• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1451-1455
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• 2000

Objective : The goal of this study is to present whether endoscopic release(ER) is superior to open release(OR) for the treatment of carpal tunnel syndrome(CTS). Method and Material : Fifty-nine wrists in 43 patients who had clnical signs and symptoms consistent with CTS, not responded to non-operative management, were entered into the study. Authors retrospectively compared 27 wrists treated with ER(February 1999-June 1999) with 32 wrists treated with OR(October 1997-March 1999). We performed conventional open surgery in 25 patients(mean age ; 46 years) and Brown's two-portal technique in 18 patients(mean age ; 53 years) under intravenous regional block or general anesthesia. Results : Sixteen patients had CTS on both hands and left hands were affected more frequently than right hand, 34 and 25 respectively. Successful and poor results of ER were similar to those of OR. For patients in OR group, mean duration of symptoms was 5 years(range 1 month-30 years), and postoperative outcome was good in 27(84.4%) of wrists and poor in 5(15.6%). For patients in ER group, mean duration of symptoms was 7 months (range 2 months-25 years), outcome was good in 23(85.2%) of wrists and poor in 4(14.8%). The average time for complete relief of pain was 1.3 weeks and 7.6 weeks, respectively for OR and ER groups. No complication was noted in either group. Conclusion : This preliminary analysis suggests that faster relief of pain was achieved when the endoscopic method was used, although there were no significant differences in their efficacies regarding the improvement of symptoms.

• Journal of Korean Neurosurgical Society
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• 제55권2호
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• pp.78-82
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• 2014

Objective : To investigate a diagnostic value of ultrasonography in carpal tunnel syndrome (CTS) patients and to evaluate a correlation of sonographic measurements with the degree of electrodiagnostic abnormalities and clinical severity. Methods : Two-hundred-forty-six symptomatic hands in 135 patients and 30 asymptomatic hands in 19 healthy individuals as control group were included. In ultrasonographic study, we measured the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve at the pisiform as well as palmar bowing (PB) of the flexor retinaculum. Sensitivity and specificity of ultrasonographic measurements were evaluated and ultrasonographic data from the symptomatic and control hands were compared to the grade of electrodiagnostic and clinical severity. Results : The mean CSA was $13.7{\pm}4.2mm^2$ in symptomatic hands and $7.9{\pm}1.3mm^2$ in asymptomatic hands. The mean FR was $4.2{\pm}1.0$ in symptomatic hands and $3.4{\pm}0.4$ in asymptomatic hands. The mean PB was $3.5{\pm}0.5$ mm in symptomatic hands and $2.6{\pm}0.3$ mm in asymptomatic hands. Statistical analysis showed differences of the mean CSA, FR and PB between groups were significant. A cut-off value of $10mm^2$ for the mean CSA was found to be the upper limit for normal value. Both the mean CSA and PB are correlated with the grade of electrophysiological abnormalities and clinical severity, respectively. Conclusion : Ultrasographic measurement of the CSA and PB is helpful to diagnose CTS as a non-invasive and an alternative modality for the evaluation of CTS. In addition, ultrasonography also provides a reliable correlation with the grade of electrodiagnostic abnormalities and clinical severity.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.232-235
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• 2013

Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.427-432
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• 2006

Purpose: Noninflammatory synovial fibrosis has been noted for main causal factor of carpal tunnel syndrome (CTS). Recently, there are some reports that heparin have not only anti-coagulative effect but also anti-inflammatory and anti-fibrotic potential and have an effect on interstitial pulmonary fiborosis. Authors examined whether heparin affects pathogenesis of CTS. Methods: First, heparin was administered to fibroblast that was cultured from patient's transverse carpal ligament. Secondly, we evaluated the expression from genes of type I, III collagen, TGF ${\beta}$ isoforms and MMP. Fibroblasts were isolated and cultured from transverse carpal ligaments of 5 patients with CTS. Heparin (0, 1, 10,$100{\mu}g/ml$) was administered to cultured fibroblast and reverse transcription PCR for mRNA expression of type I, III collagen, TGF-${\beta}$ isoforms and MMP was done. Results: Heparin suppressed gene expression of type I, III collagen and TGF-${\beta}1$, ${\beta}3$ but promoted gene expression of TGF-${\beta}2$ and MMP-2. Conclusion: Heparin directly suppress gene expression of type I, III collagen. But, It is undetermined that heparin can present it's effect mediated by TGF ${\beta}$ isoforms or MMP.

• Safety and Health at Work
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• 제11권1호
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• pp.33-40
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• 2020

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

• International Journal of Clinical Preventive Dentistry
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• 제14권4호
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• pp.235-240
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• 2018

Objective: The purpose of this study is to examine about dental hygienists' myofascial pain syndrome, lower back pain, carpal tunnel syndrome (CTS), medial and lateral epicondylitis, hand-arm vibration syndrom and work-related musculoskeletal syndrome (WMSD) experience and hygienists' posture, motion. Methods: The self-administered questionnaire was surveyed from June 1 to September 30 of 2018 targeting 280 dental hygienists in Gyeongnam province and 266 dental hygienists' answers were analyzed. Results: The average daily working hours of a dental hygienist was more than eight hours 59.0%, with an average of 33 patients per day. The average number of patients who receive treatment for more than 30 minutes is 15. The angle of motion of the subjective evaluation was above 60%. Medical position and form of movement were more than 50% above the standard level. Symptoms of posture and motion that cause WMSD were hand-arm vibration syndrome 68.1%, myofascial pain syndrome 58.6%, lower back pain 51.1%, CTS 50.4% in order. Experience WMSD related symptoms which dental hygienists experience were myofascial pain syndrome 92.9%, CTS 57.9%, lower back pain 56.4%, medial and lateral epicondylitis 37.2%, hand-arm vibration syndrome 24.4%. Conclusion: The above results showed the posture and motion of dental hygienists and were found that the experience rate which dental hygienists experience WMSD of myofascial pain syndrome, Lower back pain, and CTS was significantly more than 56%.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5305-5310
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• 2012

본 연구에서 손목터널 증후군의 발생은 손목의 정중 신경 손상에 의한다. 일반적으로 임상 발현 및 신경전도검사를 통해 진단된다. 신경전도검사는 손목터널 증후군 환자 24명을 대상으로 하여 수술 전 후 정중 신경을 비교 평가 하였고, 이중 17명을 대상으로 평가 분석 하였다. 손목터널 증후군 증상의 분석 결과는 전체 환자 수 17명(여:17, 남0), 21손(오른쪽:9, 왼쪽:4, 양쪽:4), 연령(31~60세), 평균 유병 기간 ($46.6{\pm}36.1$), NCS의 첫 번째와 두 번째 검사 간격 개월 수($20.5{\pm}7.1$), 감각 신경(감각 이상:21, 감각 저하:19, 야간통증:17), 운동 신경(무지구 위축:20, 방아쇠 손가락:2, 조조 경직:3), 수술 후 증상은(증상 소실:38.1%, >50% 개선:52.4%, <50% 개선:9.5%) 이었다. 신경전도검사는 수술 후 감각 신경전도검사에서 4명, 운동 신경전도검사에서 5명이 정상 범위 이었다. 수술 전 후의 감각신경활동전위 반응은 이전 결과보다 호전된 결과를 보였다. 앞으로 환자의 직업에 의한 손목터널증후군의 양상과 직업별 수술외적인 치료방법과 수술치료방법을 비교하여 손목터널증후군의 호전정도를 파악하고 정확한 신경전도검사를 통해 환자의 수술여부를 판단해야 된다.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.290-298
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• 2017

본 연구는 초기 손목터널증후군으로 진단된 환자의 정중신경(median nerve)과 자신경(ulnar never)의 및 F파를 대조군과 비교 분석하여 초기 손목터널증후군의 진단에서 F파가 유용한 지표가 될 수 있는지 알아보고자 하였다. 신경전도검사 결과의 주요 지표인 말단잠복기, 말단진폭, 손바닥-손목 구간의 감각신경전도속도 및 F파 잠복기를 대조군과 t-test 검정으로 비교분석하고, 또한 주요 지표간의 상관성 분석을 위하여 상관분석을 실시하였다. 연구결과, 대조군과 초기 손목터널증후군 환자의 정중신경 말단잠복기 비교에서 두 군 간에 유의성이 높은 것으로 나타났다(p<0.001). 정중신경의 감각신경전도속도 비교에서는 대조군과 손목터널증후군 간의 유의성이 높은 것으로 관찰되었다(p<0.001). 후기반응검사인 F파 잠복기 분석에서 정중신경의 경우 대조군과 손목터널증후군간 높은 유의성(p<0.001)을 보였으나, 자신경의 경우는 차이가 없는 것으로 나타났다. 상관분석 결과는 감각신경전도속도와 말단잠복기, F파와 말단잠복기에서 모두 상관성이 있는 것으로 나타났다. 이러한 결과로, F파는 말단잠복기, 감각신경전도속도와 같이 손목터널증후군의 진단에 있어 유용한 지표가 될 수 있다고 사료된다.

• 대한인간공학회지
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• 제15권2호
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• pp.139-147
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• 1996

It is known fact that the CTS patients have lower pinch strength than the normal people. And we can assume that the sensory nerve action potential(SNAP) and the nerve conduction velocity(NCV) of the CTS group are lower or slower than the normal subjects. This paper analysed the grip strength and performed EMG experiment for the group Norm, G1 and G2. The results are as follows: 1) CTS patients have lower pinch strength than normal people. 2) There was no significant difference on SNAP between the CTS group and the normal group. 3) There was significant difference on NCV among Norm, G1, and G2 group. Especially, significant level was higher in the evening after the continuous use of wrist.

• Korean Journal of Acupuncture
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• 제37권3호
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• pp.131-144
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• 2020

Objectives : The aim of this study is to analyze the details of acupuncture treatment methods and the reporting quality of acupuncture on Carpal Tunnel Syndrome (CTS). Methods : Search was conducted in Pubmed, EMBASE, and Cochrane Library for acupuncture studies on CTS. The reporting quality of acupuncture treatment was assessed using the following guidelines: Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) for analyzing the method of acupuncture treatment, Consolidated Standards of Reporting Trials (CONSORT) for analyzing study design and study process, and Risk of Bias (ROB) for analyzing bias. The number of reported items was calculated and evaluated as a proportion. The reported proportion of each study was classified into three grades: Grade A (% score ≥75), Grade B (50≤ % score <75), and Grade C (% score <50). Results : A total of 9 Randomized Controlled Trials (RCTs) were included in this study. All trials reported 12 items (66.67%) on average in STRICTA guidelines. Five studies were conducted with manual acupuncture and 3 studies were conducted with electroacupuncture. PC7 (Daereung) was most frequently used to treat CTS. In STRICTA guideline evaluation, 3 studies were classified as Grade A, 5 studies were classified as Grade B, and 1 study was classified as Grade C. In the CONSORT statement assessment, all trials reported an average of 20.56 items. Of the 9 RCTs, 6 studies were classified as Grade B and 3 studies were classified as Grade C. In ROB assessment, most studies showed a low (63.49%) or unclear (26.98%) risk of bias. The selective reporting bias and the incomplete outcome data bias were found to have the lowest risk of bias, and the allocation concealment of selection bias was found to have the most unclear risk of bias. Conclusions : Recent acupuncture studies on CTS showed moderate reporting quality. However, more detailed reports on acupuncture are still needed to establish more solid evidence of acupuncture treatment.