• Archives of Plastic Surgery
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• v.34 no.6
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• pp.771-776
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• 2007

Purpose: Complete release of the transverse carpal ligament (TCL) is accepted as the standard treatment for carpal tunnel syndrome (CTS). However, loss of grip and pinch power are reported in some patients after complete release of the TCL. This study was designed to evaluate the effectiveness of complete versus partial carpal tunnel release by using the inching technique. Methods: Nineteen patients (a total of 27 hands) who each had a confirmed diagnosis of CTS were selected from September 2002 to February 2003. The cases were divided into three groups(mild, moderate and severe) based on preoperative electrodiagnostic studies. The patients with partial carpal tunnel syndrome were classified into the mild or moderate groups, while patients with complete carpal tunnel syndrome were classified into the moderate or severe groups. Patient oriented data (functional and symptomatic) were collected and electrophysiologic studies were undertaken preoperatively and postoperatively(on the 2nd week, 1st month, 3rd month and 6th month after surgery).Results: In this study, the mild and moderate groups showed both good functional and symptomatic results and improvements in electrophysiologic studies.Conclusion: Carpal tunnel syndrome patients classified into mild or moderate groups based on nerve conduction studies, and whose precise compression sites were pinpointed using the inching technique, can be treated by partial carpal tunnel release.

• Proceedings of the KIEE Conference
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• 2006.10c
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• pp.232-234
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• 2006

Diabetic neuropathy is one of the most common diabetic complications. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum of 100mA electric stimulus to nerves causing stress and pain to patients. In this study. as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2,\;TcpCo_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group (p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance (p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient group showed statistical significance (p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471 (p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If suggested $TcpO_2$ method is used periodically. prevention and early diagnosis of diabetic neuropathy is possible.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.266-273
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• 2002

Carpal Tunnel Syndrome(CTS) is a common entrapment neuropathy of the median nerve at the wrist. An Electrophysiologic study has been widely used for the diagnosis of carpal tunnel syndrome. The subjects of this study were 48 cases (88 hands) with clinically suspected carpal tunnel syndrome who underwent electrodiagnostic examination from Jan 1, 2001 to Sep 30, 2001, The results were as follows: 1. Among 48 persons with a clinically suspected carpal tunnel syndrome, 40 patients were female 83.33$\%$ and the patients who are above 60 years old were 37.50$\%$. 2. Electrodiagnostic results were 22 cases (45.84$\%$) with bilateral carpal tunnel syndrome and 10 cases (20.83$\%$) with normal. 3. Physical findings consisted of tingling sensation in 48.86$\%$ of the involved hands, positive Phalen's Sign in 20.46$\%$ of them, thenar atrophy in 15.91$\%$ of them, and weakness in 14.77$\%$ of them. 4. Electrophysiologic studies showed a decreased sensory conduction velocity in 20 cases (22.73$\%$) of total hands, a prolonged latency in 3 cases (3.41$\%$) of them, abnormal sensory and motor fiber in 33 cases (37.50$\%$) of them, and normal in 27 cases (30.68$\%$) of them. Considering above results, we had better make a diagnosis precisely the patients with clinically suspected carpal tunnel syndrome through subjective symtoms, physical examinations, and electrophysiologic studies.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.1-12
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• 1999

The aim of this study is to examine the sensitivity and characteristics of electromyography abnormalities detected by using various paramenters in patients with lumbosacral radiculopathies. EMG is widely used for disgnosing and localizing the level of radiculopathy. The results of the study were as follow : 1. In electromyography, L5 radiculopathy usa 95 cases(51.690). S1 radiculopathy was $45m(24.5\%)$ L4 radiculopathy was 18cases $(9.8\%)$, and L2, 3 radiculopathy was 8cases$(4.3\%)$. Remains 18cases$(9.8\%)$ had no definite radiculopathy. 2. Peroneal and tibial motor nerve conduction velocity studies were not significant as compared to the side to side. 3. Latency of H-reflex in L5 radiculopathy was $30.55\pm2.47$ in affected side, $29.47\pm2.29$ in unaffected side, in S1 radiculopathy was $33.00\pm2.03$ in affected side, R30.18\pm2.21$ in unaffected side. It was statistically significant(p<0.01). H-reflex mean difference of S1 radiculopathy group was significantly prolonged as compared to the L5 and S1 radiculopathies(p<0.001). 4. In L2, 3 radiculopathy, abnormal spontaneous activities and motor unit action potentials were showed high sensitivity in upper lumber paraspinal, hip adductors, quadriceps and iliopsoas muscles. 5. In L4 radiculopathy, lower lumbar paraspinal, tibialis anterior, quadriceps muscles were showed high sensitivity. 6. In L5 radiculopathy, lower lumbar paraspinal, extensor hallucis longus, extensor digitorum longus, peroneus longus, extensor digitorum brevis, gluteus maximus, tensor fasciae latae muscles were showed high sensitivity. 7. In S1 radiculopathy, lower lumbar paraspinal, gluteus maximus, peroneus longus, soleus, abductor hallucis, hamstrings, extensor digitorum brevis, extensor hallucis lognus, gastrocnemius muscles were showed high sensitivity.

• The Korean Journal of Pain
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• v.32 no.3
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• pp.206-214
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• 2019

Background: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. Methods: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). Results: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB ($33.0{\mu}g$; interquartile range [IQR], $27.0-69.5{\mu}g$) than in the control group ($92.8{\mu}g$; IQR, $40.0-155.0{\mu}g$) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). Conclusions: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.

• PNF and Movement
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• v.18 no.3
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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.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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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.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.21-26
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• 2010

Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.445-452
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• 2015

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) 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 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a 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 the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• Journal of Acupuncture Research
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• v.30 no.2
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• pp.43-53
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• 2013

Objectives : The purpose of this study is to review of Clinical trials related to the treatment of chemotherapy induced-toxicity by acupuncture therapy. Methods : We searched PubMed by using word of "chemotherapy induced, acupuncture" (Limits : Full text available, 10 years, Clinical trials, Humans, English). We analyzed 15 research paper and examined published journals, years, countries, topic, study design, their results, interventions, participants and instruments of assessment. Results : Eleven journals with fifteen papers were searched. These papers were published in USA, Germany, etc. On the topic of these clinical trials, seven of them were about nausea(vomiting), two about peripheral neuropathy, two about hot flash, two about arthralgia and one about neutropenia, one about fatigue. Six of these studies were single blinded, randomized controlled trial. Twelve studies reported significant effect. The median for number of final participants was 35.5 persons. Assessment for outcomes were versatile questionnaire, nerve conduction studies, WBC, ANC, G-CSF examination, etc. Conclusions : Their median for impact factor was 3.650 and average modified Jadad score of six RCTs was 4.33. In order to provide appropriate evidence regarding the effectiveness of acupuncture in treatment for chemotherapy-induced toxicity, more rigorous and well-designed studies are necessary.