No abstract available.
Action Potentials* ; Adult* ; Humans ; Median Nerve* ; Ulnar Nerve*

OBJECTIVE: To determine whether flexion and extension of the wrist joint produce the change in the conduction study of the median nerve in the normal and diabetic patients, and to compare the susceptibility of median nerve compression injury in two groups. METHOD: Thirty healthy adults as control and thirty diabetic patients without carpal tunnel syndrome were studied. The wrist joint was maintained in flexion or extension position for 5 minutes before performing conduction study. The variables used for statistical analysis included the mean difference of amplitude and latency in median motor and sensory responses in neutral, flexion, and extension positions. RESULTS: The results showed that significant differences in the latency and amplitude of median motor and sensory responses between neutral, extension, and flexion of wrist within each group (p<0.01). The differences in the median sensory latency (p<0.01), amplitude (p<0.05) and the change of wrist-palm segmental conduction velocity (p<0.01) were statistically significant between the diabetes and the normal control. CONCLUSION: The results of this study suggest that median nerves are susceptible to compression pressure in diabetic patients. Therefore, the position of the wrist joint should be considered in the median nerve conduction study.
Adult ; Carpal Tunnel Syndrome ; Diabetes Mellitus* ; Humans ; Median Nerve* ; Wrist Joint ; Wrist*

No abstract available.
Congenital Hypothyroidism*

Treatment of the trigger points(TrP) is the most important thing for management of myofascial pain syndrome(MPS). The most effective treatment of TrP is local injection with various types of drug or dry needling, but the effectiveness of each drug was not the same by each investigator. The purposes of this study are to evaluate diagnostic value of Digital Infrared Thermographic Imaging(DITI) for trigger points and therapeutic effects of lidocaine and normal saline by DITI. This study included 15 patients who have TrP on upper trapezius muscles as a patient group and 10 normal adults as a control group. 2 cc of 2% Lidocaine was injected to the TrP of upper trapezius muscles in a patient group and to one side of upper trapezius muscles in a control group. One week after the first injection, 2 cc of normal saline was injected by the same method in a patient group. DITI was taken sequentially, preinjection(Pre), immediately after injection(P0), 15(P15), 30(P30), 60(P60) minutes and 24 hours(P24h) after injection. The parameters, temperature difference(deltaT) of both sides, changes of deltaT(deltadT), visual analogue scale(VAS) were recorded at each point. It was considered abnormal, when the deltaT was above 0.6oC. The patient group was subdivided as Group I(hot spot), Group II(cold spot) and Group III(no difference) according to preinjection thermographic findings of TrP. The results were as follows: 1) deltaT of control group was within 0.52oC(95% confidence interval), 2) the numbers were 9 in Group I, 3 in Group II and 3 in Group III, and the sensitivity and specificity of hot spots for MPS were 81.8% and 57.1%, respectively, 3) deltaT was more reduced after lidocaine- than normal saline-injection, 4) VAS was more reduced after lidocaine- than normal saline-injection, especially in Group I and II. It is concluded that DITI can be used as one of the diagnostic tools for TrP and lidocaine is more effective than normal saline for the treatment of TrP.
Adult ; Humans ; Lidocaine ; Myofascial Pain Syndromes ; Research Personnel ; Sensitivity and Specificity ; Superficial Back Muscles ; Thermography ; Trigger Points*

OBJECTIVE: To increase the accuracy and consistency in determining the level of radiculopathy by a needle electromyography (EMG) of multifidus muscle. METHOD: We performed the EMGs on 29 patients with a low back pain to investigate an evidence of radiculopathy. All patients had the herniated nucleus pulposus (HNP) by a myelography, CT or MRI. The exclusion criteria were the patients with a scoliosis, spondylolisthesis or history of back surgery. We examined 5 points (P 1~5) of the lumbosacral paraspinal muscles according to the paraspinal mapping by Haig et al and scored from 0~4 according to the degree of abnormalities. The scores according to the points were correlated with the segments of radiculopathy and the levels of HNP. RESULT: The maximal mean scores were 1.80+/-0.83 at P2 and 2.00+/-1.41 at P3 in a lumbar (L) 3, 4 radiculopathy, 2.00+/-0.56 at P5 in a L5 radiculopathy, and 2.13+/-0.64 at P4 and 2.63+/-0.51 at P5 in a S1 radiculopathy. The sensitivity/specificity was high at P2, P3 in a L3, 4 radiculopathy, at P4 in a L5 radiculopathy, at P5 in a S1 radiculopathy. CONCLUSION: The results suggest that the localization of lumbosacral radiculopathy by a needle EMG of multifidus muscles provides an easy accessibility, better accuracy and consistency to determine the level of radiculopathy.
Electromyography* ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Muscles ; Myelography ; Needles* ; Paraspinal Muscles* ; Radiculopathy* ; Scoliosis ; Spondylolisthesis

OBJECTIVE: To investigate the defecation pattern after discharge in stroke patients with bowel problems. METHOD: Subjects were 50 stroke patients who underwent rehabilitation program and discharged to home. The information about the defecation pattern were taken through interview or review of medical records as follows: anatomical lesion site, consciousness, admission period, operation history, co-morbidity, ambulation distance, water & food intake, assistive device use, voiding dysfunction, urine output, stool softner use, fecal incontinence, and defecation frequency. We compared the defecation frequency according to the various factors obtained from the medical records and interview. RESULT: The defecation frequency were significantly higher in patients without co-morbidily or fecal incontinence, with longer-distance ambulation, large amount of water & food intake (p<0.05). There was no significant change in the defecation frequency according to age, sex, anatomical lesion, operation history, admission period, use of assitive devices, consciousness, voiding dysfunction, or urine output (p>0.05). CONCLUSION: Considering the various factors noted above, comprehensive rehabilitation program to relieve bowel problems should be established in the rehabilitation management of stroke patients.
Consciousness ; Defecation* ; Eating ; Fecal Incontinence ; Humans ; Medical Records ; Rehabilitation ; Self-Help Devices ; Stroke* ; Walking ; Water

No abstract available.
beta-Endorphin* ; Exercise* ; Pain Threshold* ; Plasma*

OBJECTIVE: The purpose of this study was to evaluate hemodynamics for diabetes mellitus (DM) by transcranial Doppler sonography (TCD) and to evaluate the influences of risk factors to cerebral hemodynamics in DM. METHOD: We examined 54 normal persons, 17 patients with DM without risk factors, and 15 patients with DM and risk factors. The risk factors were hypertension, smoking, and hyper lipidemia (total cholesterol >240 mg/dl, low density lipoprotein >160 mg/dl). Mean blood flow velocity (MBFV) was also analyzed by Angiodine 2 Doppler system operating at 2 MHz frequency from each subjects. RESULTS: There was a significant decrease of MBFV in the diabetes in comparison to control groups (p<0.05). There was a significant decrease of MBFV in the diabetic risk group as compared to diabetic non-risk group (p<0.05). There was significantly increased total cholesterol, low density lipoprotein, low density lipoprotein/high density lipoprotein ratio in the diabetic risk group as compared to diabetic non-risk group (p<0.05). MBFV significantly decreased with increasing concentration of HbA1C and duration of DM (p<0.05). CONCLUSION: We suggest that transcranial Doppler sonography can be used as one of the useful screening tests for early detection of cerebrovascular diseases in DM.
Blood Flow Velocity ; Cholesterol ; Diabetes Mellitus* ; Hemodynamics* ; Humans ; Hyperlipidemias ; Hypertension ; Lipoproteins ; Mass Screening ; Risk Factors ; Smoke ; Smoking ; Ultrasonography, Doppler, Transcranial*

OBJECTIVE: To evaluate peripheral hemodynamics using the doppler ultrasound in the diabetic patients. METHOD: We measured mean blood flow velocity (MBFV), resistance index (RI), pulsatility index(PI) in the dorsalis pedis artery (DPA), posterior tibial artery (PTA), and radial artery (RA) from 18 normal controls (n=36), 17 diabetes patients without neuropathy (n=34), and 21 diabetes patients with neuropathy (n=42) by use of Angiodine 2 Doppler system operating at 8 MHz frequency. RESULTS: MBFV of all the examined arteries increased significantly in the diabetes with neuropathy in comparison to controls and the diabetes without neuropathy (p<0.05). RI and PI of DPA and PTA decreased significantly in the diabetes with neuropathy in comparison to controls and diabetes without neuropathy (p<0.05). The blood flow velocity profile was changed from triphasic to monophasic pattern in the diabetes with neuropathy in DPA and PTA. CONCLUSION: The Doppler ultrasound is considered as a useful tool for screening change of peripheral blood flow in the diabetic patients with neuropathy.
Arteries ; Blood Flow Velocity ; Diabetes Mellitus* ; Hemodynamics* ; Humans ; Mass Screening ; Radial Artery ; Tibial Arteries ; Ultrasonography*

OBJECTIVE: To investigate the regional differences of skin blood flow and to evaluate the effects of foot temperature on the severity of neuropathic pain and to predict the development of plantar foot ulceration by measuring of the temperature variations on the plantar surface of feet in the diabetic patients. METHOD: We measured the temperature variations on plantar surface of the feet in controls (n=18) and diabetic patients with(n=20) or without(n=23) polyneuropathy. The surface temperature from the 3rd metatarsal head(MTH), greater toe(GT), heel, medial and lateral longitudinal arch(LA) was measured by Digital Infrared Thermographic Imaging(DITI). RESULTS: The mean foot temperature of diabetic patients with polyneuropathy was significantly increased compared to controls or diabetic patients without polyneuropathy(p<0.001). The surface temperature readings of the GT, medial LA and the 3rd MTH tended to be increased in controls and patients with polyneuropathy. The mean plantar surface temperature was significantly increased according to the duration of diabetes mellitus(DM)(p<0.05). CONCLUSION: The results suggest that DITI provides a diagnostic modality in the prediction of neuropathic foot and increased risks of foot ulcer development in the diabetic patients.
Diabetic Neuropathies ; Foot Ulcer* ; Foot* ; Heel ; Humans ; Metatarsal Bones ; Neuralgia ; Polyneuropathies ; Reading ; Skin