| Jee-Eun Kim | 8 Articles |
Background
There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0–81.4%; specificity, 10.3–53.4%), diabetic neuropathy (PPV, 55.0–81.3%; specificity, 66.7–76.7%) and diabetic retinopathy (PPV, 77.0–96.6%; specificity, 2.2–89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications. Citations Citations to this article as recorded by
Electrodiagnostic studies such as nerve conduction studies (NCS) and needle electromyography (EMG) provide important and complementary information for evaluating patients with suspected neuromuscular disorders. NCS and needle EMG are reasonably safe diagnostic investigations and are generally associated with only mild transient discomfort when performed by experienced physicians. However, there is the risk of complications in some patients, because NCS involve the administration of electric current and EMG involves inserting a needle percutaneously into muscle tissue. This article reviews the potential risks of NCS and needle EMG.
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Nerve conduction study (NCS) is an electrophysiological tool to assess the overall function of cranial and peripheral nervous system, therefore NCS has been diagnostically helpful in the identification and characterization of disorders involving nerve roots, peripheral nerves, muscle and neuromuscular junction, and are frequently accompanied by a needle Electromyography. Furthermore, NCS could provide valuable quantitative and qualitative results into neuromuscular function. Usually, motor, sensory, or mixed nerve studies can be performed with using NCS, stimulating the nerves with the recording electrodes placed over a distal muscle, a cutaneous sensory nerve, or the entire mixed nerve, respectively. And these findings of motor, sensory, and mixed nerve studies often show different and distinct patterns of specific abnormalities indicating the neuromuscular disorders. The purpose of this special article is to review the neurophysiologic usefulness of NCS, to outline the technical factors associated with the performance of NCS, and to demonstrate characteristic NCS changes in the setting of various neuromuscular conditions.
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Background
Somatosensory evoked potentials are the electrical potentials generated in sensory pathways at peripheral, spinal, subcortical and cortical levels of the nervous system. Such electrical potential is frequently used to evaluate myelopathy. This study aims to determine the utility of initial posterior tibial somatosensory evoked potential (PTSEP) as a prognostic factor associated with the development of severe diving-related spinal cord decompression sickness (DCS). Methods: In order to conduct the study, 68 injured divers presenting the symptoms of spinal cord DCS from Seoul Medical Center were included in the study. The patients were divided into two groups normal PTSEP group (n=34) and abnormal PTSEP group (n=34). Diving information, time interval between symptom onset and hyperbaric treatment were studied and analyzed accordingly. The initial severity of spinal cord DCS were then rated using the Boussuges severity score and muscle power examination. The presence of sequelae was evaluated at 2 weeks. Initial recompression treatment at2.8-4 ATA (atmospheres absolute) with 100% oxygen breathing or deeper recompression. Results: Analysis of the results showed that there were no significant differences between each group in age, diving experience, depth of dive, bottom time of dive, onset to treatment, Boussuges’s score and the grade of motor power before the treatment. Marked motor power improvements were noticed in initial normal PTSEP group (70.6%) than abnormal group (29.4%). There were significant differences in degrees of motor power improvement between two groups (p=0.003). Conclusions: Initial PTSEP can be a useful prognostic factor in spinal type DCS.
Ataxia is symptomatic terminology that describes incoordination or loss of balance. This common neurological symptom can arise from various diseases as cerebellar, sensory or vestibular disorders. Differentiating sensory ataxia from cerebellar ataxia is still challenging in many clinical situations. Here, we describe clinical characteristics of sensory ataxia that help clinician distinguish sensory ataxia from cerebellar ataxia. We introduce specific diseases that involve peripheral nerve, dorsal root/ganglia or posterior column to cause sensory ataxia and suggest diagnostic approach in ataxic patients.
The most common neurological complication of varicella-zoster infection is dermatomal distributed pain after resolution of typical skin eruption. Thoracic dermatomes are most frequent site for skin eruption and postherpetic neuralgia, though motor complications in this area are extremely rare. Here, we present one patient who suffered right abdominal bulging mimicking an abdominal herniation as a result from radiculopathy cause by varicella-zoster infections.
There are several diseases that primarily involve motor neuron system and mimics amyotrophic lateral sclerosis. Even though they share several common features of lower motor neuron or/and upper motor neuron signs with amyotrophic lateral sclerosis, they have specific feature in clinical, electrophysiologic, laboratory and pathologic characteristics that can be differentiate from amyotrophic lateral sclerosis. Understanding the entity of atypical motor neuron diseases and clinical clue to differentiate amyotrophic lateral sclerosis from atypical motor neuron disease is important to support the early diagnosis of amyotrophic lateral sclerosis and to prevent misdiagnose a treatable or more benign disease as an amyotrophic lateral sclerosis.
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