Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome that characterized by pain, especially in night, sensory disturbance in median nerve dermatome of the hand, and thenar muscle atrophy. Open decompression was a treatment of choice, when operative intervention is necessary. But, endoscopic or percutaneous decompression is introduced recently. Authors analyzed 21 cases of open decompression and 22 cases of percutaneous decompression and they could be follow up over 6 months at Dept. of Orthopedics, Chonnam University Hospital from June 1990 to January 1995. The results are as follows. 1. There were no difference in age, sex, lesion side, symptoms duration until operation, etiology and occupation between percutaneous and open decompression. 2. There were excellent or good results in clinical symptom in 19 cases(90%) of open procedures and 19 cases(86%) of percutaneous procedure and more rapid relief of the pain, and grip power in percutaneous procedure than open procedure. 3. The EMG, recorded at 1 week, 4 weeks, 3 months and 6 months after operation, revealed improvement in sensory than motor function. There was more rapid recovery in percutaneous procedure than open procedure especially latency and amplitude of sensory nerve. There were 2 cases in open procedure and 3 cases in percutaneous procedure who did not respond to treatment. As a result, percutaneous procedure was more simple and rapid recovery than open procedure in clinical progressions and EMG reports, but recovery rate of symptomatic relief was similar. Therefore percutaneous procedure is thought to be more reasonable method in the treatment of carpal tunnel syndrome if surgical intervention is indicated.
Carpal Tunnel Syndrome ; Decompression ; Follow-Up Studies ; Hand ; Hand Strength ; Jeollanam-do ; Median Nerve ; Methods ; Muscular Atrophy ; Occupations ; Orthopedics ; Peripheral Nerves

To study the relationship between the bone mineral density measured by DEXA and QCT methods and to study the factors influencing on the value, bone mineral density in 208 patients with low back pain were measured by the two methods and compared statistically. Ages were varied between 17 to 79(Av. 46.7) years and male and female were 86 and 122. The results of this are as follows; 1. The values of DEXA and QCT showed statistically significant relationship(γ=0.58) as a whole. And bone mineral density in L2, L3 and L4 showed no difference in both groups. 2. Bone loss by aging(per year) in male and female was 0.99% and 1.06% by DEXA, 0,99% and 1.41% by QCT. 3. Body height and weight showed no significant influence of the value in two methods. 4. In body mass index over 27.5, the value measured by QCT was influenced to be diminished while that of DEXA was not influenced. 5. The value by QCT was influenced to be diminished by the increase of age especially over 50 years old in both sex. While the value by DEXA was influenced to be lowered than expected in female over 50 years old. It is concluded that the methods of measurement of bone mineral density have their limitation depend on the age, sex and mass index.
Body Height ; Body Mass Index ; Bone Density ; Female ; Humans ; Low Back Pain ; Male ; Spine

No abstract available.
CpG Islands* ; Methylation*

No abstract available.
Tuberculosis, Pulmonary*

BACKGROUND: Akathisia is defined as inner feeling or restlessness and can be associated with restless movement. It is a frequent and disabling complication of neuroleptics and was reportedly common in postencephalitic parkinsonism. Akathisia has been reported and appears to be common in Parkinson's disease(PD). OBJECTIVE: To determine the frequency and clinical features of akathisia and dexamine the relationship between presence of akathisia and various clinical parameters of PD, Method: we evaluated 137 PD patients from movement disorder clinics in Samsung Medical Center and Seoul National University Hospital, using a modified akathisia questionnare. We compared two groups between those with akathisia and those without akathisia. We analysed the pattern, location and chronology of akathisia, and the correlation between akathisia and clinical parameters of PD. RESULTS: 1. Of the 137 patients (76 women, 61 men), 43(22 women, 21 men) (31.4%) had akathisia. 2. Patients with akathisia had more advanced disease than those without akathisia as determined by Hoehn and Yahr stage (p<0.05). 3. Patients with akathisia were more often akinetic-rigid than tremor predominent (p<0.05). 4. Patients with akathisia were more frequently treated with levodopa than those without akathisia (p<0.05). 5. There was no difference between two groups for age, sex or disease duration(p<0.05). 6. Of the 43 patients with akathisia, 35 patients had motor restlessness and 27 patients had associated sensory complaints. 7. The whole body or legs were most frequently affected. 8. Akathisic symptoms occurred irregularly and mainly in the afternoon. 9. Nineteen patients had difficulty in their jobs due to akathisia. Conclusion: Akathisia is a common problem in PD especially in severe akinetic-rigid form. It can be the main cause of disability in PD. Recognition and proper management are needed.
Antipsychotic Agents ; Female ; Humans ; Leg ; Levodopa ; Movement Disorders ; Parkinson Disease* ; Parkinson Disease, Postencephalitic ; Psychomotor Agitation* ; Seoul ; Tremor

BACKGROUND AND PURPOSE: A carboxy-O-methyl transferase inhibitor entacapone has been introduced as an adjuvant drug for Parkinson disease (PD) patients. Although clinical trials reported beneficial role of entacapone, a long-term trial over 3 years failed to show significant effect. The goals of this study were to evaluate the clinical benefit and the efficacy of entacapone in an open clinical practice. METHODS: After the completion of a double-blind placebo-controlled entacapone study, 149 patients from 4 centers were included. Antiparkinsonian medications were optimized by the judgment of the neurologists in charge. The clinical global impression (CGI) scale was obtained at 6 months and 1 year after the initiation of entacapone treatment. RESULTS: Of the 149 patients, 117 patients chose to try entacapone in an open-label fashion. Sixty-nine (59%) patients completed the 1-year trial. Twenty-nine patients discontinued entacpaone before 6 months, and 19 between 6 months and 1 year during trial. Twelve patients out of 48 patients discontinued entacapone because of its poor efficacy. The CGI scale was 3.9 (+/-1.5) at the beginning of the trial, 4.3 (+/-1.1) at 6 month, and 3.8 (+/-1.3) at 1 year, respectively. The CGI scale of those who discontinued between 6 month and 1 year was 3.4 (+/-1.7), which was worse, but insignificantly, than that of the continuer. CONCLUSIONS: The dropout at 1 year of our study was very high at 41%. Even though entacapone is indicated for advanced PD patients with motor fluctuation, the fluctuators commonly have dyskinesia and mental symptoms, which can become more troublesome with entacapone. In the patients with advanced PD, the clinical efficacy and side effects should be carefully considered in a long-term use of entacapone.
Dyskinesias ; Humans ; Judgment ; Parkinson Disease* ; Patient Dropouts ; Transferases

Objectives: To survey daily doses of dopaminergic medications and to draw a posteriori equation of the dose in relation to the various clinical variables in Korean patients with Parkinson disease. Methods: A multi-center cross-sectional survey was conducted over a defi ned period. Information on patient demographics and clinical features including age at Parkinson disease onset, disease duration, treatment duration and Hoehn and Yahr stage, and daily doses of anti-parkinsonian drugs was obtained from the patients’ medical records. Results: A total of 1,762 patients with Parkinson disease were recruited from 6 referral centers. The mean L-dopa equivalent daily dose (LEDD) in the whole population was 608.9 mg/day, which tended to increase linearly depending on the duration of disease and Hoehn and Yahr stage. LEDD was also signifi cantly affected by age and gender. We performed multiple linear regression analyses and devised a posteriori equation of LEDD with clinical variables. Conclusions: This survey provides systematic data for mean LEDD in Korean Parkinson disease patients. In spite of profound individual variations in LEDD, our linear regression model provides an insight about the relationship between daily doses of dopaminergic medications and various clinical features of Parkinson disease.

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord

OBJECTIVE: This study was designed to assess the actual circumstances of post-operative anemia and associating factors, during the laparoscopic myomectomy. METHODS: A retrospective chart review of 172 patients who underwent laparoscopic myomectomy from 2008 to 2009 was performed. Characteristics of patients (age, parity, body mass index, and preoperative gonadotropin releasing hormone agonists injection) and fibroids (the largest diameter, number, width, type and location), and surgical outcomes (operating time, pre- and post-operative hemoglobin level, blood loss, hospital stay, and complications, including transfusion) were retrieved. RESULTS: One patient (0.6 %) required transfusion and significant hemoglobin change (> or =2.0 g/dL) occurred in 45 patients, after laparoscopic myomectomy. The largest diameter, width, type, and location of fibroids, and pre-operative gonadotropin releasing hormone agonist injection were not associated with the hemoglobin change (p=0.193, 0.172, 0.764, 0.741, and 0.954 respectively). Multivariate analysis revealed that nulliparity (p=0.195, 95% confidence interval (CI): 0.286-1.291) was not a risk factor, but long operating time (> or =90 min; p=0.048, 95% CI: 1.008-5.054) and multiple myoma (> or =3 in number; p=0.009, 95% CI: 1.320-6.717) were independent risk factors for significant hemoglobin change. CONCLUSION: In our data, symptomatic anemia after laparoscopic myomectomy was uncommon. In addition, the only useful predictive factor for hemoglobin change during the laparoscopic myomectomy was a multiplicity of myoma.
Anemia ; Body Mass Index ; Female ; Gonadotropin-Releasing Hormone ; Hemoglobins ; Humans ; Leiomyoma ; Length of Stay ; Multivariate Analysis ; Myoma ; Parity ; Retrospective Studies ; Risk Factors