• The Korean Journal of Pain
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• v.37 no.1
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• pp.34-40
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• 2024

Background: This study aimed to evaluate the efficacy of pulsed radiofrequency applied using transcutaneous electrodes in carpal tunnel syndrome (CTS). Methods: After randomization, the patients received two cycles of noninvasive pulsed radiofrequency (NiPRF), once weekly, or splinting (the control group) for three months. Clinical evaluations were recorded at baseline and weeks 4 and 8. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the functional status and symptom severity. Results: Sixty-two patients were followed up for three months. There was no difference between the groups in the BCTQ scores before and after treatment. The NiPRF group found a significant difference between the BCTQ measurements at all time intervals (paired sample t-test; P < 0.001). In the splint group, there was a significant difference only between the basal-1st month and basal-3rd month (paired samples t-test; P < 0.001). The main effect of the time variable was statistically significant (ANOVA; P < 0.001), but the group variable was not. There was no correlation between the BCTQ results measured at any time and the electroneuromyelogragphy findings in either group. Conclusions: NiPRF effectively improves symptoms and functionality in patients with CTS for up to 3 months. Thus, NiPRF can be considered an easy, safe, and useful alternative treatment modality for CTS.

• Dementia and Neurocognitive Disorders
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• v.21 no.4
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• pp.107-116
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• 2022

Attention is being paid to diagnosis and treatment of mild cognitive impairment (MCI) because early diagnosis and preventive management can slow down the progression of Alzheimer's disease. In particular, in the present era, the use of biomarkers for predicting conversion into dementia is permitted in medical practice. Therefore, authors aimed to propose additional considerations when updating guidelines for the management of MCI, including predictable biomarkers, revising treatment option after additional clinical trials for cholinesterase inhibitors, and detailed regimes for lifestyle interventions. After reviewing 3 patients with MCI by detailed evaluation, we realized that cholinesterase inhibitors were not recommended. In addition, regular exercise and cognitive training were only possible recommendations for patients according to current guidelines, although all 3 patients had evidence of β-amyloid accumulation and related neurodegeneration. Furthermore, caregivers for all 3 patients were worried whether patients could keep doing regular exercise and cognitive training by themselves and asked about the economic training system which monitors patients so that they can keep training. Therefore, we propose that guidelines for managing MCI need to be updated in the present era when the use of biomarkers for predicting conversion into dementia is permitted in medical practice.

• Journal of Pharmacopuncture
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• v.17 no.2
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• pp.57-66
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• 2014

Objectives: This study was performed to analyze single dose toxicity and the lethal dose of Scolopendrid Pharmacopuncture in rats. Methods: All experiments were conducted at the Korea Testing & Research Institute (KTR), an institution authorized to perform non-clinical studies, under the regulations of Good Laboratory Practice (GLP). Sprague-Dawley rats were chosen for the pilot study. Doses of Scolopendrid pharmacopuncture, 0.1, 0.5, and 1.0 mL, were administered to the experimental group, and 1.0 mL doses of normal saline solution were administered to the control group. This study was conducted under the approval of the Institutional Animal Ethic Committee. Results: No deaths or abnormalities occurred in any of the groups. No significant changes in the weight, hematological parameters or clinical chemistry were noted between the control group and the experimental group. To check for abnormalities in organs and tissues, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs or tissues. Conclusion: The above findings suggest Scolopendrid Pharmacopuncture is a relatively safe to use for treatment. Further studies on the subject should be conducted to yield more concrete evidence.

• Annals of Clinical Neurophysiology
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• v.6 no.2
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• pp.65-74
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• 2004

Limb-girdle muscular dystrophy (LGMD) is a heterogeneous group of inherited muscle disorders caused by the mutations of different genes encoding muscle proteins. In the past, when the molecular diagnostic techniques were not available, the subtypes of muscular dystrophies were classified by the pattern of muscle weakness and the mode of inheritance, and LGMD had been considered as a 'waste basket' of muscular dystrophy because many unrelated heterogeneous cases with 'limb-girdle' weakness were put into the category of LGMD. With the advent of molecular genetics at the end of the last century, it has been known that there are many subtypes of LGMD caused by the mutation of different genes, and now, LGMD is classified according to the results of the linkage analysis and the genes or proteins affected. Only small proportion (probably less than 10%) of LGMD is dominantly inherited, and autosomal dominant LGMD (AD-LGMD) consists of six subtypes (LGMD1A to 1F) so far. In autosomal recessive LGMD (AR-LGMD), more than 10 subtypes (LGMD2A to 2J) have been linked and most of the causative genes have been identified. Among AR-LGMDs, LGMD2A (calpain 3 deficiency), 2B (dysferlin deficiency), and sarcoglycanopathy (LGMD2C-2F) are major subtypes. The defective proteins in LGMDs are components of nuclear envelope, cytosol, sarcomere, or sarcolemma, and seem to play a different role in the pathogenesis of muscular dystrophy. It is notable that many causative genes of LGMDs are also responsible for other categories of muscular dystrophy or diseases affecting other tissue. However, by which mechanism they produce such a broad phenotypic variability is still unknown. The identification of mutation in the relevant gene is confirmative for the diagnosis, and is essential for genetic counseling and antenatal diagnosis of LGMD. Because many different genes are responsible for LGMD, differentiation of subtypes using immunohistochemistry and western blotting is the essential step toward the detection of mutation. For the effective research and medical care of the patients with muscular dystrophy in Korea, a research center with a medical facility supported by the government seems to be needed.

• Journal of Pharmacopuncture
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• v.17 no.4
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• pp.61-65
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• 2014

Objectives: In this study, we investigated the oral toxicity of Gami-Jakyak Gamcho buja Decoction (Mecasin) to develop safe treatments. Methods: All experiments were conducted at the Medvill, an institution authorized to perform non-clinical studies, under the Good Laboratory Practice (GLP) regulations. In order to investigate the oral toxicity of Mecasin, we administered Mecasin orally to rats. Sprague-Dawley rats were divided into four groups of five male and five female animals per group: group 1 being the control group and groups 2, 3, and 4 being the experimental groups. Doses of Mecasin, 500 mg/kg, 1,000 mg/kg and 2,000 mg/kg, were administered to the experimental groups, and a dose of normal saline solution, 10 mL/kg, was administered to the control group. We examined the survival rate, weight, clinical signs, and gross findings. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: No deaths or abnormalities occurred in any of the four groups. Although slight decreases in the weights of some female rats were noted on the third day, no significant changes in weights or gross findings between the control group and the experimental groups were observed. To check for abnormalities in organs, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs. Conclusion: The results showed that administration of 500 - 2,000 mg/kg of Mecasin did not cause any changes in weight or in the results of necropsy examinations. It also did not result in any mortalities. The above findings suggest that treatment with Mecasin is relatively safe. Further studies on this subject are needed to yield more concrete evidence.

• Annals of Clinical Neurophysiology
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• v.6 no.1
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• pp.35-38
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• 2004

Background: The purpose of this study is to evaluate the difference between the hemiplegic patients and controls with the newly developed three demensional electrogoniometer gait analysis program. Methods: The basic kinematic data of hip, knee and ankle joints on the sagittal plane and of temporospatial gait parameters were obtained from 25 hemiplegic patients and 25 healthy adults with three-dimensional electrogoniometer Domotion$^{(R)}$ Results: Significant difference were observed between patients and controls in kinematic parameters. Mean maximal hip flexion of healthy adults and hemiplegic limb of patient was $32.89{\pm}1.8^{\circ}$ and $18.24{\pm}4.8^{\circ}$, maximal knee flexion was $50.32{\pm}2.4^{\circ}$ and $34.98{\pm}10.4^{\circ}$, maximal ankle dorsiflexion was $5.34{\pm}1.2^{\circ}$ and $1.22{\pm}2.8^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.46{\pm}3.2^{\circ}$(p<0.05). Mean maximal hip flexion of healthy adults and unaffected limb of hemiplegic patient was $32.89{\pm}1.8^{\circ}$ and $28.36{\pm}6.6^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.62{\pm}3.7^{\circ}$, respectively(p<0.05). Conclusions: The gait parameters of hemiplegic patients showed significant differences as compared with normal gait parameters with the using of three dimensional gait analysis with electrogoniometer.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.262-268
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• 2016

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.467-473
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• 2018

Objective : The aim of this study was to determine outcome of ischemic stroke patients in the anterior circulation treated with endovascular treatment (EVT) with intravenous thrombolysis (IVT) versus EVT alone group. Methods : A systemic literature review was performed using online database from January 2004 to January 2017. Primary outcomes were successful recanalization seen on finial angiography and good outcome at three months. Secondary outcomes were mortality and the development of symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used when heterogeneity was less than 50%. Egger's regression test was used to assess publication bias. Results : Five studies were included for final analysis. Between EVT with IVT and EVT alone group, successful recanalization (odds ratio [OR] 1.467, p=0.216), good clinical outcome at three months (OR 1.199, p=0.385), mortality (OR 0.776, p=0.371), and S-ICH (OR 1.820, p=0.280) did not differ significantly. Egger's regression intercept with 95% confidence interval (CI) was 1.99 (95% CI -2.91 to 6.89) in successful recanalization and -0.27 (95% CI -6.35 to 5.80) in good clinical outcome, respectively. Conclusion : The two treatment modalities, EVT with IVT and EVT alone, could be comparable in treating acute anterior circulation stroke. Studies to find specific beneficiary group for EVT alone, without primary IVT, are needed further.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.15-20
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• 2001

Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.370-374
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• 2018

Subclavian steal syndrome is a type of obstructive artery disease caused by severe stenosis and occlusion of a left proximal subclavian artery or brachiocephalic trunk. The resulting vertebro-basilar insufficiency symptoms are due to retrograde blood flow from the contralateral vertebral and basilar arteries into the low-pressure ipsilateral upper extremity vessels. For that reason, patients usually experience dizziness or arm ischemic symptoms. Neurointervention is an effective treatment for ischemic stroke, including the subclavian artery stenosis. This paper reports a patient with subclavian steal syndrome who had a vertebral artery Doppler waveform change in duplex sonography and a 12 mmHg difference in interarm systolic blood pressure. A stenotic lesion of the subclavian artery was treated effectively by inserting a precise stent. The follow up examination showed that the vertebral artery Doppler waveform change disappeared and recovered and that the 12 mmHg difference in interarm systolic blood pressure decreased to 5 mmHg after treatment.