Repeated Local Injection of Triamcinolone Acetonide in Carpal Tunnel Syndrome

OBJECTIVE: The effect of the local steroid injection for the carpal tunnel syndrome (CTS) is well known, but there have been a few report of electrophysiologic evaluation for the effect of the local steroid injection. So this study was done to reveal the effect of local injection with triamcinolone acetonide (TA) into the carpal tunnel using the electrophysiologic changes and the improvement in symptoms. METHOD: The triamcinolone acetonide (40 mg/ml) was injected to 43 patients (70 wrists) with the CTS diagnosed clinically and electrophysiologically. And the patients were reevaluated with the visual analogue scale and the electrophysiologic study every month. The mean duration of follow-up was 6 months, and the mean number of the injection was two times. RESULTS: The improvement of symptoms was noted in 90% of the cases, and most of the electrophysiologic parameters revealed significant improvement after the local injection of TA. The number of injection did not correlate with the visual analogue scale and the electrophysiologic parameters. CONCLUSION: The local injection of TA into the carpal tunnel in the patients with CTS may be an effective therapeutic modality to improve the symptoms and the electrophysiologic parameters.

Visual Evoked Potential in Preterm Infants

OBJECTIVE: The maturation in the central nervous system and the myelination of visual pathway were shown to be reflected by the visual evoked potential (VEP) response recordings. The purpose of this study was to establish normal value of flash visual evoked potentials in preterm infants, especially left to right difference. METHOD: Forty-one preterm infants from 31 to 40 weeks of corrected age had been made VEP records using Cadwell Excel EMG/EP system. Some in whom weekly VEP records had been made at least 3 times were included in longitudinal study and others in occasionally VEP records were included in cross-sectional study. Infants with neurological problems or anomalies, perinatal infectious and other severe systemic disease were excluded. RESULTS: 1) In the VEP study, we were able to establish the reference ranges for N300 peak latency at various corrected ages. 2) The latency of N300 peak latency was not significantly correlated with birth weight, sex, head circumference. 3) The latency of N300 peak decrease linearly, the age increased and also the decrement of N300 peak latency was accelerated at 37 weeks of gestational ages. CONCLUSION: Although VEPs from preterm infants have several peaks, N300 latency is the most prominent and the most reproducible. It has been considered the most important component of the preterm VEPs.

Quality of Semen after Repeated Ejaculation Treatment in Spinal Cord Injured Men

OBJECTIVE: The study was designed to document the effects of regular drainage after penile vibrator stimulation on the quality of semen in spinal cord injured (SCI) men. METHOD: Three tetraplegics and eight paraplegics, aging from 20 to 39 years with neurological levels of C7 to L4 were examined between 1 and 11 years after injury (mean; 4 years 11 months). None had ejaculated after the injury. Eleven responders to penile vibrator stimulation (PVS) were prospectively examined. We used a vibrator (POWER MASSAGER ) with a frequency of 100 Hz and an amplitude of about 2.0 mm. Stimulations were performed mostly 2~3 times per week. Semen quality was characterized by semen analysis every visits. We compared baseline values with the values of post-treatment 1~3 months. RESULTS: The percentage of motile sperm and the total count of motile sperm per ejaculate were low but increased substantially with treatment. CONCLUSION: We concluded that repeated ejaculation treatment, for at least 1 month, using the vibrator technique improves semen quality in SCI men who have not ejaculated earlier after injury.