OBJECTIVE: To evaluate the association between neuralgic pain distribution and the severity of carpal tunnel syndrome (CTS). METHOD: Pain drawings using computerized pain chart system were collected from 131 patients (213 hands) with CTS. The presence and severity of CTS were determined by means of median motor and sensory nerve conduction studies. The severity was divided into 3 classes on the basis of electrophysiological findings: mild (93 hands), moderate (70 hands) and severe (50 hands). The similarities between pain drawing patterns and median nerve dermatome in the hands were evaluated. The pain distributions of the palmar and dorsal sides of each five fingers, palm and dorsum of hand were also evaluated. RESULTS: There were no significant differences in similarity values of pain distribution among the groups of CTS hands divided by severity: similarity values were 0.22+/-0.14 in mild CTS patients, 0.24+/-0.16 in moderate CTS patients and 0.27+/-0.14 in severe CTS patients. In the CTS patients, the pain drawings showed relatively frequent distributions in the palmar side of 2nd to 4th fingers. CONCLUSION: There was no significant correlation between pain drawing patterns and severity of CTS. The pain drawings of patients with CTS indicate distribution to be most frequent in the palmar side of 2nd to 4th fingers.
Carpal Tunnel Syndrome* ; Fingers ; Hand ; Humans ; Median Nerve ; Neural Conduction

The diagnosis of thoracic outlet syndrome (TOS) is sometimes confused by its nonspecific symptoms and various etiologies. Moreover, the paths of involving nerves and arteries are highly diverse. We report a 35 year-old man who had numbness and coldness in his left upper extremity with no improvement to medical therapy. The electrophysiologic studies were normal. Radial artery pulse was absent and the thermography revealed markedly reduced temperature below the left mid-forearm. The arteriography showed compression of the left subclavian artery between the clavicle and the 1st rib with aneurysmal change proximal to the compression. Occlusion of the left brachial artery and collateral arteries were also observed. Under the diagnosis of vascular TOS, 1st rib resection was performed and his symptoms were relieved. Vascular TOS may be considered in cases of upper limb paresthesia.
Adult ; Aneurysm ; Angiography ; Arteries ; Brachial Artery ; Clavicle ; Diagnosis ; Embolism ; Humans ; Hypesthesia ; Paresthesia ; Radial Artery ; Ribs ; Subclavian Artery ; Thermography ; Thoracic Outlet Syndrome* ; Upper Extremity

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OBJECTIVE: To acquire normal values of nerve conduction study of the superficial radial sensory nerve (SRN) distal branches to the second web space (2 WEB) and second digit (2 DIG) and compare them with the results of the conventional method. METHOD: Forty-three healthy adult subjects (25 males, 18 females) were included. Nerve conduction study was performed in both hands. Superficial radial sensory responses were obtained with 2 recording montages: 1) antidromic stimulation, recording electrode placed between the 2nd and 3rd metacarpals with stimulation 10 cm proximally on the lateral forearm (2 WEB); 2) orthodromic stimulation, stimulation at the second digit with recording 10 cm proximally at the snuff box (2 DIG). Each stimulation was performed twice, and onset latency, peak latency, and sensory nerve action potential (SNAP) amplitude (baseline-to- peak) were measured. Correlations between the values and body mass index (BMI), sex, and finger circumference were tested statistically. RESULTS: The age of the subjects was 36.0+/-10.4 years (range, 23~64 years), and the BMI was 22.6+/-2.8 kg/m2. The onset latency, peak latency and SNAP amplitude of the 2 WEB response were 1.7+/-0.1 ms, 2.2+/-0.2 ms, and 24.6+/- 8.2 micro V, respectively. The onset latency, peak latency and SNAP amplitude of the 2 DIG response were 1.6+/-0.2 ms, 2.2+/-0.2 ms, and 15.2+/-6.0 micro V, respectively. A statistically significant difference was observed between male and female subjects for both 2 WEB and 2 DIG responses. Weak correlations were found between the nerve conduction values and BMI, sex, and finger circumference. CONCLUSION: Sensory nerve action potentials can be successfully obtained from the distal branches of the superficial radial nerve.
Action Potentials ; Adult ; Body Mass Index ; Electrodes ; Female ; Fingers ; Forearm ; Hand ; Humans ; Male ; Metacarpal Bones ; Neural Conduction* ; Radial Nerve* ; Reference Values ; Tobacco, Smokeless

Nausea, vomiting and retching are universal symptoms that affect individuals' state of health and self-care activities of individuals. Accurate measurements of individual symptoms are required to gather more definitive data, and enhance understanding, planning, and implementation of self-care actions. Recently the Rhodes Index of Nausea, Vomiting, and Retching(INVR), a new format of the INV-2(the Rhodes Index of Nausea and Vomiting), was developed to measure the symptoms of nausea, vomiting and retching in an English speaking population. To determine the reliability and validity of the INVR, and the possibility of using the instrument in Korea, the Korean translation of the INVR and the INV-2 were administered to a convenient sample of 105 patients at two University Hospitals in Kwangju, Korea. The Cronbach's alpha to estimate the internal consistency of reliability for INVR was 0.844. Equivalent measures of reliability were conducted to determine the percentage of agreement and the Spearman rank correlation coefficients for responses on the two instruments. The percent agreement was 83% and the correlation coefficient was 0.906 over all. A significant differences between the INVR scores of the patients with and without nausea, vomiting, or retching were seen, which indicated a construct validity. The INVR was found to be more user friendly for the patient and the healthcare providers. As a result, it is suggested that the INVR can provide a scientific base for measuring the symptoms of nausea, vomiting, and retching for nurses to improve patients' care and quality of life.
Gwangju ; Health Personnel ; Hospitals, University ; Humans ; Korea ; Nausea* ; Quality of Life ; Reproducibility of Results ; Self Care ; Vomiting*

PURPOSE: To investigate the characteristics of non-glaucomatous eyes with peripapillary retinoschisis. METHODS: Six non-glaucomatous eyes with peripapillary retinoschisis were enrolled. Age, sex, refractive error, intraocular pressure, location and changes of peripapillary retinoschisis, and the presence of accompanied abnormalities were assessed. To determine possible abnormalities of the optic nerve head and macula, fundus photographs and cross-sectional images of the optic nerve head and macula obtained by optical coherence tomography were inspected. RESULTS: Three males and 3 females were enrolled. Age of the subjects ranged from 11 to 59 years (median, 45 years). Refractive error ranged from -6.25 to +1.00 diopter (median, -0.50 diopter). Peripapillary retinoschisis was located in the superior quadrant in four eyes, in the nasal quadrant in one eye, and in the inferior quadrant in one eye, respectively. No additional abnormalities were found in fundus photographs or in the cross-sectional images of the optic nerve head and macula that were obtained by optical coherence tomography. Longitudinal follow-up was available for two eyes and spontaneous resolution of peripapillary retinoschisis was observed in these eyes 6 and 9 months later, respectively. CONCLUSIONS: Peripapillary retinoschisis was observed in non-glaucomatous eyes. This finding was observed in subjects of various ranges of age and refractive error, and in both sexes, without any other accompanying abnormalities.
Female ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Male ; Optic Disk ; Refractive Errors ; Retinoschisis* ; Tomography, Optical Coherence

OBJECTIVE: The primary purpose of the present study is to determine the diagnostic accuracy of Kernig's sign, Brudzinski's sign, nuchal rigidity, and Jolt accentuation of headache for children suspected of meningitis. This study focuses on the clinical symptoms and signs of meningeal irritation and their relationship to the CSF pleocytosis. METHODS: We examined these meningeal irritation signs before lumbar puncture from the patients who visited Chosun University Hospital and were suspected of meningitis. RESULTS: A total of 70 children(age>4) were enrolled over 12 months. Kernig's sign (sensitivity : 41%, specificity : 77%), neck stiffness(sensitivity : 76%, specificity : 41%), and Jolt accentuation of headache(sensitivity : 76%, specificity : 48%) did not accurately discriminate the patients with meningitis(> or =6 white blood cells/mL of CSF) from the patients without meningitis. But Brudzinski's sign(sensitivity : 64%, specificity : 70%, P< 0.05) was valuable to predict the CSF pleocytosis. Among the clinical symptoms, nausea, vomiting, fever and headache(P<0.05) were shown to have diagnostic values. CONCLUSION: The objectification of neurologic sign is demanded and better bedside diagnostic tests are needed.
Child* ; Diagnostic Tests, Routine ; Fever ; Headache ; Humans ; Leukocytosis ; Meningitis* ; Muscle Rigidity ; Nausea ; Neck ; Neurologic Manifestations* ; Sensitivity and Specificity ; Spinal Puncture ; Vomiting

BACKGROUND: When surgeons plan mandible ortho surgery for patients with skeletal class III facial asymmetry, they must be consider the exact method of surgery for correction of the facial asymmetry. Three-dimensional (3D) CT imaging is efficient in depicting specific structures in the craniofacial area. It reproduces actual measurements by minimizing errors from patient movement and allows for image magnification. Due to the rapid development of digital image technology and the expansion of treatment range, rapid progress has been made in the study of three-dimensional facial skeleton analysis. The purpose of this study was to conduct 3D CT image comparisons of mandible changes after mandibular surgery in facial asymmetry patients. MATERIALS & METHODS: This study included 7 patients who underwent 3D CT before and after correction of facial asymmetry in the oral and maxillofacial surgery department of Yeungnam University Hospital between August 2002 and November 2005. Patients included 2 males and 5 females, with ages ranging from 16 years to 30 years (average 21.4 years). Frontal CT images were obtained before and after surgery, and changes in mandible angle and length were measured. RESULTS: When we compared the measurements obtained before and after mandibular surgery in facial asymmetry patients, correction of facial asymmetry was identified on the "after" images. The mean difference between the right and left mandibular angles before mandibular surgery was 7degrees, whereas after mandibular surgery it was 1.5degrees. The right and left mandibular length ratios subtracted from 1 was 0.114 before mandibular surgery, while it was 0.036 after mandibular surgery. The differences were analyzed using the nonparametric test and the Wilcoxon signed ranks test (p<0.05). CONCLUSION: The system that has been developed produces an accurate three-dimensional representation of the skull, upon which individualized surgery of the skull and jaws is easily performed. The system also permits accurate measurement and monitoring of postsurgical changes to the face and jaws through reproducible and noninvasive means.
Facial Asymmetry ; Female ; Humans ; Jaw ; Male ; Mandible ; Skeleton ; Skull ; Surgery, Oral

We experienced a case of split hand split foot(SHSF) anomaly in a male neonate who had a deficiency of the middle finger, syndactyly of the 1st and 2nd finger and a deep median cleft in both hands. He also had a deep median cleft between 2nd and 3rd toe, syndactyly of the 1st and 2nd, 3rd and 4th toe without deficiency of the middle toe in both feet. SHSF anomaly may occur either isolated or associated with other anomalies. In this case, it occurd sporadically without family history and showed an isolated type without any other specific anomalies except both posterior iris synechiae. The karyotype of patient showed 46,XY,t(7p:14q) which has not been reported yet. We reported the case with the review of the associated literatures.
Fingers ; Foot* ; Hand* ; Humans ; Infant, Newborn ; Iris ; Karyotype ; Male ; Syndactyly ; Toes

The purpose of this study was to develop an education program for hospice care and to examine the effect of program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with witch terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description after the performance of education. put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.
Chungcheongbuk-do ; Education* ; Hospice Care* ; Hospices* ; Humans ; Lectures ; Missions and Missionaries ; Philosophy