Purpose: We hereby would like to compare on the basis of the initial 12 hips and latter 18 hips by analyzing the initial results of the minimal incision total hip arthroplasty of 30 hips we experienced. Materials and Methods: For the period of December 2004 through June 2005, we performed the total hip arthroplasty with minimal incision in 10cm or shorter using the posterolateral approach on 25 patients (30 hips) whose BMI(body mass index) is 30 or lower. We compared by analyzing results of the initial 12 cases and 18 latter cases. Results: The average BMI was 23.7. There weren`t statistically meaningful differences the change in the hemoglobin value of pre-op and post-op, necessity of blood transfusion, position of component, and the Harris hip score 6 weeks after operation. But, the average initial operation time of 124 minutes was remarkably reduced to 65 minutes in average in the latter operation and the length of a skin incision was reduced from the average 9.2 cm in the initial operation to an average of 8.1cm in the latter operation. There wasn't the malposition of acetabular cup and femoral stem. Conclusion: Although we need more statistical data through more cases and the analysis of long-term results, we think that, to surgeons with much experience in the conventional total hip arthroplasty, the total hip anthroplasty using minimal incision for patients with BMI of 30 or below would be a useful approach having the advantage in a cosmetic aspect.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Blood Transfusion ; Hip ; Humans ; Learning Curve* ; Learning* ; Skin

OBJECTIVE: To evaluate the diagnostic values of segmental somatosensory evoked potentials (SEPs) in the unilevel/unilateral lumbosacral radiculopathies. METHOD: Thirty-nine radiculopathy patients of whom diagnosis was confirmed by the surgery or selective nerve root injection and 20 subjects with no evidence of radiculopathy were included in the study. Before the treatment, superficial peroneal nerve segmental SEPs and sural nerve segmental SEPs were performed. Sensitivities and specificities were delineated from the several diagnostic criteria. RESULTS: The analysis of side-to-side mean cortical P1 latency difference (>2.0 SD) reveals a segmental SEPs sensitivity for L5 radiculopathies of 12.1% and sensitivity for S1 radiculopathies of 0%. The analysis of side-to-side mean percent amplitude difference (2.0 SD) reveals a segmental SEPs sensitivity for L5 radiculopathies of 9.1% and sensitivity for S1 radiculopathies of 0%. The analysis of side-to-side mean cortical P1 latency difference (>3 ms) and the side-to-side mean amplitude reduction (>50%) show the similar results. The specificities of L5 radiculopathies and S1 radiculopathies are variable from 40.0% to 93.3%. Sensitivities of segmental SEPs are lower than needle EMG. It is not root specific, even the SEP is not obtainable unilaterally. CONCLUSION: The diagnostic values of segmental somatosensory SEPs are questionable in the unilevel/unilateral lumbosacral radiculopathies which are confirmed by the surgery or selective nerve root injection.
Diagnosis ; Evoked Potentials, Somatosensory ; Humans ; Needles ; Peroneal Nerve ; Radiculopathy* ; Sural Nerve

The purpose of the study was to find prognostic indicators of dysphagia recovery after stroke. 26 dysphagic patients with history of aspiration divided into two groups, oral feeding group and persisting aspirating group(c ontinue tube feeding after acute stage of stroke rehabilitation). We evaluated the neurologic locus of stroke lesion. Functional Independence Measure(FIM) score, parameters of the bedside swallowing test and videofluoroscopic modified barium swallow. The neurologic locus of stroke lesion was not correlate with the recovery of aspiration due to stoke. The low FIM score(less than 50), large amount of pharyngeal residue, decreased clearing ability of residue, and delayed pharyngeal transit time(over 3 sec) were bad prognostic indicators of dysphagia recovery. We may use criteria for recommendation of continuous tube feeding especially, Percutaneous Endoscopic Gastrostomy(PEG) in dysphagic patients after stroke.
Barium ; Deglutition ; Deglutition Disorders* ; Enteral Nutrition ; Gastrostomy ; Humans ; Stroke

OBJECTIVES: Heart rate variability (HRV) has gained recognition as a noninvasive marker of autonomic activity. HRV is considered a promising tool in various clinical scenarios. The optimal electrocardiogram (ECG) sampling frequency required to ensure sufficient precision of R–R intervals for HRV analysis has not yet been determined. Here, we aimed to determine the acceptable ECG sampling frequency range by analyzing ECG signals from patients who visited an emergency department with the chief complaint of acute intoxication or overdose. METHODS: The study included 83 adult patients who visited an emergency department with the chief complaint of acute poisoning. The original 1,000-Hz ECG signals were down-sampled to 500-, 250-, 100-, and 50-Hz sampling frequencies with linear interpolation. R–R interval data were analyzed for time-domain, frequency-domain, and nonlinear HRV parameters. Parameters derived from the data on down-sampled frequencies were compared with those derived from the data on 1,000-Hz signals, and Lin's concordance correlation coefficients were calculated. RESULTS: Down-sampling to 500 or 250 Hz resulted in excellent concordance. Signals down-sampled to 100 Hz produced acceptable results for time-domain analysis and Poincaré plots, but not for frequency-domain analysis. Down-sampling to 50 Hz proved to be unacceptable for both time- and frequency-domain analyses. At 50 Hz, the root-mean-squared successive differences and the power of high frequency tended to have high values and random errors. CONCLUSIONS: A 250-Hz sampling frequency would be acceptable for HRV analysis. When frequency-domain analysis is not required, a 100-Hz sampling frequency would also be acceptable.
Adult ; Electrocardiography* ; Emergencies ; Emergency Service, Hospital ; Heart Rate* ; Heart* ; Humans ; Poisoning ; Signal Processing, Computer-Assisted

OBJECTIVE: To evaluate the pattern of developmental delay of language and to correlate the language with other developmental areas in cerebral palsy children. METHOD: Sequenced Inventory of Communication Development (SICD) was studied in 31 children with cerebral palsy of age ranging from 11 months to 48 months. Korean Denver Developmental Screening Test (DDST) was also performed in 18 children simultaneously. RESULTS: On SICD, 10 children (32.3%) showed the receptive language delay and 13 children (41.9%) showed the expressive language delay. Among 15 spastic quadriplegic children, 40% showed the delay of receptive language development, 53.3% showed the delay in expressive language development. Among 10 spastic diplegic children, 30% showed the delay of both receptive and expressive language development. One spastic right hemiplegic child showed a delay of expressive language development, but 4 left hemiplegic children showed the normal language development. One hypotonic cerebral palsy child showed a delay of both receptive and expressive language development. The expressive language was delayed more than the receptive language. SICD correlated highly with the language sector of DDST. And both SICD and DDST language sectors correlated with the other sectors of DDST (personal-social, fine motor-adaptive, gross motor), especially with the fine motor sector (r=0.912, 0.918, 0.976, p<0.001). CONCLUSION: There is a considerably high incidence of developmental delay of language in cerebral palsy children, especially among spastic quadriplegic children. The early evaluation and treatment for the developmental delay of language need to be included in a general rehabilitation program for the cerebral palsy children.
Cerebral Palsy* ; Child* ; Humans ; Incidence ; Language Development ; Language Development Disorders ; Mass Screening ; Muscle Spasticity ; Rehabilitation

This prospective study following American Association of Electrodiagnostic Medicine recommended criteria in the diagnosis of Carpal Tunnel Syndrome(CTS) evaluated the sensitivity of multi-electrodiagnostic parameters and usefulness of residual latency in CTS. In 45 symptomatic hands of 26 patients with clinical diagnosis of CTS, 8 electrodiagnostic parameters-median motor distal latency, median motor residual latency, median sensory onset latency, median sensory peak latency, median to ulnar sensory onset latency difference(digit 4), median to ulnar sensory peak latency difference(digit 4), median to radial sensory onset latency difference(digit 1), median to radial sensory peak latency difference(digit 1)-were compared to the normative data obtained from the age-matched control group. In 31 CTS hands without polyneuropathy, median to ulnar sensory latency difference(digit 4), median to radial sensory latency difference(digit 1), median sensory peak latency have same sensitivity(71.0%). In 8 CTS hands with delayed proximal median motor nerve conduction velocity which were indiscernible from polyneuropathy in routine nerve conduction study, residual latency was more sensitive than median to ulnar sensory latency difference and median to radial sensory latency difference. Sensitivity difference between sensory onset latency and sensory peak latency was negligible in the electrophysiologic diagnosis of CTS. We concluded that residual latency measurement was a very useful and convenient method in the diagnosis of CTS, especially in the patients with delayed proximal median motor conduction velocity.
Carpal Tunnel Syndrome* ; Diagnosis ; Hand ; Humans ; Neural Conduction ; Polyneuropathies ; Prospective Studies

Objective: To investigate the effect of sensory-based feeding treatment for toddlers with food refusal compared with only providing nutrition education. Methods: Thirty-two toddlers with food refusal were randomly assigned to an intervention group or the control group. Toddlers in the intervention group received the sensory-based feeding intervention and the duration was for 1 hour for 5 days per week for 4 weeks, and then 1 hour, once a week for 8 weeks. Subjects in both the intervention and control groups received nutritional education once every 4 weeks for 12 weeks. The participants were evaluated at their entry into the study and 12 weeks later based on height, weight, behavior at mealtime using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), and sensory processing ability using the Infant/Toddler Sensory Profile. Results: Sixteen toddlers were included in each group. Two subjects in the intervention group and four toddlers in the control group were excluded from the final analysis. Significant improvements in child or parent subscales of the BPFAS were observed in the intervention group. In contrast, there were no significant improvements in any BPFAS scores in the control group. Conclusion Sensory-based feeding intervention was effective for improving mealtime behavior in toddlers with food refusal. Therefore, a sensory-based feeding intervention could be considered as an intervention approach to address feeding disorders in toddlers.

OBJECTIVE: This study was to evaluate the correlation of clinical symptoms and physical signs with electrodiagnostic findings in carpal tunnel syndrome (CTS), and to increase the usefulness of clinical symptoms and physical signs in the diagnosis of CTS. METHOD: We prospectively identified 322 hands from 172 subjects clinically from 5 tertiary hospitals. All subjects completed 6 clinical symptoms and 6 physical signs including 3 provocative tests. Each symptoms and signs were divided motor and sensory symptoms and signs, and the correlation between symptoms and signs and the results of motor and sensory conduction studies and needle electromyography were evaluated. The sensitivity and specificity of each valuable symptoms and signs for electrodiagnostic results were also assessed. RESULTS: Tingling sensation, nocturnal pain, worsening, and Phalen sign were correlated with motor conduction study, and falling tendency, abductor pollicis brevis weakness and atrophy, tingling sensation, hypoesthesia, and Tinel and Phalen signs were correlated with needle electromyography. The Phalen sign had the best sensitivity and specificity for median motor conduction study, and the best sensitive physical sign for needle electromyography. CONCLUSION: Motor and sensory symptoms and signs were not correlated with motor and sensory conduction studies, but motor symptoms and signs were correlated with needle electromyography. The Phalen test was the most useful evaluating tool to diagnose CTS.
Atrophy ; Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Electromyography ; Hand ; Hypesthesia ; Needles ; Prospective Studies ; Sensation ; Sensitivity and Specificity ; Tertiary Care Centers

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OBJECTIVE: To investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP. METHODS: A cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS). RESULTS: GMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility. CONCLUSION: These findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.
Cerebral Palsy ; Child ; Cross-Sectional Studies ; Disability Evaluation ; Extremities ; Hand ; Humans ; Paralysis ; Self Care ; Severity of Illness Index