Dysphagia is very prevalent conditions seen today by physiatrist. Central to the management of this pervasive medical condition are the issues of accurate diagnosis and maintaining control through appropriate treatment. This review article summarizes the recent knowledge accumulated on challenging therapies in dysphagia. The continuing evolution of the management of dysphagia is reflected in many articles and evidence-based information stemming from recent studies. The contributions of some of the more recent and salient studies and trials are mentioned here. Although some data to support the rationale and outcomes for the swallowing therapies currently used, a great deal more data are needed on their effects on specific populations.

Neck pain is common symptom; one out of three individuals can recall at least one incidence of neck pain in their lifetime. Evaluating and treating common cervical spine conditions calls for a probability analysis of what injured structure is most likely causing the patient's complaints. The newer diagnostic procedures must supplement the diagnostic approach but must never replace the proper interpretation of a careful history, the reproduction of the symptoms during the examination, or the performance of to meaningful orthopedic and neurologic examination. This review is offered to summarize all of these considerations with the intent of ascertaining proper management of the patient with pain in the neck or from the neck.
Humans ; Incidence ; Neck ; Neck Pain ; Neurologic Examination ; Orthopedics ; Reproduction ; Spine

Neck pain is common symptom; one out of three individuals can recall at least one incidence of neck pain in their lifetime. Evaluating and treating common cervical spine conditions calls for a probability analysis of what injured structure is most likely causing the patient's complaints. The newer diagnostic procedures must supplement the diagnostic approach but must never replace the proper interpretation of a careful history, the reproduction of the symptoms during the examination, or the performance of to meaningful orthopedic and neurologic examination. This review is offered to summarize all of these considerations with the intent of ascertaining proper management of the patient with pain in the neck or from the neck.
Humans ; Incidence ; Neck ; Neck Pain ; Neurologic Examination ; Orthopedics ; Reproduction ; Spine

OBJECTIVE: Hyaluronic acid is a naturally occurring glycosaminoglycan which, by virtue of its viscosity, elasticity and other theological properties, acts as lubrication and shock absorbing fluid in joints. In addition to its lubrication and cushioning properties, hyaluronic acid has been associated with in vitro anti-inflammatory activity and possible disease-modifying effect in animals. The purpose of this study was to evaluate the effect of intraarticular injection of hyaluronic acid or steroid on the healing of the experimental degenerative osteoarthritis and the therapeutic synergism between the hyaluronic acid and steroid. METHOD: 48 rabbits with experimental osteoarthritis produced by extension immobilization of knees were treated with hyaluronic acid and/or steroid and then assessed clinically, radiologically, scintigraphically and histopathologically at pre and post treatment. RESULTS: The hyaluronic acid treated group had more favorable results than other groups but the results were not statistically significant. The steroid treated group did not have significant change in comparison to the control group. Therapeutic synergism between hyaluronic acid and steroid was not found. CONCLUSIONS: The results of this study indicate that the intraarticular injection of hyaluronic acid may be effective for the treatment of patients with osteoarthritis.
Animals ; Elasticity ; Humans ; Hyaluronic Acid* ; Immobilization ; Injections, Intra-Articular ; Joints ; Knee ; Lubrication ; Osteoarthritis* ; Rabbits ; Shock ; Virtues ; Viscosity

Ultrasonographic and radiographic findings in 72 cases of pelvic masses which have been provedhistopathologically were analyzed. The results were as follows; 1. Among 72 cases, 28 cases were uterine massesand 44 cases were adnexal masses. 2. Pathologic accuracies of ultrasonographic diagnosis were 64.3% in uterinemasses, 70.5% in adnexal masses, and 68.1% in all pelvic masses. 3. Plain or IVP findings were not specific indiagnosis and showed secondary mass effects or functional disturbances. 4. Because of its high accuracy ofpathologic diagnosis and safety, ultrasonography can be regared as the most valuable and preferential study. Butin cases of cystic myomas, endometrioses, cystic missed abortions and huge masses, the accurate diagnoses weredifficult.
Abortion, Missed ; Diagnosis ; Endometriosis ; Female ; Myoma ; Pregnancy ; Ultrasonography

Dysphagia refers to an abnormality in the process of transporting food from the mouth to the stomach. Patients with dysphagia have a high risk of airway aspiration, which can often lead to fatal complications such as pneumonia and asphyxia. Recently, interest in the clinical importance of dysphagia has increased in the medical community and society at large.Current Concepts: Dysphagia can be caused by neurological diseases such as stroke and brain injury, or by non-neurological diseases such as head and neck cancer or diverticulum. Diagnosis is mainly performed using videofluoroscopic swallowing study or endoscopic evaluation of swallowing based on a detailed history and physical examination, scintigraphy or esophageal manometry may also be helpful. Recently developed imaging technology using 3-dimensional computed tomography and dynamic magnetic resonance imaging has been implemented. Treatment of dysphagia can be divided into compensatory and facilitative rehabilitation techniques. The most important principle for successful treatment of dysphagia is that it should be performed with a multidisciplinary team approach.Discussion and Conclusion: Dysphagia is an important problem that can seriously impair the patients’ quality of life. Although the general public and medical professionals are interested in dysphagia, many unknown aspects exist regarding the mechanism of dysphagia, and few treatments have been sufficiently proven in terms of safety and effectiveness. Therefore, much attention and effort is still required.

OBJECTIVE: To investigate neurodevelopmental long-term outcome in children born after in-vitro fertilization (IVF). METHOD: We performed retrospective study in which we investigated development of neurodevelopmental disability in 254 childern (113 twins, 28 singletons) born after in vitro fertilization between Janurary 1995 and December 1999. We obtained neurodevelopmental status on a certain date and disability of children from medical records or phone interviews of parents. We assessed developmental status, congenital malformation, cerebral palsy and seizure, speech disorder, other neurologic problems, prematurity, low birth weight, maternal age, intraventricular hemorrhage (IVH), retinopathy and congenital anomaly. RESULTS: Six children (2.3%) were diagnosed as cerebral palsy, three children (1.2%) as developmental delay and 11 had IVH, 6 had retinopathy, 10 had congenital anomaly (esp. abdominal wall defect). The mean maternal age was 30+/-2.8 years old and gestational age was 35+/-3.0 weeks. One hundred one children (39.7%) were born prematurely, 66.5% low birth weight. CONCLUSION: High prevalence of neurodevelopmental disabilities like cerebral palsy compared to population controls (cerebral palsy: 1.9/1000 live birth) was revealed. Therefore, we should know mild high risk of developmental disability and do developmental examination carefully in children born after IVF and long-term follow up.
Abdominal Wall ; Cerebral Palsy ; Child* ; Developmental Disabilities ; Fertilization ; Fertilization in Vitro* ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Maternal Age ; Medical Records ; Paralysis ; Parents ; Population Control ; Prevalence ; Retrospective Studies ; Seizures ; Twins

PURPOSE: This study was aimed to review findings of gray-scale ultrasonography and to assess the diagnostic value of the resistive index (RI) in patients with acute epididymitis by comparing with that in normal volunteers. MATERIALS & METHODS: Gray-scale ultrasonogram was reviewed in nine patients with acute epididymitis for echogenicity, size and reactive hydrocele. Normal values of resistive index (RI) were obtained in 20 epididymides from 10 volunteers (aged 20-28, mean 23.7). Nine patients of epididymitis (aged 18-67, mean 37.2) were examinated with color Doppler sonography and RI was measured at 11 sites on epididymal arteries. For the prediction of acute epididymitis, accuracy, sensitivity and specificity were calculated at the cut-off value of RI in 0.65 and 0.70. RESULTS: Gray-scale ultrasonography showed echogenicity that was variable among the 9 cases (hype- rechoic 2 cases, isoechoic 2, hypoechoic 5), enlargement of epididymis in 8, and reactive hydrocele in 8 cases. Normal volunteers displayed color Doppler signals in 14 out of 20. The range of RI in normal volunteers were between 0.64 and 1.00 (mean, 0.79 +/- SD 0.10). In patients with acute epididymitis, color Doppler signals were detected in all patients. The range of RI in epididymitis were 0.40-0.68 (mean, 0.56 +/- SD 0.10). At cut-off RI value of 0.65, accuracy was 88%, sensitivity 81.8%, and specificity 92.7%. At cut-off value of 0.70, accuracy was 92%, sensitivity 100%, and specificity 85.7%. CONCLUSION: In addition to the findings of gray-scale ultrasonography, resistive index and color flow changes are valuable in diagnosing acute epididymitis.
Arteries ; Epididymis ; Epididymitis* ; Healthy Volunteers ; Humans ; Male ; Reference Values ; Sensitivity and Specificity ; Ultrasonography ; Volunteers

Granular cell tumors are uncommon soft tissue tumors which arise as solitary or multiple masses. Lesionscommonly arise in the head, neck, and chest wall, but can occur in any part of the body. To our knowledge,periurethral granular cell tumor has not been previously reported. We report one such case.
Granular Cell Tumor* ; Head ; Neck ; Thoracic Wall

PURPOSE: It may be difficult to differentiate renal cell carcinoma involving collecting system from renal urothelial tumor invading into renal parenchyma. The purpose of this study was to assess the differences of CT findings between two conditions. MATERIALS AND METHODS: CT findings of 5 cases of renal cell carcinoma involving the renal collecting systems and 10 cases of renal urothelial tumors invading the renal parenchyma were compared, and analyzed about the presence or absence of hydronephrosis, normal or abnormal CT nephrogram, renal contour changes due to mass and tentative diagnosis. The diagnoses were confirmed at surgery. RESULTS: Renal cell carcinoma showed hydronephrosis in only 20% and normal CT nephrogram and outward contour bulging in all cases. In contrast, renal urothelial tumor showed hydronephrosis(70%), abnormal CT nephrogram(60%), and preservation of reniform shape(100%). CONCLUSION: Renal contour changes and CT nephrogram may be useful in distinguishing both disease entities.
Carcinoma, Renal Cell* ; Diagnosis ; Hydronephrosis