OBJECTIVE: The purpose of this study was to evaluate the most effective stimulating electrode in TENS for pain relief, and to apply to the treatment of patients with neck and shoulder problems. METHOD: The objects were 30 patients with neck and shoulder problems. In 10 of them, insulated needle electrodes were inserted into a trigger point and electrical stimulation given through the electrodes. In 10 of them, non-insulated needle electrodes were applied as the same method. The others were treated with lidocaine injection into a trigger point and electrical stimulation given through the surface electrode. The effects of pain relief were assessed by visual analogue scale (VAS), pain rating score (PRS), and pain algometer. RESULT: In the group with insulated needle electrode, the average score was reduced 48.33 24.84% in VAS score and 52.00 17.55% in PRS, the pressure of pain algometer was increased 34.97 15.33%. In non-insulated needle electrode group, reduced 43.16 34.62% in VAS score and 43.73 34.85% in PRS, the pressure was increased 22.28 30.62%. The score reduction of surface electrode group was 20.61 15.73% in VAS score and 18.22 16.27% in PRS, the pressure-pain threshold increased as 9.05 12.81%. CONCLUSION: The results suggest that insulated and non-insulated needle electrodes were more effective stimulating electrode in TENS for pain relief than surface electrode.
Electric Stimulation ; Electrodes* ; Humans ; Lidocaine ; Neck ; Needles ; Shoulder ; Transcutaneous Electric Nerve Stimulation* ; Trigger Points

OBJECTIVE: To know the clinically meaningful findings of ultrasonography in plantar fasciitis. METHOD: Thirty one feet of 24 patients who had clinical diagnosis of plantar fasciitis and 70 feet of 35 healthy volunteers were evaluated with ultrasound. Sagittal sonograms were obtained in the prone position, and the plantar fascia thickness (PFT) was measured at proximal end near its insertion into the calcaneus. Hypoechogenecity, perifascial fluid collection, tendon rupture, calcaneal spur and calcification were also evaluated. RESULTS: The plantar fascia thickness (PFT) of the symptomatic heels (SH) of patients group (4.83+/-0.86 mm) was significantly greater than that of their asymtomatic heels (ASH) (2.95+/-0.57 mm)(p<0.05) and it was also greater than that of control group (2.63+/-0.41 mm)(p<0.05). The range of difference of both PFT was 0.7~3.2 mm in patients group and 0~0.8 mm in control group. Hypoechogenecity was found in 22 SH (71%), perifascial fluid collection in 5 SH (16%) and calcification in 2 SH (6%). Calcaneal bony spur was identified in 7 SH (26%) on simple radiography. CONCLUSION: Increased thickness (>3.8 mm), difference of thickness between SH and ASH (>1.0 mm) and hypoecho genecity of plantar fascia were clinically meaningful ultrasonographic findings of plantar fasciitis, and ultrasonogrphy can be used as the inital imaging modality for the diagnosis.
Calcaneus ; Diagnosis ; Fascia ; Fasciitis, Plantar* ; Foot ; Healthy Volunteers ; Heel ; Heel Spur ; Humans ; Prone Position ; Radiography ; Rupture ; Tendons ; Ultrasonography

The characteristics of the surface recorded F responses including minimal latency, mean latency, amplitude, duration, area and shape were investigated in the posterior tibial nerves of rabbits. During a train of 100 stimuli, each F wave was divided by the recurrence of shape into repeaters and nonrepeaters. There was no significant difference between the parameters of repeaters and nonrepeaters such as mean latency, minimal latency, amplitude and area. These findings suggest that the associated discharges of motor neurons generating the repeaters of F wave represented no definite distinctions from that of nonrepeaters in the aspect of the neuron size or the number of neurons contributing to each parameters of F wave. After the sciatic nerve was exposed, it was minimally injured by compression and then F responses were studied. Mean latency and minimal latency were prolonged, and amplitude and area were diminished in post-injured group. The frequency of repeater waves was increased but was not a useful parameter in the assessment of injury model due to a wide range of normal value.
Motor Neurons ; Neurons ; Rabbits ; Recurrence ; Reference Values ; Sciatic Nerve ; Tibial Nerve

OBJECTIVE: To determine valuable radiologic criteria in diagnosis of pes cavus. METHOD: Thirty eight healthy subjects and twenty seven pes cavus cases were evaluated by radiologic measurements. We evaluated the criteria for longitudinal arch curve by measuring the calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: By comparing the pes cavus with the control group, no significant differences in the talocalcaneal angle, metatarsal angle and navicular height I and II were found. Whereas we found a significant difference between the talometatarsal angle and calcaneal pitch. Talometatarsal angle is more sensitive and specific compared to the calcaneal pitch. CONCLUSION: In diagnosis of idiopathic pes cavus, talometa tarsal angle is more reliable in the diagnosis of pes cavus. The ultimate diagnostic value of talometatarsal angle in pes cavus is 6degrees.
Diagnosis ; Foot Deformities* ; Metatarsal Bones

OBJECTIVE: This study was conducted to compare the effects of low frequency needle transcutaneous electrical nerve stimulation (TENS) and high frequency needle TENS on experimental pain threshold. METHOD: Twenty two healthy adult subjects were assigned randomly to a low-TENS group or to a high-TENS group. Experimental pain threshold at forearm was determined with pain threshold of electrical simulation using surface electrode and needle electrode. RESULTS: Low-TENS group showed that pain relief was developed after 10 minutes and persisted 3 hours after treatment cessation. Low-TENS group showed a significant increase in experimental pain threshold opposing to high TENS group. CONCLUSION: This results suggest that effect of low frequency needle TENS therapy is better and longer than high frequency needle TENS therapy.
Adult* ; Electrodes ; Forearm ; Humans ; Needles* ; Pain Threshold* ; Transcutaneous Electric Nerve Stimulation* ; Withholding Treatment

In Korea, Clonorchis sinensis infection is still highly prevalent because case detection in the field is difficult and the detected cases used to be incompletely cured due to treatment failure. The present study tried to control clonorchiasis in an endemic village by repeated treatments with praziquantel every 6 months and to evaluate sonography as a diagnostic measure. By stool examinations, the egg positive rate in the endemic village was 22.7%, but it decreased to 19.6% at 6 months, 15.1% at 12 months. 12.2% at 18 months, 6.3% at 24 months, 11.4% at 30 months, and 6.3% at 42 months after the beginning of repeated praziquantel administration. The sonography showed 61 (49.6%) positive cases of 123 screened residents: among egg-positives the sonography positive rate was 52.2% and among egg-negatives it was still 49%. The rate among cured cases was 64.3% after 6 months, 50.0% after 12 months, 50.0% after 18 months, and 66.7% after 24 months. In a non-endemic village, 64 residents were found egg-negative by fecal examination, but 20 (31.3%) of them were positive by sonography. The present findings indicate that control of clonorchiasis in an endemic village by repeated praziquantel treatment for 42 months is still insufficient and sonography is of little value for diagnosis of clonorchiasis.
Animal ; Antiplatyhelmintic Agents/administration & dosage* ; Clonorchiasis/ultrasonography* ; Clonorchiasis/prevention & control ; Clonorchiasis/epidemiology ; Follow-Up Studies ; Human ; Korea/epidemiology ; Parasite Egg Count ; Praziquantel/administration & dosage* ; Prevalence ; Sensitivity and Specificity ; Treatment Failure

OBJECTIVE: To evaluate the effects of growth hormone on metabolism and quality of life of spinal cord injured patients. METHOD: Thirteen chronic spinal cord injured patients without metabolic and psychologic disorders except growth hormone deficiency were included in the study. They were randomly divided into two groups. Seven patients received growth hormone and six patients received distilled water as control. Before and after 6 months' administration, we measured Adult Growth Hormone Deficiency Assessment (AGHDA) and Psychological General Well-Being Index (PGWBI) for assessing quality of life. Bone mineral density (BMD), osteocalcin, urine deoxypyridinoline, % lean body mass, % body fat, body mass index (BMI) and lipid profile were also examined for assessing metabolic states. RESULTS: The AGHDA score decreased significantly from 6.7+/-2.9 to 3.9+/-2.1 (p<0.05), and the PGWBI score increased significantly from 81.7+/-14.8 to 88.7+/-8.7 (p<0.05) in growth hormone treatment group. There were no significant differences in control group. Other values about metabolic states were not significantly different in all groups. CONCLUSION: Growth hormone was effective on improving quality of life in spinal cord injured patients, but there was no positive effect on metabolic values for short-term therapy.
Adipose Tissue ; Adult ; Body Mass Index ; Bone Density ; Growth Hormone* ; Humans ; Metabolism* ; Osteocalcin ; Quality of Life* ; Spinal Cord Injuries ; Spinal Cord* ; Water

OBJECTIVE: To compare the Madopar(R) (Levodopa Benserazide) test with Insulin Tolerance Test (ITT) as a provocation test for growth hormone (GH). METHOD: One hundred eighty-seven subjects who had not organic disease such as hypothalamic-pituitary disease were studied. Seventy-one subjects underwent an ITT by injection of 0.1 U/kg of regular insulin and blood samples for GH assay were taken at 0, 30, 60 and 120 minutes. One hundred sixteen subjects underwent a Madopar(R) test by administration of Madopar(R) and blood samples for GH assay were taken at 0, 60, 120 and 180 minutes. RESULTS: The GH mean peak response in ITT was significantly higher than that of the Madopar(R) test. Below 50 years, 18 of ITT and 24 of Madopar(R) test showd a GH peak response of less than 5 ng/ml. Above 50 years, 14 of ITT and 53 of Madopar(R) test showd a GH peak response of less than 5 ng/ml. CONCLUSION: The results suggested that the GH response to the Madopar(R) test was much less than that of the ITT. The Madopar(R) test was limited in diagnosis of the adult GH deficiency in normal adults.
Adult* ; Diagnosis* ; Growth Hormone* ; Humans ; Insulin

OBJECTIVE: The purpose of this study was to evaluate the ultrasonographic (US) findings in the shoulder impingement syndrome and to correlate them with the Hawkins and Kennedy's clinical stages. METHOD: 41 patients with suspected shoulder impingement syndrome were evaluated. All patients were divided into 3 clinical groups according to Hawkins and Kennedy and US examination was done in each group. RESULTS: US findings were as follows. In stage I, there were 3 normal findings, 5 tendinitis of the rotator cuff (RC), 2 partial thickness tear of RC, and 0 full thickness tear of RC. In stage II, 6 normal findings, 13 tendinitis of RC, 3 partial thickness tear of RC and 2 full thickness tear of RC. In stage III, 0 normal findings, 1 tendinitids of RC, 1 partial thickness tear of RC, and 5 full thickness tear of RC. The most common findings in the tendinits of RC were tendon thickness, focal hypoechogenicity and calcification. In partial thickness tear of RC, focal hypoechogenicity and impingement in abduction were most common findings. In full thickness tear of RC, the irregular humeral head surface and the biceps tendon effusion were most common findings CONCLUSION: The ultrasonography is a valuable means of evaluating the shoulder impingement syndrome and its findings have good correlation with clinical stages
Humans ; Humeral Head ; Rotator Cuff ; Shoulder Impingement Syndrome* ; Shoulder* ; Tendinopathy ; Tendons ; Ultrasonography*

OBJECTIVE: To assess the sensitivity and specificity of bedside swallowing evaluation for detecting tracheal aspiration. METHOD: Thirty patients who complained of swallowing difficulty or had potential for dysphagia were evaluated using videofluoroscopy and bedside swallowing evaluation for dysphagia. The bedside swallowing evaluations included gag reflex, laryngeal elevation, water swallowing test and swallowing provocation test. We compared bedside swallowing evaluations with videofluoroscopy to determine the sensitivity and specificity in detecting tracheal aspiration. RESULTS: The comparison of the all combination of bedside swallowing evaluation and videofluoroscopic results suggested that the sensitivity and specificity in the detection of tracheal aspiration was 84.6%, 47.0% respectively. CONCLUSION: Bedside swallowing evaluations are limited for screening test of tracheal aspiration, so videofluoroscopic swallowing studies would be necessary to evaluate swallowing difficulty.
Deglutition Disorders* ; Deglutition* ; Humans ; Mass Screening ; Reflex ; Sensitivity and Specificity ; Water