Cross-education Effects of Muscle Strength and Balance on Unilateral Isokinetic Exercise in Ankle

Purpose@#Unilateral strength training effects on contralateral sides have been demonstrated in previous studies for lower extremity exercise, upper extremity exercise, and unilateral surface electrical stimulation. This study was performed to investigate the effects of unilateral ankle training on muscle strength and the balance of contralateral lower extremity in healthy adults. @*Methods@#Thirty healthy subjects were randomized equally to a training or a control group. Those in the training group received unilateral ankle isokinetic strengthening training of the dominant leg (right side) for 4 weeks. Contralateral single-limb balance, including Anterio-Posterior Stability Index (APSI), Medio-Lateral Stability Index (MLSI) and Overall Stability Index (OSI), was assessed before and after intervention. @*Results@#Comparison of pre- and post-test data revealed significant improvements in ipsi- and contralateral ankle strengths, and significant improvement in contralateral single limb balance. @*Conclusion@#These results have practical implications because they demonstrate that unilateral ankle isokinetic exercise improves ankle muscle strength and balance ability of contralateral lower extremity.

Effect of Action Observation Training Using Y-Balance on Balance Capability in Young Adults

Purpose@#This study examined the effects of action-observation training using the Y-Balance on the balance ability of young adults. @*Methods@#Thirty-four healthy adults were randomized into an action-observation group (n=17) or a control group (n=17). All subjects performed the Y-Balance test before and after watching the video. The action observation group watched a video of someone performing a Y-Balance test, and the control group watched a video of scenery unrelated to the training. The subjects were measured through a Y-Balance test for both the length of the legs extended in three directions and the Y-balance composite score. @*Results@#A significant difference in the Y-balance composite score was observed between the two groups. A part of the direction of the extended leg in the action observation group was increased significantly (posteromedial direction of the right leg, posterolateral direction of the right leg, posteromedial direction of left leg) compared to the control group. @*Conclusion@#These results suggest that action observation training only could help improve balance.

Cross-education Effects of Muscle Strength and Balance on Unilateral Isokinetic Exercise in Ankle

Purpose@#Unilateral strength training effects on contralateral sides have been demonstrated in previous studies for lower extremity exercise, upper extremity exercise, and unilateral surface electrical stimulation. This study was performed to investigate the effects of unilateral ankle training on muscle strength and the balance of contralateral lower extremity in healthy adults. @*Methods@#Thirty healthy subjects were randomized equally to a training or a control group. Those in the training group received unilateral ankle isokinetic strengthening training of the dominant leg (right side) for 4 weeks. Contralateral single-limb balance, including Anterio-Posterior Stability Index (APSI), Medio-Lateral Stability Index (MLSI) and Overall Stability Index (OSI), was assessed before and after intervention. @*Results@#Comparison of pre- and post-test data revealed significant improvements in ipsi- and contralateral ankle strengths, and significant improvement in contralateral single limb balance. @*Conclusion@#These results have practical implications because they demonstrate that unilateral ankle isokinetic exercise improves ankle muscle strength and balance ability of contralateral lower extremity.

Effect of Action Observation Training Using Y-Balance on Balance Capability in Young Adults

Purpose@#This study examined the effects of action-observation training using the Y-Balance on the balance ability of young adults. @*Methods@#Thirty-four healthy adults were randomized into an action-observation group (n=17) or a control group (n=17). All subjects performed the Y-Balance test before and after watching the video. The action observation group watched a video of someone performing a Y-Balance test, and the control group watched a video of scenery unrelated to the training. The subjects were measured through a Y-Balance test for both the length of the legs extended in three directions and the Y-balance composite score. @*Results@#A significant difference in the Y-balance composite score was observed between the two groups. A part of the direction of the extended leg in the action observation group was increased significantly (posteromedial direction of the right leg, posterolateral direction of the right leg, posteromedial direction of left leg) compared to the control group. @*Conclusion@#These results suggest that action observation training only could help improve balance.

Relationship between Ipsilateral Motor Deficits on the Less-Affected Side and Motor Function Stage on the Affected Side

PURPOSE: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. METHODS: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. RESULTS: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. CONCLUSION: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

The Effect of Chair Backrest on Respiratory Function in Prolonged Sitting Position

PURPOSE: The purpose of this study was to determine the effects of a chair backrest on respiratory function after prolonged sitting. METHODS: Twenty-four young healthy subjects (12 males and 12 females) volunteered to participate in this study, and were equally allocated to a backrest (n=12) or a without backrest group (n=12). A spirometer was used to measure the respiratory functions of all subjects. RESULTS: The chair with backrest group were significant difference in forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) after sitting for 1 hour, compared with chair without backrest group (p < 0.05). The chair with backrest group showed a significantly decreased in FVC, FEV1, and PEF. CONCLUSION: Using a chair without a backrest may help to reduce lung function deterioration as compared with a chair with a backrest.

Effects of Exercise on Cervical Angle and Respiratory Function in Smartphone Users

OBJECTIVES: The aim of this study was to determine whether exercises can change the cervical angle and respiratory function in smartphone users. METHODS: Thirty healthy volunteers were recruited. The subjects were randomly divided into an exercise group and a control group. All participants used a smartphone for 1 hour while maintaining a sitting posture. Then, each group performed their assigned activity. The exercise group performed two types of exercises and the control group maintained routine activities for 20 minutes. To investigate the changes in cervical angle and respiratory function, we measured the craniovertebral angle by using a spirometer. RESULTS: Statistically significant differences were noted in the craniovertebral angle, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure of the two groups (p < 0.05). CONCLUSION: Our findings showed that proper exercise could be a good method of improving the cervical angle and respiratory function in smartphone users.

A Correlation Study on Pain, Range of Motion of Neck, Neck Disability Index and Grip Strength after Thoracic Manipulation and Cervical Stabilization Training in Chronic Neck Pain

PURPOSE: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. METHODS: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired ttest was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. RESULTS: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=−0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=−0.692, p<0.05). CONCLUSION: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.

Economic Burden and Epidemiology of Pneumonia in Korean Adults Aged over 50 Years

This study was performed to estimate the direct medical costs and epidemiology of pneumonia in adults of Korea. We conducted a multi-center, retrospective, observational study and collected data targeting for community-acquired pneumonia patients ( > or = 50 yr) from 11 hospitals. Costs attributable to the treatment of pneumonia were estimated by reviewing resource utilization and epidemiology data (distribution of pathogen, hospital length of stay, overall outcome) were also collected. A total 693 patients were included; average 70.1 ( +/- 10.5) aged, 57.3% male and average 1.16 CURB-65 (confusion, blood urea nitrogen, respiratory rate, blood pressure, age > 65 yr) scored. The pathogen was identified in the 32.9% (228 patients); Streptococcus pneumoniae accounted for 22.4% (51 patients) of identified pathogens. The hospital mortality was 3.2% (especially, for S. pneumoniae was 5.9%) and average length of stay was 9 days. The mean total cost for the treatment of pneumonia was US dollar (USD) 1,782 (SD: USD 1,501). Compared to the cost of all caused pneumonia, that of pneumococcal pneumonia was higher, USD 2,049 ( +/- USD 1,919), but not statistically significant. Charge of hospitalization accounted the greatest part of total medical costs. The economic burden of pneumonia was high in Korea, and the prevention of pneumonia should be considered as effective strategy.

A Case of Diffuse Alveolar Hemorrhage with Glomerulonephritis after Propylthiouracil Treatment / 결핵및호흡기질환

Propylthiouracil (PTU) is one of the most common drugs used in the treatment of Graves' disease. There are a number of side effects found with PTU use including fever, rash, arthralgia, and flu-like symptoms. Recently antineutrophil cytoplasmic antibodies (ANCA) positive vasculitis after PTU treatment was reported as a rare side effect, which can cause diffuse alveolar hemorrhage and glomerulonephritis. A 45-year-old woman with Graves' disease had been treated with PTU for five months, complained of hemoptysis due to pulmonary alveolar hemorrhage causing anemia, and also had hematuria. Simple chest X-ray and HRCT showed bilateral consolidation and bronchoalveolar lavage fluid revealed alveolar hemorrhage. A serologic test was positive for ANCA against myeloperoxidase and proteinase-3. Such findings suggested that the presence of PTU induced ANCA positive vasculitis. Cessation of PTU and the administration of high dose steroids improved the clinical manifestation, radiologic and serologic findings. We observed ANCA titer serially for 6 years. During the follow up period, ANCA titer decreased slowly and stayed within the acceptable upper normal limit.

A Case of Tracheal Leiomyoma Treated by Electrosurgical Resection Under Rigid Bronchoscopy / 대한내과학회지

Leiomyoma of the tracheobroncheal tree is a very rare benign tumor of the lung. Airway obstructive symptoms can be similar to those of asthma; therefore, delayed or misdiagnosis is common. Although surgical resection with bronchoplastic reconstruction has long been the standard treatment, improvements in the technique have led to therapeutic bronchoscopy replacing surgery for treatment of benign tumors of the tracheobroncheal tree. We report a case of tracheal leiomyoma that was successfully resected under rigid bronchoscopy using an electrosurgical unit and bronchial snare.

A Case of Tracheal Leiomyoma Treated by Electrosurgical Resection Under Rigid Bronchoscopy / 대한내과학회지

Leiomyoma of the tracheobroncheal tree is a very rare benign tumor of the lung. Airway obstructive symptoms can be similar to those of asthma; therefore, delayed or misdiagnosis is common. Although surgical resection with bronchoplastic reconstruction has long been the standard treatment, improvements in the technique have led to therapeutic bronchoscopy replacing surgery for treatment of benign tumors of the tracheobroncheal tree. We report a case of tracheal leiomyoma that was successfully resected under rigid bronchoscopy using an electrosurgical unit and bronchial snare.

A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation / 결핵및호흡기질환

Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

The Role of Ballooning in Patients with Post-tuberculosis Bronchial Stenosis / 결핵및호흡기질환

BACKGROUND: In order to access the role of ballooning in patients with post-tuberculosis bronchial stenosis (PTBS), medical records of patients who underwent the procedure were reviewed. METHODS: Twenty-nine PTBS patients underwent balloon dilatation between May 1999 and November 2000 at Samsung Medical Center. The median age was 28 (range 16~62 year) and most patients were female (n=27, 93%). The mean number of ballooning procedures was 2.4 (range 1~8) and the interval between ballooning procedures was 76.2+/-69.7 days. RESULTS: In general, the FEV1 was improved after ballooning (from 66.2.+/-11.9% predicted to 73.5+/-13.0% predicted, p=0.0004). Among 29 patients who underwent ballooning, a clinically successful outcome was observed in 16 patients (55%). Comparison between the successful and unsuccessful groups showed that favorable factors for a successful outcome were a higher pre-ballooning FEV1 (71.1+/-8.1 vs. 60.2+/-13.3% predicted), higher post-ballooning FEV1 (89.2+/-7.8 vs. 63.4+/-9.2% predicted) and absence of left upper lobe collapse. The clinical outcome was unsuccessful in all eight patients with a pre-ballooning FEV1 57% of predicted and there is no complete left upper lobe lung collapse.

A Case of Idiopathic Pulmonary Alveolar Proteinosis Treated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) after Partial Response to Whole Lung Lavage / 결핵및호흡기질환

Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by surfactant component accumulation in the alveolar space. Idiopathic PAP has recently been recognized as a autoimmune disease of impaired alveolar macrophage function caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). While whole lung lavage has been the standard treatment, not every patient shows a complete response. Subcutaneous injection or inhalation of GM-CSF is another promising treatment option for PAP. A 45-year-old patient visited our hospital for dyspnea, he was diagnosed as PAP and underwent whole lung lavage. Eighteen months later, the patient had not achieved complete remission in despite of initial response. After then he was administered with GM-CSF (5 microgram/kg/day, subcutaneous injection) for fivetimes a week during 2 months. Nine months later, the abnormal shadows in high-resolution computed tomography (HRCT) decreased and the patient fully recovered in forced vital capacity. After 60 months, the HRCT scan showed complete remission of PAP.

Removal of Sawdust Aspiration and Anesthetic Management: A case report / 대한마취과학회지

The aspiration of a tracheobronchial foreign body can be a life-threatening incident. Early diagnosis and the bronchoscopic removal of the foreign bodies can protect a patient from serious morbidity and even mortality. We report an unusual case of a 28-year-old man who inhaled sawdust that required emergency airway management and bronchoscopic removal of the sawdust fragments. Anesthesia for a rigid bronchoscopy is a challenging procedure for an anesthesiologist who must share the airway with the bronchoscopist and maintain the adequate depth of anesthesia. Most of the sawdust fragments were extracted successfully using a rigid bronchoscope. The patient was discharged uneventfully within one week of hospitalization.

A Case of Primary Endobronchial Leiomyosarcoma Noticed by Massive Hemoptysis / 결핵및호흡기질환

A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

A 45-year-old male patient with complaint of dyspnea on exertion / 대한내과학회지

No abstract available.

A Case of Anticonvulsant Hypersensitivity Syndrome with Subcarinal Lymph node Enlargement and Eosinophilic Pneumonia Induced by Carbamazepine / 결핵및호흡기질환

Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.

A Case of Acute Respiratory Distress Syndrome Induced by Injection of Silicone Fluid for Colpoplasty / 결핵및호흡기질환

Acute respiratory distress syndrome after silicone fluid injection is uncommon. Reasons that organic silicone is inactive in the human body and has low surface tension and is not affected by physical factors such as time or temperature make this material to be widely used as a medical product. However, lately some of its side effects have been noted and also cause respiratory problems in rare occasions. The mechanism is not clear but silicone injection cause one to cough, produce hemoptysis, fever, pleuritic chest pain, and dyspnea, and may even lead to acute respiratory failure. In other countries, these side effects were reported from 1970s and several cases started to appear in Korea from 1990s. We report a 58 years-old female who recovered from acute respiratory distress syndrome after injection of silicone fluid into vaginal wall by a conservative therapy.