Journal of Yeungnam Medical Science

Wook Nyeon Kim

4 Articles

Diagnostic Sensitivity of Several Muscles in Repetitive Nerve Stimulation Test for Myasthenia Gravis.: Hyun Jic Kim, Sung Hwan Lim, Seung Yeop Lee, Jung Sang Hah, Wook Nyeon Kim; Yeungnam Univ J Med. 2001;18(2):277-286. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.277

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Abstract PDF: BACKGROUND
This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. MATERIALS AND METHODS: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. RESULTS: The significant electrodecremental response of RNST were noted in orbicularis oculi (58.9%), nasalis (51.3%), flexor carpi ulnaris (42%), anconeus (41%) and abductor digiti quinti muscles (27%). Among the 3 muscles of upper extremity (abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles (p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. CONCLUSION: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

Comparison of the Repetitive Nerve Stimulation Test(RNST) Findings Between in Upper and Lower Extremity Muscles in Myasthenia Gravis.: Yun Seuk Jung, Jun Lee, Se Jin Lee, Jung Sang Hah, Wook Nyeon Kim; Yeungnam Univ J Med. 2000;17(2):129-136. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.129

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Abstract PDF: BACKGROUND
AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.

A Case of Idiopathic Hypoparathyroidism with Extensive Intracranial Calcification.: Wook Nyeon Kim, Jung Sang Hah; Yeungnam Univ J Med. 1997;14(1):220-226. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.220

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Abstract PDF: Idiopathic hypoparathyroidism is frequeutly associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a care of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit D3 therapy.

Significance of Dexamethasone Suppression Test in Patients with Stroke.: Wook Nyeon Kim, Seong Min Kim, Byung Soo Kee, Mee Yeong Park, Jung Sang Hah, Yeung Ju Byun; Yeungnam Univ J Med. 1994;11(1):63-71. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.63

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Abstract PDF: The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. There tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control (p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results (p<0.01). 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Significantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

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