No abstract available.

OBJECTIVE: To determine whether ankle plantar flexors stretching exercise affects functional reach in elderly men. METHOD: Twenty elderly men with an average age of 78.2 years were selected for this study. A active range of motion of ankle dorsiflexion and a functional reach (FR) distance were measured before and after ankle stretching exercise. The ankle dorsiflexion was measured by goniometer in knee extended position. The FR distance was measured in standing position. Ankle plantar flexors stretching exercises were carried out by physical therapist 4 times per week for 4 weeks. At 4 weeks after the stretching exercise, we retested the active range of motion of ankle dorsiflexion and the FR distance using the same method. RESULTS: At 4 weeks after the stretching exercise, the active range of motion of right ankle dorsiflexion was increased from 2.81 +/- 3.26degrees to 5.98 +/- 4.34degrees, and the left ankle dorsiflexion was increased from 3.15 +/- 3.77degrees to 6.35 +/- 2.45degrees. The FR distance was increased form 12.22 +/- 7.54 cm to 19.69 +/- 8.59 cm after the stretching exercise. CONCLUSION: The FR distance was significantly increased after the ankle plantar flexors stretching exercise (p<0.01). This results suggest that the ankle plantar flexors stretching excercise may be capable of increasing the FR distance in elderly.
Aged* ; Ankle Joint ; Ankle* ; Exercise ; Humans ; Knee ; Male ; Physical Therapists ; Range of Motion, Articular

PURPOSE: To determine the best routes of administration of Tobramycin, the intracameral concentrations was assessed as time progressed after administering identical amounts and concentrations of tobramycin through various methods. METHODS: 40 eyes from 20 house rabbits were administered the same amount (200 micro liter) of 0.3% tobramycin. The first group was administered topically, and the second group was administered by subconjunctival injection. Contact lenses were soaked in tobramycin for 30 minutes and were covered over the corneas of the third group. While amniotic membranes were transplanted onto the corneas and tobramycin was topically administered in the fourth group. 100 micro liter of aqueous fluid was extracted 30 min, 1 hr, 2 hr and 3 hr after the administration and intracameral concentrations of tobramycin were measured using FPIA (fluorescence polarization immunoassay). RESULTS: After topical administration and subconjunctival injection, statistically significant decreases of average concentrations were observed after 2~3 hours. The group that was covered with flexible hydrophilic contact lenses showed high concentrations after 30 minutes, and a statistically significant increases of concentration was observed after 2 hours. The group that was topically administered with 0.3% tobramycin after amniotic transplantation on the cornea, showed a gradual increase of concentration as time progressed, and statistically significant increase of concentration was observed after 1~2 hours. CONCLUSIONS: Topical administrations with more frequent instillations increased intracameral concentrations, exceeding the MIC90 concentration of Staphylococcus aureus. while low concentration (0.3%) of subconjunctival injections did not significantly increases intracameral concentrations. Using flexible contact lenses, high concentrations were observed in the early stages, exceeding the MIC90 concentrations of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Concentrations exceeded MIC90 concentration of Staphylococcus epidermidis 30 minutes after amniotic membranes transplantation, and continued to increases after 3 hours, Therefore, we can conclude that amniotic membrane can be used as a reservoir for transferring drugs.
Administration, Topical ; Amnion ; Aqueous Humor* ; Contact Lenses ; Contact Lenses, Hydrophilic ; Cornea ; Pseudomonas aeruginosa ; Rabbits ; Staphylococcus aureus ; Staphylococcus epidermidis ; Tobramycin*

We report distinctive diffusion-weighted magnetic resonance image (DWI) findings in a 65-year-old man with clinically diagnosed Creutzfeldt-Jakob disease (CJD). Four weeks before admission he developed general weakness and febrile sense which were followed by progressive dementia, ataxia, and choreo-athetoid movement of the right hand. T2-weighted magnetic resonance image (MRI) showed subtle high signal intensities only in the left basal ganglia, whereas DWI demonstrated marked hyperintensities in multiple regions including the left basal ganglia and left cerebral cortex. Five weeks after the onset of symptoms, he was noted to have myoclonus and characteristic electroencephalographic changes consisting of periodic triphasic sharp waves. In our patient, high signal changes on the DWI preceded myoclonus and typical EEG findings, a result suggesting that DWI may be useful in the early premortem diagnosis of CJD.
Aged ; Ataxia ; Basal Ganglia ; Cerebral Cortex ; Creutzfeldt-Jakob Syndrome* ; Dementia ; Diagnosis ; Electroencephalography ; Hand ; Humans ; Myoclonus

BACKGROUND AND OBJECTIVES: Although elevations of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration have been shown to be prognostically significant in patients with non-ST elevation acute coronary syndrome (ACS), the relation between the plasma level of NT-proBNP and the severity of coronary disease remains unknown. SUBJECTS AND METHODS: The NT-proBNP concentration was analyzed in 50 patients with non-ST elevation ACS. We compared plasma NT-proBNP levels and treatment method (medical treatment vs. percutaneous coronary intervention [PCI]). RESULTS: In patients with non-ST elevation ACS, NT-proBNP levels were significantly higher in the PCI (n=37) group than in the medical treatment (n=13) group (296.6 vs. 76.3 pg/mL;p<.001). In patients with unstable angina (UA), NT-proBNP levels were significantly higher in the PCI (n=22) group than in the medical treatment (n=12) group (147.6 vs. 64.5 pg/mL;p<.001). Elevated NT-proBNP level predicted PCI in patient with non-ST elevation ACS. A NT-proBNP level >125.9 pg/mL had sensitivity, specificity, positive predictive value and negative predictive value of 75.7%, 92.3%, 96.6% and 57.1%, respectively. In patients with UA, a NT-proBNP level >123.8 pg/mL had equivalent results of 68.2%, 91.7%, 93.8% and 61.1%, respectively. The area under the curve was 0.891 in non-ST elevation ACS and 0.907 in UA. Elevated NT-proBNP level was also correlated with the severity of culprit artery stenosis and multi-vessel disease. CONCLUSION: Elevated plasma NT-proBNP concentrations were associated with the severity of coronary artery disease in patients with non-ST elevation ACS. In combination with clinical factors, NT-proBNP level will provide a highly discerning tool for early risk stratification and further clinical decisions.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease ; Coronary Stenosis* ; Coronary Vessels* ; Humans ; Natriuretic Peptide, Brain ; Percutaneous Coronary Intervention ; Plasma* ; Sensitivity and Specificity

PURPOSE: To study the effect of topical autologous serum in the treatment of recurrent punctate corneal erosions. METHODS: A total of 10 eyes from recurrent corneal erosion patients, who had suffered from recurrence after initial treatment with conventional therapy were treated using topical autologous serum from October 2001 to April 2003. We investigated the efficacy of this method over conventional therapy by retrospective review of their medical records. RESULTS: The recurrence rate of erosions before treatment with autologous serum eyedrops ranged from once every 2months to twice a month. Mean follow-up time was 11.0 +/- 4.6 months (range, 6~19 months). There was one case of recurrence 3 months after first treatment with autologous serum eyedrops which was effectively cured with autologous serum eyedrops. No side effects were noted in any of the treated patients. CONCLUSIONS: Topical autologous serum application may be considered as an effective and safe treatment modality in recurrent corneal erosions.
Follow-Up Studies ; Humans ; Medical Records ; Ophthalmic Solutions ; Recurrence ; Retrospective Studies

OBJECTIVE: Poor head and neck support during sleep can exacerbate the neck pain. Based on the ideal sleep posture and pillow suggested by Cyriax, we designed a new cervical pillow and compared the degree of pain reduction, quality of sleep and pillow satisfaction with a low hospital pillow and a high pillow. METHOD: The newly designed pillow has a built-in pressure-adjustable air bag in the cervical area and provides normal cervical lordotic curve in supine position and maintains cervical and thoracic vertebrae to form a horizontal line in side-lying position. Thiry-four patients with cervical pain used low hospital pillows for the first week of 3-week randomized crossover design study. They were subsequently randomly assigned to use each of the other two pillows for 1-week period. Outcomes were measured using visual analog scale, sleep questionnaire and a pillow satisfaction scale. RESULT: Compared with the other 2 types of pillows, subjects using the newly designed pillow showed much reduced pain intensity, increased duration of sleep and sleep quality and better pillow satisfaction. CONCLUSION: We designed a cervical pillow with built-in pressure adjustable air bag and it can significantly reduce pain intensity and improve quality of sleep in patients with cervical pain.
Air Bags ; Cross-Over Studies ; Head ; Humans ; Neck ; Neck Pain ; Posture ; Surveys and Questionnaires ; Supine Position ; Thoracic Vertebrae ; Visual Analog Scale

OBJECTIVE: To investigate the correlation of main risk factors and cognitive-perceptual functions of stroke patients assessed with Mini-mental status examination (MMSE) and Motor-free visual perception test (MVPT) scores. METHOD: Subjects were 41 stroke patients from 35 to 70 years of age. Data collection was done through chart review on risk factors of stroke including hypertension, diabetes mellitus, heart disease, hypercholesterolemia, and cigarette smoking. Three months after the onset of stroke, MMSE and MVPT were performed. RESULTS: The subjects with diabetes had significantly lower scores in MMSE (p<0.05) and MVPT (p<0.05) compared to those with nondiabetics. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesion (p<0.05). CONCLUSION: Among the several risk factors, diabetes mellitus has significant relationship to cognitive and visual perceptual function in the stroke patients.
Data Collection ; Diabetes Mellitus ; Heart Diseases ; Humans ; Hypercholesterolemia ; Hypertension ; Risk Factors* ; Smoking ; Stroke* ; Visual Perception

Cerebral infarction is an uncommon complication in multiple myeloma with hyperviscosity. Serum hyperviscosity may cause a variety of clinical manifestations including bleeding from mucosal membranes, congestive heart failure, retinopathy, and various neurologic deficits. These manifestations have been attributed to the presence of large quantities of asymmetrical molecules of high molecular weight in the serum. We recently experienced a case of multiple myeloma with acute cerebral infarction, which caused by hyperviscosity, as an initial manifestation in IgG multiple myeloma, and reviewed the relevant literature of myeloma presenting with the stroke. A 68-yr-old woman abruptly developed hypesthesia and monoplegia in the left leg. The stroke confirmed by the brain MRI and MR angiography, which revealed acute infarction at the right anterior cerebral artery territory. On admission, routine blood tests showed a slight decrease in hemoglobin and a marked increase in erythrocyte sedimentation rate. Peripheral blood smear, serum protein electrophoresis, serum visocity, and bone marrow aspiration showed that she had IgG multiple myeloma with hyperviscosity. She was treated by chemotherapy with cyclophosphamide and discharged with the improved clinical condition.
Aged ; *Blood Viscosity ; Cerebral Infarction/*blood ; Electrophoresis ; Female ; Humans ; Immunoglobulin G/*blood ; Magnetic Resonance Imaging ; Multiple Myeloma/*diagnosis/immunology

BACKGROUND: Basilar arterial dolichosis (BD) has chracteristics of tortuosity and elongation. BD can cause obstructive hydrocephalus, direct compression of brainstem and cranial nerves, and cerebral ischemia or infarction. It has been reported that brainstem infarction is usually located contralateral to the side of lateral displacement. This study was aimed to reveal the relation between the location of the infarction and the some characteristics of BD. METHODS: Among the 143 patients who had brainstem infarction from January, 2003 to July, 2004, 40 patients with BD were analyzed retrospectively. Characteristics of BD and infarct site were analysed with special respect via MRI and MRA. We surveyed the relation between the location of the infarction and the lateral displacement of BD. Subjects were divided into two groups by the degree of the lateral displacement of basilar artery (BA). We made a comparison between the two in clinical characteristics and risk factors. Height of the infarct site and the maximal point of lateral displacement from arbitrarily defined standard level (lower pons) were measured. We surveyed the lesional laterality associated with relative height of the infarct site. RESULTS: Infarct lesions located to the contralateral side of the laterally displaced BA were more prevalent (25 cases, 62.5%). There was significant correlation between the lesional laterality and the lateral displacement of the BA in group B (p=0.039) and between the lesion-height and the maximal dolichosis-height (r=0.639, p<0.001). CONCLUSIONS: Patients with BD are more likely to have brainstem infarction at the contralateral side of the laterally displaced BA.
Basilar Artery* ; Brain Ischemia ; Brain Stem Infarctions* ; Brain Stem* ; Cranial Nerves ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Retrospective Studies ; Risk Factors