OBJECTIVE: To evaluate the diagnostic values of segmental somatosensory evoked potentials (SEPs) in the unilevel/unilateral lumbosacral radiculopathies. METHOD: Thirty-nine radiculopathy patients of whom diagnosis was confirmed by the surgery or selective nerve root injection and 20 subjects with no evidence of radiculopathy were included in the study. Before the treatment, superficial peroneal nerve segmental SEPs and sural nerve segmental SEPs were performed. Sensitivities and specificities were delineated from the several diagnostic criteria. RESULTS: The analysis of side-to-side mean cortical P1 latency difference (>2.0 SD) reveals a segmental SEPs sensitivity for L5 radiculopathies of 12.1% and sensitivity for S1 radiculopathies of 0%. The analysis of side-to-side mean percent amplitude difference (2.0 SD) reveals a segmental SEPs sensitivity for L5 radiculopathies of 9.1% and sensitivity for S1 radiculopathies of 0%. The analysis of side-to-side mean cortical P1 latency difference (>3 ms) and the side-to-side mean amplitude reduction (>50%) show the similar results. The specificities of L5 radiculopathies and S1 radiculopathies are variable from 40.0% to 93.3%. Sensitivities of segmental SEPs are lower than needle EMG. It is not root specific, even the SEP is not obtainable unilaterally. CONCLUSION: The diagnostic values of segmental somatosensory SEPs are questionable in the unilevel/unilateral lumbosacral radiculopathies which are confirmed by the surgery or selective nerve root injection.
Diagnosis ; Evoked Potentials, Somatosensory ; Humans ; Needles ; Peroneal Nerve ; Radiculopathy* ; Sural Nerve

BACKGROUND: In aerometabolic process, the human heart mainly utilizes free acid as fuel. During anaerobic process, lactate production by the myocardium is increased and accumulates in the myocardium. Thus it decreases the contractility of myocadium. Therefore in patients with ischemic heart disease, lactate prodution must be increased by the myocardium during myocardial ischemia. During paroxysmal supraventricular tachycardia, patients frequently experience chest pain and ST segment depression suggesting acute myocardial ischemia. However it occurs on a physiologic basis independent of ischemia. The purpose of this study was to assess whether tachycardia induced by artial pacing produces myocardial ischemia in patients without evidence of ischemic heart disease. METHODS: Between May 28, 1996 and August 13, 1996, at the University of Keimyung, Dong-San Medical center, 15 patients(male 9, female 6, mean age of 38 years) with palpititation underwent electrophysiologic testing and had radiofrequency cather ablation. There were no evidence of ischemic heart disease. Right artrial pacing was done with lengths of 500msec, 400msec and 350msec in each 5 patients. A 12 lead electrdcardiogram, left ventricular enddiastolic pressure, blood from femoral artery and coronary sinus for lactate determinations and blood gas analysis were dbtained simultaneously. They were obtained at baseline, at 1, 5, 10 and 15 minute of atrial pacing and at 1, 5, 10 minute after cessation of pacing. RESULT: Significant changes were not observed in , , concentration of , pH and saturation. In all patients, mean percent lactate extraction was above 10% and not significantly changed during atrial pacing. However ST segment depression was significantly progressive during atrial pacing and according to decrease the cycle length(p<0.05), also left ventricular end-diastolic pressure was significantly decreased during atrial pacing(p<0.05). Conclusion: Therefore tachycardia induced by atrial pacing for 15 minutes did not produce myocardial ischemia in patients without evidence of ischemic heart disease. Depression of STsegment during supraventricular tachycardia or atrial pacing, in patient without underlying heart disease is necessary to inveestigate what makes this phenomenon.
Blood Gas Analysis ; Blood Pressure ; Chest Pain ; Coronary Sinus ; Depression ; Female ; Femoral Artery ; Heart ; Heart Diseases ; Humans ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Metabolism* ; Myocardial Ischemia ; Myocardium ; Tachycardia ; Tachycardia, Supraventricular

This prospective study following American Association of Electrodiagnostic Medicine recommended criteria in the diagnosis of Carpal Tunnel Syndrome(CTS) evaluated the sensitivity of multi-electrodiagnostic parameters and usefulness of residual latency in CTS. In 45 symptomatic hands of 26 patients with clinical diagnosis of CTS, 8 electrodiagnostic parameters-median motor distal latency, median motor residual latency, median sensory onset latency, median sensory peak latency, median to ulnar sensory onset latency difference(digit 4), median to ulnar sensory peak latency difference(digit 4), median to radial sensory onset latency difference(digit 1), median to radial sensory peak latency difference(digit 1)-were compared to the normative data obtained from the age-matched control group. In 31 CTS hands without polyneuropathy, median to ulnar sensory latency difference(digit 4), median to radial sensory latency difference(digit 1), median sensory peak latency have same sensitivity(71.0%). In 8 CTS hands with delayed proximal median motor nerve conduction velocity which were indiscernible from polyneuropathy in routine nerve conduction study, residual latency was more sensitive than median to ulnar sensory latency difference and median to radial sensory latency difference. Sensitivity difference between sensory onset latency and sensory peak latency was negligible in the electrophysiologic diagnosis of CTS. We concluded that residual latency measurement was a very useful and convenient method in the diagnosis of CTS, especially in the patients with delayed proximal median motor conduction velocity.
Carpal Tunnel Syndrome* ; Diagnosis ; Hand ; Humans ; Neural Conduction ; Polyneuropathies ; Prospective Studies

No abstract available.
Genes, ras* ; Humans

PURPOSE: The purpose of this study was to compare the clinical results between the subacromial injection of the ketorolac and that of the corticosteroid in patients with subacromial shoulder impingement syndrome. MATERIALS AND METHODS: Twenty patients with shoulder impingement syndrome received an injection of 60 mg ketorolac and were evaluated in terms of visual analogue scale (VAS), range of motion (ROM) and Constant-Murley score. The outcomes are compared with the data of patients treated by 40 mg triamcinolone injection, retrospectively. RESULTS: There was no significant difference in the demographics, VAS, ROM, and Constan-Murley score between the two groups before the injection. At the 4 weeks follow-up, pain improvement was significantly greater in the corticosteroid group (2.7±1.53) than in the ketorolac group (4.9±2.08; p=0.001). However 12 weeks after the injection, there was no significant difference in pain improvement between the two groups (ketorolac: 2.9±2.32, corticosteroid: 2.6±1.82; p=0.707). The Constant-Murley score at the final follow-up improved from 33.5 to 52.1 in the corticosteroid group, and from 39.0 to 56.6 in the ketorolac group (p=0.677). ROM was increased in both groups, and external rotation was significantly greater in the ketorolac group than in the corticosteroid group at the final follow-up (ketorolac: 29.3°±9.90°, corticosteroid: 20.8°±7.99°; p=0.005). CONCLUSION: In this study, ketolorac provided an effect equivalent to triamcinolone in the treatment of subacromial shoulder impingement syndrome at 12 weeks after the injection. This result could offer better opportunities to manage patients with diabetes or local and systemic side effects of repetitive use of corticosteroids.
Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Demography ; Follow-Up Studies ; Glucocorticoids ; Humans ; Ketorolac* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder Impingement Syndrome* ; Shoulder* ; Triamcinolone

PURPOSE: The purpose of this study was to investigate the wage structure of hospital nurses in Korea and to analyze the factors that determine the level of nurses' wages. METHODS: First, a mobile survey on nurses' wages was conducted with a total of 3,742 nurses working in hospitals. A literature review was also done. Second, a regression model was applied to analyze the determinants of nurses' wages. RESULTS: The average monthly wage of 3,742 nurses based on the survey was KRW 3,588,000 and the standardized monthly income of 3,742 nurses was estimated to be KRW 3,364,000 as of the end of 2018. The results of regression analysis(R2=61.7%) showed that gender, nursing experience, designated night duty, ownership, and number of beds were statistically significant variables for nurses' wages at 1% significance level. The monthly wage of nurses working in total nursing care wards was not significantly different from those working in other wards at 5% significance level. CONCLUSION The substantial difference in nurses' wages according to job career, hospital size, region, etc may result in the low proportion of nurses with more than three to five years of service experience and the high turnover of less-experienced workers. Consideration should be given to adjust the gap in wage level and a standard nurse wage system could be effective measures.

Purpose: To assess the impact of toxoplasma immunoglobulin G (IgG) titers on the diagnosis of active ocular toxoplasmosis. Methods: We retrospectively analyzed the medical records of patients tested for toxoplasma IgG at our uveitis clinic. Active ocular toxoplasmosis was clinically diagnosed based on wide-angle fundus photography and disease progression. Patients with IgG titers ≥ 30 IU/mL were classified as seropositive-high titer, those with IgG titers of 1.6-30 IU/mL as seropositive-low titer, and the remaining patients as seronegative. We compared the proportion of active ocular toxoplasmosis among these groups. Additionally, we evaluated the sensitivity and specificity of each titer and attempted to determine an ideal reference titer for toxoplasma IgG in diagnosing active ocular toxoplasmosis. Results: Out of 824 patients, 86 (10.4%), 88 (10.7%), and 650 (78.9%) were categorized as seropositive-high titer, seropositivelow titer, and seronegative, respectively. Among these patients, 34 in the seropositive-high titer group and 2 in the seropositive- low titer group were clinically diagnosed with active ocular toxoplasmosis. The false-positive rate was significantly different between the groups, being 60.5% in the seropositive-high titer group and 97.7% in the seropositive-low titer group (p < 0.001). The receiver operating characteristic curve indicated that 37.70 IU/mL could be an ideal reference titer for diagnosing ocular toxoplasmosis. Conclusions The false-positive rate was notably lower (60.5%) in patients with IgG titers ≥ 30 IU/mL compared to those with titers of 1.6-30 IU/mL (97.7%). Therefore, not only the presence of IgG but also the level of titer appears to be important in diagnosing ocular toxoplasmosis.

Purpose: The purpose of this study is to develop a nursing salary guideline for Korean hospitals. Methods: Literature review and a mobile survey were conducted regarding staff nurses’ salary. Regression analysis and simulation model were applied to develop the nurses’ salary guideline. Results: The United Kingdom, Australia, and Germany have standard salary guidelines which demonstrated the standard salary of nurses. These were determined mainly by nursing experience and expertise. The results of the mobile survey indicated that the maximum to minimum ratio of the salary was as high as 4.5 among staff nurses working in Korean hospitals. Two models (exponential and linear) for a standard nursing salary guideline were developed and the simulation results demonstrated an improved salary structure for staff nurses. Conclusion This developed salary guideline for staff nurses is recommended to be applied in Korean hospitals which provide total nursing care services.

OBJECTIVE: This study was to evaluate the correlation of clinical symptoms and physical signs with electrodiagnostic findings in carpal tunnel syndrome (CTS), and to increase the usefulness of clinical symptoms and physical signs in the diagnosis of CTS. METHOD: We prospectively identified 322 hands from 172 subjects clinically from 5 tertiary hospitals. All subjects completed 6 clinical symptoms and 6 physical signs including 3 provocative tests. Each symptoms and signs were divided motor and sensory symptoms and signs, and the correlation between symptoms and signs and the results of motor and sensory conduction studies and needle electromyography were evaluated. The sensitivity and specificity of each valuable symptoms and signs for electrodiagnostic results were also assessed. RESULTS: Tingling sensation, nocturnal pain, worsening, and Phalen sign were correlated with motor conduction study, and falling tendency, abductor pollicis brevis weakness and atrophy, tingling sensation, hypoesthesia, and Tinel and Phalen signs were correlated with needle electromyography. The Phalen sign had the best sensitivity and specificity for median motor conduction study, and the best sensitive physical sign for needle electromyography. CONCLUSION: Motor and sensory symptoms and signs were not correlated with motor and sensory conduction studies, but motor symptoms and signs were correlated with needle electromyography. The Phalen test was the most useful evaluating tool to diagnose CTS.
Atrophy ; Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Electromyography ; Hand ; Hypesthesia ; Needles ; Prospective Studies ; Sensation ; Sensitivity and Specificity ; Tertiary Care Centers

OBJECTIVE: To investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP. METHODS: A cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS). RESULTS: GMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility. CONCLUSION: These findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.
Cerebral Palsy ; Child ; Cross-Sectional Studies ; Disability Evaluation ; Extremities ; Hand ; Humans ; Paralysis ; Self Care ; Severity of Illness Index