No abstract available.
Neural Conduction*

The oropharyngeal swallow of 26 patients with dysphagia was studied quantitatively and qualitatively using videofluoroscope. Videofluoroscopic examination was done with head in neutral position, and with three different c onsistency of test meals; thin liquid, thick liquid, and solid, When aspiration or laryngeal penetration was noted in neutral position, the study was repeated with different head positions, We compared them with each other and with 25 normal subject(previously presented). 11/26(42%) patients revealed laryngeal penetration or aspiration at least with one consistency of test meal. Aspiration occurred more frequently in thin liquid than thick liquid or solid, Head position change successfully eliminated aspiration in 10/10 patients(100%). Other one patient could not change his head position. 9 numerical parameters were derived and calculated for quantitative examination, Liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were significantly increased in patients with aspiration than in patients without aspiration. Also significantly increased than those of normal controls. Because different test meal consistency gave different values, direct comparison of values regardless of meal consistency was fruitless. And because all the process of swallowing cannot be expressed as numerical parameters qualitative examination of videofluoroscopic result was essential. In conclusion, liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were useful parameters in differentiating and quantifying dysphagia. Aspiration can be reduced when appropriate position assumed. Calculated values were different a according to the consistency of the test meal. Quantitative analysis was helpful, but qualitative examination of videofluoroscopy was essential.
Deglutition Disorders* ; Deglutition* ; Head ; Humans ; Meals ; Posture* ; Viscosity*

No abstract available.
Humans

PURPOSE: Piccolo et al. advocated the usefulness of Tc-99m-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied Tc-99m-MDP uptake pattern and lesions/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of Tc-99m-MDP scan. MATERIALS AND METHODS: Total 34 patients were studied with physical examination, mammogram and Tc-99m-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq Tc-99m-MDP. Breast uptake pattern of Tc-99m-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammo-grain. RESULTS: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of Tc-99m-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 2/7, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. CONCLUSION: Tc-99m-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Biopsy ; Biopsy, Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Mammography ; Physical Examination ; Prospective Studies ; Technetium Tc 99m Medronate*

The understandings of the characteristics of eccentric exercise are very important because all sports and daily activities under the gravity force should be well coupled between concentric contraction and eccentric contraction as accelerator and decelerator respectively. We tested 40 knee flexors and extensors of 20 normal young persons at different anglular velocities of 60o/sec and 120o/sec using Cybex 6000 (A division of Lumax, New York) isokinetic dynamometer in order to know the characteristics of eccentric isokinetic contraction parameters by comparing with concentric isokinetic parameters. Compared to the concentric isokinetic contraction, eccentric isokinetic the peak torque and average power values of knee extensor and flexor muscles showed negative values which means that eccentric contractions were coupled with concentric contractions as decelerator and energy absorptioner. The peak torque values of eccentric contraction were 38 - 61%, 44 - 79% higher in flexor and extensor, respectively than those of concentric contraction and not so decreased as the peak torque of concentric contraction decreased in high angular velocity. The average power values of knee flexor and extensor muscles were definitely low in eccentric contracton than those of concentric contraction but were increased simultaneously with high angular velocity contraction. Further studies about the velocity dependency, muscle soreness, methodology to measure real eccentric activities and other parameters of eccentric contraction are needed imminently.
Absorption ; Exercise Test* ; Gravitation ; Humans ; Knee ; Muscles ; Myalgia ; Sports ; Torque

OBJECTIVE: To compare the diagnostic significance of H reflex and somatosensory evoked potential(SEP) in the diagnosis of S1 radiculopathy, and to explore the possible interpretations on the discrepancies of the test results. METHOD: Twenty-eight patients who were diagnosed as a S1 radiculopathy by the clinical and radiological correlations, and thirty-five controls with no evidence of S1 radiculopathy by the clinical or radiological studies were studied by the H reflex, sural SEP, and needle electromyography. RESULTS: The sensitivity of H reflex study was 64% for the S1 radiculopathy, and the specificity was 86%. The sensitivity and the specificity of the sural SEP study for the S1 radiculopathy were 50% and 80% respectively. Within 1 month from the onset, the sensitivity of H reflex increased to 75%. The needle electromyography showed 19% for the sensitivity and 100% for the specificity. The probability of the S1 radiculopathy was 70% in 10 cases who had the abnormal H reflex and normal SEP values and 36% in 8 cases who had the normal H reflex and abnormal SEP values. CONCLUSION: H reflex study was the most sensitive test in the electrodiagnosis of the S1 radiculopathy and the electrodiagnostic significance of sural SEP was obscure.
Diagnosis ; Electrodiagnosis ; Electromyography ; Evoked Potentials, Somatosensory* ; H-Reflex* ; Humans ; Needles ; Radiculopathy* ; Sensitivity and Specificity

No abstract available.
Myopathies, Nemaline*

Osteoporosis is the most common generalized skeletal disease, which lays a significant socioeconomic burden to Korea. The early diagnosis and treatment of osteoporosis are of the great interest to minimize the economic co nsequence. We have studied vertebral BMD and bone scan of 30 patients with osteoporotic compression fractures. The purpose of this study was to investigate the effect of osteoporotic compression fracture on bone mineral density(BMD). We have measured the vertebral heights, vertebral bone mineral density, and bone scan counts of vertebral bodies on osteoporotic patients. Vertebral BMD was measured from T12 to L4 using dual photon absorptiometry. Anterior(Ha), middle(Hm), and posterior(Hp) height of vertebrae were measured from T12 to L4, and the spinal deformity indices(Ha/Hp, Hm/Hp, and Hp/Hi ratios) were calculated. The bone scan counts were measured from T12 to L4, and bone scan ratios were calculated. The BMD of fractured vertebrae was significantly higher than that of non-fractured vertebrae The spinal deformity indices were not correlated to the BMD of fractured vertebrae. The bone scan ratio was correlated to the BMD of fractured vertebrae. This study suggests that the increased BMD observed in fractured vertebrae is related to metabolic effect of compression fractures rather than mechanical effect.
Absorptiometry, Photon ; Bone Density* ; Congenital Abnormalities ; Early Diagnosis ; Fractures, Compression* ; Humans ; Korea ; Osteoporosis ; Spine

The purpose of this study was to evaluate the association between glycated hemoglobin (HbA1c) and all-cause mortality in type 2 diabetes mellitus. We conducted a community-based prospective cohort study of 352 type 2 diabetic patients aged 30-92 who participated in a community diabetes complications screening program in Gokseng-gun, Jeollanamdo, Korea. HbA1c levels were categorized as <6.5%, 6.5-6.9%, 7.0-7.9%, 8.0-8.9% and ≥9.0%. Patients were followed up on for a mean of 6.9 years. The Cox proportional hazards model was used to evaluate the relationship between HbA1c levels and all-cause mortality. During the mean follow-up period of 6.9 years, 77 patients (21.9%) died. A J-shaped association was found between HbA1c and all-cause mortality, with the lowest mortality at 6.5-6.9% of HbA1c levels. Compared to patients with HbA1c of 6.5-6.9%, patients with <6.5%, 7.0-7.9%, 8.0-8.9% and ≥9.0% had an adjusted hazard ratio (95% confidence interval) for all-cause mortality of 1.71 (0.76-3.84), 1.23 (0.53-2.82), 1.32(0.51-3.44) and 2.66 (1.01-7.02), respectively. We found a J-shaped association between glycated hemoglobin and all-cause mortality in Korean type 2 diabetic patients.
Cohort Studies ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Follow-Up Studies ; Hemoglobin A, Glycosylated ; Humans ; Jeollanam-do ; Korea ; Mass Screening ; Mortality ; Proportional Hazards Models ; Prospective Studies

PURPOSE: We conducted a study on patients who underwent hip joint arthroplasty because of unstable femur intertrochanteric fractures with greater trochanter bony fragments. After dividing patients into three groups depending on their fracture patterns, we evaluated the clinical and radiological outcomes of different operation methods applied to each of these groups. MATERIALS AND METHODS: Using Evan's classification, we defined an unstable intertrochanteric fracture as those characterized as stage 4 or 5. Of the 137 patients presenting with an intertrochanteric fracture with osteoporosis (bone mineral density, <−2.5) between March 2014 and October 2015, 63 met the eligibility criteria and were included in this study. Next, patients were divided into three groups based on their greater trochanter fracture patterns (discerned with three-dimensional computed tomography images); different fixation methods were applied to each group by a single orthopaedic surgeon. RESULTS: Taken as a whole, 50 out of 63 patients experienced no reduction in walking distance in their daily lives. Harris hip score increased from 74.8 to 85.7 point and we considered this a relatively good result. Radiologically, we observed complete bone union in 62 cases (98.4%); the lone exception was in a patient who experienced osteolysis. There were also 3 cases who removed greater trochanter reattachment device due to broken implant and 1 case of dislocation. CONCLUSION: The different fixation methods applied to three distinct groups with varying fractures patterns were successful in achieving proper reduction and fixation of greater trochanteric fractures. We also observed reduced bone union periods when arthroplasty was performed in patients with unstable intertrochanteric fractures. Lastly, we believe these approaches may also aid in achieving early ambulation and early rehabilitations.
Arthroplasty* ; Classification ; Dislocations ; Early Ambulation ; Femur* ; Hip ; Hip Fractures* ; Hip Joint ; Humans ; Methods* ; Miners ; Osteolysis ; Osteoporosis ; Walking