Effect of Ultrasound-Guided Perineural Injection with Dextrose for Direct Traumatic Injury of Median Nerve

Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

Architectural Changes in the Medial Gastrocnemius on Sonography after Nerve Ablation in Healthy Adults

Architectural changes in healthy muscle after denervation have not yet been reported. This study aimed to investigate architectural changes in the medial head of the gastrocnemius muscle (GCM) after aesthetic tibial nerve ablation in healthy adults using ultrasonography (US). The effects of tibial nerve ablation were verified by visual observation and surface electromyography analysis. US images of medial GCMs were taken by one trained physician using B-mode and real-time US with a linear-array probe before nerve ablation, at 1 week after nerve ablation and at 3 months after nerve ablation in an anatomic standing position with the feet about shoulder-width apart in 19 healthy adults (17 females and 2 males). Muscle thickness was significantly reduced on the left side at 1 week and 3 months after the procedure and on the right side at 3 months after the procedure (p<0.050). Although fascicle length was not significantly changed, pennation angle was significantly reduced on both sides at 3 months after the procedure (p<0.050). Muscle thickness and pennation angle of the muscle fascicle were significantly reduced, although fascicle length was not significantly changed, after tibial nerve ablation in the medial GCM of healthy adults.

Lifestyles and Cardiovascular Factors of Diabetic Patients / 임상당뇨병

BACKGROUND: There are many studies on lifestyle management of diabetic patients, but few provide sufficient data comparing a diabetic group with an abnormal fasting glucose group and a normal, non-diabetic group. In this study, we compare the lifestyle management of diabetic patients with those of others groups. METHODS: Among patients visiting the health promotion center of a single university hospital, we retrospectively collected medical records and survey responses regarding patient information. RESULTS: No difference was found in smoking status or smoking intake among the three groups. Alcohol consumption was high in the diabetes group, followed by the abnormal fasting glucose group and the normal group. The diabetes group reported a higher frequency of exercise per week than the normal group. With regard to systolic BP, both the diabetes and abnormal fasting glucose groups were higher than the normal group, with a level greater than the therapeutic goal of 130 mmHg. Both the diabetes group and the abnormal fasting glucose group had a higher triglyceride level than the normal group, with a measure greater than the therapeutic goal of 150 mg/d. The diabetes group had a higher highly sensitive C-reactive protein level than other two groups, with a level greater than 1 mg/dL. CONCLUSION: Management of smoking and alcohol consumption is not sufficient in diabetes patients, suggesting the need for tighter control of BP and triglyceride level in such individuals. For these patients, follow-up of highly sensitive C-reactive protein level should also be considered.