• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.404-410
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• 2006

Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.

• Journal of Acupuncture Research
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• 제36권2호
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• pp.100-106
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• 2019

Background: In Korean medicine, carpal tunnel syndrome is treated by stimulating the acupoints around the wrist. Although a deep understanding of anatomy and guidance is needed to stimulate these acupoints to avoid undesirable side-effects, currently there are no published guidelines for acupotomy treatment. The aim of this study is to evaluate the effectiveness and safety of fluoroscopy-guided acupotomy compared with conventional acupotomy treatment. Methods: This is a randomized, patient-assessor, patient blind, parallel clinical trial. A total of 30 patients will be enrolled at Wonkwang University Gwangju Hospital, and will be allocated to either an experimental group or a control group. The experimental group will be treated using fluoroscopy-guided acupotomy and the control group will be treated using the conventional acupotomy method. Results: The primary outcome measure will be identification of a cross-section area of the median nerve measured by ultrasonography, and the secondary outcome measure will be the alleviation of pain measured by the Visual Analogue Scale, improvement in the Nerve Conduction Study, Tinel test, Phalen's test, EuroQol 5-dimension scale, and Boston Carpal Tunnel Questionnaire score. Safety components will be measured by monitoring vital signs, electrocardiographs, blood tests, general chemical tests, urine tests and pregnancy tests. In addition, observations for adverse effects will be performed during the trial. Conclusion: This study will provide a more effective, and less harmful way of treating carpal tunnel syndrome compared with conventional acupotomy. Fluoroscopy-guided acupotomy will help practitioners to be accurate in direction and depth of the needle for treating carpal tunnel syndrome.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.11-15
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• 2010

Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle's tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.108-113
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• 2002

Background and Objective : Carpal tunnel syndrome (CTS) is the most common mononeuropathy encountered in clinical practice. No single procedure or group of procedures has demonstrated adequate sensitivity. F-wave study in CTS is very rarely reported. To determine the diagnostic usefulness of new parameters of F-wave and comparative study of F-wave parameters of median and ulnar nerves in patients with CTS. Methods : F-wave responses of median and ulnar nerves were analyzed from 27 patients with clinically diagnosed CTS and 22 age and gender-matched normal control. Conventional F-wave parameters were studied. Also, the usefulness of new parameters such as mean and maximal ulnar-median F-wave latency differences, ulnar-median F-wave persistence and chronodispersion differences, median/ulnar F-wave amplitude ratio, and F-wave conduction velocity (FCV) using mean and maximal latency were assessed. Results : Compared with controls, median F-wave minimal, maximal and mean latencies, mean F-wave amplitude/M-wave amplitude, minimal, mean and maximal ulnar-median F-wave latency differences, and FCVs using minimal, maximal and mean latency were significant (P<0.05~0.001). Median F-wave minimal, maximal and mean latencies, mean ulnar-median F-wave latency difference, and FCVs using minimal, maximal and mean latency showed high sensitivity and specificity. Mean ulnar-median F-wave latency difference and FCVs using maximal and mean latency were new parameters. Conclusion : New F-wave parameter including mean ulnar- median F-wave latency difference and FCVs using maximal and mean latency may be a useful to assess the CTS. Also, median F-wave minimal, maximal and mean latencies, and FCV using minimal latency may be included in routine diagnostic tests in CTS.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.26-30
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• 2004

Background: Electrophysiologic study accurately predicts the degree of degenerated motor axons but cannot give precise information on the type of injury that occurred in Bell's palsy. Because of these limitation for prognostic prediction in Bell's palsy, we evaluated divergence of electrophysiological time course for the purpose of presuming the type of injury in Bell's palsy. Methods: We did bilateral facial nerve conduction studies in 103 Bell's palsy patients, who visited to Han-Gang sacred heart hospital from 1998 to 2001. We compared the CMAP amplitude of disease site with that of normal site and suggested that decremental CMAP amplitude ratio (percentage) as a degree of denervation of affected facial nerve. Then we demonstrated the time course of denervation percentage. After defining normal range of CMAP amplitude difference from normal control group, we also evaluated if distinct time course of early minimal denervation is present. Results: Our results show that time course of the denervation in early stage of Bell's palsy reflect various injury type such as axonotmesis, neurotmesis or other unidentified type. We cannot identify the distinct time course of early minimal denervation. Conclusions: The time course as well as the maximal value of denervation are the best prognostic guidelines in Bell' s palsy. So repeated serial electrophysiologic test are inevitable to assess prognosis. As an another topic, early minimal denervation for prognostic prediction deserve to be evaluated as a future work up for prognostic prediction.

• The Korean Journal of Physiology
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• 제26권1호
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• pp.75-88
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• 1992

It is well established that neurons in ventrolateral medulla play a key role in determining the vasomotor tone. The purpose of present study is to identify sympathetic related, medullospinal tract neurons in ventrolateral medulla and to show that these mediate somato-sympathetic reflex. Medullospinal tract cells were identified by antidromic stimulation to intermediolateral nucleus (IML) of the second thoracic ($T_2$) spinal cord in anesthetized cats. Peripheral nerves were stimulated for orthodromic activation of these cells and peripheral receptive fields were determined. Post R wave histogram of unit and spike triggered averaging of sympathetic nerve discharge (SND) were used to define sympathetic related cell. A total of 113 neurons was recorded in ventrolateral medulla that had the axonal projections to $T_2$ spinal cord. Thirty four of these medullospinal cells showed spontaneous discharges and the others not. Between these two groups, rostro-caudal coordinate of the distribution from obex [$4.7{\pm}0.2\;$ (mean S.E.) mm, 4.1 0.1 mm], depth from dorsal surface ($5.5{\pm}0.2mm,\;4.9{\pm}0.1mm$ and conduction velocity ($9.9{\pm}1.7m/sec,\;16.7{\pm}1.9\;m/sec$) were significantly different (p<0.05). In spontaneously discharging group, characteristics of rostral and caudal groups were significantly different and we demonstrated that cells in rostral group mediate somatosympathetic reflex. From these results, we conclude that a certain portion of spontaneously discharging medullospinal tract cells in rostral ventrolateral medulla comprise the efferent outputs of somatosympathetic reflex to sympathetic preganglion neurons.

• 대한의용생체공학회:의공학회지
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• 제20권3호
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• pp.307-314
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• 1999

M-wave 는 신경전도 연구에 있어서 후기반응 현상 중 직접적인 반응으로, 반응 후 일정시간내에 정보가 존재하는 단발 반응의 특성을 가지고 있다. 이러한 M-wave 는 신경계통의 질환을 진단하기 위한 유용한 요소이며, 따라서 M-wave 의 형태 및 시간에 관한 정보가 간단히 표현될 수 있다면 신경질환 연구에 많은 도움이 될 것이다. 따라서 본 연구에서는 Ar 모델링 방법이 이러한 M-wave 의 정보 압축에 있어서 효과적임을 증명하였다. 이로 인해 먼저 실제로 측정된 M-wave 신호에서 Ar 파라메터를 추정하였으며, 추정된 파라메터를 가지고 근사화한 곡선과 최근의 M-wave의 정보압축에 관한 연구인 Hermite 변환을 이용한 방법에 따른 근사화 곡선을 비교하였다. 제안된 방법의 구체적인 검증을 위해 실신호와 근사화 곡선의 정규화 평균자승오차(NMSE)를 구하여 비교하였다. 결론적으로 M-wave 의 정보를 압축하는데 있어 Hermite 변환은 30개의 파라메터가 필요한 반면, 본 연구에서 제시한 AR 모델링방법은 3개의 파라메터만 가지고도 효과적으로 M-wave 의 특징을 압축할 수 있음을 보였다.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• 대한약침학회지
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• 제4권2호
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• pp.105-112
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• 2001

In Oriental Medicine, mononeuropathy belongs to or . Common peroneal neuropathy(CPN) is the most frequently encountered mononeuropathy in the lower extremity. It is usually caused by direct surgery injury, compression, leg crossing, trauma, traction etc, occasionally by nerve tumor. A 47-year-old healthy man was complained of the sudden development of left foot drop and sensory manifestation owing to suspected compression and habitual leg-crossing. Acupuncture along with bee-venom acupuncture, moxibustion was performed mainly at Stomach and Gallbladder Meridian specially ST36, ST37, ST40, GB34 and GB39. Nerve conduction study and electromyography was also performed three times. Symtoms was relieved fast, and full recovery took about 110 days. Acupuncture and bee-venom acupuncture are considered to be beneficial to CPN. More clinical trials and studies are needed.

• The Korean Journal of Pain
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• 제34권1호
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• pp.82-93
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• 2021

Background: This study used bibliometric analysis of articles published about the topic of regional anesthesia from 1980-2019 with the aim of determining which countries, organizations, and authors were effective, engaged in international cooperation, and had the most cited articles and journals. Methods: All articles published from 1980-2019 included in the Web of Science database and found using the keywords regional anesthesia/anaesthesia, spinal anesthesia/anaesthesia, epidural anesthesia/anaesthesia, neuraxial anesthesia/anaesthesia, combined spinal-epidural, and peripheral nerve block in the title section had bibliometric analysis performed. Correlations between the number of publications from a country with gross domestic product (GDP), gross domestic product (at purchasing power parity) per capita (GDP PPP), and human development index (HDI) values were investigated with the Spearman correlation coefficient. The number of articles that will be published in the future was estimated with linear regression analysis. Results: Literature screening found 11,156 publications. Of these publications, 6,452 were articles. The top 4 countries producing articles were United States of America (n = 1,583), Germany (585), United Kingdom (510), and Turkey (386). There was a significant positive correlation found between the GDP, GDP PPP, and HDI markers for global countries with publication productivity (r = 0.644, P < 0.001; r = 0.623, P < 0.001, r = 0.542, P < 0.001). The most productive organizations were Harvard University and the University of Toronto. Conclusions: This comprehensive study presenting a holistic summary and evaluation of 6,452 articles about this topic may direct anesthesiologists, doctors, academics, and students interested in this topic.