OBJECTIVE: To investigate the effect of mirror therapy on recovery of upper limb function and strength in subacute hemiplegia after stroke. METHOD: Fourty subacute hemiplegic stroke patients (onset <6 months) were enrolled and randomly assigned to either the mirror therapy (MT, n=19), or control group (n=21). MT group received mirror therapy for 30 minutes after each treatment, additionally with the traditional rehabilitation programs, 5 days per week for 4 weeks; 2 hours or more per day, 3 days or more per week. To measure the outcome, we performed the manual muscle test (MMT), manual function test (MFT) and Jarmar grip strength test. RESULTS: MT group showed significant improvements in MMT, grasp and lateral pinch force of grip strength test (p<0.05), compared to control group. Improvement in MFT was more evident in MT group (p<0.05). CONCLUSION: Mirror therapy can be used as an adjuvant therapeutic technique for improving upper limb function and strength for subacute hemiplegia.
Hand Strength ; Hemiplegia ; Humans ; Muscle Strength ; Muscles ; Organometallic Compounds ; Stroke ; Upper Extremity

BACKGROUND AND OBJECTIVES: The repolarization abnormalities, after radiofrequency catheter ablation (RFCA) of accessory pathway (AP) in patients with Wolff-Parkinson-White (WPW) syndrome, is commonly appeared in standard 12 lead electrocardiogram (ECG) as inverted T waves. We analyzed the serial ECGs after RFCA of AP in patients with WPW syndrome, in order to understand the repolarization abnormalities after RFCA. MATERIALS AND METHOD: The study patients were consisted of ninety two patients (mean age: 35 years old, male: 56 patients) out of 157 patients whose ECGs were taken at before, immediately after, one day, one, four, eight, twelve week (s) after RFCA from December 1992 to July 1997. RESULTS: The seventy three patients (79%) out of ninety two patients showed the repolarization abnormalities and the thirteen patients (14%) showed normalization of secondary T wave changes immediately after RFCA. In contrast, six patients (7%) did not show any T wave changes after RFCA and they had left lateral AP. The lead that most frequently showed inverted T wave changes after RFCA was lateral lead (lead I, aVL) in case of left lateral AP and inferior lead (II, III, aVF) in case of other APs. The incidence of repolarization abnormalities after RFCA was significantly higher in patients whose preRFCA QRS duration is longer (> or =0.12 sec). The concordance rate of repolarization abnormalities after RFCA was 86% (63 patients of 73 patients showing repolarization abnormalities after RFCA). The normalization of repolarization abnormalities after RFCA was acquired in sixty four patients (94%) out of sixty eight patients who showed repolarization abnormalities and followed up to twelve weeks after RFCA. The mean time interval to the normalization of repolarization abnormalities after RFCA was 4.3+/-3.2 weeks. The time interval to the normalization of repolarization abnormality after RFCA was not related with age, AP or preRFCA QRS duration. CONCLUSION: The ECG lead, in which the repolarization abnormalities occurs after RFCA , is related with the location of the AP. The repolarization abnormalities after RFCA were more common in patients with longer preRFCA QRS duration. The repolarization abnormalities after RFCA could not be understood only by cardiac memory.
Adult ; Catheter Ablation* ; Electrocardiography ; Humans ; Incidence ; Male ; Memory ; Wolff-Parkinson-White Syndrome

OBJECTIVES: The purpose of this study is to evaluate the incidence of secondary T wave changes in WPW syndrome and the relation between the incidence of the secondary T wave changes and sex, age (duration of preexcitation), mean and maximal QRS duration (from the onset of delta wave to the end of S wave) of standard 12 lead electrocardiogram (ECG) and the site of accessory pathway (AP). The secondary purpose of this study is to evaluate the relation between the site of secondary T wave changes and the location of the AP. METHODS: Of the total 128 patients (pts) with WPW syndrome, standard 12 lead ECGs of 125 pts (mean age 35, male 71 pts) who were free from bundle branch block (n=2) and myocardial ischemia (n=1) were analyzed. The locations of Aps were divided into 4 categories (anterior, left lateral, posterior and right lateral) by intracardiac mapping. RESULTS: 82 (66%) pts of 125 pts showed secondary T wave changes. The incidence of secondary T wave changes was not related to sex or duration of preexcitation, but mean QRS duration (<0.12: 46%, 0.12: 88%, p<0.001), maximal QRS duration (<0.12: 32%, 0.12: 73%, p<0.001) and the site of AP (right: 80%, left: 54%, p=0.003). The most frequent lead showing secondary T wave changes in ECG was lateral (lead I, aVL) in pts with anterior (43%, 9 out of 21), posterior (50%, 25 out of 50) and right lateral (86%, 6 out of 7) AP. But, no secondary T wave change was found in most pts with left lateral (n=47) AP. CONCLUSION: The incidence of the secondary T wave changes in pts with WPW syndrome is high (66%). These changes are not related to sex and duration of preexcitation, but to the mean and maximal QRS duration during preexcitation and the location of the AP. The ECG lead showing secondary T wave changes in pts with WPW syndrome appears to be related to the location of the AP and the most frequent lead is I and aVL.
Bundle-Branch Block ; Electrocardiography ; Humans ; Incidence ; Male ; Myocardial Ischemia ; Wolff-Parkinson-White Syndrome

PURPOSE: The aim of this study is to evaluate morphological changes of the medial nerve in patients with carpal tunnel syndrome (CTS) before and after endoscopic release of the transverse carpal ligament, and to correlate the ultrasonography (US) findings with the use of high resolution US and the surgical outcome for the median nerve. MATERIALS AND METHODS: Thirty patients with CTS confirmed by a clinical and electrophysiological study underwent high resolution US. The US instrumentation was equipped with a high frequency linear transducer to measure the cross sectional area, flattening ratio and swelling ratio of the medial nerve at the distal radioulnar joint, proximal and distal carpal tunnel before and three months after surgery. RESULTS: The cross sectional area (CSA) of the median nerve at the distal radioulnar level showed a decrease from 0.13 +/- 0.03 cm2 before surgery to 0.11 +/- 0.03 cm2 after surgery, and the CSA of the proximal carpal tunnel showed a decrease from 0.17 +/- 0.07 cm2 to 0.14 +/- 0.05 cm2; these differences were statistically significant. There was no statistically significant correlation between the morphological change and symptom improvement. CONCLUSION: This study confirmed a decreasing CSA of the medial nerve at the distal radioulnar and proximal carpal tunnel in a postoperative patient with CTS, as determined by the use of high resolution US. No association was found between a change in the CSA of the median nerve and symptom improvement. A further study based on multiple measurements of the median nerve with a longer period is necessary to establish the association between a change in the CSA of the median nerve and symptom improvement.
Carpal Tunnel Syndrome ; Humans ; Joints ; Ligaments ; Median Nerve ; Transducers

Stroke in young adults is uncommon and may require extensive evaluation to elucidate an underlying cause. A 21- year-old male professional golfer experienced left side weakness, dysarthria, headache during golfing. Magnetic resonance imaging (MRI) revealed broad ischemia on right basal ganglia, frontal and temporal lobes. Magnetic resonance angiography (MRA) and 4-vessel angiography revealed beading of right intracranial internal carotid and middle cerebral arteries which suggests fibromuscular dysplasia. We report a case of intracranial fibromuscular dysplasia without renal involvement resulting in cerebral infarction in young male professional golfer.
Angiography ; Basal Ganglia ; Carotid Artery, Internal, Dissection ; Cerebral Infarction ; Dysarthria ; Fibromuscular Dysplasia ; Golf ; Headache ; Humans ; Ischemia ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; Stroke ; Temporal Lobe ; Young Adult

Solitary fibrous tumors (SFTs) are spindle-cell tumors that rarely arise within extrathoracic area. Massive SFTs involving the pterygopalatine fossa are extremely rare and surgical excision represents a multidisciplinary surgical challenge. We present a case of 64-year-old female with a huge mass originating from the pterygopalatine fossa invading the skull base. Distinct microscopic findings and a positive nuclear staining of signal transducer and activator of transcription 6 (STAT-6) pathologically confirmed SFT. The right internal maxillary artery branch was embolized preoperatively and a surgical excision was performed through a combined technique of transpalatal, mid-facial degloving and endoscopic approach. Postoperative radiotherapy successfully removed the remnant tumor adjacent to the carvenous sinus. Follow- up MR images showed no evidence of recurrence for two years. To our knowledge, there has been no previous report of the successful treatment of this vast extent of SFT in the pterygopalatine region via endoscopic-external-combined approach and radiotherapy.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.