PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Cellulitis ; Foot ; Hand ; Humans ; Male* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Sprains and Strains ; Tendons ; Weight-Bearing

No abstract available.
Acupuncture ; Sarcoidosis

BACKGROUND: Obesity is a risk factor for metabolic abnormalities. We investigated the relationship of adiponectin levels and visceral adiposity with insulin resistance and β-cell dysfunction. METHODS: This cross-sectional study enrolled 1,347 participants (501 men and 846 women aged 30–64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Serum adiponectin levels and visceral fat were measured using enzyme-linked immunosorbent assay kits and dual-energy X-ray absorptiometry, respectively. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance (HOMA-IR) and Matsuda insulin sensitivity index. β-cell dysfunction was evaluated using the homeostatic model assessment of β-cell function (HOMA-β), insulinogenic index, and disposition index. RESULTS: Regarding insulin resistance, compared with individuals with the highest adiponectin levels and visceral fat mass < 75th percentile, the fully adjusted odds ratios (ORs) for HOMA-IR ≥ 2.5 and Matsuda index < 25th percentile were 13.79 (95% confidence interval, 7.65–24.83) and 8.34 (4.66–14.93), respectively, for individuals with the lowest adiponectin levels and visceral fat ≥ 75th percentile. Regarding β-cell dysfunction, the corresponding ORs for HOMA-β< 25th percentile, insulinogenic index < 25th percentile, and disposition index < 25th percentile were 1.20 (0.71–2.02), 1.01 (0.61–1.66), and 1.87 (1.15–3.04), respectively. CONCLUSION: Low adiponectin levels and high visceral adiposity might affect insulin resistance and β-cell dysfunction.
Absorptiometry, Photon ; Adiponectin* ; Adiposity ; Cross-Sectional Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat* ; Male ; Metabolic Diseases ; Obesity ; Odds Ratio ; Risk Factors

Bell's palsy is a relatively common, unilateral facial paralysis of unknown etiology. The purpose of this study was to evaluate the prognostic value of several electrophysiologic tests in Bell's palsy. Blink reflex (BR), side-to-side compound muscle action potential (CMAP) amplitude comparison, and side-to-side nerve excitability test (NET) threshold differ once have been studied during the first 2 weeks in 66 patients with Bell's palsy. According to the early response of BR(Rl), the patients were divided into 3 groups: Rl< or = 13ms(17cases) ; Rl>13ms(22cases), and absent BR(27cases). There was a remarkable tendency towards a satisfactory recovery from paralysis if BR occurred during the first 2 weeks from onset(p<0.001). In patients with normal BR, 88.2% had a satisfactory recovery, when the reflex was absent a bad prognosis was given in 59.3% of the patients. According to side-to-side CMAP amplitude comparison, the patients were divided into 2 groups; CMAP amplitude comparison > or = 25% (35cases), and CMAP amplitude comparison <25% (31cases). There was a tendency towards a satisfactory recovery from paralysis if side-to-side CMAP amplitude comparison was more than 25% (p < 0,003). In patients with more than 25% of CMAP amplitude comparison, 82.9% of the patients had a satisfactory recovery, but in patients with less than 25% of CMAP amplitude comparison, 51.6% of the patients had a bad prognosis. According to side-to-side NET threshold difference, the patients were divided into 2 groups, NET threshold difference < or = 3.5mA(43cases), and NET threshold difference >3.5mA (23cases). When the threshold of electrical excitability on both sides differs 3.5mA or more an unsatisfactory recovery has strongly to expected(p<0.001). In patients with less than 3.5mA of NET threshold, 81.4% had a satisfactory recovery, but in patients with more than 3.5mA of NET threshold, 60.9% had a bad prognosis. BR, side-to-side CMAP amplitude comparison, and side-to-side NET threshold difference seem to be useful independent indices for predicting the prognosis an early stage of the paralysis.
Action Potentials ; Bell Palsy* ; Blinking ; Facial Paralysis ; Humans ; Paralysis ; Prognosis ; Reflex

No abstract available.
Humans ; Pericardial Effusion*

OBJECTIVE: With rapid increase of HIV infection worldwide, researchers have been naturally concerned about their psychosocial adjustment and problems to living with AIDS. This study examined coping and psychosocial variables, and their interrelationship to evaluate the psychosocial adjustment and problems of HIV-positive patients. METHOD: A total of 27 HIV-positive patients were interviewed and they completed self administered scales of the ways of coping, HADS, perceived stress, family support, and SF-36. Also, the control subjects included two samples of 27 hematopoietic cell transplantation patients, and 30 healthy persons. The data were analyzed using analysis of variance and scheffe's multiple range test to check for significant differences among the mean scores in three samples. RESULTS: 1) As for the coping styles, there were no significant differences among the three groups. 2) The mean scores of perceived stress in HIV-positive patients were significantly higher than those in normal controls. 3) The mean scores of family support scale were significantly lower in HIV-positive patients than those in normal controls. 4) The mean scores of depression and anxiety on HADS were significantly higher in HIV-positive patients than those in normal controls. 5) There were no significant associations between active or passive coping styles and depressive/anxiety or perceived stress in HIV-positive patients. 6) The mean scores of health status(SF-36) were significantly lower in HIV-positive patients than those in normal controls. CONCLUSION: Although coping styles had no significant influence on depression/anxiety, HIV-positive patients showed higher scores on depression/anxiety, and perceived stress compared with normal controls. They received lower family support than hematopoietic stem cell transplantation patients and normal controls. HIV-positive patients rated their general health status as worse than normal controls. These findings might point to the need for more attention to some psychosocial variables in HIV-positive patients.
Anxiety ; Cell Transplantation ; Depression ; Hematopoietic Stem Cell Transplantation ; HIV Infections ; Humans ; Transplants ; Weights and Measures

OBJECTIVE: We report an analysis of the clinical outcome of surgical treatment of lumbar facet cyst. METHODS: From March, 1996 to June, 2001, we analyzed the symptom and sign, cyst level, combined disease, treatment method, pathology and surgical result(Prolo's scale) of 11 patients. RESULTS: Mean age of 11 patients was 55.6 years and mean follow up duration was 27 months. Of 11 patients, six cases had low back pain and five cases had radiating leg pain as chief complaint. Five had only facet cyst that compressed the nerve root without other combined diseases. Of six patients who had facet cyst with combined disease, three had intraspinal stenosis and the remaining three had spondylolytic spondylolisthesis. There was one case of bilateral facet cyst. We had totally excised facet cyst and treated combined degenerative disease such as lumbar stenosis, lumbar instability or spondylolytic spondylolithesis. The pathologic result were synovial cyst for eight cases and ganglion for three cases. In all cases, symptoms improved without complication or recurrence. CONCLUSION: Surgical outcome of lumbar facet cyst is good and surgical intervention is recommended in facet cyst with back pain, radiculopathy and combined degenerative diseases.
Back Pain ; Constriction, Pathologic ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Leg ; Low Back Pain ; Pathology ; Radiculopathy ; Recurrence ; Spondylolisthesis ; Synovial Cyst

BACKGROUND: Ambulatory blood pressure monitoring is widely available in clinical practice. To evaluate the pattern of normal 24 hour variation of blood pressure and the problems in analysis of data which was obtained with use of automatic blood pressure recorder, 24 hour ambulatory blood pressure was measured. METHODS: Ambulatory blood pressure was recorded for 24 hours with automatic blood pressure monitor in 22 normotensive young adolescents. RESULTS: 1) Average 24-hour BP was 109mmHg in systolic(115+/-30 for male, 102+/-30 for female), 66mmHg in diastolic(69+/-18 for male, 63+/-19 for female) and pulse rate was 72 beats per minute(70+/-23 for male, 75+/-26 for female). 2) Data obtained from ambulatory blood pressure monitor should be analyzed after deletion of unacceptable data with use of conventional criteria. Blood pressure increase which is not accompanied by increase in pulse rate increase can be used as another criteria to rule out unacceptable blood pressure data. 3) Blood pressure was low from mid-night to 6 A.M. and began to rise slowly till mid-day and then maintained steadily through the remainder of the day. And 24 hour variation of blood pressure was more adequately assessed after application of Fourier analysis. CONCLUSIONS: These results suggest that certain deletion criteria was inevitable during analysis of the data which were obtained from ambulatory blood pressure recorder and Fourier analysis can be used as valuable smoothing technique to assess the 24-hour blood pressure profiles.
Adolescent* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Fourier Analysis ; Heart Rate ; Humans ; Male

Hereditary spastic ataxia is a familial neurological disorder which exhibit the features of a progressive combined pyramidal tract and cerebellar deficiency. The main features are progressive gait disturbance, incoordination, nystagmus, visual impairment, hyperreflexia, extensor plantar response, peripheral neuropathy, and pes cavus. A 27-year-old male patient with spastic ataxic gait was evaluated. He showed characteristic features of hereditary spastic ataxia. There were another twelve affected members in four generations of his family which may be inherited by autosomal dominant pattern. One of them is reported with review of the literature on familial spastic ataxia.
Adult ; Ataxia* ; Family Characteristics ; Foot Deformities ; Gait ; Humans ; Male ; Muscle Spasticity* ; Nervous System Diseases ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Reflex, Abnormal ; Reflex, Babinski ; Vision Disorders

The spontaneous hematomyelia is an uncommon event and its predisposing conditions are vascular malformation, syringomyelia, pregnancy and delivery, angioma, hemophilia, anticoagulant therapy, etc. We have recently experienced the patient with spontaneous onset and resolving hematomyelia in the cervical spinal cord. A 30-year-old male patient with non-traumatic spinal shock was evaluated. On MRI, a hematomyelia along cervical spi-nal cord was revealed. A suspicious AV malformation was noticed at C3-4 level. Fol-low-up MRIs showed spontaneous resolution of the hematoma.
Adult ; Hemangioma ; Hematoma ; Hemophilia A ; Humans ; Magnetic Resonance Imaging ; Male ; Pregnancy ; Shock ; Spinal Cord ; Spinal Cord Vascular Diseases* ; Syringomyelia ; Vascular Malformations