No abstract available.
Diabetic Neuropathies*

Traumatic knee contracture is a common complication after an operative procedure. It occurs mainly due to an intraarticular adhesion and results in a significant knee dysfunction and disability. Patients with a contracture have different ways of recovery, however there is no reliable clinical data regarding a recovery to the full range of motion after knee injury. A proper therapeutic plan is needed to the physiatrists during a rehabilitation of the traumatic knee contracture. The purpose of this study was to obtain a clinical insight into the course of recovery to the normal range of motion after a traumatic knee contracture. One hundred and fourty-seven cases of traumatic knee contracture patients who underwent an operative treatment at the Department of Orthopedic Surgery, St. Mary's Hospital between the years of 1992 to 1996, were reviewed. Knee contractures were most frequent in the second and third decades with a traffic accident being the most common cause. A factor that influenced regaining a normal range of motion was the injury type with an earlier recovery in the order of an injury to the meniscus, cruciate ligament, collateral ligament, a complex injury, and a bone fracture. Persistent contracture groups showed a higher incidence of bone fractures around the knee and open surgeries, while there was no discrepancy in sex, age, and operation time. In conclusion, the results of this study are expected to give some insights to clinicians and to help them in treating patients with the traumatic knee contracture after operation.
Accidents, Traffic ; Collateral Ligaments ; Contracture* ; Fractures, Bone ; Humans ; Incidence ; Knee Injuries ; Knee* ; Ligaments ; Orthopedics ; Range of Motion, Articular ; Reference Values ; Rehabilitation ; Surgical Procedures, Operative

OBJECTIVE: To provide normal reference values of the sonographic diameters and cross sectional area (CSA) of the posterior tibialis tendon (PTT) in Korean adults for early diagnosis and treatment of PTT dysfunction. METHOD: 240 feet from 120 healthy volunteers (63 males; 57 females, mean age: 36.40+/-11.37) were included in this study. Those with a previous history of surgery or trauma to the lower extremities and systemic disease, such as, hypertension, diabetes, or rheumatoid arthritis were excluded. PTT was examined through ultrasonograhy with the patient placed in the prone oblique position, with the knee extended, and ankle dorsiflexed to neutral angle. We evaluated the anterioposterior (AP) and transverse diameter and CSA of the PTT along the line that connected from the posteroinferior angle of the medial malleolus to the heel. RESULTS: The AP diameter of PTT measured by sonography was 3.42+/-0.03 mm and the transverse diameter of the PTT was 9.20+/-0.08 mm. The CSA was 21.46+/-0.26 mm2. Differences in diameters and CSA related to sidedness, sex did not show statistical significance (p>0.05). There was weak linear relationship in AP and transverse diameter and CSA with weight, height, leg and foot length. CONCLUSION: The normal Korean reference values of the PTT diameter and CSA that we obtained from ultrasonography can be used as useful reference data in diagnosing early pathologic conditions of PTT dysfunction.
Adult ; Animals ; Ankle ; Arthritis, Rheumatoid ; Early Diagnosis ; Female ; Foot ; Heel ; Humans ; Hypertension ; Knee ; Leg ; Lower Extremity ; Reference Values ; Tendons

OBJECTIVE: Nowadays half body bathing (H-bath) became popular with increasing interests of health and well-being. H-bath is expected to be beneficial and safe as well as conventional whole body bathing (W-bath). However, there has been no formal report on the safety and effectiveness of H-bath. Therefore, this study tried to evaluate and compare the cardiovascular response during H-bath and W-bath in patients with or without cardiovascular disease. METHOD: 17 subjects with at least one cardiovascular risk factor and 15 subjects without any cardiovascular risk factor took H-bath while 22 healthy control group without any cardiovascular risk factor took W-bath. Changes of skin and oral temperature as well as hemodynamic responses (systolic blood pressure, diastolic blood pressure, heart rate) were measured. RESULTS: Increasing of systolic blood pressure and heart rate in H-bath was statistically lowered compared to W-bath as time goes by in bathing (p<0.05). There were no significant difference in patients with and without cardiovascular disease. CONCLUSION: Heart rate, temperature, systolic blood pressure showed a more gradual increase during H-bath than during W-bath. We propose that H-bath could be a more safe and compliant method of cardiac rehabilitation in patients with cardiovascular disease.
Baths* ; Blood Pressure ; Cardiovascular Diseases ; Heart ; Heart Rate ; Hemodynamics* ; Humans ; Rehabilitation ; Risk Factors* ; Skin

No abstract available.
Anemia, Aplastic* ; Discitis* ; Humans ; Low Back Pain*

Videofluoroscopic swallowing study (VFSS) used for the diagnosis of dysphagia has limitations in objectively assessing the contractility of the pharyngeal muscle or the degree of the upper esophageal sphincter relaxation. With a manometer, however, it is possible to objectively assess the pressure changes in the pharynx caused by pharyngeal muscle contraction during swallowing or upper esophageal sphincter relaxation, hence remedying the limitations of VFSS. The following case report describes a patient diagnosed with lateral medullar infarction presenting a 52-year-old male who had dysphagia. We suggested that the manometer could be used to assess the specific site of dysfunction in patients with dysphagia complementing the limitations of VFSS. We also found that repetitive transcranial magnetic stimulation was effective in treating patients refractory to traditional dysphagia rehabilitation.
Complement System Proteins ; Deglutition ; Deglutition Disorders* ; Diagnosis* ; Esophageal Sphincter, Upper ; Humans ; Infarction ; Male ; Manometry* ; Middle Aged ; Pharyngeal Muscles ; Pharynx ; Rehabilitation ; Relaxation ; Transcranial Magnetic Stimulation*

OBJECTIVE: To evaluate the feasibility of ultrasound guided atlanto-occipital joint injection. METHOD: Six atlanto-occipital joints of three cadavers were examined. Cadavers were placed in prone position with their head slightly rotated towards the contra-lateral side. The atlanto-occipital joint was initially identified with a longitudinal ultrasound scan at the midline between occipital protuberance and mastoid process. Contrast media 0.5cc was injected into the atlanto-occipital joint using an in-plane needle approach under ultrasound guide. The location of the needle tip and spreading pattern of the contrast was confirmed by fluoroscopic evaluation. RESULTS: After ultrasound guided atlanto-occipital joint injection, spreading of the contrast media into the joint was seen in all the injected joints in the anterior-posterior fluoroscopic view. CONCLUSION: The ultrasound guided atlanto-occipital injection is feasible. The ultrasound guided injection by Doppler examination can provide a safer approach to the atlanto-occipital joint.
Atlanto-Occipital Joint ; Cadaver ; Contrast Media ; Head ; Joints ; Mastoid ; Needles ; Prone Position

Since being introduced by Gauderer et al. in 1980, percutaneous endoscopic gastrostomy (PEG) has proved to be a safe and effective procedure that has become a popular way to establish long term enteral feeding in situations where oral intake is not possible. Indications of PEG are broad, with a few exceptions such as total obstruction of pharynx or esophagus and poor transillumination conditions. In those cases, percutaneous radiologic gastrostomy (PRG) or surgical gastrostomy is feasible. We reported a case of percutaneous radiologic gastrostomy (PRG) in locked-in syndrome patient.
Deglutition Disorders ; Enteral Nutrition ; Esophagus ; Gastrostomy* ; Humans ; Pharynx ; Quadriplegia* ; Transillumination

Atlantoaxial subluxation in undifferentiated spondyloarthropathy is extremely rare and has not been reported. We describe a case of 27-year-old man who was diagnosed as undifferentiated spondyloarthropathy with atlantoaxial subluxation with an initial complaint of painful swelling of right 1st metatarsophalangeal joint and posterior neck pain. Roentgenograms showed sclerotic change and increased hazziness in right 1st metatarsophalangeal joint. Magnetic resonance images and roentgenograms of the cervical spine showed inflammation of odontoid process and atlantoaxial subluxation. Bone scan showed hot uptakes in left sacroiliac joint, right 1st & 4th metacarpophalangeal joints and 1st metatarsophalangeal joint. HLA-B27 gene was positive. Spontaneous atlantoaxial subluxation and undifferentiated spondyloarthropathy was diagnosed and conservatively treated with oral medication. Currently, there is no definite neurological sign. Early recognition and awareness of potential clinical complications is important in preventing compressive damage on central nervous system.
Adult ; Central Nervous System ; HLA-B27 Antigen ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Metacarpophalangeal Joint ; Metatarsophalangeal Joint ; Neck Pain ; Odontoid Process ; Sacroiliac Joint ; Spine ; Spondylarthropathies

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been reported rarely in systemic lupus erythematosus (SLE). We report a case of a 33 year-old woman who was diagnosed as SLE 2 years ago and presented with both feet and hands tingling sensation over 2 months. She also showed clinical features of areflexia, elevated CSF protein, and demyelination in the nerve conduction study. Her lower limb weakness and ataxic gait gradually progressed. Her symptoms which had shown minimal improvement to immunoglobulin therapy responded to immunosuppressant treatment.
Demyelinating Diseases ; Female ; Foot ; Gait ; Hand ; Humans ; Immunization, Passive ; Immunoglobulins ; Lower Extremity ; Lupus Erythematosus, Systemic ; Neural Conduction ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; Sensation