. Conclusions: In terms of the diagnostic sensitivity for detecting diabetic neuropathy, there had been no significant statistical difference between three different methods. Our study suggested that MPN conduction study using Hemmi's method is simple and useful screening test for early diabetic neuropathy, and is comparable with Oh's method.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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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.

• Science of Emotion and Sensibility
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• v.19 no.4
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• pp.111-118
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• 2016

Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

• Biomolecules & Therapeutics
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• v.22 no.5
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• pp.445-452
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• 2014

The purpose of this study was to investigate the therapeutic effects of DA-9801, an optimized extract of Dioscorea species, on diabetic peripheral neuropathy in a type 2 diabetic animal model. In this study, db/db mice were treated with DA-9801 (30 and 100 mg/kg, daily, p.o.) for 12 weeks. DA-9801 reduced the blood glucose levels and increased the withdrawal latencies in hot plate tests. Moreover, it prevented nerve damage based on increased nerve conduction velocity and ultrastructural changes. Decrease of nerve growth factor (NGF) may have a detrimental effect on diabetic neuropathy. We previously reported NGF regulatory properties of the Dioscorea genus. In this study, DA-9801 induced NGF production in rat primary astrocytes. In addition, it increased NGF levels in the sciatic nerve and the plasma of type 2 diabetic animals. DA-9801 also increased neurite outgrowth and mRNA expression of Tieg1/Klf10, an NGF target gene, in PC12 cells. These results demonstrated the attenuation of diabetic peripheral neuropathy by oral treatment with DA-9801 via NGF regulation. DA-9801 is currently being evaluated in a phase II clinical study.

• The Journal of Korean Physical Therapy
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• v.18 no.4
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• pp.11-17
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• 2006

Purpose: This study aims to suggest clinical basis of physical therapy to skeletal system complication in type II diabetic patients through a variety of analysis methods. Methods: 75 subjects(type II diabetic patients; age from 40 to 80) of this study were participated in BMD(Bone Mineral Density) and Dual energy X-ray absorptiometry, blood test to their skeletal system. Results: Incidence of osteopenea was higher than normal group as women(91.2%) and men(53.5%) in diabetes group. However, women were showed no significantly difference in comparison group. Above age 60(in diabetes group; men and women) showed to highly incidence of osteopenea as well as significantly difference in osteopenea(peripheral neuropathy). As a result of analyzing blood through presence and absence of osteopenea in diabetes group, men were showed significantly difference in DPD/creatinine ratio and women were showed significantly difference in Alkaline phosphatase, Corrected Calcium. Conclusion: This study shows that decreased BMD and increased osteopenea through type II diabetes. Women were particularly lower BMD and higher incidence of osteopenea than men and men influence of type II diabetes on change of BMD was greater than women.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.151-158
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• 1999

Neuropathy is a common and often debilitating complication of diabetes, Diabetic peripheral neuropathy(DN) includes a variety of different disorders that affect the peripheral nervous system. The most common type of DN is the predominantly sensory distal polyneuropathy. Typically, symptoms begin in the foot and proximally during the course of the discease, reflecting the fact that longer fibres are involved earlier that shorter ones. Reviewed the pathogenesis, the diagnosis of DN, the gait pattern and the excercise, the treatment of pain in DN patient.

• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.33-37
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• 2008

Diabetic polyneuropathy (DPN) is the most common form of diabetic neuropathy, and causes a significant morbidity with an impact on the quality of life in the patients with diabetes. Since DPN frequently induces foot deformity and ulceration, which finally leads to foot amputation, the early detection and treatment is very important for the prevention of a permanent structural change. In the early stage of DPN, the diagnostic methods which can evaluate the function or structure of small nerve fibers should be employed because small nerve fibers are first involved in the course of DPN. However, the nerve conduction study cannot reflect the function of the small nerve fibers, and thus, has a definite limitation in the early diagnosis of DPN. For the early detection of DPN, electrodiagnostic data should be interpreted on a clinical context, along with the careful evaluation of the small nerve fiber functions using the tests such as the analysis of intraepidermal nerve fiber density.

• Annals of Clinical Neurophysiology
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• v.24 no.1
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• pp.7-16
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• 2022

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.2
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• pp.13-23
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• 2004

This study aimed at examining the effects of percutaneous electrical nerve stimulation(PENS) applied to different parts of the streptozotocin(STZ) induced diabetic rats on the change of glucose level and spinal neuron excitability. A total of twenty-eight SD rats, divided into four groups, were used as experiment animal. Experiment group I, the normal control group, was composed of normal rats without diabetes induction. Experiment group was composed II of the rats without any treatment after experimental diabetes induction. Experiment group III was composed of the rats with 2 Hz and $200\;{\mu}s$ of PENS to the acupuncture points related with diabetes for 20 minutes after diabetes induction. Experiment group IV was composed of the rats with 2 Hz and $200\;{\mu}s$ of PENS to the parts unrelated with diabetes for 20 minutes after diabetes induction. The results can be summarized as follow: As for glucose level, the group I showed no change within normal range, and the group III showed significant increase, compared with other groups (p<0.05). As for the change of H latency, M and H amplitude, the group III showed significant differences in decrease of latency and amplitude (p<0.05). As for Hmax/Mmax ratio, the normal and other groups showed no significant differences in decrease of amplitude. It can be concluded from the above results that PENS to the acupuncture points of the STZ-induced diabetic rats was effective for spinal neurone excitability, in particular, for those of the group with PENS to the acupuncture points. This study was conducted in the period of acute diabetes induction, and therefore, further study should be conducted in the period of chronic diabetes to research both acute and chronic diabetes.

• YAKHAK HOEJI
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• v.44 no.6
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• pp.539-544
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• 2000

Many diabetic patients develop serious complications during the course of the disease, including cardiovascalar disorders, nepropathy, neuropathy and retinopathy. Because some physiological changes occurring in diabetes mellitus patients could alter the pharmacokinetics of drugs used to treat the disease, the pharmacokinetics of gentamycin was investigated after intravenous administration (2 mg/kg) to control rabbits and acute or chronic alloxan-induced diabetes mellitus rabbits (AIDRs). After intravenous administration, the serum concentrations of gentamycin were significantly higher between 6 and 12 hr in chronic AIDRs compared with those in control rabbits. The AUC was significant greater in chronic ($31.91\;{\pm}\;3.76\;{\mu}g/ml{\cdot}hr$) AIDRs than that in control ($21.60\;{\pm}\;2.45\;{\mu}g/ml{\cdot}hr$) rabbits. Total body clearance (CLt) in AIDRs were significantly decreased compared with that in control rabbits. Cumulative urinary excretion of gentamycin was decreased, although not significantly, in AIDRs compared with that in control rabbits.