OBJECTIVE: To evaluate the effects of heel-opened ankle foot orthosis (HOAFO) on hemiparetic gait after stroke, especially on external foot rotation, and to compare the effects of HOAFO with conventional plastic-AFO (pAFO) and barefoot during gait. METHODS: This cross-over observational study involved 15 hemiparetic patients with external rotation of the affected foot. All subjects were able to walk independently, regardless of their usual use of a single cane, and had a less than fair-grade in ankle dorsiflexion power. Each patient was asked to walk in three conditions with randomized sequences: 1) barefoot, 2) with a pAFO, and 3) with an HOAFO. Their gait patterns were analyzed using a motion analysis system. RESULTS: Fifteen patients consisted of nine males and six females. On gait analysis, hip and foot external rotation were significantly greater in pAFO (-3.35degrees and -23.68degrees) than in barefoot and HOAFO conditions (p<0.05). Wearing an HOAFO resulted in significant decreases in hip (0.78degrees, p=0.04) and foot (-17.99degrees, p<0.01) external rotation compared with pAFO; although there was no significant difference between HOAFO and barefoot walking. Walking speed and percentage of single limb support were significantly greater for HOAFO than in barefoot walking. CONCLUSION: HOAFO was superior to pAFO in reducing hip and foot external rotation during the stance phase in patients with post-stroke hemiparesis. HOAFO may, therefore, be useful in patients with excessive external rotation of the foot during conventional pAFO.
Animals ; Ankle ; Canes ; Extremities ; Female ; Foot ; Foot Orthoses ; Foot Rot ; Gait ; Hip ; Humans ; Male ; Orthotic Devices ; Paresis ; Stroke ; Walking

PURPOSE: The aim of the study is to determine whether late preterm infants from normal oral GTT (glucose tolerance test) but positive GCT (glucose challenge test) mothers are associated with adverse postnatal outcome. METHODS: A retrospective study was performed from singleton infants who were born at 34(+0)-36(+6) weeks between January 2008 and December 2012 and prenatally checked at CHA Gangnam Medical Center. Infants were categorized into three groups according to the results of 50 g oral GCT and 100 g oral GTT; NG group (normal glucose tolerance group, n=603) vs. GIG group (gestational impaired glucose tolerance group; infants of normal oral GTT but positive GCT mothers, n=77) vs. GDM group (gestational diabetes group, n=52). Neonatal outcomes were compared among the three groups. RESULTS: GIG group showed significantly increased incidence of jaundice compared to NG group (9.6% vs. 19.5%, P=0.031). The number of old mothers (> or =35 years at delivery) was significantly higher in GIG group compared to NG group (27.5% vs. 33.8%, P=0.006). After stratification by maternal age, GIG group showed significantly increased respiratory diseases compared to NG group (44% vs. 65.4%, P=0.04). Hypocalcemia and feeding problem increased across the groups (NG vs. GIG vs. GDM; 13.3% vs. 26.9% vs. 32.0%, P= 0.024; 6.0% vs. 11.5% vs. 20.0%, P=0.05, respectively). CONCLUSION: Late preterm infants of normal oral GTT but positive GCT mothers, especially in older mother, have increased risk of postnatal morbidities such as respiratory distress, jaundice, hypocalcemia or feeding intolerance. Thus, careful follow up may be needed in this group since antepartum period.
Diabetes, Gestational* ; Diagnostic Tests, Routine* ; Female ; Follow-Up Studies ; Glucose ; Glucose Intolerance ; Humans ; Hypocalcemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice ; Mass Screening* ; Maternal Age ; Mothers* ; Pregnancy ; Retrospective Studies

We would like to correct the author affiliations.

Turner syndrome with abnormalities of X chromosome is generally characterized by gonadal dysgenesis causing premature ovarian failure, primary and secondary amenorrhea. Premature ovarian failure is often caused by X chromosome aberrations. It has been shown that gross X chromosome abnormalities such as monosomy X usually result in primary amenorrhea and poor pubertal development, whereas mild X chromosome abnormalities such as partial X deletions usually lead to secondary amenorrhea and fairly good pubertal development. Fertility has been reported in several patients with relatively small Xq deletions before the onset of premature ovarian failure, and the X chromosome abnormality is often inherited by offspring. We describe a 46,X,del(X)(q26) female with normal pregnancy, in whom same karyotype was found in the fetus by amniocentesis. We report this case with brief review of related literatures.
Amenorrhea ; Amniocentesis ; Female ; Fertility ; Fetus* ; Gonadal Dysgenesis ; Humans ; Karyotype* ; Pregnancy ; Pregnant Women* ; Primary Ovarian Insufficiency ; Turner Syndrome ; X Chromosome

The Canal of Nuck is the portion of the processus vaginalis within the inguinal canal in women. A hydrocele of the Canal of Nuck is equivalent to an encysted hydrocele of the spermatic cord in men. Little about this rare condition in the adult female patient has been reported in the literature. In this paper, we report on a case of hydrocele of the Canal of Nuck in a 30-year-old female. The diagnosis was made based on sonography and CT, and then confirmed during surgery. Although rare, a hydrocele of the Canal of Nuck must be included in the differential diagnosis of a groin lump in female patients.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Groin ; Humans ; Inguinal Canal ; Male ; Spermatic Cord ; Ultrasonography*

OBJECTS: 99mTc-lactosylated human serum albumin (LSA) is a newly synthesized radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically presented on the hepatocyte membrane. Hepatic uptake and blood clearance of LSA were evaluated in rat with acute hepatic injury induced by dimethylnitrosamine (DMN) and results were compared with corresponding findings of liver enzyme profile and these of histologic changes. MATERIALS AND METHODS: DMN (27 mg/kg) was injected intraperitoneally in Sprague-Dawley rat to induce acute hepatic injury. At 3 (DMN-3), 8 (DMN-8), and 21 (DMN-21) days after injection of DMN, LSA injected intravenously, and dynamic images of the liver and heart were recorded for 30 minutes. Time-activity curves of the heart and liver were generated from regions of interest drawn over liver and heart area. Degree of hepatic uptake and blood clearance of LSA were evaluated with visual interpretation and semiquantitative analysis using parameters (receptor index : LHL3 and index of blood clearance : HH3), analysis of time-activity curve was also performed with curve fitting using Prism program. RESULTS: Visual assessment of LSA images revealed decreased hepatic uptake in DMN treated rat, compared to control group. In semiquantitative analysis, LHL3 was significantly lower in DMN treated rat group than control rat group (DMN-3: 0.842, DMN-8: 0.898, DMN-21: 0.91, Control: 0.96, p< 0.05), whereas HH3 was significantly higher than control rat group (DMN-3: 0.731, DMN-8: 0.654, DMN-21: 0.604, Control: 0.473, p< 0.05). AST and ALT were significantly higher in DMN-3 group than those of control group. Centrilobular necrosis and infiltration of inflammatory cells were most prominent in DMN-3 group, and were decreased over time. CONCLUSION: The degree of hepatic uptake of LSA was inversely correlated with liver transaminase and degree of histologic liver injury in rat with acute hepatic injury.
Animals ; Asialoglycoprotein Receptor ; Dimethylnitrosamine* ; Heart ; Hepatocytes ; Humans ; Liver* ; Membranes ; Necrosis ; Radionuclide Imaging* ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin*

Myers-Briggs Type Indicator (MBTI) is a personality type test book, which is widely used in the field of personal counseling, team organization, school education and research. This study carried out MBTI of 361 medical students in the second grade of premedical course of Keimyung University School of Medicine from 2014 to 2018, and analyzed the data to use them for the students' education. The personality type was mostly distributed to ISTJ, ISTP, ESTP and ESTJ in order among 16 types. According to preference tendency, it was found out that the introverted type was extroverted, the recognition type was intuition type, the thinking type was emotional type, and the recognition type was more distributed than the judgment type. The psychological functions were ST, SF, NF, NT. MBTI type analysis of medical students shows that it is possible to organize members in group activities to improve their ability to understand themselves and understand others in class scenes. In addition, we expect to be able to design for improvement of stress management, conflict management, and communication ability. In the career counseling scene, in addition to the MBTI data analysis, it is expected that it will be possible to recommend a major suitable for the student personality type in parallel with other psychological tests. In addition, we expect to study the preferred field of study, satisfaction with the major in the future research by continuous data accumulation and analysis.
Communication ; Counseling ; Education ; Education, Medical* ; Humans ; Intuition ; Judgment ; Personality Inventory ; Psychological Tests ; Statistics as Topic ; Students, Medical* ; Thinking ; Vocational Guidance

OBJECTIVE: To compare a high acceleration three-dimensional (3D) T1-weighted gradient-recalled-echo (GRE) sequence using the combined compressed sensing (CS)-sensitivity encoding (SENSE) method with a conventional 3D GRE sequence using SENSE, with respect to image quality and detectability of solid focal liver lesions (FLLs) in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced liver MRI. MATERIALS AND METHODS: A total of 217 patients with gadoxetic acid-enhanced liver MRI at 3T (54 in the preliminary study and 163 in the main study) were retrospectively included. In the main study, HBP imaging was done twice using the standard mDixon-3D-GRE technique with SENSE (acceleration factor [AF]: 2.8, standard mDixon-GRE) and the high acceleration mDixon-3D GRE technique using the combined CS-SENSE technique (CS-SENSE mDixon-GRE). Two abdominal radiologists assessed the two MRI data sets for image quality in consensus. Three other abdominal radiologists independently assessed the diagnostic performance of each data set and its ability to detect solid FLLs in 117 patients with 193 solid nodules and compared them using jackknife alternative free-response receiver operating characteristics (JAFROC). RESULTS: There was no significant difference in the overall image quality. CS-SENSE mDixon-GRE showed higher image noise, but lesser motion artifact levels compared with the standard mDixon-GRE (all p < 0.05). In terms of lesion detection, reader-averaged figures-of-merit estimated with JAFROC was 0.918 for standard mDixon-GRE, and 0.953 for CS-SENSE mDixon-GRE (p = 0.142). The non-inferiority of CS-SENSE mDixon-GRE over standard mDixon-GRE was confirmed (difference: 0.064 [−0.012, 0.081]). CONCLUSION: The CS-SENSE mDixon-GRE HBP sequence provided comparable overall image quality and non-inferior solid FFL detectability compared with the standard mDixon-GRE sequence, with reduced acquisition time.
Acceleration ; Artifacts ; Consensus ; Dataset ; Humans ; Liver ; Magnetic Resonance Imaging ; Methods ; Noise ; Retrospective Studies ; ROC Curve

OBJECTIVE: To investigate the synergic effects of mirror therapy and neuromuscular electrical stimulation (NMES) for hand function in stroke patients. METHOD: Sixty patients with hemiparesis after stroke were included (41 males and 19 females, average age 63.3 years). Twenty patients had NMES applied and simultaneously underwent mirror therapy. Twenty patients had NMES applied only, and twenty patients underwent mirror therapy only. Each treatment was done five days per week, 30 minutes per day, for three weeks. NMES was applied on the surface of the extensor digitorum communis and extensor pollicis brevis for open-hand motion. Muscle tone, Fugl-Meyer assessment, and power of wrist and hand were evaluated before and after treatment. RESULTS: There were significant improvements in the Fugl-Meyer assessment score in the wrist, hand and coordination, as well as power of wrist and hand in all groups after treatment. The mirror and NMES group showed significant improvements in the Fugl-Meyer scores of hand, wrist, coordination and power of hand extension compared to the other groups. However, the power of hand flexion, wrist flexion, and wrist extension showed no significant differences among the three groups. Muscle tone also showed no significant differences in the three groups. CONCLUSION: Our results showed that there is a synergic effect of mirror therapy and NMES on hand function. Therefore, a hand rehabilitation strategy combined with NMES and mirror therapy may be more helpful for improving hand function in stroke patients than NMES or mirror therapy only.
Electric Stimulation ; Female ; Hand ; Humans ; Male ; Muscles ; Paresis ; Stroke ; Wrist

We present a 55-year-old female patient who underwent burr-hole drainage due to chronic subdural hematoma, with obstructive prosthetic aortic valve dysfunction. Anesthetic management of a patient with severe obstructive prosthetic aortic valve dysfunction can be challenging. Similar considerations should be given to patients with aortic stenosis with an additional emphasis on thrombotic complication due to discontinuation of anticoagulation, which may further jeopardize the valve dysfunction. This case emphasizes the importance of a comprehensive understanding of the etiology and hemodynamic consequences of obstructive prosthetic valve dysfunction and the adequacy of anticoagulation for patients undergoing noncardiac surgery even after a successful valve replacement.
Aortic Valve Stenosis ; Aortic Valve* ; Drainage ; Echocardiography ; Female ; Heart Valve Prosthesis ; Hematoma, Subdural, Chronic ; Hemodynamics ; Humans ; Middle Aged ; Thrombosis