OBJECTIVE: To investigate the musculoskeletal causes of anterior chest pain and know the prevalencies of the diseases. METHOD: During 4-year periods (1997-2001), 37 patients with anterior chest wall pain was analyzed with regard to the causes of pain and the frequencies of the diseases. RESULTS: 17 patients (45.9%) had systemic diseases and 20 patients (54.1%) had focal joint problems. Systemic disease included the undifferentiated spondyloarthropathy (18.9%), ankylosing spondylitis (13.5%), psoriatic arthritis (2.7%), SAPHO (Synovitis, Acne, Psoriasis, Hyperostosis, Osteitis) syndrome (8.1%), and rheumatoid arthritis (2.7%). Focal joint diseases included costochondritis (10.8%), sterno clavicular inflammatory arthropahty (5.4%), sternoclavicular hyperostosis (2.7%) and infective arthritis (2.7%). Other focal joint problems were pain in sternoclavicular joint with the tenderness and swelling (2.7%), pain in costochondral joint (13.6%), sternoclavicular joint (5.4%), xyphoid process (2.7%) with only focal tenderness. 3 (8.1%) patients had pain in chest wall which had no focal tenderness and swellings on the joint. CONCLUSION: Diverse systemic diseases were identified as causes of the anterior chest wall pain. So physiatrist keep in mind this result and make use of them in diagnostic approaching of the anterior chest pain due to chest wall skeletal involvemen.
Acne Vulgaris ; Acquired Hyperostosis Syndrome ; Arthritis ; Arthritis, Psoriatic ; Arthritis, Rheumatoid ; Chest Pain ; Humans ; Hyperostosis ; Joint Diseases ; Joints ; Psoriasis ; Spondylarthropathies ; Spondylitis, Ankylosing ; Sternoclavicular Joint ; Thoracic Wall* ; Thorax*

OBJECTIVE: Cisplatin has effectiveness in the treatment of solid tumor by active cytotoxic action, but with significant side effects such as peripheral neuropathy. To investigate the prevention of neuropathy, nimodipine was examined. METHOD: Fifty female rats (Sprague-Dawley strain; BW 210-260 g, 12-15 week old) were used: control group; cisplatin group; cisplatin-nimodipine 2 week group, 10; ciplatin-nimodipine 4 week group; base group. Peripheral neuropathy was induced by intraperitoneal injection of the cisplatin (0.04 mg/ml, 1 ml/kg/ip/ for 2 weeks). Nimodipine was injected intraperitoneally for 2 weeks and 4 weeks in cisplatin-nimodipine 2 week group and cisplatin-nimodipine 4 week group, respectively. Motor and sensory nerve conduction studies were done using in rat tail nerve from the beginning and biweekly till to 10th week. RESULTS: Weight reduction was significant in cisplatin group at 2nd week (p<0.05). The latencies of motor and sensory nerves were delayed in 2nd, 4th week in all groups with cisplatin (p<0.05) and the recovered after 6th week in all groups. The amplitudes of motor and sensory nerves in these groups haven't made any difference compared with control group (p>0.05). CONCLUSION: The neurotoxicity of cisplatin revealed in motor and sensory neurons. The neuropathy has recovered to control value in 6th week and the preventive effect of nimodipine was transient.
Animals ; Cisplatin* ; Female ; Humans ; Injections, Intraperitoneal ; Neural Conduction ; Nimodipine* ; Peripheral Nervous System Diseases ; Rats ; Sensory Receptor Cells ; Tail ; Weight Loss

OBJECTIVE: The purpose of this study is to evaluate the arteiovenous fistula effects on peripheral nerve in patients with chronic renal failure by nerve conduction studies. METHOD: Nerve conduction studies were performed in 23 patients with chronic renal failure. We not only measured distal latencies, amplitudes, and conduction velocities of median and ulnar motor nerves but also measured same parameters of radial sensory nerves at both upper limbs. In case of pateints with suspected peripheral polyneuropathy, we checked peripheral nerves at one lower limb. The results of nerve conduction studies and the frequency of cubital tunnel syndrome or carpal tunnel syndrome were compared between arteiovenous fistula side and non-arteiovenous fistula side. RESULTS: The amplitudes of median motor, ulnar motor nerves and radial sensory nerve in arteiovenous fisula side are statistically lower than those in non-arteiovenous fisula side (p<0.05). In the 14 patients with peripheral polyneu ropathy, the difference is also statistically significant between two sides (p<0.05). Compared arteiovenous fisula side with non-arteiovenous fisula side, the frequency of cubital tunnel syndrome or carpal tunnel syndrome was not different between two sides. CONCLUSION: Arteiovenous fisula may damage to the peripheral nerve in patients with chronic renal failure.
Carpal Tunnel Syndrome ; Cubital Tunnel Syndrome ; Fistula* ; Humans ; Kidney Failure, Chronic* ; Lower Extremity ; Neural Conduction ; Peripheral Nerves* ; Polyneuropathies ; Upper Extremity

OBJECTIVE: This study was performed to determine the relations of glycosylated hemoglobin (HbA1c) and parameters of nerve conduction study (NCS) in diabetic peripheral polyneuropathy patients. METHOD: Prospectively, total 40 patients with non-insulin dependent diabetes mellitus were included in the study. NCS was performed on median, ulnar, posterior tibial, deep peroneal, superficial peroneal, and sural nerves. Distal latency and conduction velocity (CV) of compound muscle action potential (CMAP), distal latency and amplitude of sensory nerve action potential (SNAP) were used as parameters of NCS. Multiple linear regression analysis were used to analyze the relations of HbA1c and parameters of NCS, after adjustment for age, height, weight, and disease duration of diabetes mellitus. RESULTS: HbA1c level had an inverse relation to CV of median motor nerve (beta= 1.272, p<0.01), ulnar motor nerve (beta= 1.287, p<0.01), posterior tibial nerve (beta= 0.982, p<0.05), and deep peroneal nerve (beta= 1.449, p<0.05). CONCLUSION: This study indicates that HbA1c level was inversely related to motor nerve CV, and that sustained hyperglycemia may be involved in demyelination of motor nerves. Analysis of motor nerve CV related to HbA1c is expected to be useful in the follow-up or efficacy study of diabetes mellitus neuropathy as baseline data.
Action Potentials ; Demyelinating Diseases ; Diabetes Mellitus ; Hemoglobin A, Glycosylated* ; Humans ; Hyperglycemia ; Linear Models ; Neural Conduction* ; Peroneal Nerve ; Polyneuropathies* ; Prospective Studies ; Sural Nerve ; Tibial Nerve

OBJECTIVE: To determine the sensitivity of electrodiagnostic parameters in the patients with asymptomatic diabetic neuropahty. METHOD: The subjects were 26 patients with asymptomatic diabetic neuropathy and 40 healthy adults as control group. All subjects underwent electrodiagnostic evaluation of the following motor nerves: median, ulnar, tibial, and peroneal. Sensory nerves included: median, ulnar, radial, superficial peroneal, sural, lateral dorsal cutaneous branch of the sural nerve (LDSN) and medial plantar. And other studies were the sural/radial amplitude ratio, LDSN/sural amplitude ratio, peroneal and tibial F-responses, and H-reflex recorded from the soleus muscle. The frequency of abnormal parameters in the patients with asymptomatic diabetic neuropathy was obtained by comparison with the normative limits obtained from the control group. RESULTS: The most frequent abnormal electrodiagnostic parameters were the LDSN onset latency and the amplitude ratio of LDSN/sural (84.6%, respectively) followed by the LDSN peak latency, LDSN amplitude, and medial plantar onset and peak latency (80.8%, respectively). CONCLUSION: We concluded that the LDSN and medial plantar nerve conduction studies are useful for early detection of neuropathy in diabetes mellitus.
Adult ; Diabetes Mellitus ; Diabetic Neuropathies* ; H-Reflex ; Humans ; Muscle, Skeletal ; Sural Nerve ; Tibial Nerve

OBJECTIVE: This study was purposed to reveal the differences of the findings of pudendal somatosensory evoked potential (PSEP) and electrophysiological bulbocavernosus reflex (EBCR) according to the type of neurogenic bladder. METHOD: The subjects were 65 patients with neurogenic bladder. The causes of neurogenic bladder were consist of seven brain lesions; 39 spinal cord injuries; 15 cauda equina syndromes; and four peripheral polyneuropathies. PSEP and EBCR were done. RESULTS: Of the patients with hyperreflexic bladder (43.1%), PSEP latency was normal in 21.4%, delayed in 21.4%, and not obtainable in 57.2%. Of the patients with areflexic bladder (56.9%), PSEP latency was normal in 24.3%, delayed in 21.6%, and not obtainable in 54.1%. Of the patients with hyperreflexic bladder, EBCR latency was normal in 82.1%, delayed in 14.3%, and not obtainable in 3.6%. Of the patients with areflexic bladder, EBCR latency was normal in 16.2%, delayed in 37.8%, and not obtainable in 46.0% (p<0.01). CONCLUSION: There was significant correlation between EBCR and type of neurogenic bladder, but not with PSEP. These results seem to be reflected from the neuro-anatomical lesion of the neurogenic bladder.
Brain ; Evoked Potentials, Somatosensory* ; Humans ; Polyneuropathies ; Polyradiculopathy ; Reflex* ; Spinal Cord Injuries ; Urinary Bladder ; Urinary Bladder, Neurogenic*

OBJECTIVE: To determine the optimal number of muscles to detect lumbosacral radiculopathies. METHOD: Electrodiagnostic data of 152 patients who had been diagnosed as lumbosacral radiculopathy with the findings of operative record were obtained retrospectively. The findings of needle electromyography were reviewed and the frequency of abnormal spontaneous activities in L5 and S1 myotomes was investigated. We selected 8 individual muscles which had high sampling rate. These muscles were combined into different muscle screens and the detection rates were calculated that the frequency with which one or more muscles in the screen displayed abnormal spontaneous activity was divided by the total number of radiculopathies. RESULTS: The detection rates of lumbosacral radiculopathy were compared according to the number of muscle screens. Including paraspinal muscle, the detection rate of 6 muscle screens was higher than 5 muscle screens (p<0.05), but there was no significant difference of detection rate between 6 muscle screens and 7 muscle screens. The detection rates of each muscle screens without paraspinal muscle were lower than those including paraspinal muscle for all screens (p<0.05). CONCLUSION: Although there is controversy about selection of muscles, six muscle screen including paraspinal muscles may be optimal number for detecting lumbosacral radiculopathy.
Electromyography ; Humans ; Muscles* ; Needles ; Paraspinal Muscles ; Radiculopathy* ; Retrospective Studies

OBJECTIVE: To investigate objectively the postoperative change of the gait pattern in patients with cervical myelopathy through gait analysis. METHODS: Thirty nine patients who underwent cervical decompression and fusion for cervical myelopathy were studied. Preoperatively, gait disturbance was present in all patients. The patients were evaluated with Nurick classification, Functional Independence measure (FIM) score and gait analysis using three dimensional motion analyzer before surgery, 1 week and 3 months after surgery. RESULTS: In the Nurick classification there was statistically significant change but no significant change in FIM score after surgery. In the gait analysis there were statistically significant improvements in all the linear parameters, kinetic (ankle plantarflexion moment) and kinematic (knee range of motion in swing phase) parameters (p<0.05). CONCLUSION: This study suggests that gait analysis can be used as a quantitative tools of postoperative gait improvement in patient with cervical myelopathy.
Classification ; Decompression ; Gait* ; Humans ; Range of Motion, Articular ; Spinal Cord Diseases*

OBJECTIVE: This study was carried out to help the comprehensive rehabilitation of cervical cord injuries by measuring propulsion force and endurance on their wheelchair hand- rims, predicting the differences between neurological levels and analysing the factors which contributed to maintain the wheelchair propulsion force. METHOD: The BTE work simulator was used on 17 cervical cord injuries to test the force and endurance during wheel chair propulsion. The 141 large wheel of BTE work simulator and standard wheelchair which was removed handrims was used for simulating wheelchair propulsion. Wilcoxon rank sum test was used to compare force and endurance among the groups. RESULTS: The wheelchair propulsion force and endurance showed significant differences between neurological levels and types of the life style. The lower the level, the higher the strength and endurance (p<0.001). The wheelchair propulsion force of cervical cord injuries showed statistically significant differences between those with and without jobs (p<0.05). The outdoor wheelchair users and wheelchair propulsion exercise group showed significantly high maximum isometric strengths compared to the indoor users and the only ROM exercise group, respectively (p<0.05). CONCLUSION: During the rehabilitation period cervical cord injured persons need the wheelchair propulsion exercise using BTE work simulator to improve the quality of life.
Humans ; Life Style ; Quality of Life ; Rehabilitation ; Wheelchairs*

OBJECTIVE: To investigate the pathologic pulmonary mechanics and analyze the factors affecting cough ability in patients with Duchenne muscular dystrophy (DMD). METHOD: Thirty-one patients with DMD were investigated. The vital capacity (VC), maximum insufflation capacity (MIC), maximal inspiratory (MIP), and expiratory pressure (MEP) were measured. Unassisted peak cough flow (UPCF) and assisted PCF at three different conditions were evaluated. RESULTS: The mean value of MICs (1, 873 +/- 644 cc) was higher than that of VCs (1, 509 +/- 640 cc). MIP and MEP were 48.8 +/- 21.4% and 29.5 +/- 19.5% of predicted normal value respectively. MIP was correlated with UPCFs as well as MEP. All of three assisted cough methods showed significantly higher value than unassisted method (p<0.01). The manual assisted PCFs at MIC significantly exceeded those produced by manual assisted or PCFs at MIC. The positive correlation between the MIC-VC difference and PCF at MIC-UPCF difference was seen (p<0.01). CONCLUSION: Inspiratory muscle strength and the preservation of pulmonary compliance is important for the development of effective cough as well as expiratory muscle power. Thus, the clinical implication of the inspiratory phase in assisting a cough should be emphasized.
Compliance ; Cough* ; Humans ; Insufflation ; Mechanics* ; Muscle Strength ; Muscular Dystrophy, Duchenne* ; Reference Values ; Vital Capacity