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1.
Article in English | WPRIM | ID: wpr-899881

ABSTRACT

Background@#Pediatric sedation in the emergency department (ED) is widely performed in Korea; thus exploring the trends of its use is necessary. This study aimed to investigate the characteristics of patients and sedatives use in the ED and verify their changes over recent years. @*Methods@#A nationwide population-based retrospective study was conducted including pediatric patients aged ≤ 15 years who received sedative medication in the ED and were discharged during 2007–2018, using the Korean Health Insurance Review and Assessment Service database. Patient characteristics (age, sex, level of ED, and diagnosis) and type of sedative used were analyzed. @*Results@#Sedation was performed in total 468,221 visits during 2007–2018 (399,320 visits, at least 3.8% of overall ED visits during 2009–2018). Among these, 71.0% were children aged 1–3 years and 93.5% were sedated to support diagnosis of injury. An increase in total sedation was observed in patients aged 4–6 years during the study period (from 13.8% to 21.8%). A gradual decrease in the use of chloral hydrate (CH) compared with an increase in ketamine use was observed (CH, from 70.6% to 28.6%; ketamine, from 23.8% to 60.7%). Therefore, ketamine was the most used sedative since 2014. The most frequently used sedatives over the study period differed according to age groups (CH in <1 year and 1–3 years; ketamine in 4–6 years and 7–10 years; and midazolam in 11–15 years). @*Conclusions@#The characteristics of patients related to sedatives use in the ED have changed over time. These changes should be considered in the development of future Korean guidelines regarding pediatric sedation in the ED.

2.
Article in English | WPRIM | ID: wpr-892177

ABSTRACT

Background@#Pediatric sedation in the emergency department (ED) is widely performed in Korea; thus exploring the trends of its use is necessary. This study aimed to investigate the characteristics of patients and sedatives use in the ED and verify their changes over recent years. @*Methods@#A nationwide population-based retrospective study was conducted including pediatric patients aged ≤ 15 years who received sedative medication in the ED and were discharged during 2007–2018, using the Korean Health Insurance Review and Assessment Service database. Patient characteristics (age, sex, level of ED, and diagnosis) and type of sedative used were analyzed. @*Results@#Sedation was performed in total 468,221 visits during 2007–2018 (399,320 visits, at least 3.8% of overall ED visits during 2009–2018). Among these, 71.0% were children aged 1–3 years and 93.5% were sedated to support diagnosis of injury. An increase in total sedation was observed in patients aged 4–6 years during the study period (from 13.8% to 21.8%). A gradual decrease in the use of chloral hydrate (CH) compared with an increase in ketamine use was observed (CH, from 70.6% to 28.6%; ketamine, from 23.8% to 60.7%). Therefore, ketamine was the most used sedative since 2014. The most frequently used sedatives over the study period differed according to age groups (CH in <1 year and 1–3 years; ketamine in 4–6 years and 7–10 years; and midazolam in 11–15 years). @*Conclusions@#The characteristics of patients related to sedatives use in the ED have changed over time. These changes should be considered in the development of future Korean guidelines regarding pediatric sedation in the ED.

3.
Article in Korean | WPRIM | ID: wpr-918675

ABSTRACT

Button battery ingestion requires emergency endoscopic removal since severe complications, such as esophageal perforation, can develop within 4 hours of the ingestion. Given that guardians do not witness the children’s foreign body ingestion 40% of the time, physicians can only guess what was swallowed based on plain radiography. We report a case of a 45-month-old-boy who visited the emergency department after swallowing an unknown foreign body and whose radiographs showed “circle-within-a-circle appearance” on the anteroposterior view and “step-off appearance” on the lateral view, suggesting button battery ingestion. We conducted emergency endoscopic removal, and found stacked coins mimicking a button battery on the radiographs. The coins were pushed into the stomach and came out through defecation 3 weeks later without further complications. Distinguishing between stacked coins and a button battery through radiography may help avoid unnecessary emergency endoscopy.

4.
Article in Korean | WPRIM | ID: wpr-918674

ABSTRACT

We report a case of inguinal hernia that contained the entire uterus and both adnexa, presenting with an irreducible soft mass in the left groin and asymmetric labia majora, in a 2-month-old, full-term girl who visited the emergency department. Ultrasonography was performed immediately, and urgent surgical repair was performed without complications. Although inguinal hernia is a common surgical disease, it is rare that the hernia contains the uterus with its adnexa, and presents as a mass of the labia majora. Unlike the bowel herniation, the entity can be complicated by strangulation of the ovary, leading to infertility. To preserve fertility, rapid and accurate diagnosis using ultrasonography should be considered in an infant with an irreducible inguinal mass and asymmetric labia majora.

5.
Article in English | WPRIM | ID: wpr-741404

ABSTRACT

OBJECTIVE: To assess whether virtual expiratory (VE)-computed tomography (CT)/ultrasound (US) fusion imaging is more effective than conventional inspiratory (CI)-CT/US fusion imaging for hepatic interventional procedures. MATERIALS AND METHODS: This prospective study was approved by the Institutional Review Board, and informed consent was obtained from each patient. In total, 62 patients with focal hepatic lesions referred for hepatic interventional procedures were enrolled. VE-CT images were generated from CI-CT images to reduce the effects of respiration-induced liver motion. The two types of CT images were fused with real-time US images for each patient. The operators scored the visual similarity with the liver anatomy upon initial image fusion and the summative usability of complete image fusion using the respective five-point scales. The time required for complete image fusion and the number of point locks used were also compared. RESULTS: In comparison with CI-CT/US fusion imaging, VE-CT/US fusion imaging showed significantly higher visual similarity with the liver anatomy on the initial image fusion (mean score, 3.9 vs. 1.7; p < 0.001) and higher summative usability for complete image fusion (mean score, 4.0 vs. 1.9; p < 0.001). The required time (mean, 11.1 seconds vs. 22.5 seconds; p < 0.001) and the number of point locks (mean, 1.6 vs. 3.0; p < 0.001) needed for complete image fusion using VE-CT/US fusion imaging were significantly lower than those needed for CI-CT/US fusion imaging. CONCLUSION: VE-CT/US fusion imaging is more effective than CI-CT/US fusion imaging for hepatic interventional procedures.


Subject(s)
Ethics Committees, Research , Humans , Informed Consent , Liver , Prospective Studies , Respiration , Ultrasonography , Weights and Measures
6.
Hip & Pelvis ; : 23-28, 2018.
Article in English | WPRIM | ID: wpr-740412

ABSTRACT

PURPOSE: We evaluated the medium- to long-term outcomes of cortical strut allografts used to treat periprosthetic bone defects to better understand the correlation between radiological and clinical outcomes. MATERIALS AND METHODS: We retrospectively reviewed outcomes from 19 patients undergoing cortical strut allografts to treat periproshtetic bone defects from 2001 to 2015. The mean age at index operation was 59.4 years and the average follow-up period was 8.6 years. Surgeries were performed because of aseptic loosening (n=9), periprosthetic fractures (n=5), and infections (n=5). Each case was characterized and described in detail including the length of allograft and the union period; possible correlations between allograft length and detailed classification and union period was analyzed. Clinical evaluations included the Harris hip score and Kaplan-Meier survivorship. RESULTS: In revision total hip arthroplasty (THA), the average length of allografts used in patients experiencing fractures was significantly longer than those with aseptic loosening or infection. Of the 19 cases, incorporation was observed in 18 cases (94.7%). The average time to incorporation was 21.2 months and the time to incorporation was not significantly different among the two groups (fracture vs. aseptic loosening or infection). No positive correlation was identified between the length of allograft and incorporation period or in the time to cortical strut allograft incorporation among Paprosky or Vancouver subgroups. CONCLUSION: Results of cortical strut allografts show excellent incorporation rates based on medium- to long-term follow-up. Cortical strut allografts may be considered useful for the treatment of femoral bone defects experienced during revision THA and following periprosthetic fracture.


Subject(s)
Allografts , Arthroplasty, Replacement, Hip , Classification , Follow-Up Studies , Hip , Humans , Periprosthetic Fractures , Retrospective Studies , Survival Rate
7.
Article in Korean | WPRIM | ID: wpr-28097

ABSTRACT

A modified Broström procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified Broström procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified Broström procedure.


Subject(s)
Ankle , Expert Testimony , Humans , Joint Instability , Ligaments , Obesity , Prognosis , Risk Factors
8.
Article in Korean | WPRIM | ID: wpr-169688

ABSTRACT

The purpose of this study was to verify the validity of Mealworms as a hospital meal with increased nutrition density. We provided a meal for postoperative patients and conducted analysis of dietary intake and nutritional status of patients and assessment of acceptability of the meal. This study was carried out as a randomized control trial. Patients were supplied either a hospital meal using Mealworms (Experimental group) or a regular hospital meal (Control group). We investigated the administration amounts of parenteral nutrition (PN) and food intake of patients after surgery and measured anthropometry, body composition, and blood tests before surgery and at hospital discharge. We included 34 postoperative patients who were admitted to Gangnam Severance Hospital from March to September. In the groups of patients not supplied with PN, the experimental group (964.68±284.6 kcal, 38.82±12.9 g) had significantly higher dietary calorie and protein intake than the control group (666.62±153.7 kcal, 24.47±4.9 g)(P<0.05). Additionally in the group of patients not supplied with PN, the experimental group (1.37%) showed a significantly higher increase in fat free mass index than the control group (−3.46%)(P<0.05). In all subjects, calorie density and protein density were significantly higher in the experimental group (P<0.001), and acceptability of calorie (P=0.036) and protein (P=0.001) was also significantly higher in the experimental group. Therefore, the results of this study support the validity of the introduction of hospital meals using Mealworms.


Subject(s)
Anthropometry , Body Composition , Eating , Hematologic Tests , Humans , Meals , Nutritional Status , Parenteral Nutrition , Tenebrio
9.
Article in Korean | WPRIM | ID: wpr-14469

ABSTRACT

PURPOSE: We evaluated clinical outcomes after treating patients with proximal interphalangeal (PIP) joint fracture-dislocation with dynamic external fixator with which early joint motion can be undertaken to prevent joint stiffness effectively and fixate joints firmly. METHODS: Dynamic external fixators were applied for 20 fracture-dislocation of the PIP joints in 19 patients. The joints involved were 2nd PIP joint in two patients, 3rd PIP joint in three patients, 4th PIP joint in five patients, 5th PIP joint in eight patients. One patient had both 3rd and 4th PIP joint fracture-dislocation. Surgery was performed at least within four weeks. The mean age of the patients was 30.5 years (range, 15-54 years) and the mean follow-up duration was 1.85 years (range, 1-2.3 years) years. All patients were clinically and radiologically assessed on an outpatient basis after being discharged. RESULTS: At the final follow-up, the mean range of motion of PIP joints in flexion was 100.1° (flexion range, 88°-110°), the mean extension lag was 3.0° (extension range, 0°-10°), and the mean visual analogue scale score was 0.8. On anterior-posterior and lateral radiographs, congruity of the joint was satisfactory and 1 mm step off was present in three cases. CONCLUSION: We attained satisfactory clinical outcomes on the recovery of joint movement and joint congruity after treating PIP joint fracture-dislocation injury with dynamic external fixator.


Subject(s)
Joint Dislocations , External Fixators , Fingers , Follow-Up Studies , Humans , Joints , Outpatients , Range of Motion, Articular
10.
Article in Korean | WPRIM | ID: wpr-127233

ABSTRACT

PURPOSE: Asthma is a chronic airway inflammatory disease characterized by bronchial hyperresponsiveness and reversible airway obstruction. Bronchial challenge with methacholine or adenosine-5'-monophosphate (AMP) has been used to diagnose asthma. Recently, measurement of exhaled nitric oxide (eNO) can also be used for the diagnosis of asthma. The aim of this study was to compare the diagnostic value for asthma between challenge with methacholine or AMP and eNO in children with chronic nonspecific respiratory symptoms. METHODS: One hundred thirty-three children who have chronic nonspecific respiratory symptoms were enrolled. Bronchial challenge with methacholin and AMP were performed, and eNO was measured in all subjects. Subjects were defined as asthma based on the clinical symptoms and bronchodilator response during follow-up of at least 3 months after test. RESULTS: Thirty-three subjects (34%) were finally diagnosed as asthma among 97 patients after 3-month follow-up. The area under the receiver operating characteristic curves for the diagnosis of asthma were 0.903 (95% confidence interval [CI], 0.838-0.969; P<0.001) for methacholline challenge, 0.867 (95% CI, 0.783-0.950; P<0.001) for AMP challenge, and 0.588 (95% CI, 0.467-0.709, P=0.156) for eNO measurement. The cutoff values of these tests were methacholine PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second) 12.0 mg/mL (sensitivity, 87.9%; specificity, 82.8%), AMP PC20 566.2 mg/mL (sensitivity, 84.8%; specificity, 85.9%), and eNO 18.5 ppb (sensitivity, 45.5%; specificity, 71.9%). CONCLUSION: Measurement of eNO may be inferior to challenge with methacholine and AMP for the diagnosis of asthma in children.


Subject(s)
Airway Obstruction , Asthma , Bronchial Provocation Tests , Child , Diagnosis , Follow-Up Studies , Forced Expiratory Volume , Humans , Methacholine Chloride , Nitric Oxide , ROC Curve , Sensitivity and Specificity
11.
Article in English | WPRIM | ID: wpr-178912

ABSTRACT

PURPOSE: To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. MATERIALS AND METHODS: Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). RESULTS: The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (> or =50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). CONCLUSION: In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.


Subject(s)
Bile Duct Neoplasms , Bile Ducts , Bile , Disease-Free Survival , Humans , Multivariate Analysis , Palliative Care , Radiotherapy Dosage , Radiotherapy , Radiotherapy, Adjuvant , Recurrence , Retrospective Studies
12.
Article in English | WPRIM | ID: wpr-90249

ABSTRACT

BACKGROUND: Cerebral small vessel disease (SVD) induces vascular cognitive impairment (VCI) such as subcortical vascular dementia (SVaD) and subcortical vascular mild cognitive impairment (svMCI). We compared MRI parameters between SVaD and svMCI and determined which MRI parameters best correlated with cognitive function and disability on cross-sectional and longitudinal analyses within them. METHODS: Twenty-four patients with SVaD and twelve with svMCI were recruited. They underwent multimodal MRIs including fluid-attenuated inversion recovery lesion load, lacunar infarct number, and fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI), neuropsychological testing, Sum of Boxes of Clinical Dementia Rating Scale (CDR-SB), Barthel Index, and the Korean version of a Geriatric Depression Scale (GDS-K). Seventeen patients were retested after 20 months for a brain MRI and clinical evaluation. RESULTS: There were significant differences in average MD and peak height of MD histograms within normal-appearing brain tissue (NABT) between SVaD and svMCI patients. In the cross-sectional analysis, average MD within NABT significantly correlated with the composite neuropsychology score (r=-0.80, p<0.001), the composite executive function score (r=-0.67, p< 0.001), and the CDR-SB (r=0.54, p=0.001), and the Barthel Index correlated with peak heights of the MD histograms (r=0.37, p=0.03) in NABT. Changes of CDR-SB was associated with changes of average MD within WMH (r=0.57, p=0.02), and changes of GDS-K was associated with changes of WMH volume (r=0.51, p=0.04) on a longitudinal scale. CONCLUSIONS: DTI parameters in NABT correlated with cognitive impairment and disability in VCI associated with SVD. Clinical progression of SVD was associated with some increment of WML volume and ultrastructural changes in WMH.


Subject(s)
Anisotropy , Brain , Cerebral Small Vessel Diseases , Cross-Sectional Studies , Dementia , Dementia, Vascular , Depression , Diffusion , Diffusion Tensor Imaging , Executive Function , Glycosaminoglycans , Humans , Cognitive Dysfunction , Neuropsychological Tests , Neuropsychology , Stroke, Lacunar
13.
Article in English | WPRIM | ID: wpr-57855

ABSTRACT

OBJECTIVE: To investigate the factors influencing the quiet standing balance of patients with incomplete cervical spinal cord injuries. Also to find the correlations between posturographic parameters and clinical balance tests as well as to find the correlation between posturographic parameters and functional independence. METHOD: We conducted a tetra-ataxiometric posturography, lower extremity motor score (LEMS), Korean version of the Berg Balance Scale (K-BBS), Timed Up and Go test (TUG), and Korean Version of the Modified Barthel Index (K-MBI) of 10 patients. 10 healthy adults carried out the posturography. We checked stability, weight distribution, Fourier and synchronization indices of eight positions, and the fall index of the posturography. RESULTS: The patient group showed significantly higher stability and weight distribution indices in all eight positions. Stability indices significantly increased with eyes closed or standing on pillows. Weight distribution indices were significantly higher with eyes closed or the head bent backwards. The patient group showed significantly higher Fourier indices of low, low-medium, and high frequency in eight positions. The Fourier indices at high-medium frequency were significantly higher with eyes closed on pillows or in variable head positions. There were no significant differences of synchronization indices between the patient and the control group. The falling index of the patient group significantly correlated with K-BBS, TUG, and K-MBI. LEMS had significant correlation with some synchronization indices, but not with the falling index. CONCLUSION: The quiet standing balance of the patients was influenced by somatosensory limitations or insufficient visual compensation. We should try to improve the postural balance and functional independence of patients through proper proprioceptive and lower extremity strength training for better postural and pedal control, and to make efforts to minimize environmental hazards.


Subject(s)
Adult , Compensation and Redress , Eye , Hazardous Substances , Head , Humans , Lower Extremity , Postural Balance , Posture , Resistance Training , Spinal Cord , Spinal Cord Injuries
14.
Article in English | WPRIM | ID: wpr-724388

ABSTRACT

OBJECTIVE: To determine the nutritional status of children with cerebral palsy (CP) and to compare their anthropometric and functional indices. METHOD: Seventy children with cerebral palsy, were at class I (12), II (17), III (18), IV (9) and V (14) on Gross Motor Function Classification System (GMFCS). They varied by age from 25 to 130 months with a mean of 48 months, and consisted of spastic diplegic cerebral palsy (30), quadriplegia (28), triplegia (3), hemiplegia (4), athetoid (4) and hypotonia (1). Evaluation of weight, height, subcutaneous fat thickness, brachial circumference, Body Mass Index (BMI), level of albumin, lymphocyte and blood ferritn were conducted. To identify the factors affecting nutritional status, dietary status and symptoms of dysphagia were investigated. RESULTS: Low BMI percentile was in 23 children (32.9%) and obese condition in 3 children (4.3%). Low BMI percentile tends to frequently observed in groups III, IV, V of GMFCS. BMI percentile with subcutaneous fat thickness, Gross Motor Function Measure (GMFM) score were significantly related (p<0.05). Seen from the symptom of dysphagia, low BMI percentile was correlated with decreased tongue motion (p<0.05). CONCLUSION: Cerebral palsy children with lower GMFM score, decreased tongue motion were significantly related with low BMI percentile. Subcutaneous fat thickness can be useful tool for evaluation of malnutrition of cerebral palsy children.


Subject(s)
Body Mass Index , Cerebral Palsy , Child , Deglutition Disorders , Hemiplegia , Humans , Lymphocytes , Malnutrition , Muscle Hypotonia , Muscle Spasticity , Nutritional Status , Quadriplegia , Subcutaneous Fat , Tongue
15.
Article in English | WPRIM | ID: wpr-724380

ABSTRACT

OBJECTIVE: To evaluate whether the change of heel pad thickness improves the pain after Modified Low-Dye Taping (MLDT) in the patient with heel pad atrophy. METHOD: Thirty-five feet of 20 volunteers with heel pad atrophy were selected for the measurement of heel-pad thickness and compressibility index (CI) of the center of calcaneus bone using ultrasound. The subjects were laid in prone with the knees flexed to 90degrees, and an electronic body weight scale was inserted beneath the anterior surface of their knees to take measurements of both UHPT (unloaded heel pad thickness) and LHPT (6 kg-loaded heel pad thickness), which were repeated 3 times respectively. CI was calculated base on LHPT divided by UHPT. After MLDT, the same method was repeated. visual analogue scale (VAS) score was checked at first visit and followed up at second visit. RESULTS: Prior to MLDT, the average value of UHPT (cm), LHPT (cm) and CI value was 0.92+/-0.11, 0.25+/-0.06 and 0.27+/-0.04 respectively. After MLDT, the average was 1.24+/-0.17 for UHPT (cm) and 0.42+/-0.11, for LHPT (cm) while CI stood at 0.33+/-0.06. VAS before MLDT was 7.35+/-1.27 and after MLDT was 3.50+/-1.36, which presented 54% of decrease than initial. CONCLUSION: It was confirmed that the average values of the heel-pad thickness, CI and VAS of patients with heel pad atrophy were improved for MLDT. Accordingly it is considered that application of MLDT is an efficacious treatment and thus further study is needed to develop foot orthoses for heel pad atrophy using the principle of MLDT.


Subject(s)
Atrophy , Body Weight , Calcaneus , Electronics , Electrons , Foot , Foot Orthoses , Heel , Humans , Knee
16.
Article in Korean | WPRIM | ID: wpr-38225

ABSTRACT

Anti-glomerular basement membrane disease is a rare autoimmune disease characterized by rapidly progressive renal failure and/or pulmonary hemorrhage. The presence of severe crescentic glomerular inflammation with linear deposition of immunoglobulin G along the glomerular basement membrane is pathognomonic. Because renal function is rapidly and often irretrievably destroyed, many patients require hemodialysis all through their lifetime. We report a case of 33 year(s)-old man who was diagnosed as anti-glomerular basement membrane disease without pulmonary hemorrhage. The patient was treated with pulse methylprednisolone and plasmapheresis followed by oral corticosteroid and cyclophosphamide. His renal function was successfully recovered with early diagnosis and aggressive treatment.


Subject(s)
Adrenal Cortex Hormones , Anti-Glomerular Basement Membrane Disease , Autoimmune Diseases , Cyclophosphamide , Early Diagnosis , Glomerular Basement Membrane , Hemorrhage , Humans , Immunoglobulin G , Immunosuppression , Inflammation , Methylprednisolone , Plasmapheresis , Renal Dialysis , Renal Insufficiency
17.
Article in Korean | WPRIM | ID: wpr-723285

ABSTRACT

OBJECTIVE: To evaluate the difference of coracohumeral ligament (CHL) thickness between asymptomatic shoulders and adhesive capsulitis. METHOD: Ultrasound examination was performed in 44 consecutive shoulders of 24 individuals (12 males and 12 females). Nine were diagnosed as adhesive capsulitis by clinical examination. We measured the maximum thickness of CHL. For CHL assessment, participants were scanned in sitting position with shoulder in maximal external rotation, elbow in 90 degrees flexion, forearm in neutral position, and hand in fist. The transducer was positioned between coracoid process and greater tuberosity of humerus. We used t test to compare the CHL thickness between asymptomatic and adhesive capsulitis and bivariate correlation analysis to assess a correlation between age and CHL thickness. RESULTS: There was a significant positive linear relationship between age and CHL thickness (p<0.01, gamma=0.424). In female, there was a positive linear relationship between age and CHL thickness (p<0.01, gamma=0.610). However, in male, there was no significant correlation (gamma=0.224). The mean value of CHL thickness was 1.53 mm in 9 adhesive capsulitis and 0.92 mm in 35 asymptomatic ones. CHL thickness was significantly greater in adhesive capsulitis than in asymptomatic ones (p < 001). CONCLUSION: The thickened CHL is a good suggestive diagnostic value of adhesive capsulitis.


Subject(s)
Adhesives , Bursitis , Elbow , Female , Forearm , Hand , Humans , Humerus , Ligaments , Male , Shoulder , Transducers
18.
Article in Korean | WPRIM | ID: wpr-724655

ABSTRACT

OBJECTIVE: To compare the effects of spinal stabilization exercise against with lumbar extensor strengthening exercise. METHOD: Sixty patients with chronic low back pain were enrolled into the study and randomly classified into three groups. Groups were treated with spinal stabilization exercise (Group 1), lumbar extensor strengthening exercise using a MedX machine (Group 2), or with a combination program (Group 3) for 8 weeks. Patients were not given any other treatment modalities. Isometric peak torque of the lumbar extensors, pain rating score (PRS), Medical Outcomes Study Short Form-36 (SF-36) score, and the Oswestry low back pain disability questionnaire (OLBPD-Q) were assessed at 0, 4, and 8 weeks of exercise. RESULTS: 1) After 8 weeks, all groups showed incremental improvements in maximal isometric torque of the lumbar extensors and exhibited improvement in SF-36, PRS, and OLBD-Q scores (p<0.05). 2) There were no significant differences in the degree of improvement among the three groups after 8 weeks of exercise. 3) The percentage of patients with scores of good or excellent in Group 3 was higher than in Groups 1 and 2 according to all evaluation tools. CONCLUSION: In the treatment of chronic low back pain, all exercise groups showed decreased pain, improved quality of life, and increased lumbar extensor strength regardless of the exercise type employed. We suggest that exercise programs in general are effective for the treatment of chronic low back pain and a combination exercise program seems to be most beneficial.


Subject(s)
Humans , Low Back Pain , Quality of Life , Surveys and Questionnaires , Torque
19.
Article in Korean | WPRIM | ID: wpr-724485

ABSTRACT

OBJECTIVE: To identify the effects of isokinetic strengthening of trunk muscles on balance in hemiplegic patients after stroke. METHOD: All participants were ambulatory hemiplegic patients, injured at least 6 months prior to study. The patients (n=16) were randomly divided into two groups. The control group received neurodevelopmental treatments and gait training 3 times a week. In addition to the same treatments provided for the control group, the experimental group received trunk isokinetic strengthening exercises using isokinetic dynamometer 3 times a week. Trunk muscle peak torque and balance in the experimental group were compared with those in control group at baseline and 4 weeks after treatments. RESULTS: There were no significant differences in age, lesion of hemiplegia, time after stroke onset, trunk muscle strength and Berg balance score before treatments between two groups. In the experimental group, peak torques of trunk extensor increased significantly at 60degrees/sec and 90degrees/sec at 4 weeks (p<0.05), but there were no significant improvements in peak torques of trunk flexor at all degree and extensor peak torques at 120degrees/sec. Both the extensor and flexors showed no significant changes in the control groups. In the experimental group, a mean percent change in peak torque involving the trunk extensor was significantly increased at 60degrees/sec. In the experimental group, Berg balance scores, 10 m gait velocity, sit to stand and gait 3 m and return, and 10 seconds stair up and down were improved (p<0.05). No significant improvements were noted in the control group. CONCLUSION: Isokinetic strengthening of trunk muscles can improve balance in hemiplegic patients.


Subject(s)
Exercise , Gait , Hemiplegia , Humans , Muscle Strength , Muscles , Stroke , Torque
20.
Article in Korean | WPRIM | ID: wpr-724282

ABSTRACT

OBJECTIVE: To evaluate the clinical importance of effusion in bicipital tendon sheath and the change of ultrasonographic findings according to the treatment. METHOD: Thirty patients with hemiplegia, clinically diagnosed as adhesive capsulitis in hemiplegic shoulder, were investigated. To confirm the location and existence of effusion and to measure the largest diameter and cross sectional area (CSA) of bicipital tendon sheath, the longitudinal and transverse scan of the shoulder were used. Each patient was treated with a series of three intraarticular injections with triamcinolone under ultrasonographic guidance. After each intraarticular injection, the diameter and CSA of bicipital tendon sheath, and passive range of motion of the affected shoulder were measured and compared to the unaffected side. RESULTS: The initial ultrasonographic examination showed increased amount of effusion in the affected bicipital tendon sheath compared to the unaffected side (p<0.01). After intraarticular injection, the amount of effusion was decreased (p<0.01) and passive range of motion of the shoulder was increased (p<0.05). CONCLUSION: The ultrasonographic evaluation of effusion in the bicipital tendon sheath, and interval change of effusion according to the treatment, can be useful tool for diagnosis and follow-up of adhesive capsulitis in hemiplegic shoulder.


Subject(s)
Adhesives , Bursitis , Diagnosis , Follow-Up Studies , Hemiplegia , Humans , Injections, Intra-Articular , Range of Motion, Articular , Shoulder , Tendons , Triamcinolone , Ultrasonography
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