OBJECTIVE: Several kinds of steroids had been used epidurally for the treatment of low back pain, but there were few available medical reports as to the effects of each steroid. The purposes of this study were to evaluate the effects of epidural steroid injections and to investigate the factors affecting the results. METHOD: Forty four backache patients were randomly assigned to one of three groups: Group 1, epidural saline as a control group(n=12); Group 2, epidural triamcinolone and 1% lidocaine(n=13); Group 3, epidural dexamethasone and 1% lidocaine(n=19). The effects of epidural injections were measured by pain self-assessment scale(pain score) and Rubin scale(success rate). RESULTS: The pain scores of steroid groups after one to seven days after the injections were significantly lower than those of the control group(p<0.05), but there were no statistical differences(p>0.05) between two steroid groups. The overall success rate of the steroid groups was 68.8%. Although there were no statistically significant differences between the steroid groups with respect to sex, age and duration, the younger age group seemed to respond better to the treatment. CONCLUSION: We founded that epidural steroid injection could be a valuable adjunct to the management of low back pain but its effective duration was relatively short. Physicians should keep in mind that comprehensive treatment including rest, medication, physical therapy, exercise and education ought to be provided for the better clinical results.
Back Pain ; Dexamethasone ; Education ; Exercise Therapy ; Humans ; Injections, Epidural ; Low Back Pain* ; Self-Assessment ; Steroids ; Triamcinolone

OBJECTIVE: Recently, cultured myoblast transplantation has been extensively studied as a gene complementation approach in such genetic diseases as Duchenne muscular dystrophy (DMD). In the present work we investigated the stimulating effects of the growth factors, such as basic fibroblast growth factor (bFGF), leukemia inhibitory factor (LIF) and interleukin-1 (IL-1), on growth rate and differentiation of myoblast. METHOD: Human myoblasts were cultured from biopsy and treated in vitro with various concentration of bFGF, LIF and IL-1. In serum-free defined medium the following observation were made to evaluate differentiation. RESULTS: bFGF and LIF except IL-1 were found to have stimulating effect of myoblast proliferation comparing to control group (p<0.05), yet there were no statistically significant differences among each growth factors (p<0.05). The most significant growth stimulation of myoblasts in culture was achieved by adding 3.0 ng/ml of bFGF, producing a stimulation effect up to 2.01-fold. All myoblasts treated with growth factors differentiated into myotube. CONCLUSION: Our findings indicate that bFGF and LIF stimulate the proliferation of myoblast, which may result in an effective way in producing large numbers of myoblasts for clinical myoblast transplantation in DMD patients.
Biopsy ; Complement System Proteins ; Fibroblast Growth Factor 2 ; Fibroblast Growth Factors* ; Fibroblasts* ; Genes, vif ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1* ; Leukemia Inhibitory Factor* ; Leukemia* ; Muscle Fibers, Skeletal ; Muscular Dystrophy, Duchenne ; Myoblasts*

Brain tumors are receiving increasing attention in cancer rehabilitation due to their high rate of neurological deterioration. Motor dysfunction, cognitive deterioration, and emotional problems are commonly present in patients with brain tumors. Other medical complications, such as seizures, headache, and dysphagia are also common. An individualized multidisciplinary rehabilitation intervention is necessary to treat functional impairment due to the tumor itself and/or treatment-related dysfunction. Herein, we discuss rehabilitation treatment strategies in relation to the neurological and functional complications that commonly occur in patients with brain tumors.

OBJECTIVE: The phenomenon of fibroblast overgrowth is one of the major problems encountered during long-term culture such as myoblast culture. The first goal of the study is to determine the effects of proline analogue and cytosine arabinoside to reduce fibroblasts in myoblast culture. The second goal is to investigate whether the chemicals influence the growth and differentiation of myoblast. METHOD: Muscle tissues were obtained from legs of healthy men, and then fibroblasts and myoblasts were isolated and cultured. Those mixed cells were divided into three groups; control group, proline analogue (cis-hydroxyproline) treated group and cytosine arabinoside (araC) treated group. We evaluated the effectiveness of cis-hydroxyproline and araC on selective removal of fibroblasts in culture. We have also determined if cis-hydroxyproline and araC could alter differentiation of myoblast in each group. RESULTS: The treatment with araC was effective to eliminate fibroblasts comparing to the control group (p<0.05) while there was no statistically significant difference between proline analogue and control group (p>0.05). Myoblasts of all three groups were differentiated into myotube. CONCLUSION: Using araC, we could reduce a number of fibroblasts in myoblast culture where contamination and subsequent overgrowth with fibroblasts remained a problem.
Cytarabine* ; Cytosine* ; Fibroblasts* ; Humans ; Leg ; Male ; Muscle Fibers, Skeletal ; Myoblasts* ; Proline*

Radiofrequency energy, such as that used in neuroablation, has been applied in various medical and surgical fields. However, no consensus exists regarding neuroablation protocols using radiofrequency. This study aimed to report the effect of a radiofrequency neuroablative technique on spastic foot management in a patient with stroke and present its safety and persistence. A 59-year-old man with hemiplegic gait by the intracerebral hemorrhage had radiofrequency ablation of the motor nerve branch supplying the medial gastrocnemius. The patient’s subjective and objective measurements of the spastic limb improved after the intervention. The effect lasted for 3 months. Radiofrequency neuroablative technique may be beneficial for treating spastic gait in patients with stroke. The above technique must be used to verify patients with spasticity, and research should be investigated to determine appropriated parameters.

Neurological deficits commonly associated with anterior choroidal artery infarction (AChAI) include hemiplegia, hemisensory loss, and homonymous hemianopsia, while neuropsychological and perceptual deficits are uncommon. Prominent cognitive function impairment has rarely been reported. Here, we report a case of AChAI with prominent cognitive function impairment without motor deterioration. In contrast to the typical clinical features of AChAI, near complete and rapid motor recovery was observed, while cognitive impairment persisted despite rehabilitation therapy.
Cerebral Infarction* ; Hemianopsia ; Hemiplegia ; Internal Capsule ; Rehabilitation

OBJECTIVE: To evaluate clinical features in general and possible complications in Duchenne muscular dystrophy (DMD) which could be used for comprehensive rehabilitation management. METHOD: One hundred and seventy-two patients with DMD were followed over 3 year period to provide clinical profile causing impairment and disability. We measured height, weight and manual muscle testing (MMT) when the patients visited the hospital. And we could measure pulmonary function, electrocardiogram (EKG), and intelligence quotient (IQ) test in cooporative patients. RESULTS: The median height and weight of DMD boys were normally distributed before age 12, but during the second decade height was markedly reduced, and weight was no longer normally distributed. The MMT measurement showed loss of strength in a fairly linear fashion according to increasing age, and extensor of lower extremities were weaker than flexors showing typical contractures of legs. There was a direct relationship between pulmonary function and MMT scores of upper extremities. There was a high occurrence (40%) of abnormal EKG, but none of the patients had a history of cardiovascular complication. DMD children suffered wide spectrum of psychological disturbance such as somatic complaints, attention and emotional problems in addition to expected psychological problems due to chronic disease and its progression, and 50.9% of them were below average on the IQ test. CONCLUSION: These data on DMD subjects provide clinicians with useful information regarding the prevalence and severity of measurable impairment at different stages of the disease.
Child ; Chronic Disease ; Contracture ; Electrocardiography ; Humans ; Intelligence ; Leg ; Lower Extremity ; Muscular Dystrophy, Duchenne* ; Prevalence ; Rehabilitation ; Upper Extremity

This case report describes a severe nerve injury to the right ulnar nerve, caused by bee venom acupuncture. A 52-year-old right-handed man received bee venom acupuncture on the medial side of his right elbow and forearm, at a Traditional Korean Medicine (TKM) clinic. Immediately after acupuncture, the patient experienced pain and swelling on the right elbow. There was further development of weakness of the right little finger, and sensory changes on the ulnar dermatome of the right hand. The patient visited our clinic 7 days after acupuncture. Electrodiagnostic studies 2 weeks after the acupuncture showed ulnar nerve damage. The patient underwent steroid pulse and rehabilitation treatments. However, his condition did not improve completely, even 4 months after acupuncture.
Acupuncture* ; Bee Venoms* ; Bees* ; Elbow ; Fingers ; Forearm ; Hand ; Humans ; Medicine, Korean Traditional ; Middle Aged ; Rehabilitation ; Ulnar Nerve* ; Ulnar Neuropathies

OBJECTIVE: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. METHODS: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later. We analyzed sensitivity, specificity, positive and negative predictive values of each significant change in SEPs and MEPs. RESULTS: The overall sensitivity and specificity of SEPs or MEPs were 100% and 61.3%, respectively. The intraoperative MEP monitoring alone showed both higher sensitivity (67.9%) and specificity (83.2%) than SEP monitoring alone for postoperative motor deterioration. Two patients with persistent motor deterioration had significant changes only in SEPs. There are no significant differences in reliabilities between anatomical types, except with hemangioma, where SEPs were more specific than MEPs for postoperative motor deterioration. Both overall positive and negative predictive values of MEPs were higher than the predictive values of SEPs. However, the positive predictive value was higher by the dual monitoring of MEPs and SEPs, compared to MEPs alone. CONCLUSION: For spinal cord tumor surgery, combined MEP and SEP monitoring showed the highest sensitivity for the postoperative motor deterioration. Although MEPs are more specific than SEPs in most types of spinal cord tumor surgery, SEPs should still be monitored, especially in hemangioma surgery.
Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Hemangioma ; Humans ; Intraoperative Neurophysiological Monitoring* ; Muscle Strength ; Postoperative Complications ; Sensitivity and Specificity ; Spinal Cord Neoplasms* ; Spinal Cord*

Wilson’s disease (WD) is a genetic disease caused by an ATP7B gene mutation. Although dysphagia is known as a neurological manifestation of WD, clinical case reports with post-treatment long-term follow-up are scarce. A 17-year-old male was admitted to hospital complaining of general weakness and swallowing difficulty. He was diagnosed with WD by genetic confirmation. Assessment of the videofluoroscopic swallowing study (VFSS) determined an initial videofluoroscopic dysphagia scale (VDS) score of 48. After 11 months treatment with D-penicillamine and neuromuscular electrical stimulation therapy (NMES) with oromotor exercises, the VDS score improved to 23, especially in the following areas: mastication, apraxia, premature bolus loss, triggering of pharyngeal swallow, and laryngeal elevation. Dysphagia is an early neurological symptom of WD, and is reversible when properly treated with early diagnosis. Thus, since WD is treatable, patients presenting with dysphagia should be indicative of high probability of the disease, and evaluated at the earliest. NMES treatment in combination with D-penicillamine helps to improve the deglutition function in both oral and pharyngeal phases. To investigate the characteristics of dysphagia and the specific clinical efficacy of NMES in WD, further studies with larger number of patients are required.