• Journal of Korean Neurosurgical Society
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• v.55 no.2
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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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• v.52 no.2
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• pp.75-79
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• 2012

Objective : The study examined the difference in the incidence of symptomatic cerebral vasospasm with magnesium supplementation in aneurysmal subarachnoid hemorrhage (SAH) in a Korean population. Methods : This retrospective analysis was performed in 157 patients diagnosed with aneurysmal SAH from January 2007 to December 2011 at a single center. Seventy patients (44.6%) received a combination treatment of nimodipine with magnesium and 87 patients (55.4%) received only nimodipine. A matched case-control study using propensity scores was conducted and 41 subjects were selected from each group. A dosage of 64 mmol/day of magnesium was administrated. Results : The infusion of magnesium did not reduce the incidence of symptomatic cerebral vasospasm (n=7, 17.1%, p=0.29) compared with simple nimodipine injection (n=11, 26.8%). The ratios of good clinical outcome (modified Rankin scale 0-2) at 6 months were similar, being 78% in the combination treatment group and 80.5% in the nimodipine only group (p=0.79). The proportions of delayed cerebral infarction was not significantly lower in patients with combination treatment (n=2, 4.9% vs. n=3, 7.3%; p=0.64). There was no difference in the serum magnesium concentrations between the patients with symptomatic vasospasm and without vasospasm who had magnesium supplementation. No major complications associated with intravenous magnesium infusion were observed. Conclusion : Magnesium supplementation (64 mmol/day) may not be beneficial for the reduction of the incidence of symptomatic cerebral vasospasm in patients with aneurysmal SAH.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.282-286
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• 2005

Objective: Symptomatic chronic subdural hematoma(CSDH) is a well-known neurosurgical entity and most of the lesion is managed by surgical treatment. The authors analyze the surgical indication and the treatment results of twist drill craniostomy with closed-system drainage(TDD) for the symptomatic CSDH. Methods: From March 2001 through December 2003, 31 patients who were treated with TDD for the symptomatic CSDH and followed more than 6months were included. The radiologic criteria of TDD in this study were 1) homogeneous density of hematoma on computed tomography(CT), 2) no septation of hematoma on magnetic resonance imaging(MRI), and 3) thicker hematoma more than twice thickness of skull. Surgical procedures were performed on the maximum thickness of hematoma on CT/MRI. Short and long Steinman pins were used to penetrate the skull and hematoma membrane. As the 5L catheter was inserted through the drill hole, it was kept for 1 - 7days for the drainage of CSDH. The patients of CSDH were followed with clinical symptoms and CT studies. Results: Most of all the 31 patients were improved. However, one patient was suffered from postoperative epidural hematoma and the other patients have received the secondary operation because of the recurrence of CSDH on 3 months after initial surgery. Conclusion: TDD is safe procedure for the symptomatic CSDH if the patients are selected appropriately.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.133-139
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• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.30-33
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• 2013

Objective : To suggest a new useful diagnostic technique, principles of the selective excitation technique-magnetic resonance images (Proset-MRI), and to know the precise radiologic findings that can prove symptomatic foraminal and extraforaminal stenosis at L5-S1. Methods : Nineteen patients with symptomatic L5-S1 stenosis were checked by Proset-MRI. Four patients were performed decompressive surgery and 15 patients were performed selective nerve root block (SNRB) at L5. The pain scale of patients was checked by Visual Analogue Scale (VAS) scores at the pre- and post-treatment state. Results : Proset-MRI findings of patients with symptomatic stenosis are root swelling (RS) and indentation. The comparisons with VAS scores had a meaningful statistical result at each RS (p<0.01) and indentation (p<0.01). However, the findings of RS combined with indentation lacked statistical significance (p=0.0249). In addition, according to a comparison with the treatment modalities, reducing of VAS scores had statistical meaningful significance in decompressive surgery cases (p<0.01), and also in SNRB cases (p<0.01) after a 3-month follow-up period. Conclusion : The three dimensional Proset-MRI is very useful and sensitive technique to diagnose the symptomatic foraminal and extraforaminal stenosis at L5-S1.

• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.273-277
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• 2013

This study was performed to compare clinical and diagnostic imaging features between asymptomatic and symptomatic extrahepatic portosystemic shunts in dogs. The data of thirty patients diagnosed with extrahepatic PSS by multi-detector CT were reviewed, and the dogs were divided into asymptomatic (9/30) and symptomatic (21/30) groups. Signalments, hematologic results, liver size, morphologic classifications and main portal vein to abdominal aortic ratio (PV/AO) at the porta hepatis level from CT images were evaluated in two groups. Shih-tzu (5/9) was the most frequent breed in asymptomatic group, and various breeds were presented in symptomatic group. Mean age of asymptomatic group ($9.2{\pm}3.2$ years) was significantly higher than that of symptomatic group ($4.5{\pm}3.2$ years). The most morphologic form of shunt vessel was the splenophrenic shunt (16/30). PV/AO of asymptomatic group ($1.1{\pm}0.19$) was significantly higher than the values of symptomatic group ($0.55{\pm}0.19$). Clinical signs, hematologic results and diagnostic imaging findings of asymptomatic PSS are too nonspecific to suspect PSS. Therefore, considering of patient's age and CT examination with application of PV/AO ratio could be useful for the diagnosis of asymptomatic PSS.

• Journal of Sasang Constitutional Medicine
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• v.21 no.1
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• pp.28-34
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• 2009

1. Objective This study aims to establish the concept and classification of the Gochangl(鼓脹) pathology introduced in the Sasang Constitutional Medicine literature. 2. Methods Different editions of Donguisusebowon, including the Gabo version and the Sinchuk version, were compared for differences and similarities in the concept, symptomology, pathology, and therapeutics concerning the Soyangin Gochang disease. 3. Results and Conclusion (1) In the Gabo edition, Gochang(鼓脹) is introduced to Eumheohwadongwiyeolyukran(陰虛火動胃熱肉爛) disease category of the Interior-Based Symptomatic Pattern in the "Soyangin Interior Large Intestine Disease" section and is introduced to the conditions progressed from edema included in the Exterior-Based Symptomatic Pattern in the "Articles added to the Soyangin Bladder and Large Intestine Disease" section. (2) In the Sinchuk edition, Gochang(鼓脹) is introduced ro the conditions progressed from Jungso(中消) of the Interior-Based Symptomatic Pattern in the "Soyangin Interior-heat-disease by the fever in the stomach" section and "Articles added to the Soyangin" section. (3) It is reasonable to think that Soyangin's Gochang is considered to Interior-Based Symptomatic Pattern because the Sinchuk edition is developed from the Gabo edition and Gochang is introduced to Jungso(中消) category after the distinction between Gochang and edema in the Sinchuk edition.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.73-77
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• 2016

Purpose: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. Materials and Methods: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. Results: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. Conclusion: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.133-144
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• 2022

The objective was to propose effectiveness of conservative treatments including Korean medical treatments for symptomatic Schmorl's nodes (SNs). We conducted retrospective study that analyzed the medical records of two patients with the symptomatic SNs. They were treated by conservative treatments including Korean medical treatments for 3 weeks. We evaluated numeric rating scale (NRS), Oswestry disability index (ODI) and EuroQol-5 dimension (EQ-5D) index. After treatment, NRS, ODI were decreased and EQ-5D index was increased. We performed literature search to analyze the mechanisms of its treatment and evaluate clinical trials. There were three major mechanisms: (1) Improving constructive stability of vertebrae, (2) alleviating pain, and (3) controlling autoimmunity. When comparing operative treatment (OT) trials and conservative treatment (CT) trials, we couldn't find conclusive basis that support which one is more effective. As OT trials reported some severe adverse events, CT trials reported mild adverse events. The conservative treatments that we used encompasses those mechanisms and is relatively safe. To obtain exact evidence of effectiveness, further studies are needed.

• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.110-113
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• 2014

Perineurial cysts (Tarlov cysts) are lesions of the nerve root that are often observed in the sacral area. There is debate about whether symptomatic perineurial cysts should be treated surgically. We presented three patients with symptomatic perineurial cyst who were treated surgically, and introduced sacral recapping laminectomy. Patients complained of low back pain and hypesthesia on lower extremities. We performed operations with sacral recapping technique for all three. The outcome measure was baseline visual analogue score and post operative follow up magnetic resonance images. All patients were completely relieved of symptoms after operation. Although not sufficient to address controversies, this small case series introduces successful use of a particular surgical technique to treat sacral perineural cyst, with resolution of most symptoms and no sequelae.