• Title/Summary/Keyword: sensory nerves

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The Importance of Age as a Factor of Carpal Tunnel Syndrome management (수근관 증후군 치료결정의 한 요인으로 연령의 중요성)

  • Kim, Ja-Young;Park, Hae-Yoon;Kang, Sung-Soo
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.15-20
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    • 2001
  • Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.

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Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery

  • Park, Sun Kyung;Sung, Min Ha;Suh, Hae Jin;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.18-22
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    • 2016
  • Background: The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be $2.8{\pm}2.6$ and $1.1{\pm}1.8$, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.

XENOTRANSPLANT OF HUMAN BONE MARROW STROMAL CELLS; EFFECT ON THE REGENERATION OF AXOTOMIZED INFRAORBITAL NERVE IN RATS (인간 골수 기질세포 이종이식이 백서의 축삭절단 안와하 신경 재생에 미치는 효과)

  • Park, Eun-Jin;Kim, Eun-Seok;Kim, Jin-Man;Kim, Hyun-Ok;Yum, Kwang-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.3
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    • pp.239-247
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    • 2005
  • This study demonstrated that xenogenic human marrow mesenchymal stem cells (hMSCs) could elicit the regeneration of the sensory nerve after axotomy in the adult rats infraorbital nerves without immunosuppression. For this, we evaluated the behavioral testing for functional recovery of the nerve and histological findings at weeks 3 and 5 compared to controls. Xenogenic hMSCs did not evoke any significant inflammatory or immunologic reaction after systemic and local administrations. HMSCs-treated rats exhibited significant improvement on sensory recovery tested with von Frey monofilaments. At 5 postoperative weeks, in the hMSCs treated nerve, expression of myelin basic protein (MBP), neurofilament (NF) at the site of axotomy was higher than control. And mRNA expression of neurotropin receptor Trk precursor (TrkPre), nerve growth factor receptor (NGFR) and neuropeptide (NPY) in trigeminal ganglion were also higher. The number of myelinated nerve at distal stump and cells in trigeminal ganglion were higher in hMSC treated rats. So it was supposed that transplanted MSCs contributed to reducing post-traumatic degeneration and production of neurotrophic factors. Immunofluorescence labeling showed small portion of hMSCs (<10%) expressed a phenotypic marker of Schwann cell (S-100). Xenogenic or allogenic mesenchymal stem cells might have immune privileged characteristics and useful tool for cell based nerve repair.

Comparison of Weighted Needle Pinprick Sensory Thresholds and Sensory Nerve Conduction Studies in Diabetic Patients (당뇨병(糖尿病) 환자(患者)에서의 가중침자(加重針刺) 감각역치와 감각신경(感覺神經) 전도검사(傳導檢査)와의 비교(比較))

  • Yoo, Jae-Kwan;Kim, Seong-Ah;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.899-910
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    • 1995
  • This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.

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MAXILLARY OSTEONECROSIS;RARE COMPLICATION IN PATIENTS WITH HERPES ZOSTER (대상포진 환자에서 발생된 상악골 골괴사)

  • Kim, H.J.;Kim, B.Y.;Cha, I.H.;Park, H.S.;Yoon, J.H.;Kim, J.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.515-520
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    • 1994
  • Herpes Zoster is an acute viral infection characterized by the appearance of vesicles that occur on the skin and mucous membrane along the pathway of an involved sensory nerve. Although Herpes zoster is usually as benign viral infection, complications may occur especially when cranial nerves are involved. There are few reports of bony and dental complications by Herpes Zoster infection, all of which were isolated in a single quadrant. These include devitalized teeth, abnormal development of permanent teeth, internal resoption and spontaneous exfoliation of teeth with osteonecrosis of the alveolar bone. No agreement has been reached concerning the pathogenesis of osteonecrosis and tooth exfoliation associated with herpes zoster infection. We recently experienced series of maxillary osteonecrosis and spontaneous teeth exfoliation in patients with Herpes Zoster infection and present two cases with review of literature.

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Microstructural Organization of the Central Nervous System in the Orb-Web Spider Araneus ventricosus (Araneae: Araneidae)

  • Park, Yong-Ki;Moon, Myung-Jin
    • Applied Microscopy
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    • v.43 no.2
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    • pp.65-74
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    • 2013
  • Although the geometrical difference in body position between web-building and wandering spiders could affect the organization of their central nervous system (CNS), however most of our informations about spider's CNS are dependent on those revealed from the wandering spiders. Therefore, this paper describes microstructural organizations of the CNS in the geometric orb-web spider Araneus ventricosus. Similarly to other wandering spiders, the CNS of A. ventricosus is also consisted of a dorsal supraesophageal ganglion and a ventral subesophageal mass. The supraesophageal ganglia are fused together and made up of a large sized nerve cell clusters, whereas the subesophageal ganglia are made up of the foremost part of the ventral nerve cord. It has been revealed that the only nerve arising from the supraesophageal mass was the optic nerve which connected with four pairs of eyes, whereas a pair of pedipalpal and four pairs of appendage nerves including abdominal nerve pairs were arisen from the subesophageal nerve mass. Fibrous masses are highly organized into longitudinal and transverse tracts, and are only consisted of processes of neurons and the terminal ramnifications of peripheral sensory neurons. In addition, central fibrous mass of both the brain and the subesophageal mass are totally devoid of nerve cell bodies.

The literatual study on the cerebral vascular dementia in oriental and occidental medicine (뇌혈관성(뇌혈관성) 치매(痴?)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Ann, Tak-Weon;Hong, Seog;Kim, Hee-Chul
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.40-70
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    • 1996
  • In the literatual study on the cerebral vascular dementia, the results were as follows : 1. Cerebral vascular dementia is so called apoplectic dementia, because it almost occurs after apoplexy, the attack rate has gradually increased by increase of life, so it exert a harmful influence to geriatric diseases. 2. The etiological factors are summarized on deficiency in the heart, kidney, liver(心, 腎, 肝虛), pathogenic wind(豊) pathogenic fire(火) phlegm(痰) and stagnated blood(瘀血) in the oriental medicine, and multiple cerebral infarction, cerebral anemia, decrease of cerebral vascular flow are etiological factors in the occidental medicine. 3. The region of infarction and attack of cerebral vascular dementia have a close connection, and generally the cerebral vascular dementia easily occur in injury of white matter of brain. 4. Symptoms of cerebral vascular dementia are dysphasia, walking disorder, hemiplegia, sensory paralysis, disturbance of memory, judgement, calculation, emotion incontinence, speech impediment, silence or talkative, lower thinking ability and depersonalization, and symptoms are aggravated by stage. 5. Therapeutic herb medicines are Palpungsan(八風散), Baepungsan(排風散), Jinsaanshinhwan(辰砂安神丸), Sabacksan(四白散), Kanghwalyupungsan(姜活愈風散), Woohwangchungshimhwan(牛黃淸心丸), and they are used to dispelling pathogenic wind(祛風), soothe the nerves(安神), dispel pathogenic heat from lung, nourish the blood(淸肺養血).

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Intra-operative Neurological Monitoring and Anesthesia

  • Park, Sang-Ku;Lim, Sung-Hyuk;Park, Chan-Woo;Park, Jin-Woo;Kim, Dong-Jun;Kang, Ji-Hyuk;Jee, Hyo-Geun;Kim, Gi-Bong
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.4
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    • pp.184-198
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    • 2012
  • The purpose of intra-operative neurological monitoring (INM) is to minimize surgically induced nerve damage, sensory nerves and motor neurons without affecting the operations to proceed during surgery such as evoked potentials (EP), electromyography (EMG), electroencephalography (EEG), transcranial doppler (TCD), etc. During the course of checking a patient's condition, surveillance of ambulatory patients is a very different thing to check if the test is done under general anesthesia. INM can be possible or impossible depending on the type of drugs used and their concentrations because the monitoring is performed under anesthesia. Therefore, it is emphasized on the necessity of reviewing anesthesia which influences on INM.

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Reconstruction of a Severely Crushed Leg with Interpositional Vessel Grafts and Latissimus Dorsi Flap

  • Park, Chan Woo;Kim, Youn Hwan;Hwang, Kyu Tae;Kim, Jeong Tae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.417-421
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    • 2012
  • We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

Temperature in Nerve Conduction and Electromyography (신경전도와 근전도검사에서의 체온)

  • Kim, Doo-Eung
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.125-134
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    • 2006
  • Among the various physiological factors that affect nerve conduction velocity (NCV), temperature is the most important. Because the influence of temperature is the most important source of error. It is known from animal experiments that conduction is eventually completely blocked at low temperatures, the myelinated A fibers being the first affected and the thin fibers of group C the last. Many studies showed that the NCV decreases linearly with lowering temperature within the physiological range. The distal motor latency increased by $0.2msec/^{\circ}C$ drop in temperature between $25^{\circ}C$and $35^{\circ}C$ in the median, ulnar and peroneal nerves. The temperature affect the neuromuscular transmission; The miniature endplate potential (MEPP) and endplate potential (EPP) are increase with increasing temperature. In myasthenia gravis, the reduction in the decremental response is observed following cooling. The lowering temperature make increase the amplitude of sensory compound action potential; make enlarge the surface area of compound muscle action potential with very little increase in amplitude; make diminish the fibrillation potential and increase the myotonia in needle electromyography (EMG). Because of these findings mentioned above, the skin temperature should be routinely monitored and controlled during nerve conduction tests and needle EMG and should be taken into account when interpreting the findings.

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