OBJECTIVE: To understand the injury pattern of contact burns from therapeutic physical modalities. METHOD: A retrospective study was done in 864 patients with contact burns who discharged from our hospital from January 2005 to December 2008. The following parameters were compared between patients with contact burns from therapeutic modalities and from other causes: general characteristics, burn extent, cause of burn injury, place of occurrence, burn injury site, treatment methods, prevalence of underlying disease, and length of hospital stay were compared between patients with contact burns. RESULTS: Of the 864 subjects, 94 patients were injured from therapeutic modalities. A hot pack (n=51) was the most common type of therapeutic modality causing contact burn followed by moxibustion (n=21), electric heating pad (n=16), and radiant heat (n=4). The lower leg (n=31) was the most common injury site followed by the foot & ankle (n=24), buttock & coccyx (n=9), knee (n=8), trunk (n=8), back (n=6), shoulder (n=4), and arm (n=4). Diabetes mellitus was associated with contact burns from therapeutic modalities; the odds ratio was 3.99. Injuries took place most commonly at home (n=56), followed by the hospital (n=33), and in other places (n=5). CONCLUSION: A hot pack was the most common cause of contact burns from therapeutic modalities, and the lower leg was the most common injury site. Injuries took place most commonly at home. The patients with contact burns from therapeutic modalities showed high correlation to presence of diabetes mellitus. These results would be helpful for the prevention of contact burns due to therapeutic modalities.
Animals ; Ankle ; Arm ; Burns ; Buttocks ; Coccyx ; Diabetes Mellitus ; Foot ; Heating ; Hot Temperature ; Humans ; Hypogonadism ; Knee ; Leg ; Length of Stay ; Mitochondrial Diseases ; Moxibustion ; Odds Ratio ; Ophthalmoplegia ; Physical Therapy Modalities ; Prevalence ; Retrospective Studies ; Shoulder

Myasthenia gravis (MG), which is the most common autoimmune neuromuscular junction disorder, is characterized by weakness of musdes and increased fatigability after repetitive use, and recovery after rest. The diagnosis is based on a detailed history, physical examination, and pharmacological, electrophysiological, and immunological testing. Stapedial reflex abnormalities are noted, so the stapedial reflex decay test (SRDT) can be attempted. There are no reports regarding the SRDT in Korea. We report a case of MG presenting hyperacusia and ptosis that was diagnosed by the SRDT. We recommend using the SRDT in the clinical diagnosis of MG.
Hyperacusis ; Immunologic Tests ; Korea ; Myasthenia Gravis ; Neuromuscular Junction Diseases ; Physical Examination ; Reflex

PURPOSE: To provide epidemiologic data of the burn injuries in stroke patients and to determine the most effective prevention and education methods. METHODS: We retrospectively reviewed the medical records of patients who had been admitted to the burn center at the Hangang Sacred Heart Hospital between January 2002 and June 2008. Burn cause, size, depth, duration of hospital stay, rate of operation performed, outcomes and time from stroke onset to burn were reviewed and compared. RESULTS: We reviewed the charts of total 87 patients (57 men and 30 women with a mean age of 61.95+/-14.48 years). Places of burn were divided into two groups (at home: n=52, outside: n=25) and patients injured at home were more than twice than who were outside. According to etiology of infarction, patients group was divided into ischemic (n=49) and hemorrhagic (n=38) group. Most of the patients were injured from flame burn. The rate of operation for ischemic group was significantly higher than hemorrhagic group. The etiology of infarction and cause of burn were not significant to prognosis. Chronic group (defined as burn occurred 6 months after the onset of stroke) had the higher incidence of burn injuries. But, there was no significant relationship between the time from stroke onset to burn and burn cause, prognosis, rate of operation, total body surface area burned. Non-survivor group had a higher operation rate than survivor group, although there was no difference in total burn surface area. CONCLUSION: Functional recovery of stroke was not associated with burn injury in our study. Flame burn took the highest percentage of burn causes. We believe that studies pooling different center's results are need to improve significance of conclusion drawn from these data.
Body Surface Area ; Burn Units ; Burns ; Female ; Heart ; Humans ; Incidence ; Infarction ; Length of Stay ; Male ; Medical Records ; Prognosis ; Retrospective Studies ; Stroke ; Survivors

PURPOSE: Patients who have a elbow flexion limitation from burn often contend with a severe functional problem in activity of daily living. Positional splint or serial casting have been invented to prevent from elbow contracture, which splint could not improved the range of motion more than 90 flexion. The purpose of this article is to present a dynamic forced elbow flexion orthosis with limited motion joint to overcome the problem of less effective function of correctability of conventional splints. METHODS: The cases were 3rd degree burned patients of upper extremities who had a elbow joint flexion limitation from the post burn skin or joint contracture. This dynamic elbow flexion brace device was fabricated with the dynamic force of the elbow joint, which was induced by a rubber band or spring device into the orthotic joint. The orthosis kept a lower grade constant corrective force with coustom made design and strong strap fixation with comfortable material. RESULTS: This dynamic elbow flexion brace device was fabricated for two burn patients who had 24% and 37% TBSA in a flame burn with extensive involvement of the upper extremities. They developed hypertrophic scar and skin contracture around both elbow joint. Both patients had moderate to severe elbow joint limitation of motion. Patients with elbow limitation had improved the range of motion more than 90 flexion by this dynamic elbow flexion brace. CONCLUSION: The dynamic forced elbow flexion orthosis with limited motion joint had improved the range of motion more than 90 flexion, however those has some problems which ought to be improved to more effective and comfortable function.
Braces ; Burns ; Cicatrix, Hypertrophic ; Contracture ; Elbow ; Elbow Joint ; Humans ; Joints ; Orthotic Devices ; Range of Motion, Articular ; Rubber ; Skin ; Splints ; Upper Extremity

BACKGROUND: Clopidogrel inhibits platelet P2Y12 adenosine diphosphate (ADP) receptors and has been widely used in patients with ischemic stroke. However, a considerable number of patients suffer from cerebrovascular events despite the use of clopidogrel. The rapid platelet function assay (RPFA) has been used for monitoring the antiplatelet effects on the P2Y12 ADP receptor. This study was performed to measure the platelet response to clopidogrel using RPFA in patients with ischemic stroke, and to identify the clinical factor related with clopidogrel resistance. METHODS: A total of 86 patients taking clopidogrel (75 mg/day) were enrolled. Demographic data, vascular risk factors, the presence of obesity and metabolic syndrome, drug history, hemoglobin, platelet counts, and stroke subtypes were recorded. RPFA presented the results as P2Y12 Reaction Units (PRU), base PRU (BASE), and Inhibition (%). Inhibition was calculated as (1-PRU/BASE)x100. The patients showing ineffective aggregation- inhibition (percentage of Inhibition < 20) on RPFA were defined as non-responders to clopidogrel. RESULTS: The response of platelet aggregation-inhibition to clopidogrel showed a variable distribution with mean and standard deviation of 32.2+/-22.3%. Twenty four (27.9%) patients showed the inhibition below 20%. There was no difference between responders and non-responders regarding the clinical factors above. We found no influence of co-medication with the statins on platelet response to clopidogrel. CONCLUSIONS: There is a patient variability in response to clopidogrel and a considerable portion of stroke patients have clopidogrel resistance on the platelet function test. The clinical usefulness of routine platelet function test requires further validation.
Adenosine Diphosphate ; Blood Platelets ; Hemoglobins ; Humans ; Obesity ; Platelet Aggregation ; Platelet Count ; Platelet Function Tests ; Receptors, Purinergic P2 ; Risk Factors ; Stroke ; Ticlopidine

Cerebrospinal fluid (CSF) leak or shunt overdrainage is a well-known cause of orthostatic headaches and low CSF pressures. We report two cases of orthostatic headache with pneumocephalus on brain imaging. The orthostatic headache developed after drainage of spinal operation site and epidural block. Brain MRI revealed characteristic findings of CSF hypovolemia including pachymeningeal enhancement and mild subdural fluid collections. Air was also observed in the ventricular or subarachnoid space in both patients, which might enter the subarachnoid or ventricular space during a procedure via the pressure gradient or an injection.
Brain ; Drainage ; Headache ; Humans ; Hypovolemia ; Neuroimaging ; Pneumocephalus ; Subarachnoid Space

A 72-year-old man presented with aggravating dyspnea and swelling of the face due to thymic carcinoma, which was diagnosed based on a transfemoral biopsy specimen. Chest computed tomography and transthoracic echocardiogram showed a mediastinal mass that invaded the superior vena cava and the right atrium. The patient underwent successful chemotherapy with multimodal regimens including cyclophosphamide, vincristine and the dyspnea, facial edema improved. Here, we present a case of spreading thymic carcinoma identified as an intraluminal growth spreading from the mediastinum into the superior vena cava and cardiac cavity.
Aged ; Biopsy ; Cyclophosphamide ; Drug Therapy ; Dyspnea* ; Edema ; Heart Atria ; Heart Neoplasms ; Humans ; Mediastinal Neoplasms ; Mediastinum ; Thorax ; Thymoma ; Thymus Gland* ; Thymus Neoplasms* ; Vena Cava, Superior ; Vincristine

A 72-year-old man presented with aggravating dyspnea and swelling of the face due to thymic carcinoma, which was diagnosed based on a transfemoral biopsy specimen. Chest computed tomography and transthoracic echocardiogram showed a mediastinal mass that invaded the superior vena cava and the right atrium. The patient underwent successful chemotherapy with multimodal regimens including cyclophosphamide, vincristine and the dyspnea, facial edema improved. Here, we present a case of spreading thymic carcinoma identified as an intraluminal growth spreading from the mediastinum into the superior vena cava and cardiac cavity.
Aged ; Biopsy ; Cyclophosphamide ; Drug Therapy ; Dyspnea* ; Edema ; Heart Atria ; Heart Neoplasms ; Humans ; Mediastinal Neoplasms ; Mediastinum ; Thorax ; Thymoma ; Thymus Gland* ; Thymus Neoplasms* ; Vena Cava, Superior ; Vincristine

Imperforate hymen is a rare congenital malformation, but it can make hematocolpometra and complications. In most cases definite finding is noticed after menarche as retention of menstrual flow results in abdominal pain, distension of the lower abdomen and often in acute urinary retention. A case of imperforate hymen associated with hematocolpometra at age of 12 was treated satisfactorily by simple crucial incision of hymen and drained of about 450 cc of tarry blood. We present a case of imperforate hymen with a brief review of literatures concerned.
Abdomen ; Abdominal Pain ; Female ; Hymen* ; Menarche ; Urinary Retention

BACKGROUND: Oculopalatal tremor (OPT) is a delayed complication of damage to the dentato-rubro-olivary pathway (Guillain-Mollaret triangle) and subsequent hypertrophic olivary degeneration. Mixed torsional-vertical pendular nystagmus in OPT has been considered to signify unilateral brainstem damage while symmetrical vertical nystagmus has been regarded to indicate bilateral disease. However, 3-dimensional oculographic analysis of OPT has been sparse. METHODS: In 8 patients with OPT; binocular 3-dimensional analyses of ocular oscillations were performed by using a magnetic search coil technique. Lateralization of the lesions was determined by the imaged olivary hypertrophy in the MRI. RESULTS: One patient had conjugate vertical pendular nystagmus and four showed mixed torsional-vertical pendular nystagmus. Two patients showed mixed horizontal-torsional-vertical nystagmus. One patient had predominantly horizontal pendular nystagmus. MRI demonstrated increased signal or hypertrophy of the inferior olivary nucleus, unilateral in six and bilateral in two. Unilateral olivary changes were associated with mixed torsional-vertical nystagmus in three patients, mixed horizontal-torsional-vertical nystagmus in another two patients, and predominantly horizontal pendular nystagmus in the remaining one patient. Bilateral olivary changes were visible in one patient with conjugate vertical pendular nystagmus and in the other patient with mixed torsional-vertical nystagmus. Palatal tremor appeared to be symmetrical in all patients. CONCLUSIONS: Three-dimensional analyses of OPT indicate that conjugate vertical and mixed torsional-vertical pendular nystagmus do not correspond to the laterality of signal changes in the inferior olivary nucleus. Ocular oscillations often have all the vertical, horizontal and torsional components.
Brain Stem ; Humans ; Hypertrophy ; Magnetic Resonance Imaging ; Nystagmus, Pathologic ; Olivary Nucleus ; Telescopes ; Tremor*