• PNF and Movement
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• 제18권3호
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• pp.393-401
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• 2020

Purpose: In recent years, there has been increasing interest in using blood flow-restricted exercise (BFRE) or KAATSU training. The KAATSU training method, which partially restricts arterial inflow and fully restricts venous outflow in the working musculature during exercise at reduced exercise intensities, has been proven to result in substantial increases in both muscle hypertrophy and strength. The purpose of this study was to investigate the proper level of pressure for KAATSU training using compound muscle action potential (CMAP) analysis. Methods: Twenty-two healthy adults voluntarily participated in this study. CMAP was conducted by measuring the terminal latency and amplitude using a motor nerve conduction velocity test. For reference-line, supramaximal electrical stimulation was applied to the median nerves of the participants to obtain CMAP for the abductor pollicis brevis. For baseline, the intensity of the electrical stimulation was decreased to a level at which the CMAP amplitude was about a third of the CMAP amplitude obtained by the supramaximal electrical stimulation. The pressure levels for the KAATSU were set as a systolic blood pressure (strong pressure), the median values of systolic and diastolic blood pressure (intermediate pressure), and diastolic blood pressure (weak pressure). In the KAATSU condition, CMAP was performed under the same conditions as baseline after low-intensity thumb abduction exercises were performed at the subjects' own pace for one minute. Results: As the pressure increased, the CMAP amplitude was significantly increased, signifying that more muscle fibers were recruited. Conclusion: This study found that KAATSU training recruited more muscle fibers than low-intensity exercise without the restriction of blood flow.

• 한방재활의학과학회지
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• 제32권3호
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• pp.55-64
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• 2022

Objectives The objective of this study was to assess the effectiveness of acupotomy for carpal tunnel syndrome. Methods Based on seven domestic and foreign databases. We analyzed the randomized controlled trials using acupotomy for carpal tunnel syndrome. The treatment group was treated with acupotomy and the control group was no restrictions on treatment methods. Results In this study, the effect of acupuncture treatment for carpal tunnel syndrome was investigated. Each study reported that acupotomy could be an effective treatment for carpal tunnel syndrome. However, as a result of meta-analysis of Levine carpal tunnel syndrome questionnaire scores, visual analog scale, and sensory nerve conduction velocity, the results were more clinically significant than those of the control group. Due to the small number of randomized controlled trial studies and the nature of acupotomy treatment, blinding of interventions was impossible, resulting in a high risk of bias. Conclusions In this regard, it is thought that well-planned randomized controlled studies on patients with carpal tunnel syndrome are needed in the future to secure the clinical evidence for acupotomy treatment.

• Korean Journal of Radiology
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• 제23권2호
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• pp.237-245
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• 2022

Objective: Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods: This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results: Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group (p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group (p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group (p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA (p = 0.030) and 0.705 for SWE (p = 0.035). Conclusion: Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

• 한국의류학회지
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• 제16권2호
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• pp.237-244
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• 1992

The purpose of this study was to comparatively evaluate thermal and water transmission properties of several vapor permeable water repellent (VPWR) fabrics and synthetic battings that became available in recent years. Five VPWR fabrics evaluated were Hipora in three coating variants, $Gore-Tex^{\circledR}$ and $Aitace^{\circledR}$. Battings evaluated were $Viwarma^{\circledR}$, $Uniwarmr^{\circledR}$, $Thinsulate^{\circledR}$, and $Airseal^{\circledR}$ Thermal resistance and water vapor transmission were measured for each fabric and batting and in all combinations. Thermal resistance at zero and 37 cm/sec air velocity was determined by the Thermo Labo II technique for simultaneously measuring conduction and radiation heat transfer. Water vapor transmission over 24 hours was measured by a modified weight-gain method in a compact humid chamber at conditions simulating the clothing climate under heavy exercise ($40{\pm}1^{\circ}C$, $90{\pm}2\%$ R.H., and 0.5 m/sec air velocity). Fabric porosity was calculated from fiber density and fabric weight, thickness, and area. Thermal resistance results for the fabrics showed the effectiveness of coatings in inhibiting heat transfer. Measurements taken in wind were: $31.1\~37.6\%$ for $Hipora^{\circledR}$ variants; $31.0\%$ for $Gore-Tex^{\circledR}$; and $18.4\%$ for $Aitaca^{\circledR}$ Measurements without wind were higher but in the same order. Water vapor transmission results were in reverse order: $Aitac^{\circledR}$, $8.8 kg/m^{2};\;Gore-Tex^{\circledR}$, 6.4 kg/$m^{2}$; and $Hipora^{\circledR},\;4.4\~6.0\;kg/m^{2}$. In general thermal resistance increased with porosity. For battings, the thermal resistance with wind results were: $Viwarmu^{\circledR}$, $65.0\%;\; Thinsulate^{\circledR}$, $62.0\%$; $Uniwarm^{\circledR}$, $61.0\%$; and $Airseala^{\circledR},\;53.1\%$. Thermal resistance was proportional to thickness. Thermal resistance of fabric-batting combinations were $20\%$ higher than those of the battings only. Water vapor transmission for combinations was mainly affected by that for the VPWR fabric used.

• The Korean Journal of Physiology
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• 제24권1호
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• pp.181-194
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• 1990

Vasomotor area로 알려져 있던 외측연수망상체는 최근 rostral ventrolateral medulla로 불리 면서 sympathoexcitatory neuron이 집중적으로 분포하는 연수내 부위로서, 체성교감신경반사에 중요한 역할을 하는 것으로 알려지고 있어 이 부위로의 입력정보가 그동안 많은 연구가 되어온 내측 척수망상로 세포와 어떤 차이를 보이는가를 규명하고자 하였다. 1) Medial SRT 세포는 34 cell중 약 60%가 동측으로 향하였으나, lateral SRT cell의 경우 47 cell의 약 60%가 반대측으로 향하였다. 2) 각 군의 세포를 말초자극에 대한 반응성에 따라, LT cell, Deep cell, HT cell및 WDR cell로 나누었으며 유해자극을 전달하는 세포를 HT와 WDR cell이라 하고, 무해자극을 전달하는 세포와 유해자극을 전달하는 세포의 비율로 볼 때, 다른 부위에 비하여 rostral VLM에 유해자극정보가 비교적 많이 전달됨을 볼 수 있었다. 3) 평균 전도 속도는 각 군간에 유의한 차이가 없었으나, Deep cell은 HT cell보다 유의하게 빠른 전도속도를 보였다. 4) Medial SRT 세포는 척수 회백질 내에서 Rexed laminae VII및 VIII에 주로 분포하며, LRN projecting SRT cell의 경우엔 전 lamina에 걸쳐 고루 분포하였다. 이상의 결과는 내측 및 외측 망상체간의 말초 입력 정보의 차이를 보여주고 있으며, 연수 망상체의 세 부위중 특히 rostral ventrolateral medulla로 많은 동통정보가 입력되고 있어 RVLM의 기능중 하나인 체성교감반사의 통합과 연관된 역할을 하리라 기대된다.

• 전자공학회논문지SC
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• 제44권3호
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• pp.1-8
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• 2007

당뇨병성 신경병증은 당뇨병성 신증, 당뇨병성 망막병증과 함께 당뇨병의 가장 흔한 합병증 중의 하나로 임상에서는 신경전도검사(nerve conduction velocity: NCV)를 실시하여 신경병증의 유무를 진단한다. 그러나 신경전도검사는 피부에 직접적으로 최대 100mA의 전기자극을 가하므로 피검자가 놀라거나 고통을 호소하는 경우가 많다. 본 논문에서는 $TcpO_2$를 이용하여 비관혈적으로 신경병증이 있는 그룹과 정상인 그룹 간의 $TcpO_2$와 $SpO_2$의 차이를 확인하고, $TcpO_2$와 $SpO_2$가 어떠한 관계인지 살펴보았다. 또한 $TcpO_2$ 측정방법을 당뇨병성 신경병증의 새로운 조기 진단 방법으로 제안하고자 하였다. 실험은 정상인 50명과 NCV를 통해 신경병증으로 확진 받은 당뇨병 환자 50명을 대상으로 하였으며, 분석 파라미터는 $TcpO_2$, $TcpCO_2$, $SpO_2$이었다. 측정결과 $TcpO_2$는 정상인과 당뇨병성 신경병증 환자 그룹 간에 손과 발에서 모두 통계적으로 유의한 차이가 있었다(p<0.01). $SpO_2$는 검지에서는 정상인과 당뇨병성 신경병증 환자 간에 통계적으로 차이가 없었지만(p>0.05), 엄지발가락에서는 유의한 차이가 있었다(p<0.01). 손가락의 $SpO_2$와 손의 $TcpO_2$는 상관관계가 0.400(p<0.01), 발가락의 $SpO_2$와 발의 $TcpO_2$는 0.471(p<0.01)로 통계적으로 유의한 상관관계를 발견하였다. 정상인과 당뇨병성 신경병증 환자 그룹 간에 손과 발의 $TcpO_2$ 방법의 민감도는 66%, 특이도는 92%로 나타났다. 본 연구를 통해서 $TcpO_2$ 방법이 신경병증의 유무를 확인할 수 있는 사전검사 도구로 사용이 가능할 수 있으며, 주기적인 $TcpO_2$ 검사를 통해 혈관폐색과 신경병증을 조기에 발견할 수 있어 당뇨병으로 인한 혈관폐색과 신경병증을 조기에 진단 할 수 있는 유용한 방법이 될 것으로 사료된다.

• The Korean Journal of Physiology and Pharmacology
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• 제1권6호
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• pp.603-611
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• 1997

The motor evoked potentials (MEPs) have been advocated as a method of monitoring the integrity of spinal efferent pathways in various injury models of the central nervous system. However, there were many disputes about origin sites of MEPs generated by transcranial electrical stimulation. The purpose of present study was to investigate the effect of major extrapyramidal motor nuclei such as lateral vestibular nucleus (VN) and medullary reticular nucleus (mRTN) on any components of the MEPs in adult Sprague-Dalwey rats. MEPs were evoked by electrical stimulation of the right sensorimotor cortex through a stainless steel screw with 0.5mm in diameter, and recorded epidurally at T9 - T10 spinal cord levels by using a pair of teflon-coated stainless steel wire electrodes with 1mm exposed tip. In order to inject lidocaine and make a lesion, insulated long dental needle with noninsulated tips were placed stareotoxically in VN and mRTN. Lidocaine of $2{\sim}3\;{\mu}l$ was injected into either VN or mRTN. The normal MEPs were composed of typical four reproducible waves; P1, P2, P3, P4. The first wave (P1) was shown at a mean latency of 1.2 ms, corresponding to a conduction velocity of 67.5 m/sec. The latencies of MEPs were shortened and the amplitudes were increased as stimulus intensity was increased. The amplitudes of P1 and P2 were more decreased among 4 waves of MEPs after lidocaine microinjection into mRTN. Especially, the amplitude of P1 was decreased by 50% after lidocaine microinjection into bilateral mRTN. On the other hand, lidocaine microinjection into VN reduced the amplitudes of P3 and P4 than other MEP waves. However, the latencies of MEPs were not changed by lidocaine microinjection into either VN or mRTN. These results suggest that the vestibular and reticular nuclei contribute to partially different role in generation of MEPs elicited by transcranial electrical stimulation.

• 전자공학회논문지SC
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• 제43권3호
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• pp.60-66
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• 2006

본 논문은 photoplethysmography(PPG)와 Laser doppler(LD)를 이용하여 당뇨병 환자의 신경병증을 조기 진단하기 위한 시스템을 구성하여 손가락과 발가락의 혈류량을 측정하고 그 비율을 이용하는 방법을 제안하였다. 당뇨병 환자의 신경병증 진단을 위해 임상에서는 신경전도검사(NCV)가 사용되고 있으나 이 검사는 피부에 전기자극을 가하므로 환자에게 스트레스와 고통을 준다. 이에 본 논문에서는 고통이 전혀 없으며, 비관혈적이고 측정방법이 간단한 PPG와 LD를 이용하여 신경병증 진단법을 제안하였다. PPG가 LD에 비해 손가락 및 발가락의 혈류량 및 온도와의 상관관계, 민감도 및 특이도에서 더 우수하였다. 분석결과 50명의 신경병성 당뇨환자의 혈류비($0.96{\pm}0.20$)가 64명의 정상인의 혈류비($0.46{\pm}0.15$)에 비해 유의하게 높았다(p<0.000). 또한 신경병성 당뇨환자의 발가락 온도($30.5{\pm}1.4^{\circ}C$)가 정상인의 발가락 온도($29.3{\pm}2.0^{\circ}C$)에 비해 유의하게 높았다(p<0.000). 본 연구로부터 도출된 최적 혈류비(0.678)에 대한 측정 방법의 높은 민감도(95.3%)와 특이도(95.3%)를 확인하였다. 마지막으로 신경병성 당뇨환자 그룹의 경우 모두 손가락과 발가락의 온도차가 $4.5^{\circ}C$ 미만이었다.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.