• Annals of Clinical Neurophysiology
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• v.24 no.2
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• pp.46-52
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• 2022

Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.149-152
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• 2012

Purpose: The vessels of peripheral nerves have been extensively studied since Breidenbach used vascularizd nerve grafts. Tayor and Pinel studied the course and distribution of the vessels of peripheral nerves. However, the vessels of digital nerves are still not well known. The objective of this study was to prove vessels of digital nerves and to investigate the pathway of that. Materials and Methods: 36 patients and 2 fresh human cadavers were studied under the microscope and histologic sections under the light microscope.. Results: We found that digital nerves had own arterioles and venules as well as peripheral nerves. This small vessels of digital nerves paralleled the digital nerves or run in a spiral. Digital nerves were abundantly vascularized throught their length by a succession of vessels and by their repeated divisions and anastomoses. Conclusion: The clinical implications of this results can be discussed in relation to the dissection of nerves, the possibility of vasculized nerve grafts.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.45-47
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• 2024

Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/ tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

• Journal of Korean Physical Therapy Science
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• v.3 no.1
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• pp.907-918
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• 1996

Evoked potentials(EP) are defined as electric responses of the nerves system to sensory stimulation. EPs are used mainly to test conduction in the visual, auditory, and somatosensory systems, especially in the central parts of these systems. Somatosensory evoked potentials (SEP) are the potentials elicited by stimulation of peripheral nerves and recorded at various sites along the sensory pathway. SEPs types consist mainly of SEPs to electric stimulation of arm or leg nerves. SEPs to arm stimulation are usually recorded simultaneously from clavicular, cervical, and scalp electrodes; SEPs to leg stimulation are recorded from lumbar, low thoracic, and scalp electrodes. Subject variables that have practical impotance are age, limb length, body height, and temperature. General clinical interpretation of abnormal SEPs wave decreases of peripheral conduction time, and abolition of SEPs recorded from different levels to identify lesions of peripheral nerves, plexus, nerve root, spinal cord, cauda equina, hemispheric brainstem, and cerebral parts of the somatosensory pathway.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.427-439
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• 2022

Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1120-1126
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• 2001

Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.5
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• pp.547-554
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• 2018

Itching is a common clinical symptom of skin disease that significantly affects a patient's quality of life. Transient receptor potential vanilloid 1 (TRPV1) receptors of keratinocytes and peripheral nerve fibers in skin are involved in the regulation of itching as well as pain. In this study, we investigated whether curcumin, which acts on TRPV1 receptors, affects histamine-induced itching in mice, using behavioral tests and electrophysiological approaches. We found that histamine-induced itching was blocked by topical application of curcumin in a concentration-dependent manner. In ex-vivo recordings, histamine-induced discharges of peripheral nerves were reduced by the application of curcumin, indicating that curcumin acts directly on peripheral nerves. Additionally, curcumin blocked the histamine-induced inward current via activation of TRPV1 (curcumin $IC_{50}=523nM$). However, it did not alter chloroquine-induced itching behavior in mice, which is associated with transient receptor potential ankyrin 1 (TRPA1). Taken together, our results suggest that histamine-induced itching can be blocked by topical application of curcumin through the inhibitory action of curcumin on TRPV1 receptors in peripheral nerves.

• The Korean Journal of Physiology
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• v.29 no.2
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• pp.309-321
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• 1995

In the present study, the relationship between the somatosympathetic reflexes and arterial blood pressure responses to electrical stimulation of the peripheral nerve was investigated in cats anesthetized with ${\alpha}-chloralose$. Single sympathetic postganglionic fiber activities were recorded from the hindlimb muscle and skin nerves and also from the cervical and abdominal sympathetic chains. Effects of the morphine on responses of the sympathetic nerve and arterial blood pressure to activation of the peripheral $A{\delta}-$ and C-afferent nerves were analyzed. The following results were obtained. 1) Arterial blood pressure was depressed by peripheral AS-afferent stimulation (A-response) and was elevated during C-afferent activation (C-response). 2) Intravenously administered morphine enhanced the C-response while the A-response decreased insignificantly, Only the C-response was decreased by intrathecal morphine. 3) All the ten recorded cutaneous sympathetic fibers showed periodic discharge pattern similar to respiratory rhythm and five of them also showed cardiac-related rhythm. However, most of the muscular sympathetic fibers had cardiac-related rhythm and only four fibers showed respiratory rhythm. 4) Morphine decreased the sympathetic C-reflex elicited by the peripheral C-afferent activation and the abdominal sympathetic A-reflex was also decreased by morphine. From the above results, it was concluded that supraspinal mechanisms were involved in the enhanced arterial pressor response to peripheral C-afferent activation by intravenous morphine.

• Investigative Magnetic Resonance Imaging
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• v.20 no.2
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• pp.81-87
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• 2016

Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. Conclusion: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.115-126
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• 2003

Although painful conditions of varying degrees of severity involving the soft tissues (i .e., muscles, tendons, ligaments, periosteum and peripheral nerves) occur frequently, their underlying pathogenesis is poorly understood. The term peripheral neuropathic pain has recently been suggested to embrace the combination of positive and negative symptoms in patients whose pain is due to pathological changes or dysfunction in peripheral nerves or nerve root. The spinal nerve root, because of its vulnerable position, is very easily prone to injury from pressure, stretch, angulation, and friction. Therefore, not a few of musculoskeletal chronic pains are result of nerve root dysfunction. Neuropathic changes due to nerve root dysfunction are primarily in soft tissue especially muscle, tendon and joint. It shows tenderness over muscle motor points and palpable muscle contracture bands and restricted Joint range. Careful palpation and physical examination is the important tool that, be abne to detect all of these phenomena.