Purpose: This study was aimed to identify the effect of Mulligan knee taping (MKT) application on the hip joint muscle activity and lower extremity kinematic during single leg squat. Methods: Twenty healthy male partisipants, aged between 19 and 29 years, were measured for hip joint muscle activity, medial knee displacement, and hip adduction angles according to the application of MKT. In single leg squat, the eccentric, isometric, and concentric contraction phases were performed until the knee flexed at a depth of 60°. The muscle activity (unit, %MVIC) of hip joints in each phase and the medial knee displacement (unit, cm) and hip adduction angle (unit, °) were analyzed before and after the application of MKT during single leg squat. All measurements were performed with the dominant leg, and the order of MKT and non-taping was randomly determined by drawing lots. Results: During single leg squat, the muscle activity of the gluteus maximus muscle in the eccentric and isometric contraction phases significantly increased when MKT was applied than when non-taping (p=0.048 and p=0.012, respectively). There was no statistically significant difference between the muscle activity of other lower extremity muscles and the medial knee displacement and hip adduction angle (p＞ 0.05). Conclusion It was confirmed that the activity of the gluteus maximus muscle increased in the case where single leg squat was performed after applying MKT, compared to the case where it was performed without application. Therefore, MKT application is recommended to increase the muscle activity of the gluteus maximus during single leg squat.

Purpose: This study was aimed to identify the effect of taping applied to both hamstring on the horizontal velocity of the center of mass (COM) and the angle and peak angular velocity of the knee and hip joints in the sagittal plane during the crouching start. Methods: Seven elite sprinters (three male 100-m sprinters and four male 400-m sprinters) who enrolled in Korea National Sport University and placed in the National Sports Festival participated in this study. The crouching start is divided into four separate phases by the five events: set position (E1), rear block exit (E2), initial contact of rear leg (E3), take-off of rear leg (E4), and initial contact of front leg (E5). The angle (°) of knee and hip joints in each event and the velocity of COM (m/sec) and peak angular velocity (°/sec) in each phase were analyzed before and after the application of kinesiology taping (KT) on both hamstring and placebo taping (PT). Results: There were no significant differences in the velocity of COM and the angle and peak angular velocity of knee joint among the taping conditions. In 400-m sprinters, the front hip joint with KT or PT flexed less than without taping at E1 (p=0.039), E4 (p=0.018), and E5 (p=0.018). Also, during the phase from E1 to E2, the rear hip joint with both KT and PT extended at lower angular velocity compared to without taping (p=0.018). Conclusion While taping may be a beneficial practice for elite sports performance, the application of KT on both hamstring does not enhance sprinters’ start performance.

Purpose: This study was aimed to identify the effect of taping applied to both hamstring on the horizontal velocity of the center of mass (COM) and the angle and peak angular velocity of the knee and hip joints in the sagittal plane during the crouching start. Methods: Seven elite sprinters (three male 100-m sprinters and four male 400-m sprinters) who enrolled in Korea National Sport University and placed in the National Sports Festival participated in this study. The crouching start is divided into four separate phases by the five events: set position (E1), rear block exit (E2), initial contact of rear leg (E3), take-off of rear leg (E4), and initial contact of front leg (E5). The angle (°) of knee and hip joints in each event and the velocity of COM (m/sec) and peak angular velocity (°/sec) in each phase were analyzed before and after the application of kinesiology taping (KT) on both hamstring and placebo taping (PT). Results: There were no significant differences in the velocity of COM and the angle and peak angular velocity of knee joint among the taping conditions. In 400-m sprinters, the front hip joint with KT or PT flexed less than without taping at E1 (p=0.039), E4 (p=0.018), and E5 (p=0.018). Also, during the phase from E1 to E2, the rear hip joint with both KT and PT extended at lower angular velocity compared to without taping (p=0.018). Conclusion While taping may be a beneficial practice for elite sports performance, the application of KT on both hamstring does not enhance sprinters’ start performance.

BACKGROUND: The use of monitored anesthesia care (MAC) as the technique of choice for a variety of invasive or noninvasive procedures is increasing. The purpose of this study to compare the outcomes of two different methods, spinal anesthesia and ilioinguinal-hypogastric nerve block (IHNB) with target concentrated infusion of remifentanil for inguinal herniorrhaphy. METHODS: Fifty patients were assigned to spinal anesthesia (Group S) or IHNB with MAC group (Group M). In Group M, IHNB was performed and the effect site concentration of remifentanil, starting from 2 ng/ml, was titrated according to the respiratory rate or discomfort, either by increasing or decreasing the dose by 0.3 ng/ml. The groups were compared to assess hemodynamic values, oxygen saturation, bispectral index (BIS), observer assessment alertness/sedation scale (OAA/S), visual analogue scale (VAS) for pain score and patients' and surgeon's satisfaction. RESULTS: BIS and OAA/S were not significantly different between the two groups. Hemodynamic variables were stable in Group M. Thirteen patients in the same group showed decreased respiratory rate without desaturation, and recovered immediately by encouraging taking deep breaths without the use of assist ventilation. Although VAS in the ward was not significantly different between the two groups, interestingly, patients' and surgeon's satisfaction scores (P = 0.0004, P = 0.004) were higher in Group M. The number of the patients who suffered from urinary retention was higher in Group S (P = 0.0021). CONCLUSIONS: IHNB under MAC with remifentanil is a useful method for inguinal herniorrhaphy reflecting hemodynamic stability, fewer side effects and higher satisfaction. This approach can be applied for outpatient surgeries and patients who are unfit for spinal anesthesia or general anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Hemodynamics ; Herniorrhaphy ; Humans ; Nerve Block ; Oxygen ; Piperidines ; Respiratory Rate ; Urinary Retention ; Ventilation

Purpose: This study aimed to investigate the relative workload via a global positioning system (GPS) unit that was related to noncontact injuries in the lower extremities of college football player. Methods: Data were collected from 18 players who were enrolled in a university football team using a GPS unit during competitions. The noncontact injury in the lower extremities were recorded for each competition by well-trained medical practitioners. Players’ ratio of acute to chronic workload (ACWR) of each GPS variable was calculated by dividing the most recent 1 week (acute) workload by the prior 4 weeks (chronic) workload. The ACWR in the time of player’s injury (injury-related block) was compared to the time before the injury-related block (preinjury block) and from the beginning of the data collection to the point of injury (total injured average), and the end of the data collection (total non-injured average). Results: Eight players suffered 12 injures, indicating that an incidence rate was 13.28 injuries per 100 athlete exposures. Injured player had a higher ACWR of repeated high-intensity effort bouts (RHIE) and work-rest ratio (WRR) in the injury-related block compared to the preinjury block (F=3.151, p=0.039 and F=7.577, p=0.001, respectively). Also, they had a higher ACWR of maximal velocity (MV) in the injury-related block and total injured average compared to total non-injured average (F=5.592, p=0.004). Conclusion This study illustrated that the high ACWR in RHIE, WRR, and MV in the injury-related block may be related to noncontact injuries in the lower extremities of college football player. Many questions remain, but the results of this study may provide coaches and staffs in college football with useful quantitative information on preventive approach to sports-related injuries.

Preoperative clinical staging in the prostate cancer does not always accurately predict the surgical-pathological outcome. We evaluated how the clinical staging, and other clinical parameters including preoperative PSA and Gleason`s score could reflect on the surgicopathological findings in 30 patients with prostate cancer, who underwent radical prostatectomy. Twelve of 24 patients with clinical T1 or T2 disease were understaged by clinical staging determined by digital rectal examination, bone scan, and radiologic studies including CT and MRI with endorectal coil. MRI with endorectal coil accurately reflected the extracapsular disease only in 59.1% of 22 patients studied. At the same time, it also showed low sensitivity (50%) with high specificity (100%) in detecting lymph node metastasis. Preoperative levels of PSA in patients with P2, P3, and N+ disease were 17.8 +/- 4.5, 47.9 +/- 11.3, 93.5 +/- 20.5ng/ml, respectively. The level of PSA was less than 20ng/ml in 9 of 12 patients with P2 disease, while they were greater than 20ng/ml in 9 of 12 patients with P3 disease. PSA may have a role to rule out lymph node metastasis when its level is less than 10ng/ml, although it did not reach the statistical significance because of small sample size. Gleason`s scores in patients with P2 disease were quite similar to those in patients with P3 disease (5.92 +/- 0.69 vs 5.67 +/- 0.56), whereas Gleason`s scores in all 6 patients with N+ disease were 9 or greater. Neoadjuvant hormonal therapy with LH-RH analogue and androgen receptor blocker for 1.5 to 3 months had no impact on the reduction of margin positivity or downstaging in 10 patients. PSA failure rate in patients with P2 and P3 disease was 25% at 1 year after operation. PSA is a good marker for differentiating between P2 and P3 disease (,p=0.0214) and can safely rule out N+ disease if its level is below 10ng/ml, while Gleason`s score may reflect the lymph node metastasis when it is 9 or greater (p=0.0012). Among the candidates for radical prostatectomy, selection of the patients on the basis of PSA and Gleason`s score might improve the surgical-pathological outcome.
Digital Rectal Examination ; Gonadotropin-Releasing Hormone ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Receptors, Androgen ; Sample Size ; Sensitivity and Specificity

OBJECTIVE: A recent revision of the FIGO staging system does not recommend the mandatory use of cystoscopy and sigmoidoscopy. The objective of this study was to assess the clinical utility of CT or MRI scans for ruling out bladder or rectal invasion and determine the indication for endoscopy in patients with cervical cancer. METHODS: We retrospectively reviewed 769 patients with cervical cancer, who underwent imaging and endoscopic work-up between January 1997 and December 2010. Using endoscopy as the standard reference for comparison, we calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the imaging modality for bladder or rectal invasion. RESULTS: The CT scan showed 68.2% and 85.7% for sensitivity and 96.4% and 98.9% for specificity in detecting bladder and rectal invasion, respectively. CT scan provided a low PPV (51.7%, 54.5%) and a high NPV (98.2%, 99.8%). MRI scan showed 88.0% and 75.0% for sensitivity and 93.1% and 98.9% for specificity in detecting bladder and rectal invasion, respectively. MRI scan provided a low PPV (35.6%, 42.9%) and a high NPV (99.4%, 99.7%). The accuracies of CT and MRI scans in identifying bladder invasion were 94.9% and 92.8%, respectively. The accuracies of CT and MRI in identifying rectal invasion were 98.7% and 98.6%, respectively. CONCLUSION: The results of this study demonstrate that additional invasive endoscopy is not necessary for patients who present with no invasion on imaging work-up, and therefore, endoscopy should be considered a tool for confirming cases that are positive for invasion based on imaging work-up.
Cystoscopy ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity ; Sigmoidoscopy ; Urinary Bladder ; Uterine Cervical Neoplasms