OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Hand ; Humans ; Shock

OBJECTIVE: To determine whether transplanted human adipose tissue derived stem cells (hATSCs) can survive and increase the amount of proteoglycans in degenerated intervertebral disc. METHOD: Lumbar disc degeneration was induced in thirty New Zealand white rabbits by injection of chondroitinase ABC(R). After 2 weeks, hATSCs were transplanted in degenerated disc in hATSCs group. Control group received phosphate buffered saline. The histologic grading and height of disc were measured at 2, 4, and 8 weeks after transplantation. The viability of donor cells was identified by using beta-Actin gene polymerase chain reaction (PCR). RESULTS: 4 and 8 weeks after hATSCs transplantation, the histologic grading showed significantly high score in hATSCs group (p<0.05), but the amount of proteoglycans was not significantly different between the two groups. The change of disc height was not significantly increased in hATSCs group. In the beta-Actin gene PCR analysis, positive signal in the hATSCs group was observed. CONCLUSION: hATSCs transplantation may be useful in decelerating disc degeneration in experimental models and provide new hopes for treatment of degenerative disc disease in humans
Actins ; Adipose Tissue* ; Hope ; Humans* ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Mesenchymal Stromal Cells* ; Models, Theoretical ; Polymerase Chain Reaction ; Proteoglycans ; Rabbits ; Stem Cells ; Tissue Donors

Patients with ankylosing spondylitis are more susceptible to spine fractures than healthy people. Because of their underlying back pain, vertebral fracture induced pain is not easily controlled by bed rest, physical therapy and medications. Thus, new treatment methods should be introduced. We report a 63 year-old man with ankylosing spondylitis who fell down 4 weeks ago and suffered a fracture of T6 spine. He complained of a mid thoracic pain. Although he was treated with bed rest, physical therapy, second-line bisphosphonate agents, the pain persisted. Therefore, intravenous zoledronate which was approved for palliative treatment of bone metastases in patients with breast cancer, 4 mg was administrated. The severity of pain was decreased by half within 2 days and sustained over 4 weeks.
Back Pain ; Bed Rest ; Breast Neoplasms ; Humans ; Middle Aged ; Neoplasm Metastasis ; Palliative Care ; Spine ; Spondylitis, Ankylosing*

OBJECTIVE: There is increasing interest in growth hormone (GH) replacement therapy to improve quality of life (QoL) of elderly with age-related decline in GH level (somatopause). The aim of this study was to evaluate the effect of GH replacement on the QoL in patients with somatopause. METHOD: A prospective study of 56 adults with somatopause was conducted. They were replaced with a GH over a 6-month period. QoL was assessed by using three self-rating questionnaires: the Nottingham Health Profile (NHP), the Psychological General Well-Being Index (PGWBI) and theAssessment of Growth Hormone Deficiency in Adults (AGHDA). RESULTS: Significant impairment in QoL as measured by NHP, PGWBI and AGHDA were noted in patients with somatopause compared with age and sex matched normal population (p<0.05). There was significant improvement in QoL after 6-month of GH replacement (p<0.05). CONCLUSION: Six months GH replacement induced an improvement in the QoL of patients with somatopause.
Adult ; Aged ; Growth Hormone* ; Humans ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires

OBJECTIVE: To evaluate the prevalence and characteristics of anemia in the long distance runners. METHOD: Subjects included 61 long distance runners and 40 control. The 61 subjects averaged 39.9+/-4.5 years of age. Long distance runners has been training for at least 6 months. Hemoglobin, iron, total iron binding capacity, reticulocyte count, peripheral blood smear, urine hemosiderin were evaluated. WHO criteria cut off value of hemoglobin for the diagnosis of anemia was used, 13 g/dl in men and 12 g/dl in women. Iron deficiency was defined as the percent transferrin saturation less than 15. The percent transferrin saturation was calculated by dividing the serum iron level by the total iron-binding capacity. RESULTS: Anemia occurred in only 2.0% and 9.0% of the male and female long distance runners respectively and other laboratory findings supported diagnosis of iron deficiency anemia. The percentage of iron deficiency anemia was lower than normal control. Iron deficiency was evident in 6.0% and 18.1% of the male and female long distance runners respectively. CONCLUSION: Recreational long distance runners were at no greater risk for developing a frank anemia than the non-exercising population.
Anemia* ; Anemia, Iron-Deficiency ; Diagnosis ; Female ; Hemosiderin ; Humans ; Iron ; Male ; Prevalence* ; Reticulocyte Count ; Transferrin

OBJECTIVE: To evaluate the effects of growth hormone on metabolism and quality of life of spinal cord injured patients. METHOD: Thirteen chronic spinal cord injured patients without metabolic and psychologic disorders except growth hormone deficiency were included in the study. They were randomly divided into two groups. Seven patients received growth hormone and six patients received distilled water as control. Before and after 6 months' administration, we measured Adult Growth Hormone Deficiency Assessment (AGHDA) and Psychological General Well-Being Index (PGWBI) for assessing quality of life. Bone mineral density (BMD), osteocalcin, urine deoxypyridinoline, % lean body mass, % body fat, body mass index (BMI) and lipid profile were also examined for assessing metabolic states. RESULTS: The AGHDA score decreased significantly from 6.7+/-2.9 to 3.9+/-2.1 (p<0.05), and the PGWBI score increased significantly from 81.7+/-14.8 to 88.7+/-8.7 (p<0.05) in growth hormone treatment group. There were no significant differences in control group. Other values about metabolic states were not significantly different in all groups. CONCLUSION: Growth hormone was effective on improving quality of life in spinal cord injured patients, but there was no positive effect on metabolic values for short-term therapy.
Adipose Tissue ; Adult ; Body Mass Index ; Bone Density ; Growth Hormone* ; Humans ; Metabolism* ; Osteocalcin ; Quality of Life* ; Spinal Cord Injuries ; Spinal Cord* ; Water

OBJECTIVE: To evaluate and quantify the postural instability in patients with Parkinson's disease (PD) using computerized posturography. METHOD: Twenty subjects with PD group (10 men, 10 women) and 20 control group (10 men, 10 women) were matched for age and sex. Average Hoehn-Yahr stage of PD group was 2.3+/-0.3. Sensory dysfunction, voluntary motor impairments and functional limitation were measured by determining the subject's response to reduced or altered sensory and voluntary motor control of balance. RESULTS: PD subjects demonstrated wider area of sway (degrees) under eye closed condition in modified sensory organization test and lower directional control (%) in right/left rhythmic weight shift (p<0.05). No significant difference was observed for sit to stand. Wider area of turn sway (degrees) and longer turn time (sec) during left step/quick turn were demonstrated in PD subjects (p<0.05). CONCLUSION: Computerized posturography shows that sensory dysfunction scores, voluntary motor impairment scores and functional limitation test scores were reduced in patients with PD.
Humans ; Male ; Parkinson Disease*

PURPOSE: We wanted to evaluate the risk factors for developing lymphedema following axillary lymph node dissection in breast cancer patients. METHODS: Ninety-six patients who underwent axillary dissection for breast cancer were followed-up for up to 1 year. Lymphedema was assessed using a serial circumferential measurement method. More than a 2 cm difference in circumference was considered as clinically significant lymphedema. The effects of age, the body mass index (BMI), the cancer stage, chemotherapy, radiotherapy, the location of cancer and creating a latissimus dorsi (LD) flap on the development of lymphedema were analyzed. RESULTS: The incidence of lymphedema was increased with the advancing cancer stage. Radiotherapy was found to increase the incidence of lymphedema. Patients who had received an LD flap showed a lower incidence of lymphedema. CONCLUSION: These results could be useful as a clinical guideline for creating a management plan for postoperative lymphedema. Because there are some differences in the results between all the relevant reports, including ours, further research is needed in the form of a large, multi-center, long-term study.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema* ; Radiotherapy ; Risk Factors* ; Superficial Back Muscles

OBJECTIVE: To assess the effect of vitamin K2 in addition to risedronate on postmenopausal osteoporosis METHOD: We enrolled 21 postmenopausal osteoporosis women (age: 65.2+/-7.8 years). Ten subjects received risedronate (35 mg, weekly) and vitamin K2 (45 mg, daily) and eleven subjects only received risedronate. They all received calcium citrate 2,130 mg and vitamin D 600 IU daily. The duration of treatment was 7.7+/-1.4 months. Bone mineral density (BMD) of lumbar spine and both femurs, serum osteocalcin and urine deoxypyridinoline were examined at baseline and after treatment. RESULTS: After treatment, BMD, serum osteocalcin and urine deoxypyridinoline were improved in each group but there was no statistical difference between the groups. CONCLUSION: There was no evidence of the benefit of vitamin K2 in addition to risedronate in bone metabolism on postmenopausal osteoporosis.
Bone Density ; Calcium Citrate ; Female ; Femur ; Humans ; Metabolism ; Osteocalcin ; Osteoporosis, Postmenopausal* ; Risedronate Sodium ; Spine ; Vitamin D ; Vitamin K 2* ; Vitamins*

OBJECTIVE: To evaluate effects of short stretch bandage and electrical stimulation therapy (EST) for the complex regional pain syndrome (CRPS) in hemiplegic patients METHOD: 10 hemiplegic CRPS patients after stroke or traumatic brain injury were included in the study. We established CRPS from clinical symptoms and triphasic bone scan. Short stretch bandage was applied on affected limb and changed every 24 hours for 2 weeks. EST was tried for 10 minutes twice per day. It was applied at finger and wrist flexor muscles. We measured hand volume of pre-and posttreatment using hand volumeter. Also compared pre-and posttreatment pain-free range of motion (ROM) of metacarpophalangeal (MCP) joint and third proximal interphalangeal (PIP) joint circumference. RESULTS: Mean difference of hand volume between the affected and the unaffected prior to treatment was 20.5+/-4.9 ml (7.9+/-2.3%). After treatment, mean volume change was 15.5+/-4.9 ml (5.5+/-1.8%) (p<0.05). Mean change of pain-free ROM was 8.0+/-4.8 degree (10.9+/-7.1%), mean change of PIP joint circumference was 3.1+/-1.4 mm (5.9+/-2.4%) (p<0.05). CONCLUSION: Short stretch bandage and EST complex therapy is effective for the reduction of paralyzed hand edema and pain in hemiplegic CRPS patients. However further control study is required.
Bandages* ; Brain Injuries ; Edema ; Electric Stimulation Therapy* ; Electric Stimulation* ; Extremities ; Fingers ; Hand ; Humans ; Joints ; Muscles ; Range of Motion, Articular ; Stroke ; Wrist