This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<(0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.
Fingers ; Humans ; Needles* ; Neural Conduction* ; Sensory Thresholds* ; Sural Nerve

OBJECTIVES: Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure. METHODS: Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done. RESULTS: The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2). CONCLUSIONS: The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.
Acrylamide* ; Action Potentials ; Discrimination (Psychology) ; Foot ; Hand ; Humans ; Korea ; Male ; Mass Screening ; Median Nerve ; Neurologic Examination ; Peroneal Nerve ; Questionnaires ; Sural Nerve ; Ulsan

From Mar. 1984 to Mar. 1994, we carried out 18 revision operations in patients who received Girdlestone operation due to the infection of hip was 7 cases, tuberculosis of hip was 3 cases, deep infections after implant insertion of hip were 5 cases, and pyogenic sequela was 1 case. The mean conversion period was 27 months. The leg length discrepancy, range of motion of hip, and Trendelenberg gait were examined before and after conversion to a total hip arthroplasty. The last functional state was evaluated and radiological examination was performed. In summary and Conclusion; 1. The time of performing revision hip arthroplasty was assessed by clinical, radiologic and laboratory finding, and the average time of conversion to total hip arthroplasty was 7.6 months after Girdlestone operation. 2. There was no case of recurrence of infection after revision operations. 3. At last follow-up after revision hip arthroplasty, the mean Harris Hip Score was 87.2(69.6–92.2) point. 4. Six patients had no pain, 8 patients had mild pain, and 2 patients had moderate pain. Nine patients were able to walk without ambulatory aids and 7 patients needed crutch or cane for walking. 5. At the time of revision hip arthroplasty, the average shortening of the resected limb was 4.2cm(1.6–7.3cm), and after revision operation, the average shortening was reduced to 1.2cm(0.8–2.2cm) 6. The technical difficulties, such as increased bleeding, bone deficiency, scar tissue formation, and limb shortening were encountered in all cases. 7. The peroneal nerve injury was developed in one patient who had conversion hip arthroplasty at 13 months after Girdlestone operation.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Cicatrix ; Extremities ; Follow-Up Studies ; Gait ; Hemorrhage ; Hip ; Humans ; Leg ; Peroneal Nerve ; Range of Motion, Articular ; Recurrence ; Tuberculosis ; Walking

In a series of 20 young rats, three cortical lesions were made in each hemisphere. Two of these lesions were filled with avitene and gelfoam, while the third was left empty as a control. The animals were killed successively on weeks 1, 2, 4 and 8 after the operation. The results were as follows : 1) Although there was no difference in the type of tissue reactions, avitene was more rapid and profound than gelfoam in the process and degree of inflammatory reaction at the same periods. 2) Avitene biodegradaded more rapidly than gelfoam. 3) The extent of fibrosis and adhesion to the surrounding brain tissues were not grossly different between these two agents but more profound histopathologically in avitene at the same periods. With these results, we could conclude that the avitene was superior to the gelfoam as the hemostatic agent in neurosurgical area.
Animals ; Brain* ; Collagen ; Fibrosis ; Gelatin Sponge, Absorbable ; Rats

Recent studies suggest that coronary endothelial dysfunction in atherosclerosis may contribute to the predisposition both for coronary spasm as well as for thrombus formation. The integrity of at least one aspect of endothelial function can be assessed by the intracoronary administration of acetylcholine. Eleven(13.4%, mean age 48+13, male 11) out of 82 consecutive patients with acute myocardial infarction showed angiographically normal or near normal coronary arteries at 7~10 in-hospital days. Ten(91%) had history of heavy smoking and 7 patients(64%) had no history of previous angina. Anterior myocardial infarction was in 8 and inferior in 3 patients. After intracoronary administration of acetylcholine(incremental dose of 20, 50ug for the right and 20, 50, 100ug for the left), 9(82) of 11 infarct related arteries showed total or subtotal occlusion, but only in 3(17%) out of 18 non-infarct related arteries of 10 patients. Multivessel spasm was noticed in 3. Ergonovine test(graded doses of 0.05, 0.1 and 0.2 mg intravenously) was performed 30 minutes after completion of acetylcholine test in 5 patients. In 1 patients, acetylcholine test was positive and but ergonovine test was negative. Conclusion : 1) Eleven(13.4%) out of 82 patients with acute myocardial infarction had angiographically normal coronary arteries. 2) Ach positive responses of infarct-related arteries are more frequent(82%) than that of non-infarct related arteries(17%), suggesting that the infarction might be related to coronary artery spasm. 3) Positive Ach responses of non-infarct related arteries occurred in 30% of Patients. 4) Ach and Erg induced vasospasm developed at the same site in 5, which suggests that local hyperreactivity might be related to spasm.
Acetylcholine* ; Arteries ; Atherosclerosis ; Coronary Vessels* ; Ergonovine ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Smoke ; Smoking ; Spasm* ; Thrombosis

Percutenous transluminal coronary angioplasty(PTCA) for total coronary occlusion was performed in 20 patients(mean age 51+11years, male 16, female 4) including 12 patients with recent myocardial infaction. Primary success rate of procedure was 71%(15 out of 21 lesions). The success rate with occlusion<3 months duration was 11 out of 13(85%) lesions vs 4 out of 8(50%) with occlusion>3 months duration(P=NS). There was no difference in success rate according to vessel dilated(left anterior descending and intermediate branch 70%, right coronary artery 83%, left circumflex 67%). All patients had well developled(>grade 2 in 15 patients) collateral flow to the occluded vessel. The leng of occluded lesion more than 1.5cm was in 4 out of 21, and 3 of them had procedural failure because of inability to cross with a guide wire. Six procedsural failures included inability to cross the lesion with a guide wire in 5 and one in inability to dilate the lesion due to recoiling. Complications included intimal dissection in 3(1.5%), prolonged chest pain in 1 1 and one death due to cardiogenic shock. Although the primary success rate is relatively lower than that associated with conventional stenotic lesions, coronary angioplasty could be performed safely and successfully in the majority of patients with coronary occlusion.
Angioplasty* ; Chest Pain ; Coronary Occlusion ; Coronary Vessels* ; Female ; Humans ; Male ; Shock, Cardiogenic

Intracoronary acetylcholine and intravenous ergonovine tests have been used to induce coronary artery spasm. To evaluate the usefulness of these provocative tests, acetylcholine and ergonovine tests were performed in 86 patients with normal or near normal coronary angiograms(clinically variant angina in 30, effort angina in 6, unstable angina in 5, myocardial infarction in 6, atypical chest pain in 39 patients). Acetylcholine was injected into each coronary artery in incremental doses (0.02, 0.05 and 0.1 mg into left coronary artery, 0.02 and 0.05 mg into right coronary artery) and ergonovin was given intravenously in graded doses of 0.05, 0.1 and 0.2 mg after completion of acetylcholine test. The results were as follow : 1) Among 86 patients, both acetylcholine and ergonovine tests were positive in 29 patients, both tests were negative in 50 patients, and acetylcholine test was positive but ergonovine test was negative in 7 patients ; The responses of acetylcholine and ergonovine tests were concordant in 92% of patients. The sensitvity and specificity of the acetylcholine test with reference to ergonovine test were 100% and 88% respectively. 2) In 7 patients(8%) acetylcholine test was positive but ergonovine test was negative, and this group may represent a spectrum of coronary spasm syndrome. CONCLUSION: Acetylcholine test is a safe and useful provocative test for coronary artery spasm, especially in the multivessel spasm.
Acetylcholine* ; Angina, Unstable ; Chest Pain* ; Coronary Vessels ; Ergonovine* ; Humans ; Myocardial Infarction ; Sensitivity and Specificity ; Spasm ; Thorax*

Intracoronary acetylcholine and intravenous ergonovine tests have been used to induce coronary artery spasm. To evaluate the usefulness of these provocative tests, acetylcholine and ergonovine tests were performed in 86 patients with normal or near normal coronary angiograms(clinically variant angina in 30, effort angina in 6, unstable angina in 5, myocardial infarction in 6, atypical chest pain in 39 patients). Acetylcholine was injected into each coronary artery in incremental doses (0.02, 0.05 and 0.1 mg into left coronary artery, 0.02 and 0.05 mg into right coronary artery) and ergonovin was given intravenously in graded doses of 0.05, 0.1 and 0.2 mg after completion of acetylcholine test. The results were as follow : 1) Among 86 patients, both acetylcholine and ergonovine tests were positive in 29 patients, both tests were negative in 50 patients, and acetylcholine test was positive but ergonovine test was negative in 7 patients ; The responses of acetylcholine and ergonovine tests were concordant in 92% of patients. The sensitvity and specificity of the acetylcholine test with reference to ergonovine test were 100% and 88% respectively. 2) In 7 patients(8%) acetylcholine test was positive but ergonovine test was negative, and this group may represent a spectrum of coronary spasm syndrome. CONCLUSION: Acetylcholine test is a safe and useful provocative test for coronary artery spasm, especially in the multivessel spasm.
Acetylcholine* ; Angina, Unstable ; Chest Pain* ; Coronary Vessels ; Ergonovine* ; Humans ; Myocardial Infarction ; Sensitivity and Specificity ; Spasm ; Thorax*

To assess the likelihood of procedural success in patients with multivessel coronary artery disease, 46 consecutive patients (male 34, female 12, mean age 60+/-9 years) umderwent single or multiple site angioplasty. The clinical diagnosis of unstable angina was in 20(44%), stable angina in 10 and acute or old myocardial infarction in 16. Coronary angiographic findings of 2 vessel disease was in 38(83%), triple vessel disease in 8. Left ventricular function was generally well preserved (mean ejection fraction 65+/-12%, range 30-82%) and mean 2.0 stenosis per patient angic, lasty had attempted. Single vessel angioplasty (SVA) was performed in 13 and multivessel angioplasty (MVA) in 33. Procedural success was achieved in 79(86%) out of total 92 stenoses. Sixty-six(88%) out of 75 stenoses in MVA and 13(76%) out of 17 stenoses in SVA had procedural success respectively. According to angiographic morphology of lesions, procedural success of type A stenoses was 17/17(100%), type B stenoses 57/66(86%) and type C stenoses was 5/9(33%). In 13 failures included inability to pass the guide wire cross the lesion in 7, inability to guide the griding catheter in 2 and inability to dilate lesions in 4. Before and after angioplasty, treadmill test (modified Bruce protocol)could be performed in 29 patients. Total duration of exercise and maximal double product improved significantly from 8.5+/-2.3 minute 5188+/-2403 to 12.2+1.3 min., 23,062+/-4111 respectively (p<0.001). 17 out of 24 patients who had positive treadmill test before angioplasty showed negative conversion after procedure. Complications included dissection in 29, prolongd chest pain in 5, acute closure in 3, cardiac tamponade in 1 and ventricular fibrillation due to side branch oclusion in 1. Thus, coronary angioplasty in selected paients with multivessel coronary artery disease might be useful and have relatively good immediate results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Cardiac Tamponade ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Exercise Test ; Female ; Humans ; Myocardial Infarction ; Ventricular Fibrillation ; Ventricular Function, Left

OBJECTIVE: To investigate the clinical characteristics of fibromyalgia syndrome and to determine the usefulness of visual analogue scale (VAS) in global pain as predictor of symptoms and functional disabilities of daily activities and to evaluate the relationship between social environmental factors and fibromyalgia syndrome. METHOD: : Fourth-three patients with fibromyalgia syndrome who have met 1990 ACR criteria and 30 control patients with rheumatoid arthritis were included in the study. Clinical features, functional disabilities, VAS and psychological impact due to life stress by criteria and 30 control patients with rheumatoid arthritis were included in the study. Clinical features, functional disabilities, VAS and psychological impact due to life stress by social environmental factors were studied by direct interviews and questionnaires. RESULT: The mean age of the patients with fibromyalgia syndrome was 48+/-11 years old. The physical findings revealed that tender points were 15.5+/-1.4 and skin fold tenderness presented in 59% of patients. The most frequent symptoms with scores and ratio of symptom presented were fatigue(2.2, 93%), morning stiffness(2.2, 80%), arthralgia(2.1, 90%), lower back pain(2.1, 98%), depression(1.6, 95%). The majority of functional disabilities in fibromyalgia group were less severe than those of rheumatoid arthritis group. The VAS in global pain had correlationship with age, arthralgia, fatigue, hurt all over, morning stiffness, tender points as well as the majority of functional disabilities of daily activities. Although living together mother-in-law was not different significant ly from each other groups, the duration of living together was longer in fibromyalgia group. There were more histories and frequencies of artificial abortions in patients with fibromyalgia syndrome. CONCLUSION: The patients with fibromyaliga showed various symptoms. The visual analogue scale in global pain have had significant correlation with some symptoms and functional disabilities in daily activities. Fibromyalgia patients revealed more social and obstetrical life stress which may suggest more psychological impact.
Arthralgia ; Arthritis, Rheumatoid ; Fatigue ; Fibromyalgia* ; Humans ; Surveys and Questionnaires ; Skin ; Social Environment ; Stress, Psychological