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To evaluate the effects of early regular exercise and to assess the electrophysiological and histopathological findings of the rat tail nerve in relation to the timing of exercise training for swimming exercise in rats with diabetic neuropathy.
We used 70 Sprague-Dawley male rats, and the experimental group comprised 60 rats, and the control group comprised 10 rats. Diabetes was induced by intraperitoneal injection of streptozotocin. Blood glucose concentrations were measured in tail vein blood samples. The experimental group was divided into 6 subgroups according to insulin treatment and swimming exercise: group 1, diabetic control; group 2, insulin treated; group 3, insulin untreated with early swimming exercise; group 4, insulin treated and early swimming exercise; group 5, insulin treated and late swimming exercise; and group 6, insulin untreated with late swimming exercise. Sensory and motor nerve conduction studies were performed weekly up to the 13th week using rat tail nerves. The effect on structural diabetic neuropathy was assessed by morphometry and ultrastructural examination of the rat tail nerve fiber at the 14th week.
An exercise effect was observed in the insulin treated groups, but it was not observed in the insulin untreated groups. The sensory nerve conduction study in the rat tail revealed significantly prolonged latency and decreased amplitude in groups 1 and 6, and a further delay was observed in group 5 when compared to group 4. Decreased thickness of myelin was found in groups 1 and 6 through morphometry.
Early regular exercise programs in addition to conventional insulin treatment may retard the progression of diabetic peripheral neuropathy.
Citations
To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes.
A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by an electrodiagnostic study, participated in this study. US-guided injection into the cubital tunnel was performed with 40 mg triamcinolone and 2 mL of 1% lidocaine. Outcomes of the injections were evaluated at pre-injection, 1st week and 4th week after injection. Visual analog scale, self-administered questionnaire of the ulnar neuropathy at the elbow (SQUNE), and McGowan classification were used for clinical evaluation. Cross-sectional area of the ulnar nerve by US and the electrophysiological severity scale through a nerve conduction study were utilized in the evaluation of morphologic and electrophysiological changes. The cross-sectional area of the ulnar nerve was measured at 3 points of condylar, proximal, and distal level of the cubital tunnel.
No side effects were reported during the study period. The visual analog scale and cross-sectional area showed a significant decrease at 1st week and 4th week, as compared to baseline (p<0.05). The electrophysiological severity scale was significantly decreased at the 4th week, as compared with baseline and 1st week (p<0.05). Among the quantitative components of the scale, there were statistically significant improvements with respect to the conduction velocity and block.
The new approach of US-guided injection may be a safe tool for the treatment of CuTS. Symptomatic and morphologic recoveries preceded the electrophysiological improvement.
Citations
To determine an ideal stimulation site of the medial antebrachial cutaneous nerve (MACN) using ultrasound measurement and to compare the efficiency of the new stimulation site with the conventional stimulation site on the nerve conduction study.
Both arms of 15 healthy participants were measured using ultrasound. The MACN was identified in the transverse view at each 0, 2, 4, 6, and 8 cm proximal sites from the medial epicondyle, and the distances to the median nerve and to the skin from the MACN were measured. The ideal stimulation site should be located at the level which can give the shortest distance from the skin and the longest distance from the median nerve in terms of volume conduction. To confirm the efficiency of the ideal site, we measured the amplitude of the MACN conduction study at the ideal site against one at the 4 cm proximal to the medial epicondyle (conventional site).
The ultrasound showed the ideal stimulation site for the MACN could be the elbow crease line. However, the nerve conduction study revealed that the amplitudes of the MACN were significantly larger at the 4 cm proximal to the medial epicondyle compared with ones at the ideal site.
The ideal stimulation site based on the ultrasound did not permit better stimulation site for the nerve conduction study of the MACN compared with the conventional site. Careful adjustment of the stimulation site on the basis of this study would contribute to an accurate conduction study of the MACN.
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