OBJECTIVE: To investigate the feasibility of ultrasound (US)-guided steroid injection by in-plane approach for cubital tunnel syndrome (CuTS), based on symptomatic, morphologic and electrophysiological outcomes. METHODS: A total of 10 patients, who were clinically diagnosed as CuTS and confirmed by an electrodiagnostic study, participated in this study. US-guided injection into the cubital tunnel was performed with 40 mg triamcinolone and 2 mL of 1% lidocaine. Outcomes of the injections were evaluated at pre-injection, 1st week and 4th week after injection. Visual analog scale, self-administered questionnaire of the ulnar neuropathy at the elbow (SQUNE), and McGowan classification were used for clinical evaluation. Cross-sectional area of the ulnar nerve by US and the electrophysiological severity scale through a nerve conduction study were utilized in the evaluation of morphologic and electrophysiological changes. The cross-sectional area of the ulnar nerve was measured at 3 points of condylar, proximal, and distal level of the cubital tunnel. RESULTS: No side effects were reported during the study period. The visual analog scale and cross-sectional area showed a significant decrease at 1st week and 4th week, as compared to baseline (p<0.05). The electrophysiological severity scale was significantly decreased at the 4th week, as compared with baseline and 1st week (p<0.05). Among the quantitative components of the scale, there were statistically significant improvements with respect to the conduction velocity and block. CONCLUSION: The new approach of US-guided injection may be a safe tool for the treatment of CuTS. Symptomatic and morphologic recoveries preceded the electrophysiological improvement.
Classification ; Cubital Tunnel Syndrome ; Elbow* ; Humans ; Lidocaine ; Neural Conduction ; Pilot Projects* ; Triamcinolone ; Ulnar Nerve ; Ulnar Neuropathies* ; Ultrasonography ; Visual Analog Scale ; Surveys and Questionnaires

OBJECTIVE: To evaluate the effect of caffeine on balance control of hemiparetic stroke patients, we investigated the difference in postural stability before and after drinking coffee by observing changes in stability index (SI) from posturography. METHODS: Thirty patients with history of stroke and 15 age-matched healthy subjects participated in this study. Effect of group factor (of the control and stroke groups) and treatment factor (pre- and post-drinking of coffee) on SI were tested in three conditions: with eyes opened, with eyes closed, and with a pillow support. The effects of these factors on visual deprivation and somatosensory change of subjects were also tested. RESULTS: Under all conditions, SI was higher in the stroke group than in the control group. Under eyes-open condition, the treatment factor was not statistically significant. Under eyes-closed condition, the interaction between group and treatment factor was statistically significant. After the subjects drank coffee, SI in the control group was increased. However, SI in the stroke group was decreased. Under pillow-supported condition, the interaction between group and treatment factor appeared marginally significant. For visual deprivation effect, the interaction between treatment and group factor was statistically significant. After caffeine consumption, the visual deprivation effect was increased in control group but decreased in the stroke group. For somatosensory change effect, the interaction between group and treatment factor was not statistically significant. CONCLUSION: Postural stability of hemiparetic stroke patients related to somatosensory information was improved after intake of usual dose of caffeine.
Caffeine* ; Coffee ; Drinking ; Humans ; Stroke*

In order to define osteoporosis on the basis of bone mineral measurements, one must define an acceptable normal range or fracture threshold. It is clear that the normal range cannot be compared between different ethnic groups. We have measured spinal bone mineral density (BMD) by dual photon absorptiometry in 277 women without spinal fracture, aged 30-91 years, and in 53 women with asymptomatic spinal fracture to provide such a database for normal Korean women. Peak bone mass at the 3rd decade was 1.24 g/cm2. BMD from age 40-69 was strongly correlated with age (r = -0.7) and the annual decrease averaged 0.018gm/cm2. The rate of annual loss slowed by 50% in women after 70% years of age. Fracture threshold was evaluated at the 90th percentile for spinal BMD in patients with vertebral fractures. The fracture threshold of the vertebra was 0.94 g/cm2. Approximately 50% of normal women over 50 years of age had values below this threshold. These findings suggest that the way of developing low bone mass in Korean women is to peak high and lose fast.
Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; *Bone Density ; European Continental Ancestry Group ; Female ; Fractures, Bone/etiology ; Humans ; Korea ; Menopause/metabolism ; Middle Aged ; Osteoporosis/*metabolism ; Spine/*chemistry

BACKGROUND: Orbital complications may be occured by means of surgical injury to lamina papyracea during endoscopic sinus surgery or intranasal ethmoidectomy. The frequency of orbital complications increases when the natural dehiscence of lamina papyracea(NDLP) with or without prolapse of orbital content into ethmoid sinus is present. OBJECTIVES: The aim of this study is to evaluate the incidence and radiologic characteristics of NDLP, and to evaluate association NDLP with anatomical variations of nasal cavity and paranasal sinuses. MATERIALS AND METHOD: The axial and coronal paranasal sinus CT scans of 183 patients with chronic paranasal sinusitis(366 sides) who had undergone endoscopic sinus surgery were retrospectively reviewed and analyzed. The incidence and radiologic features of NDLP, and the association NDLP with anatomical variations of paranasal sinus and nasal cavity were analyzed. RESULTS: The NDLP was found in 18 patients(9.8%, n=183 patients) or 22 sides(6.0%, n=366 sides). The most common site of NDLP was superior portion(45.5%) in coronal image of paranasal sinus CT scans and anterior ethmoid sinus area(68.2%) in axial image. Grade 1 of NDLP(86.4%) was observed most commonly. NDLP was not associated with anatomical variations of paranasal sinus. CONCLUSION: The incidence of NDLP with prolapse of orbital content is far beyond general expectation, and close preoperative evaluation of paranasal sinus CT scans is important to avoid possible orbital complications.
Ethmoid Sinus ; Humans ; Incidence ; Intraoperative Complications ; Nasal Cavity ; Orbit* ; Paranasal Sinuses ; Prolapse* ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: As the incidence of bovine brucellosis increases in Korea, the incidence of human brucellosis is also increasing since 2002. However, it is difficult to identify Brucella species by using the conventional methods. METHODS: Three strains of gram-negative coccobacilli were isolated from blood specimens of three patients with prolonged fever, which were not identified by using the conventional methods. After extracting total DNA from these isolates, PCR amplification of 16S rRNA and omp2 genes was performed. These sequences secured by PCR assay were compared with known sequences by using GenBank BLAST. RESULTS: DNA sequences were obtained from 3 isolates by using PCR amplification of 16S rRNA. These sequences had more than 99.9% similarities with Brucella species by using GenBank BLAST. In the second place, after comparing DNA sequences secured by PCR amplification of omp2a and omp2b by using GenBank BLAST, these isolates were confirmed as B. abortus. CONCLUSIONS: DNA sequence analysis is a rapid and accurate method for identification of uncommon microorganisms, such as Brucella species.
Animals ; Base Sequence ; Brucella abortus* ; Brucella* ; Brucellosis ; Brucellosis, Bovine ; Cattle ; Databases, Nucleic Acid ; DNA ; Fever ; Humans ; Incidence ; Korea ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; Sequence Analysis, DNA

BACKGROUND: Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. MATERIALS AND METHODS: Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). RESULTS: A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies < or =1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. CONCLUSION: Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.
Agglutination Tests ; Aminoglycosides ; Animals ; Antibodies ; Brucella ; Brucella abortus ; Brucellosis* ; Brucellosis, Bovine ; Cattle ; Diagnosis ; Doxycycline ; Fatigue ; Fever ; Genes, rRNA ; Humans* ; Incidence ; Korea* ; Male ; Musculoskeletal System ; Rifampin

BACKGROUND: Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. MATERIALS AND METHODS: Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). RESULTS: A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies < or =1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. CONCLUSION: Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.
Agglutination Tests ; Aminoglycosides ; Animals ; Antibodies ; Brucella ; Brucella abortus ; Brucellosis* ; Brucellosis, Bovine ; Cattle ; Diagnosis ; Doxycycline ; Fatigue ; Fever ; Genes, rRNA ; Humans* ; Incidence ; Korea* ; Male ; Musculoskeletal System ; Rifampin