• 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.

• Biomolecules & Therapeutics
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• 제17권4호
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• pp.362-369
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• 2009

We have investigated the effect of glucosamine on the retinal cells after continuous infusion into cerebroventricle by using osmotic minipump to avoid peripheral effect. Continuous intracerebroventricular (i.c.v) infusion of glucosamine with the rate of 0.1 ${\mu}mol$/10 ${\mu}l$/hr for 7 days resulted in morphological changes of the optic nerve in electron microscopic level as well as morphological changes of the retina in light microscopic level. Retinal sections were immunostained for the detection of morphological changes of astrocytes. GFAP immunoreactivity appeared not only in the Muller cells but also many of the radial processes of Muller cells. The optic nerve showed deformed axon and slight lamellar separation of myelin sheath after continuous infusion of glucosamine in observing with electron microscope. Interestingly, vacuoles were observed in deformed axons and retinal layers were folded and detached. These results suggested that glucosamine plays a role in induction of morphological dysfunction in retina and optic nerves.

• Applied Microscopy
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• 제44권1호
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• pp.21-29
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• 2014

Retinal glial responses to hypertensive glaucomatous injury were spatiotemporally surveyed. Retinas as a whole or vertical sections were processed for anti-glial fibrillary acidic protein (GFAP), anti-Iba1, anti-nerve growth factor (NGF), and anti-tumor necrosis factor (TNF)-${\alpha}$ immunohistochemistry for confocal microscopic analyses. The optic nerve head of paired controls was processed for electron microscopy. GFAP positive astrocytes appeared in the nerve fiber layer in the glaucomatous and control retinas, changing from fine protoplasmic to stout fibrous parallel to glaucomatous duration. Iba1 positive microglia appeared in both retinas, and enormous reaction appeared at the latest glaucomatous. M$\ddot{u}$ller reaction detected by GFAP reactivity expanded from the end feet to whole profile following to duration in the glaucomatous. NGF reactivity expended from the end feet to the proximal radial processes of the M$\ddot{u}$ller cells in both retinas according to glaucomatous duration. TNF-${\alpha}$ immunoreactivity in the nerve fiber layer was stronger in both the glaucomatous and controls than in the normal, and exceptionally at the latest glaucomatous was even lower than the normal. The astrocytes in the optic nerve head are interconnected with each other via gap junction. These results demonstrate that astrocyte reaction propagates to the contralateral via physical links, and TNF-${\alpha}$ is correlated with NGF production for neuroprotection in response to hypertensive glaucomatous injury.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.93-98
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• 2001

Purpose : This describes our experience with a tenocutaneous free flap from the dorsum of the foot or radial forearm to reconstruct the dorsal skin and extensor tendons of the hand. Material and Methods : Between february 1987 and July 1998, we treated 9 patients with composite tissue loss on the dorsal hand caused by crushing injury. Nine men had an average age of 26.4 years(range, $19{\sim}47$). We treated 5 patients with the free dorsalis pedis flap including the extensor tendons and the superficial peroneal nerve and 4 patients with reverse forearm flap including the brachioradialis tendon and/or superficial radial nerve. Flap size was average 4.4(3,2cm. Evaluation of the results was based on the survived flap rate, the recovery rates for range of motion of the metacarpophalageal joints in the operated fingers. two-point discrimination. Results : All flaps were well vascularized and survived completely. Recovery rates for range of motion of the metacarpophalageal joints in operated fingers range from $78%{\sim}99%$(average, 90%). Two-point discrimination of the transferred flaps in 5 patients average $20{\pm}3.5mm$. Conclusion : The advantages of this procedure are mass action reconstruction with tendon, one-stage operation, faster healing with less adhesion formation, and early mobilization.

• Archives of Reconstructive Microsurgery
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• 제8권1호
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• pp.15-21
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• 1999

Soft tissue defect on heel area of the foot present difficult problems particularly because of anatomic property of plantar surface of the foot. There is a paucity of available local tissue in the foot for coverage. In addition to having little expandable tissue, the foot's plantar surface has a unique structure, making its replacement especially challenging. Plantar skin is attached to the underlying bone by fibrous septa, preventing shear of the soft-tissue surfaces from the underlying skeleton. Plantar surface of foot is in constant contact with the environment. Protective sensibility also would be maintained or restored in the ideal reconstruction. So the ideal flap for reconstruction of the heel should include thin, durable hairless skin with potential for reinnervation. The aim of this article is to present a clinical experience of free lateral arm neurosensory flap for reconstruction of the heel. From March 1995 to December 1997, a total 16 lateral arm free flaps were performed to soft tissue defects on the weight-bearing area of the hindfoot. we used tibial nerve as recepient nerve in 11 and calcaneal branch of tibial nerve in 5 for restoration of sensibility of flap. All cases survived completely. A static two-point discrimination of 14 to 34mm was detected in the flap. Radial nerve palsy which was caused by hematoma in donor site occured in one case, but recorverd in 3 weeks later completely. In conclusion, the lateral arm free flaps are versatile, reliable and sensible cutaneous flap and especially indicated for soft tissue defect on plantar surface of the hindfoot which are not good indications for other better-known flaps.

• 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 Plastic Surgery
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• 제36권5호
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• pp.667-669
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• 2009

Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

• 전기전자학회논문지
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• 제24권4호
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• pp.1039-1049
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• 2020

신경의수를 제어하기 위해서는 사용자의 의도를 인식하는 신경신호 디코딩이 중요하다. 본 논문에서는 다채널 말초 신경신호의 실시간 디코딩 방법을 제안한다. 말초 신경신호는 정중신경과 요골신경에서 측정되었으며 운동잡음은 국소 근사 다항식에 의해 제거되었다. 다음으로 활동전위는 k-평균 알고리즘으로 분류되었다. 특징벡터는 활동전위의 발화율로부터 추출되었으며 자기 조직화 특징지도를 통해 차원이 축소되었다. 마지막으로 다층 퍼셉트론으로 손동작을 분류하였다. 원숭이 실험에서 모든 신호처리가 실시간 제한조건 이내에 완료되었으며 높은 성공률로 손동작을 인식할 수 있었다.

• Journal of Ginseng Research
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• 제18권3호
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• pp.165-174
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• 1994

To investigate the significant indicators Improving the undisturbed memory in animal behavior, we employed several behavioral methods (learning, relearning in radial maze, and active avoidance) with ginseng components. Results showed that the repeated intranasal administration of $Rb_1$ and total saponins from Korean red ginseng induced direct effects on the brain mechanisms in rats, and improved the spatial memory during the learning, relearning and retention in the 12-arm radial maze test. The intranasal treatment of the total saponins also effectively improved the disturbed memory (amnesia) by pentylentetrazole, and simultaneously protected the brain by decreasing the severity of motor epileptic seizures. The intraperitonial administration of polysaccharide fraction of Korean red ginseng could improve avoidance behavior (amount of the total ecapes) in the active-avoidance test. In addition, local changes of the temperature and resistance of skin observed after Rb, administration were suggested to reflect some action of sympathetic nerve Key words Memory, intranasal administration, pentylenetetrazole, Korea red ginseng.