The evaluation of peripheral nerve disorders has traditionally relied on clinical history, physical examination and electrodiagnostic studies. The electrodiagnostic study is currently the most popular procedure to analyse the nerve lesion, but it is painful and its result is operator dependent. The purpose of this study is to evaluate the significance of MRI signal change of denervated muscle in peripheral nerve as an adjuvant study of electrodiagnostic study. After the compression of sciatic nerves in 20 rabbits and severance of scitic nerve in 10 rabbits, the signal change of both T1WI(TR; 450 msec, TE; 15 msec) and T2WI(TR; 3,000 msec TE; 90 msec) of calf muscles were compared with EMG findings of the same muscles. Signal intensity ratio(SIR) of calf muscles was measured and compaired with the grade of abnormal spontaneous activity in the same muscles in needle EMG study. Serial studies were done on 4th day, 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks after sciatic nerve injury. Among 25 rabbits showing abnormal spontaneous activity in needle EMG, the signal intensity of both T1WI and T2WI was increased in 13 rabbits. The signal intensity began to increase at 1 week in 10 rabbits and 2 weeks in 3 rabbits following nerve injury which was about 1 week later than appearance of abnormal spontaneous activity in needle EMG study. There were no signal intensity increase in rabbits which showed no abnormal spontaneous activity in needle EMG study. The signal intensity ratio and grade of abnormal spontaneous activity had a good correlation(Spearman's correlation coefficiency : 0.635). The signal intensity of 3 rabbits which showed regeneration evidence in needle EMG study returned to normal. These findings suggest that MRI study of denervated muscle can be used as an evaluation method for severe peripheral nerve injury, howeverits value is doubtful in mild peripheral nerve injury.
Magnetic Resonance Imaging* ; Muscles ; Needles ; Peripheral Nerve Injuries ; Peripheral Nerves ; Physical Examination ; Rabbits ; Regeneration ; Sciatic Nerve*

PURPOSE: This study investigated visual acuity (VA) values and differences depending on optical coherence tomography (OCT) findings in patients with acute central retinal artery occlusion (CRAO). METHODS: A retrospective chart review was performed on patients with acute CRAO who underwent macular and disc OCT. We evaluated changes in macular thickness and retinal nerve fiber layer (RNFL) thickness after acute CRAO onset based on OCT. We also determined the association of thickness changes with VA improvement. RESULTS: This study involved both eyes in a total of 12 patients with acute CRAO. A significant increase was observed in foveal (1 mm) thickness (p = 0.002), parafoveal (3 mm) thickness (p = 0.002), and peripapillary RNFL thickness (p = 0.005) in affected eyes with CRAO, but not in central foveal thickness (p = 0.266). A significant small difference in both eyes (affected eye – fellow eye) was shown in foveal (1 mm) and mean parafoveal (3 mm) thickness in the improved VA group (p = 0.008 and p = 0.004, respectively), but not in central foveal or peripapillary RNFL thickness (both p = 0.283). CONCLUSIONS: Both macular and RNFL thickness increased in patients with acute CRAO. RNFL thickness decreased over time with progression of RNFL atrophy. Less macular damage caused by acute CRAO could be predicted by a small difference in macular thickness between eyes (affected eye – fellow eye). In such cases, patients had a greater chance of VA improvement.
Atrophy ; Humans ; Nerve Fibers ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence* ; Visual Acuity

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 ; Communicable Diseases ; Dapsone ; Facial Nerve* ; Humans ; Leprosy* ; Mycobacterium leprae ; Peripheral Nerves ; Trigeminal Nerve

PURPOSE: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. METHODS: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. RESULTS: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. CONCLUSIONS: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.
Animals ; Bone Regeneration ; Calcium ; Fibroblast Growth Factor 2 ; Hyaluronic Acid ; Hyperbaric Oxygenation ; Membranes ; Osteogenesis ; Oxygen ; Parietal Bone ; Radiotherapy ; Rats ; Skull ; Transplants

Objective: To investigate long-term changes in femoral anteversion angle (FAA) in children with intoeing gait and to identify factors that affect FAA changes. Methods: We retrospectively analyzed three-dimensional computed tomography data from 2006 to 2022 of children with intoeing gait with ≥3 years of follow-up without active treatment. The study examined the mean changes in FAA, the effects of sex, age, and initial FAA on FAA change, and mean FAAs by age. Changes in FAA severity up to eight years of age were also observed and analyzed by sex. Results: A total of 126 lower limbs of 63 children (30 males, 33 females) with intoeing gait were included, with a mean age of 5.11±1.05 years and a mean follow-up period of 43.59±7.74 months. The initial FAA was 41.42°±8.29° and the follow-up FAA was 33.25°±9.19°, indicating a significant decrease (p<0.001). Significant correlations were observed between age and changes in FAA, as well as between initial FAA and changes in FAA (r=0.248, p=0.005; r=-0.333, p<0.001). At age 8 years, only 22 limbs were classified as having mild FAA severity. Conclusion During the follow-up period, children with intoeing gait had a significant decreased in FAA. No significant difference in FAA change was found between sex, but younger children and those with greater initial FAA were more likely to have decreased FAA. However, most children retained moderate to severe severity of increased FAA. Further studies are required to validate these findings.

PURPOSE: This study aimed to investigate the diagnosis and severity of patients who were referred to tertiary medical centers according to the type and function of the referral hospitals. METHODS: First-visit patients referred from July 2015 to June 2016 were retrospectively reviewed with regard to referral hospital, final diagnosis, treatment necessity, and medical fees for the six months after their first hospital visit. Based on these data, differences in type and function of medical institution were examined. RESULTS: In a comparison of hospitals according to their number of beds, clinics, hospitals and, tertiary hospitals had no differences in the ratio of patients who needed treatment (p = 0.075) and their medical fees over six months (p = 0.372). When hospitals were classified by functional capability in terms of doctors' medical specialty, increasing ratios of patients requiring medical treatment (p < 0.001) and medical fees for six months (p < 0.001) were found in the order of non-eye specialists, eye specialists, and eye specialists in trainee hospital. CONCLUSIONS: Efficient healthcare delivery systems should classify medical institutions by functionality capability based on medical specialties rather than hospital size according to the number of beds.
Delivery of Health Care ; Diagnosis ; Fees, Medical ; Health Facility Size ; Humans ; Ophthalmology* ; Referral and Consultation* ; Retrospective Studies ; Specialization ; Tertiary Care Centers ; Tertiary Healthcare

OBJECTIVE: To examine the intra-rater, inter-rater, and inter-instrumental reliability of the digitalized pinch muscle strength dynamometer. METHOD: Thirty normal subjects were examined for pinch strength, using both the Preston pinch gauge and the digitalized pinch dynamometer. The participants performed all pinch strength tests in the seated position as recommended by the American Society of Hand Therapists (ASHT). Three successive measurements were taken for each hand. The mean of the three trials was used for data analysis. The pinch strength tests performed used a repeated measure design and measurements were taken by each rater. RESULTS: The relationship between the Preston pinch gauge and the digitalized pinch dynamometer in pinch strength was reliable (the ICC were 0.821 and 0.785 in rater 1 and rater 2 respectively). The relationship between the first session and second session in pinch strength using the digitalized pinch dynamometer was reliable (the ICC were 0.872 and 0.886 in rater A and rater B respectively). The relationship between rater A and rater B in pinch strength using the digitalized pinch dynamometer was reliable (the ICC was 0.754). CONCLUSION: The pinch strength measurement using the digitalized pinch dynamometer is reliable within the rater and between raters. Thus, the Preston pinch gauge and the digitalized dynamometer measure grip strength equivalently, and can be used interchangeably.
Hand ; Hand Strength ; Muscle Strength ; Muscle Strength Dynamometer ; Pinch Strength ; Statistics as Topic

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.