OBJECTIVE: The purposes of this study were to obtain the reference values of latency and amplitude of the medial plantar sensory nerve action potential(SNAP) in normal controls and to evaluate the diagnostic sensitivity of medial plantar sensory nerve conduction study(NCS) in diabetic neuropathy. METHOD: Thirty healthy controls(mean age, 48.7 years; range, 38~59 years) and 33 diabetic patients(mean age, 50.8 years; range, 37~64 years) were included in this study. The inclusion criteria for diabetic patients were subjects with the normal peroneal and tibial compound muscle action potentials, obtainable sural SNAPs and intact pressure-perception to Semmes-Weinstein monofilament 5.07. RESULTS: The medial plantar sensory nerve action potentials were obtainable in all control subjects and the reference values of onset latency and peak to peak amplitude were 4.29+/-0.49 msec and 3.1+/-1.34 V, respectively. All 33 diabetic patients showed the normal latency and 3 of them showed the low amplitude in sural SNAPs. The medial plantar SNAPs were obtainable in 24 diabetic patients. Among 9 patients with unobtainable medial plantar SNAPs, 6 showed the normal sural SNAPs and 3 showed the low sural SNAPs. The sensitivities of medial plantar SNAPs to sural nerve and sural SNAPs to medial plantar sensory nerve were 100%(3/3) and 27.3%(3/11) respectively. CONCLUSION: We concluded that medial plantar sensory NCS was more valuable in the early diagnosis of diabetic neuropathy than the sural NCS and Semmes-Weinstein monofilament (North Coast Medical Inc, USA).
Action Potentials ; Diabetic Neuropathies ; Early Diagnosis ; Humans ; Neural Conduction* ; Reference Values ; Sural Nerve ; Tibial Nerve

The purposes of the study was to measure the normal value of peak torque of lumbar extensors at various degrees of lumbar flexion and to compare this with the chronic low back pain patient. 100 normal subjects, 70 men(age, 49.0+/-.3) and 30 women(age, 48.1+/-.4), completed isometric lumbar extension strength test. 26 low back pain subjects, 9 men(age, 35.3+/-4.7) and 17 women(age, 42.6+/-0.1), completed isometric lumbar extension strength test. Normal male peak torques of lumbar extensors were 125+/-8 Ft-1bs at 0 degree, 164+/-3 at 12 degree, 200+/-3 at 24 degree, 221+/-6 at 35 degree, 241+/-0 at 48 degree, 257+/-0 at 60 degree, and 262+/-1 at 72 degree of lumbar flexion. Normal female peak torques of lumbar extensors were 78+/-4 at 0 degree, 105+/-7 at 12 degree, 120+/-38 at 24 degree, 135+/-5 at 36 degree, 142+/-7 at 48 degree, 151+/-0 at 60 degree, and 157+/-1 at 72 degree of lumbar flexion. Normal peak torques of lumbar extensors increase as degrees of lumbar flexion increase. Body weight in more correlated with peak torque than body mass index. Male peak torques of lumbar extensors with low back pain were 91+/-7 ft-1bs at 0 degree. 129+/-6 at 12 degree, 156+/-7 at 24 degree, 178+/-1 at 36 degree, 197+/-4 at 48 degree, 217+/-1 at 60 degree, and 218+/-2 at 72 degree of lumbar fiexion. Female peak torques of lumbar extensors with low back pain were 45+/-4 at 0 degree, 73+/-8 at 12 degree, 98+/-2 at 24 degree, 117+/-4 at 35 degree, 130+/-0 at 48 degree, 138+/-1 at 60 degree, and 148+/-6 at 72 degree of lumbar fiexion. Peak torques of lumbar extensors with 1cw back pain increase as degrees of lumbar flexion increase. Comparison of the normal male peak torque of lumbar extensors with low back pain group revealed statistical differences at 48 and 72 degree of lumbar extensors. And the female group revealed statistical difference at 0, 12, and 24 degree of lumbar flexion.
Back Pain ; Body Mass Index ; Body Weight ; Female ; Humans ; Low Back Pain* ; Male ; Reference Values ; Torque

OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

Glucocorticoid (GC) excess, including Cushing's syndrome, is a common cause of secondary osteoporosis. Thirty to fifty percent of Cushing's syndrome patients experience non-traumatic fractures, which is often the presenting manifestation of Cushing's syndrome. However, there have been rare cases of Cushing's syndrome diagnosed only based upon bone manifestations. We describe a case of Cushing's syndrome that was diagnosed in a 44-year-old woman who initially visited our hospital due to multiple non-traumatic rib fractures. She did not exhibit any other manifestations of Cushing's syndrome such as moon face, buffalo hump or abdominal striae. Initially, we evaluated her for bone metastases from a cancer of unknown origin, but there was no evidence of metastatic cancer. Instead, we found a left adrenal incidentaloma. As a result of the hormone study, she was diagnosed as having Cushing's syndrome. Interestingly, her bony manifestation of Cushing's syndrome, which was evident in the bone scan and bone mineral densitometry, completely recovered after a left adrenalectomy. Therefore, the possibility of Cushing's syndrome as a cause of secondary osteoporosis should be considered in young patients with non-traumatic multiple fractures, with or without any other typical features of Cushing's syndrome.
Adrenalectomy ; Adult ; Buffaloes ; Cushing Syndrome* ; Densitometry ; Female ; Humans ; Neoplasm Metastasis ; Osteoporosis ; Rib Fractures*

L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the 7th RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.
Aged ; Disease Progression ; Female ; Humans ; Hypothyroidism ; Iodine ; Lymph Nodes ; Middle Aged ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Pleural Effusion ; Pleural Effusion, Malignant* ; Pleurodesis ; Quality of Life ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Hormones ; Thyroid Neoplasms ; Thyrotropin ; Thyroxine

A primary sarcoma of the pulmonary artery is a rare disease. The symptoms of the disease are nonspecific, so it is very difficult to get an exact diagnosis in an emegency situation. A 48-year-old man was admitted to our emergency center with the history of syncope. The patient had no symptoms of a chest problem. During the diagnostic work up, we found an increased density in the left upper lung field on the chest PA, which was the only diagnostic clue to the patient 's illness. A chest CT, a chest MRI, and other studies were done to diagnose the undelying cause of syncope. We found a large intraluminal mass in the pulmonary artery and anterior mediastinal lymph node enlargement. A firm tumor, which arose from the main pulmonary artery and caused a near total obstruction of the left main pulmonary artery, was found during operation, and a partial resection of the tumor mass was done. Histologic and immunohistochemical staining revealed the tumor to be poorly differentiated spindle cell sarcoma. We report the case of a pulmonary artery sarcoma patient, along with a brief review of related literature.
Diagnosis ; Emergencies ; Hemangiosarcoma* ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Pulmonary Artery* ; Rare Diseases ; Sarcoma ; Syncope ; Thorax ; Tomography, X-Ray Computed

Central core disease is a rare autosomal dominantly inherited non-progressive congenital myopathy, which is pathologically characterized by the formation of a "core". We report a 28-year-old female with non-progressive muscle weakness, who had a hypotonic posture at birth. The developmental milestones were delayed with her first walking at 18 months of age. She could not run or walk a long distance and weight-bearing tasks were almost impossible. None of her family members showed motor symptoms. An investigation of the electromyography and nerve conduction velocity showed non-specific results. A gastrocnemius muscle biopsy revealed central cores in approximately 70% of myofibers with a type 1 myofiber predominance and deranged sarcolemmal structures. To the best of our knowledge, this is the fifth report of central core disease in the Korean literature.
Adult ; Biopsy ; Electromyography ; Female ; Humans ; Muscle Weakness ; Muscle, Skeletal ; Muscular Diseases ; Myopathy, Central Core* ; Neural Conduction ; Parturition ; Posture ; Walking ; Weight-Bearing

No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*