Low back pain is one of the most popular disorders in the industrized country. About 80% of adults will experience low back pain at some time in their lives. Low back pain is a symptom that can be caused by various disease entities and can be affected by various factors. To treat and prevent low back pain we have to educate patients about proper position and exercise. Exercise can improve muscle strength and flexibility. Spine consists of 33 vertebrae. The 33 vertebrae of the spine are divided into five regions : cervical, thoracic, lumbar, sacral, and coccygeal. Between each of the cervical, thoracic, and lumbar vertebrae lie intervertebral disks that act as important shock absorbers for the spines. The major ligaments are the anterior longitudinal, the posterior longitudinal, and the supraspinous. The muscles that extend the spine and rotate the vertebral column can be classified as either superficial or deep. The superficial muscles extend from vertebrae to ribs. The deep muscles attach one vertebrae to another and function to extend and rotate the spine. To prescribe exercise to patients with back pain, it is essential to evaluate the patients status such as duration, cause, age, and muscle condition. The components of exercise prescription include type, intensity, duration, and frequency of exercise. Muscle groups for stretching include hamstrings, back extensors, lumbar rotators, lumbar lateral flexors, and hip muscles. Stretching exercise should be performed gently and slowly at first. Back extension exercise reduces neural tension and load on the disk which in turn decreases its pressure. Furthermore the exercise increases the strength and endurance of the extensor muscles. Flexion exercise has many positive effects. It reduce the articular stresses on the facet joint and stenosis of the spinal canal. Increasing intraabdominal pressure increases abdominal muscle strength and tone. Exrcise is essential for treating low back pain and patients should take proper exercise prescription from doctor.
Abdominal Muscles ; Adult ; Back Pain ; Constriction, Pathologic ; Exercise Therapy* ; Hip ; Humans ; Intervertebral Disc ; Ligaments ; Low Back Pain* ; Lumbar Vertebrae ; Muscle Strength ; Muscles ; Pliability ; Prescriptions ; Ribs ; Shock ; Spinal Canal ; Spine ; Zygapophyseal Joint

A case of urticaria pigmentosa, the first case of nodulo-bullous variety in Korea, is herein, described. A 4-mo#nth old female baby was brought: to our hospital by her mother with the presenting signs of darkish brown infiltrated macules and nodules scattered on the trunk, neck, and extremities. The first lesion was noticed by her mother as a pea sized flat macule of pinkish brown, which was seated on the right shin at birth For the period of 4 months, it has developed into multiple similar macules on the above mentioned areas, and most of them became gradually to the nodules with lichenoid surface, She also experienced frequent bullae on them and occasional facial flushing without any specific cause. A strong stroke, performed on the nodule, produced a severe whea1ing reaction followed by marked erythema around it. and facial flushing ensued, The histologic findings of the nodule revealed massive infiltration of cuboidal cells throughout the entire dermis which proved to be mast cells on toluidine blue staining. Oral administration of the reserpine and periactin proved to be effective in this case.
Administration, Oral ; Cyproheptadine ; Dermis ; Erythema ; Extremities ; Female ; Flushing ; Humans ; Korea ; Mast Cells ; Mothers ; Neck ; Parturition ; Peas ; Reserpine ; Stroke ; Tolonium Chloride ; Urticaria Pigmentosa* ; Urticaria*

It has been emphasized that the treatment of choice for the trochantric fracture of the femur is open reduction and rigid internal fixation to reduce complications by early ambulation. The incidence of trochanteric fracture of the femur in the young age group has been considerably increased in recent years because of increased traffic and industrial accidents. The author treated 38 cases of trochanteric fracture of the femur in the year 1974 through 1979, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. In sex distribution, 24 out of 38 were males and 14 were females. 16 cases out of 24 male patients were in the age group 20-40 and 9 cases out of 14 female were over 60 years of age. Over all mortality was 7.9%. 2. The numbers of patients of type I and III were 11 cases in each type out of 38 trochanteric fracture. 3. 26 cases out of 38 cases were treated by open reduction and internal fixation and the others were by traction and cast. 4. The applied metal devices were 3 types: Smith-Peterson nail and Thornton or McLaughlin plate, compression hip screw, and multiple pinning. 5. Mean duration of bony union is shorter in the group of open reduction and internal fixation (13 weeks) than the group of traction and cast (15 weeks). The cause of difference is that the 6 out of 9 cases of type IV and V were included in conservative group. 6. The incidece of the complications such as coxa vara, slipping screw, long nail and traction palsy occurred higher in the group fixed with Smith-Peterson nail and plate than the group fixed with compression hip screw.
Accidents, Occupational ; Coxa Vara ; Early Ambulation ; Female ; Femur ; Hip ; Humans ; Incidence ; Male ; Mortality ; Paralysis ; Sex Distribution ; Traction

Arotinolol, a now alpha and beta bloking agent, was administered orally in 32 hypertensive patients for 8 weeks in order to evaluate the antihypertensive effects and side effects. The doses were from 20mg to 30mg a day. The serum chemistries and chest X-ray were taken before and after Arotinolol administration. The results were as follows; 1) Blood pressure which was measured in sitting, supine and standing position was 176.37+/-4.73/116.54+/-4.34, 170.14+/-5.35/103.12+/-3.67, 156.37+/-7.54/104.31+/-3.34mmHg in control and 144.63+/-2.78/94.41+/-2.87, 146.47+/-5.41/89.12+/-4.34, 140.71+/-4.47/89.73+/-3.71mmHg in the treatment group. The differences between both blood pressure were statistically significant(P<0.001). 2) There was no significant change in pulse rate before and after medication. 3) There was no significant change in the laboratory findings such as CTR, GOT, GPT, alkaline phosphatase, CPK, creatinine, BUN, uric acid, cholesterol, fasting blood sugar and triglyceride before and after treatment. 4) The side effects of arotinolol were observed in 6 of 32 cases(18.7%), which were not required discontinuing the medication or decreasing the dose.
Alkaline Phosphatase ; Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Fasting ; Heart Rate ; Humans ; Hypertension ; Thorax ; Triglycerides ; Uric Acid

Insulinoma is clinically characterized by fasting hypoglycemia, various neuropsychiatric symptoms, and these caused by secondary to hypoglycemia.Of patients with insulinoma, 80 percent have single benign tumors, 11 percent have multiple benign tumors, 6 percent have single malignant tumors, and the remainder have multiple malignant tumors or islet hyperplasia according to Service's statement.A 42 year-old male chemical engineer who had insulinoma associated with regional lymph node metastasis has been successfully performed with curative resection and consecutive postoperative therapy with streptozotocin.He entered to this hospital because of frequent occasion of bizarre behavior and language, transient unconsiousness and syncopal episode, and sweating associated with hypoglycemia especially in night four months prior to addmission in November 1992. Those symptoms and hypoglycemia were controlled by intravenous glucose injection and/or oral feeding of glucose riched stuffs.No physical abnormalities were found except neuropsychiatric symptoms. On admission the fasting blood glucose level was 10 mg/dl, plasma immunoreactive plasma insulin level was 125.23 uU/ml, and plasma C-peptide level was 10.24 ng/ml, respectively.Abdominal CT was suggestive of retroperitoneal tumor just behind the pancreas. Selective celiac axis angiography demonstrated hypervascular mass supplied by dorsal pancreatic artery which was compatible with insulinoma. Surgical intervention including distal pancreatectomy, as well as splenectomy and parital omental resection were performed successfully. Consecutive postoperative treatment of streptozotocin was done without any side effects.His condition is very good and enjoyed his life with full activity to date.
Angiography ; Arteries ; Blood Glucose ; C-Peptide ; Fasting ; Glucose ; Humans ; Hyperplasia ; Hypoglycemia ; Insulin ; Insulinoma ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pancreas ; Pancreatectomy ; Plasma ; Splenectomy ; Streptozocin ; Sweat ; Sweating ; Syncope

OBJECTIVE: To compare the therapeutic effects between stellate ganglion block and steroid therapy in post-stroke complex regional pain syndrome. METHOD: In this controlled study, thirty-eight patients with post-stroke complex regional pain syndrome were randomly divided into two groups. One group received a total of five repeated stellate ganglion block every three days and the other group received an oral corticosteroid therapy. Therapeutic effects were assessed before treatment, after fifteen days and thirty days in the each group and evaluated via volume of the involved hand, circumference of the middle finger, shoulder and hand pain score. RESULTS: In both groups, hand edema and circumference of middle finger were decreased after fifteen days and thirty days of treatment. However, the stellate ganglion block group showed more significant improvement in mean change of hand edema and circumference compared to the steroid therapy group. The hand and shoulder pain were also decreased significantly after fifteen days in both groups. In stellate ganglion block group, patients' pain kept decreased even after thirty days had passed since the treatment. However, in the other group who got the steroid therapy, there was no further decrease from the fifteenth day after the therapy. CONCLUSION: Although both treatment were effective in relieving symptoms of post-stroke complex regional pain syndrome, the stellate ganglion block was more effective. However, further controlled study is required.
Edema ; Fingers ; Hand ; Humans ; Shoulder ; Shoulder Pain ; Stellate Ganglion*

We found the funding acknowledgment in this article was omitted as published.

OBJECTIVE: To evaluate the effect of custom molded foot orthoses on children with growing pains of the lower extremities. METHODS: Children with growing pains were recruited during a clinic visit. None had any bony deformities, inflammatory joint disease or depression. Resting calcaneal stance position (RCSP) and calcaneal pitch angle were measured, and individual custom molded rigid foot orthoses were prescribed using the inverted orthotic technique to control for foot overpronation using the RCSP angle. Pain sites, degree and frequency of pain, and balance ability were evaluated using Balance Master computerized posturography prior to foot orthosis fitting, and 1 and 3 months later. RESULTS: Twenty children completed the study. Seventeen (75%) had overpronated feet. Significant improvements were noted after 1 and 3 months in pain degree and frequency, and after 3 months in balancing ability. CONCLUSION: The use of custom molded foot orthoses is a good method for treating children with multiple musculoskeletal pains in the leg.
Ambulatory Care ; Child* ; Congenital Abnormalities ; Depression ; Foot ; Foot Orthoses* ; Fungi ; Humans ; Joint Diseases ; Leg ; Lower Extremity* ; Musculoskeletal Pain ; Orthotic Devices ; Pediatrics ; Postural Balance

OBJECTIVE: To evaluate the cardiovascular response during head-out water immersion, underwater treadmill gait, and land treadmill gait in stroke patients. METHODS: Ten stroke patients were recruited for underwater and land treadmill gait sessions. Each session was 40 minutes long; 5 minutes for standing rest on land, 5 minutes for standing rest in water or on treadmill, 20 minutes for treadmill walking in water or on land, 5 minutes for standing rest in water or on treadmill, and 5 minutes for standing rest on land. Blood pressure (BP) and heart rate (HR) were measured during each session. In order to estimate the cardiovascular workload and myocardial oxygen demand, the rate pressure product (RPP) value was calculated by multiplying systolic BP (SBP) by HR. RESULTS: SBP, DBP, mean BP (mBP), and RPP decreased significantly after water immersion, but HR was unchanged. During underwater and land treadmill gait, SBP, mBP, DBP, RPP, and HR increased. However, the mean maximum increases in BP, HR and RPP of underwater treadmill walking were significantly lower than that of land treadmill walking. CONCLUSION: Stroke patients showed different cardiovascular responses during water immersion and underwater gait as opposed to standing and treadmill-walking on land. Water immersion and aquatic treadmill gait may reduce the workload of the cardiovascular system. This study suggested that underwater treadmill may be a safe and useful option for cardiovascular fitness and early ambulation in stroke rehabilitation.
Blood Pressure ; Cardiovascular System ; Early Ambulation ; Gait ; Heart Rate ; Humans ; Immersion ; Oxygen ; Rehabilitation ; Stroke* ; Walking ; Water

OBJECTIVE: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia. METHODS: Subacute (<3 months), unilateral hemispheric stroke patients with dysphagia were randomly assigned to the conventional dysphagia therapy (CDT), rTMS, or NMES groups. In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks). In NMES group, electrical stimulation was applied to the anterior neck for 30 minutes per session (5 days per week for 2 weeks). All three groups were given conventional dysphagia therapy for 4 weeks. We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks. RESULTS: Forty-seven patients completed the study; 15 in the CDT group, 14 in the rTMS group, and 18 in the NMES group. Mean changes in FDS and PAS for liquid during first 2 weeks in the rTMS and NMES groups were significantly higher than those in the CDT group, but no significant differences were found between the rTMS and NMES group. No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups. CONCLUSION: These results indicated that both low-frequency rTMS and NMES could induce early recovery from dysphagia; therefore, they both could be useful therapeutic options for dysphagic stroke patients.
Deglutition ; Deglutition Disorders* ; Electric Stimulation ; Hearing ; Humans ; Neck ; Rehabilitation ; Stroke* ; Transcranial Magnetic Stimulation