1.Comparison of Amplitude to Area of Compound Muscle Action Potentials after Peripheral Nerve Injury.
Chulho YOON ; Heesuk SHIN ; Eunsinn LEE ; Youngsik JEONG ; Namhoon KANG
Journal of the Korean Academy of Rehabilitation Medicine 1997;21(5):920-927
The evaluation of peripheral nerve disorders has traditionally relied on clinical history, physical examination, and electrodiagnostic studies. The electrodiagnostic study is currently most popular procedure. The purpose of this study is to assess the significance of the changes of amplitude and area of compound muscle action potentials(CMAPs) in peripheral nerve injury. After compression of sciatic nerve in 65 Korean house rabbits, the amplitude and the area of CMAPs were compared to each other before and after compression injury. The correlation coefficients between the changes of the parameters, amplitude and area, were obtained at a scheduled interval, and the parameters were also assessed when the evidence of denervation and regeneration was seen. In addition, the relationship between the degree of abonormal spontaneous activities and each parameter was assessed. At preinjury state, there was a significantly high correlationship between two parameters. The correlation coefficients were 0.764 and 0.756 with distal and proximal stimulations respectively in abductor hallucis recordings, and 0.649 in gastrocnemius recording. At postinjury, there was more significant high correlationship between two parameters. The correlation coefficients were 0.955 and 0.962 with distal and proximal stimulations respectively in abductor hallucis recordings, and 0.930 in gastrocnemius recording. Nineteen cases showed denervation activities at postinjury 4th day. Of those cases, the amplitude was decreased earlier in 2 cases and the area in 3 cases at the same day. Of 10 cases regenerated, the amplitude was normalized earlier than the area in 2 cases. There was a significant decrement tendency in both amplitude and area with the degree of abnormal spontaneous activities. Therefore, both the amplitude and the area of CMAPs are good quantitative indices of peripheral neuropathy and useful parameters in long-term follow up study.
Action Potentials*
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Denervation
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Follow-Up Studies
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Peripheral Nerve Injuries*
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Peripheral Nerves*
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Peripheral Nervous System Diseases
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Physical Examination
;
Rabbits
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Regeneration
;
Sciatic Nerve
2.Facial Nerve Conduction Study in Cured Leprosy Patients.
Heesuk SHIN ; Chulho YOON ; Eunsinn LEE ; Youngsik JEONG ; Namhoon KANG ; Jongchul KIM
Journal of the Korean Academy of Rehabilitation Medicine 1997;21(3):565-571
Leprosy is an infectious disease caused by Mycobacterium leprae and characterized by dermal and peripheral nerve lesions. The facial nerve is also frequently involved in leprosy. There are a few electrophysiologic studies on the facial nerve involvement in leprosy patients, but there is no electrophysiologic study on the facial nerve involvement in cured leprosy patitents. So we performed facial nerve conduction study and Blink reflex study in 19 cured leprosy patients who have been managed with Dapsone for a long time. Facial motor latencies were prolonged in 11 patients(57.9%).: 10 of 15 patients in lepromatous type; 1 of 4 patients in tuberculoid type. Prolonged latencies were shown in temporal branch, zygomatic branch, buccal branch, and mandibular branch in 9(47.4%), 6(31.6%), 5(26.3%), and 3(15.8%), respectively. Blink reflex study suggests combined facial nerve and trigeminal nerve lesion in 2 patients.
Blinking
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Communicable Diseases
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Dapsone
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Facial Nerve*
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Humans
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Leprosy*
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Mycobacterium leprae
;
Peripheral Nerves
;
Trigeminal Nerve
3.A Quantitative Comparison of the Vertebral Artery and Transverse Foramen Using CT Angiography.
Chulho KIM ; Seung Hoon LEE ; Sang Soon PARK ; Beom Joon KIM ; Wi Sun RYU ; Chi Kyung KIM ; Mi Young OH ; Jong Won CHUNG ; Byung Woo YOON
Journal of Clinical Neurology 2012;8(4):259-264
BACKGROUND AND PURPOSE: The vertebral artery (VA) is important for the development of the transverse foramen (TF). Most studies of these structures have focused on anatomical anomalies. Therefore, we investigated quantitatively the association between the relative sizes of the TF and VA. METHODS: We recruited a consecutive series of subjects who underwent CT angiography to estimate the relative sizes of the VA and TF in axial source images. Two neurologists independently reviewed the axial CT images of 208 patients who had no history of transient ischemic attack or stroke. Averaged areas of the VA and TF were defined by the sum of the areas at each level from C3 to C6, divided by 4. Correlation analyses were adjusted for age, sex, and vascular risk factors. RESULTS: The mean age of the subjects was 53 years. The interobserver and intraobserver reliabilities of TF size were good. There was a linear relationship between the sizes of the VA and TF on each side (right side: r2=0.58, p<0.001; left side: r2=0.62, p<0.001). The area of the VA was significantly associated with that of the TF after adjusting for vascular risk factors. CONCLUSIONS: The size of the VA is strongly and linearly correlated with the size of the TF. These findings suggest that measurement of the TF and VA with CT angiography is a reliable method for evaluating VA diseases, and may provide new insight into the differentiation between VA hypoplasia and atherosclerosis of the VA.
Angiography
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Atherosclerosis
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Humans
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Ischemic Attack, Transient
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Stroke
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Vertebral Artery
4.Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study
Minsik KONG ; Hongsik JO ; Chang Han LEE ; Se Woong CHUN ; Chulho YOON ; Heesuk SHIN
Annals of Rehabilitation Medicine 2018;42(1):137-144
OBJECTIVE: To evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT). METHODS: The 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (≥4 and <6 years), group 2 (≥6 and <8 years), and group 3 (≥8 and <10 years). Initial and follow-up FAAs were measured using 3D-CT. Mean changes in FAAs were calculated and compared. RESULTS: A total of 200 lower limbs of 100 children (48 males and 52 females, mean age of 6.1±1.6 years) were included. The mean follow-up period was 18.0±5.4 months. Average initial and follow-up FAA in children with intoeing gait was 31.1°±7.8° and 28.9°±8.2°, respectively. The initial FAA of group 1 was largest (33.5°±7.7°). Follow-up FAA of group 1 was significantly reduced to 28.7°±9.2° (p=0.000). FAA changes in groups 1, 2, and 3 were −6.5°±5.8°, −6.4°±5.1°, and −5.3°±4.0°, respectively. These changes of FAA were not significantly (p=0.355) different among the three age groups. However, FAA changes were higher (p=0.012) in females than those in males. In addition, FAA changes showed difference depending on initial FAA. When initial FAA was smaller than 30°, mean FAA change was −5.6°±4.9°. When initial FAA was more than 30°, mean FAA change was −6.8°±5.4° (p=0.019). CONCLUSION: FAA initial in children with intoeing gait was the greatest in age group 1 (4–6 years). This group also showed significant FAA decrease at follow-up. FAA changes were greater when the child was a female, younger, and had greater initial FAA.
Bone Anteversion
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Child
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Female
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Follow-Up Studies
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Gait
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Humans
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Imaging, Three-Dimensional
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Lower Extremity
;
Male
;
Retrospective Studies
5.2022 Update of the Korean Clinical Practice Guidelines for Stroke: Antithrombotic Therapy for Patients with Acute Ischemic Stroke or Transient Ischemic Attack
Hong-Kyun PARK ; Sang-Bae KO ; Keun-Hwa JUNG ; Min Uk JANG ; Dae-Hyun KIM ; Joon-Tae KIM ; Jay Chol CHOI ; Hye Seon JEONG ; Chulho KIM ; Ji Hoe HEO ; Joung-Ho RHA ; Sun U. KWON ; Jong S. KIM ; Byung-Chul LEE ; Hee-Joon BAE ; Byung-Woo YOON ; Keun-Sik HONG
Journal of Stroke 2022;24(1):166-175
Antithrombotic therapy is a cornerstone of acute ischemic stroke (AIS) management and secondary stroke prevention. Since the first version of the Korean Clinical Practice Guideline (CPG) for stroke was issued in 2009, significant progress has been made in antithrombotic therapy for patients with AIS, including dual antiplatelet therapy in acute minor ischemic stroke or high-risk transient ischemic stroke and early oral anticoagulation in AIS with atrial fibrillation. The evidence is widely accepted by stroke experts and has changed clinical practice. Accordingly, the CPG Committee of the Korean Stroke Society (KSS) decided to update the Korean Stroke CPG for antithrombotic therapy for AIS. The writing members of the CPG committee of the KSS reviewed recent evidence, including clinical trials and relevant literature, and revised recommendations. A total of 35 experts were invited from the KSS to reach a consensus on the revised recommendations. The current guideline update aims to assist healthcare providers in making well-informed decisions and improving the quality of acute stroke care. However, the ultimate treatment decision should be made using a holistic approach, considering the specific medical conditions of individual patients.