• 한국임상약학회지
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• 제22권4호
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• pp.356-366
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• 2012

Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

• 대한물리치료과학회지
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• 제3권2호
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• pp.1011-1019
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• 1996

The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권1호
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• pp.41-48
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• 2020

Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). Results: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). Conclusion: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

• 생물정신의학
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• 제24권4호
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• pp.188-195
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• 2017

Objectives Schizophrenia is characterized by disturbances in perception and cognition. Attenuated mismatch negativity (MMN) reflects central auditory dysfunction in schizophrenia. The aim of this study is to compare MMN changes before and after treatment in schizophrenia patients and to assess their association with treatment response. Methods Twenty-three schizophrenia patients underwent an oddball paradigm. MMN was calculated by the difference waveforms of the event-related potentials (ERPs) elicited by subtracting standard from deviant stimulus. The clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), the Psychotic Symptom Rating Scale (PSYRATS). Follow-up evaluation was conducted when the PANSS total score decreased by 30% or more (treatment response group) or before discharge (non-response group). Results The treatment response group showed significantly larger MMN amplitude improvement and latency reduction than the non-response group after treatment (Fz ; mean amplitude p = 0.035, FCz ; p = 0.041). The auditory hallucination group showed shorter latency than that of the group without hallucinations. Additionally, auditory hallucination was associated with prolonged MMN latency and shortened after treatment in the auditory hallucination response group (Fz ; p = 0.048). Conclusions These results suggest that the attenuated MMN amplitude reflects the progression of the disease. The increment of MMN amplitude and shortening of latency after treatment may reflect cognitive functional recovery of central auditory sensory processing.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.100-108
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• 1998

Surgical treatment of cubital tunnel syndrome has been reported according to a wide variety of techniques since the end of the last century. Theses range from simple decompression to various forms of nerve transposition and medial epicondylectomy. However, we could find only few reports which compare the results between different types of operations. The treatment results of medial epicondylectomy and anterior subcutaneous transposition, were analysed retrospectively. From March 1984 to January 1996, a total of 110 patients had operations for cubital tunnel syndrome. Seventy four of them were followed-up for more than one year, and only they were included in this study. Anterior subcutaneous transposition was performed in 26 patients; and medial epicondylectomy in 48 patients. There were 52 males and 22 females, with an average age of 34 years (range, 13 to 75). The average follow-up period was 40 months (range, 12 to 132). Grading system by Gabel and Amadio were used for evaluation of the patients; pain, sensory and motor dysfunction were checked preoperatively and at last follow-up. In 26 patients of anterior subcutaneous transposition, 7 (27%) were graded as excellent, 11 (42%) good, 3 (12%) fair and 5 (19%) poor. In 48 patients of medial epicondylectomy, 16 (34%) were excellent, 27 (56%) good, 3 (6%) fair and 2 (4%) poor. Sixty nine percent were excellent or good in anterior subcutaneous transposition group, while ninty percent in medial epicondylectomy group. This difference was significant statistically (p<0.01 )., From our experiences, we suggest medial epicondylectomy for the treatment of cubital tunnel syndrome, rather than anterior subcutaneous transposition.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1642-1649
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• 2000

Objectives : Transverse myelitis(TM) is characterized by bilateral motor, sensory, and autonomic dysfunction of the spinal cord in the absence of pre-existing neurologic disease. It is an uncommon but not rare condition. But it remains as poorly understood syndrome not only etiologically but also in terms of its clinical behavior. Neurosurgically, It is often quite difficult to distinguish from other surgical intramedullary lesions. We present our clinical experiences of TM in order to assess its clinical behavior and to define the radiological characteristics that can distinguish TM from other intramedullary lesions. Methods : From June 1991 to May 1997, twenty-nine patients with transverse myelitis were admitted to our department. All cases revealed acute or subacute syndrome of non-compressive myelopathy and intramedullary lesions in the MRI. We analyze the radiological data and medical records retrospectively. Results : Patients ranged in age from 16 to 66 years, with 22 males and 7 females. Mean follow-up period was 53 months. For the offending levels, cervical was 5, thoracic 21, and lumbar 3 in number. The patients who presented the return of symptoms after a diminution or abatement of initial symptoms were 7(24%). In the MRI, TM showed typical characteristics of high signal intensity lesions in the center of spinal cord in T2 weighted images and low- to iso-signal intensity in T1 weighted images. A focal nodular enhancement pattern was observed in 58.6%(17/29) of the patients. MR follow-up studies were done in the 21 patients and radiological improvement were verified. Biopsies were done in 3 patients. Normal to good outcome was achieved in 62% of the patients. Conclusion : Transverse myelitis has characteristic radiological findings that can be distinguished from other intramedullary lesions. In our series, it is associated with significant recurrence rates thus, should not be considered a selflimiting disease with good prognosis.

• The Korean Journal of Physiology and Pharmacology
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• 제24권4호
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• pp.287-298
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• 2020

Ca²⁺ signaling of endothelial cells plays a critical role in controlling blood flow and pressure in small arteries and arterioles. As the impairment of endothelial function is closely associated with cardiovascular diseases (e.g., atherosclerosis, stroke, and hypertension), endothelial Ca²⁺ signaling mechanisms have received substantial attention. Increases in endothelial intracellular Ca²⁺ concentrations promote the synthesis and release of endothelial-derived hyperpolarizing factors (EDHFs, e.g., nitric oxide, prostacyclin, or K⁺ efflux) or directly result in endothelial-dependent hyperpolarization (EDH). These physiological alterations modulate vascular contractility and cause marked vasodilation in resistance arteries. Transient receptor potential (TRP) channels are nonselective cation channels that are present in the endothelium, vascular smooth muscle cells, or perivascular/sensory nerves. TRP channels are activated by diverse stimuli and are considered key biological apparatuses for the Ca²⁺ influx-dependent regulation of vasomotor reactivity in resistance arteries. Ca²⁺-permeable TRP channels, which are primarily found at spatially restricted microdomains in endothelial cells (e.g., myoendothelial projections), have a large unitary or binary conductance and contribute to EDHFs or EDH-induced vasodilation in concert with the activation of intermediate/small conductance Ca²⁺-sensitive K⁺ channels. It is likely that endothelial TRP channel dysfunction is related to the dysregulation of endothelial Ca²⁺ signaling and in turn gives rise to vascular-related diseases such as hypertension. Thus, investigations on the role of Ca²⁺ dynamics via TRP channels in endothelial cells are required to further comprehend how vascular tone or perfusion pressure are regulated in normal and pathophysiological conditions.

• 가정∙방문간호학회지
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• 제5권
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• pp.32-46
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• 1998

Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.

• 대한한의학회지
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• 제38권3호
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• pp.111-123
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• 2017

Objectives: To develop and investigate the reliability of the pathologic aging scale based on korean medical theory and korean medical pattern identification for dementia. Methods: We searched the textbook of korean neurophychiatry and Donguibogam and selected items through professional consensus. We compared between dementia(n=40) and normal elderly(n=38) and tested the reliability of two scales. Results: After professional consensus, we drafted the Korean Medical Pathologic Aging Scale(12 items, Likert 3 scale) and Korean Medical Pattern Identification for Dementia(4 patterns, 28 items, Likert 5 scale). On Korean Medical Pathologic Aging Scale, There is no significant difference between two groups. We had good internal consistency(Cronbach's alpha = 0.6) and test-retest reliability(r=0.631) but low inter-rater reliability(r=0.430). On Korean Medical Pattern Identification for Dementia, dementia patients diagnosed with Qi deficiency are significantly more than those in normal group. We had fairly good internal consistency(Cronbach's alpha = 0.574) and excellent test-retest(kappa= .800) and inter-rater reliability(kappa = .733). Conclusions: Korean Medical Pattern Identification for Dementia is appropriate for diagnosing korean medical pattern. But Korean Medical Pathologic Aging Scale isn't appropriate to discriminate dementia from normal elderly because of many subjective items. Therefore objective measurement of sensory dysfunction would be needed to measure pathologic aging based on korean medical theory.