Evaluation of Foot Deformity according to the Occupational Condition in the Labor of the Industry

OBJECTIVE: The purpose of this study was to evaluate the correlation between each variable on occupational condition and foot deformity by Harris mat footprint. METHOD: Subjects were 227 labors having no neurologic or musculoskeletal problems. They were evaluated by clinical history and Harris mat footprint. Three optional parameters of footprints were medial arch angle, metatatarsal arch grade, and hallux valgus angle. RESULTS: 1) Hallux valgus angles were significantly increased in group of female, above 39 years old, labor, and duration of duty more than 6 years. 2) Medial arch angles were significantly decreased in female, above 39 years old, obese person, and labor. 3) Metatarsal arch grades were significantly increased in group of female, above 39 years old, and more than 20 numbers of conveyance, less than 6 years of duration of duty. Foot pain was not related to medial arch angle, metatatarsal arch grade, and hallux valgus angle, respectively. CONCLUSION: These results suggest that deformity of foot were related to female, above 39 years old, obese person, position of duty, duration of duty, and standing time. So these peoples maybe helpful for weaning proper modified shoes.

Evaluation of Peripheral Polyneuropathy in Patients with Diabetes Mellitus Using Quantitative Sensory Test

OBJECTIVE: The purpose of this study was to determine whether quantitative sensory test can be used as a screening test of peripheral polyneuropathy in patients with diabetes mellitus, and to evaluate the severity of peripheral polyneuropathy in patients with diabetes mellitus using quantitative sensory test. METHOD: We performed nerve conduction study to right upper and left lower extremity of the patients. Quantitative sensory test was performed using TSA-2001 thermal sensory analyser on right thenar and left foot dorsum in both diabetic and control groups. RESULTS: 1) The warm sense and heat pain threshold were higher, the cold sense and cold pain threshold were lower in diabetic group than age-matched control group (p<0.05). 2) The warm sense and heat pain threshold were higher, the cold sense and cold pain threshold were lower in diabetic group than young-aged control group (p<0.05). 3) As nerve conduction study results were severe, the cold sense threshold in right thenar were decreased (p<0.05). CONCLUSION: Quantitative sensory study in patients with diabetes mellitus are sensitive to identify neuropathic change; thus, they would be used as the screening method of diabetic peripheral polyneuropathy.

Retrospective Study of Low Back Pain during Pregnancy

OBJECTIVE: This study was designed to evaluate the demand for lumbosacral corset and to get a base line data for rehabilitation approach, management trends, demand for education of back pain, and incidence of back pain during pregnancy in Korean population. METHOD: One hundred and fifty two postpartum women were included in this study. Each subject's demographic data, gynecologic data, back pain associated factors, and neonatal factors were collected. RESULTS: The incidence of back pain during pregnancy was 81%. Average age of back pain group and pain free group were 29.8+/-4.51 and 26.8+/-5.50, respectively. Average age of back pain group was significantly older than pain free group. Patients with previous back pain suffered from back pain during pregnancy more frequently than the patients without previous back pain. Sites of back pain were lumbar area (49.2%), midback area (29.5%), and sacroiliac area (21.3%). CONCLUSION: Correlation factors of back pain during pregnancy were maternal age, previous history of back pain, and history of back pain during menstruation. Long term follow up study for back pain after delivery and early evaluation of back pain during antenatal care are recommended.

A Usefulness of Pudendal Nerve Block in the Dorsal Approach under EMG Monitoring: A case report

This study was designed to evaluate the usefulness of pudendal nerve block in the dorsal approach under EMG monitoring. The patient is placed in the prone position. The location of pudendal nerve is identified using the both ischial tuberosities and greater trochanter. We have performed the pudenal nerve block with 5% phenol solution, under the EMG monitoring. The patient was able to void with percussion method. There has been no impairment in urinary continence. We experienced an excellent effect of bilateral pudendal nerve block in the dorsal approach, under EMG montoring, using 5% phenol solution in detrusor sphincter dyssynergia of neurogenic bladder.

Diagnosis of Osteoporosis of the Foot in Patients with Diabetes Mellitus Using Bone Densitometry

OBJECTIVE: The purpose of this study was to evaluate the severity and frequency of osteoporosis of the foot in patients with diabetes mellitus using bone densitometry, and to determine whether plain radiologic evaluation can be used as a cheap and reliable screening of osteoporosis. METHOD: We studied plain X-ray including AP and lateral views of the feet of the patients. Bone densitometry studies were performed on the feet of both diabetic and age-matched control groups. RESULTS: Forefoot bone densitometry scores were significantly lower in the male diabetic group compared to the control group (p<0.05). Furthermore, the female diabetics had significantly lower bone densitometry scores for forefoot and hindfoot than the control group (p<0.05). Bone densitometric evaluation of the diabetic patients' feet revealed scores significantly lower than those of the controls in cases which the radiologist interpreted as normal finding in plain roentgenogram alone (p<0.05). CONCLUSION: Plain radiologic studies of the feet in patients with diabetes mellitus are not effective in identifying osteoporotic change; thus, they should not be used as the screening method of diabetic foot lesions.

Feasibility of Low-Molecular-Weight-Heparin (Fraxiparine) for Primary Stenting in Acute Myocardial Infarction

BACKGROUND AND OBJECTIVES: The optimal anti-thrombotic strategy for primary stenting in acute myocardial infarction (AMI) is still controversial. We evaluated prospectively the efficacy and safety of low-molecular-weight-heparin (LMWH) for primary stenting in AMI. MATERIALS AND METHOD: From 1/1997 to 7/1998, 54 AMI pts underwent primary stenting with 96% of procedural success rate (52/54). Of these, five pts were excluded from the study for warfarinization or use of GP II b/ III a inhibitor despite of successful stenting (TIMI 3 flow and less than 30% of residual stenosis). In 47 pts included in the study, 5,000-10,000 U of unfractionated heparin was administered (IV/bolus) bofore primary stenting. After sheath removal, LMWH(Fraxiparine, 7500 U/S.C.BID) maintained for 10.6+/-5.7 days. Aspirin and ticlopidine (500mg/day for > or =4 weeks) were given before stenting. Pts were followed to determine early (0-30 days) and late (31-180 days) major adverse cardiac events (MACE). Subsequent revascularization involving other coronary arteries did not constitute an end point. RESULTS: In 47 Pts (M:F=32:15, age=57.7+/-11.3 yrs, range: 37-88), 50 stents (Nir:38, micro:7, Jo:5, LAD:LCX:RCA-=24:9:14) were implanted. Their immediate post-stenting MLD and diameter-stenosis (%) were 2.9+/-0.4 mm, 4.3+/-8.7%, respectively. No patient showed sub-acute stent thrombosis or major bleeding requiring blood transfusion or surgery. During 0-30 days, the primary combined end point occurred in 2 (4.2%):one repeated angioplasty for in-stent restenosis; one hospital death for pump failure (1 of 2 Killip IV pts at admission). 44 patients were followed for 180 days and additional three TVR (3/44(6.8%), one CABG, one repeated angioplasty and one recurrrent myocardial infarction)occurred between 30-180 days due to recurrent ischemia. CONCLUSION:Anti-thrombotic therapy with LMWH (Fraxiparine) is safe and feasible for primary stenting in AMI. But to illuminate the impact on the clinical outcomes such as major adverse cardiac events and restenosis, we need more large and controlled study.