No abstract available.
Ischemia* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: To evaluate the change of abnormal spontaneous activities according to the clinical and radiologic findings, and to the time course after onset in hemiplegic upper limb. METHOD: We scored abnormal spontaneous activities of hemiplegic upper limb muscles (infraspinatus, deltoid, extensor carpi radialis, abductor pollicis brevis, abductor digiti minimi) in 100 hemiplegic patients without peripheral neuropathy. The abnormal spontaneous activities were evaluated according to their radiologic findings and to Brunnstrom stage and the presence of reflex sympathetic dystrophy (RSD), and the time course after the onset (A cross-sectional study). In addition we repeatedly examined 40 hemiplegic patients until 12 weeks after the onset to define the pattern of change (A prospective study). RESULTS: There was no significant difference in the score of abnormal spontaneous activities according to the radiologic findings. The score of abnormal spontaneous activities decreased while Brunnstrom stage progressed. In both the cross-sectional and prospective studies, we found that the abnormal spontaneous activities decreased according to the time course after the onset in the limb without RSD, but sustained in the limb with RSD. CONCLUSION: Abnormal spontaneous activities decreased according to the progression of Brunnstrom stages. The hemiplegic patients with RSD showed more profuse and sustained abnormal spontaneous activities at needle EMG study of hemiplegic upper limb than the patients without RSD.
Extremities ; Humans ; Muscles ; Needles ; Peripheral Nervous System Diseases ; Prospective Studies ; Reflex Sympathetic Dystrophy ; Upper Extremity*

OBJECTIVE: In adhesive capsulitis, assessment of the mobility of the shoulder are likely to have intrinsic error because of the altering scapulohumeral rhythm and extrinsic error. For more objective and the precise assessment of shoulder mobility in adhesive capsulitis, we observed proper glenohumeral movement, the change of scapulohumeral angle, the scapulohumeral rhythm were evaluated with radiography and compared with clinical measurement of shoulder range of motion (ROM). METHOD: The subjects were 19 patients (21 shoulder) with adhesive capsulitis of the shoulder and undertook combination treatment of distention arthrography, per os medication of non-steroid anti- inflammatory drug, stellate ganglion block, physical therapy including exercise. We assessed change in visual analogue scale (VAS), joint space capacity, shoulder mobility by measurement of ROM, and scapulohumeral angle in active shoulder abduction under the fluroscopy. RESULTS: All the subjects experienced pain relief, increased shoulder mobility and restoration of scapulohumeral rhythm. The improvement of the shoulder extension and scapulohumeral angle is well correlated with the change of VAS and joint capacity. However, the improvement of the shoulder flexion, abduction, external rotation and internal rotation were poor correlated with them. CONCLUSION: We propose the measurement of scapulohumeral angle with active shoulder abduction in shoulder AP view as an assessment method for shoulder mobility in adhesive capsulitis.
Adhesives* ; Arthrography ; Bursitis* ; Humans ; Joints ; Radiography* ; Range of Motion, Articular ; Shoulder* ; Stellate Ganglion ; Treatment Outcome*

OBJECTIVE: To evaluate how to influence static lumbar lordosis by different heel heights in normal adults and patients with spondylolisthesis. METHOD: The lumbolumbar angles, lumbosacral angles and slip angles were examined while standing on barefoot, on heel support with 5 cm heel, and with 10 cm heel in 14 normal adults and 10 patients with first grade of spondylolisthesis. Standing lumbar spine lateral view was performed by one half hour adaptation with corresponding shoe types. RESULT: The lumbolumbar angles (angles between upper margin of 2nd lumbar body and low margin of 5th lumbar body) and the lumbosacral angles (between upper margin of 2nd lumbar body and low margin of 1st sacral body) in normal are 36.8+/-6.5degrees, 50.1+/-9.5degrees on barefoot, 36.0+/-7.3degrees, 49.6+/-7.4degrees on heel support with 5 cm heel, and 36.1+/-7.6degrees, 49.7+/-8.3degrees with 10 cm heel. Lumbolumbar angles and lumbosacral angles in 10 patients with spondylolisthesis 38.8 8.3degrees on barefoot, 47.2+/-10.4degrees on heel support with 5 cm heel, 38.3+/-7.0degrees, 47.7+/-9.2degrees with 10 cm heel. The slip angles in 10 patients with spondylolisthesis are 29.8+/-1.2degrees on barefoot, 30.2+/-1.8degrees on heel support with 5 cm heel, and with 10 cm heel. CONCLUSION: The changes of heel height did not significantly influence the lumbar lordosis in normal adults and patients with spondylolisthesis. There were no significant differences in average slip angle according to heel height in patients with spondylolisthesis were found.
Adult* ; Animals ; Heel* ; Humans ; Lordosis* ; Shoes ; Spine ; Spondylolisthesis*

OBJECTIVE: To evaluate a child who presented bilateral hypoplasia of the thenar eminences and clumsy hands without sensory loss or nocturnal pain. METHOD: A careful history taking, physical examination, plain X-ray and electrophysiologic examination. RESULT: No familial history nor a systemic etiology were identified in this patient. Physical examination revealed a marked flattening of both thenar eminences and weakness of the abductor pollicis brevis and opponens pollicis of both hands. There was no sensory loss nor neurologic abnormality. X-rays of the hands showed thin both proximal end of the first metacarpals. The electrophysiologic examination showed electreical silence of both thenar eminences. History taking, physical examination, X-ray findings and electrophysiologic findings were all compatible with the Cavanagh syndrome. CONCLUSION: A careful history taking, physical examination and electrophysiologic examination are improtant for the diagnosis of congenital carpal tunnel syndrome.
Carpal Tunnel Syndrome* ; Child ; Diagnosis ; Hand ; Humans ; Metacarpal Bones ; Physical Examination

Facioscapulohumeral muscular dystrophy (FSHD) is a genetically trarlsmitted benign muscular dystrophy which has autosomal dominant inheritance pattern. It starts anytime within the first 30 years of life, and usually involves the face and shoulder girdle, and finally the pelvic muscles with very slow progression. Authors-report a fanily consisting of a father, two sons and one daughter, who had suffered from exertional dyspnea, weakness of facial muscle and winged scapulae, all wlth a slow progressive course. Two of these patients were biopsied arld confirmed light microscopically and electron microsopically.
Dyspnea ; Facial Muscles ; Fathers ; Humans ; Inheritance Patterns ; Muscles ; Muscular Dystrophies ; Muscular Dystrophy, Facioscapulohumeral* ; Nuclear Family ; Scapula ; Shoulder

OBJECTIVE: To determine the correlation between osteoporosis and the related factors through retrospective study. METHOD: Data from 1002 patients (834 women and 168 men) were analyzed through medical records [bone mineral density (BMD), age, height (Ht), body weight (BW), body mass index (BMI), and the accompanying conditions]. BMD of lumbar spine (L1-4) and femur (neck, Ward's triangle, trochanter, and shaft) were measured using dual energy x-ray absorptiometry (DEXA) and were correlated with age, Ht, BW, BMI, and accompanying diseases, and fracture incidence. RESULTS: 1) BMD of lumbar spine and femur neck in women significantly correlated with age and that of lumbar spine in men significantly correlated with BMI, Ht, BW. 2) The accompanying conditions in osteoporosis were diabetes mellitus (5.9%), Cushing syndrome (3.7%), oophorectomy (2.8%), hyperthyroidism (2.6%), and chronic renal failure (1.0%). 3) Fracture sites and their incidences were single spine (4.89%), multiple spine (2.99%), and femur (2.0%). 4) Mean BMD and T-score in fracture group was 0.687+/-0.16 g/cm2, 3.51+/-1.3 in lumbar spine and 0.578+/-0.14 g/cm2, 2.70+/-1.1 in femur, respectively. CONCLUSION: Osteoporosis is a major public health problem among the elderly, demanding effective strategic approach for prevention and treatment. We concluded that further studies of male osteoporosis are required.
Absorptiometry, Photon ; Aged ; Body Mass Index ; Body Weight ; Bone Density* ; Cushing Syndrome ; Diabetes Mellitus ; Female ; Femur ; Femur Neck ; Humans ; Hyperthyroidism ; Incidence ; Kidney Failure, Chronic ; Male ; Medical Records ; Osteoporosis* ; Ovariectomy ; Public Health ; Retrospective Studies ; Spine

Mononeuritis multiplex may be a manifestation of systemic vasculitis or of other illnesses such as sarcoidosis, diabetes, lymphoma, and AIDS. Anti-neutrophil cytoplasmic autoantibody(ANCA) is a serologic marker for pauci-immune crescentic glomerulonephritis and systemic necrotizing arteritis, including polyarteritis nodosa, Wegener's granulomatosis and so-called ANCA-associated vasculitis. We report a case of mononeuritis multiplex due to ANCA associated vasculitis. A 46-year-old female visited hospital because of peripheral edema, pain and dyspnea. We diagnosed neuropathy associated with vasculitis by electrophysiologic study, sural nerve biopsy and angiography. The patient was treated with prednisolone and cyclophosphamide. Her symptoms and signs improved and her ANCA test was converted from positive to negative.
Angiography ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Cytoplasm* ; Dyspnea ; Edema ; Female ; Glomerulonephritis ; Humans ; Lymphoma ; Middle Aged ; Mononeuropathies* ; Polyarteritis Nodosa ; Prednisolone ; Sarcoidosis ; Sural Nerve ; Systemic Vasculitis ; Vasculitis* ; Wegener Granulomatosis

In vivo 31P NMR spectra were obtained in eight infant brain at 4.7T. Each phosphorus metabolite and its ratio were analyzed to evaluate the brain damage and maturity, and compared with the reported data obtained at the lower field strength. Measurement of T1 relaxation time at 4.7T was done in an infant and a cat brain in vivo. PCr/Pi and PCr/β-ATP ratio were used as a marker of brain damage. PME/PDE revealed higher values than those of the reported data obtained at the lower field strength and the difference was partly attributed to the long T1 relaxation time of PME rather than the brain immaturity. Although the resolution of the spectrum was improved at 4.7T, a long repetition time is recommended to minimize T1difference of phosphorus metabolites of brain at 4.7T.
Animals ; Brain* ; Cats ; Humans ; Infant ; Magnetic Resonance Spectroscopy* ; Phosphorus ; Relaxation

Polycystic liver is the most common extra-renal manifestation associated with autosomal dominant polycystic kidney disease (ADPKD), comprising up to 80% of all features. Patients with polycystic liver often suffer from abdominal discomfort, dyspepsia, or dyspnea; however, there have been few ways to relieve their symptoms effectively and safely. Therefore, we tried transcatheter arterial embolization (TAE), which has been used in treating hepatocellular carcinoma. We enrolled four patients with ADPKD in Seoul National University Hospital, suffering from enlarged polycystic liver. We embolized the hepatic arteries supplying the dominant hepatic segments replaced by cysts using polyvinyl alcohol particles and micro-coils. The patients were evaluated 12 months after embolization for the change in both liver and cyst volumes. Among four patients, one patient was lost in follow up and 3 patients were included in the analysis. Both liver (33%; 10%) and cyst volume (47.7%; 11.4%) substantially decreased in two patients. Common adverse events were fever, epigastric pain, nausea, and vomiting. We suggest that TAE is effective and safe in treating symptomatic polycystic liver in selected ADPKD patients.
Aged ; Catheterization ; Cysts/*therapy ; Embolization, Therapeutic/instrumentation/*methods ; Female ; Hepatic Artery ; Humans ; Liver/pathology/physiology ; Liver Diseases/pathology/*therapy ; Middle Aged ; Polycystic Kidney, Autosomal Dominant/diagnosis/*therapy ; Polyvinyl Alcohol/therapeutic use ; Tomography, X-Ray Computed