The Effect of Laterally Wedged Insoles on Standing Balance of Patients with Osteoarthritis in the Medial Compartment of Knees

OBJECTIVE: To investigate the effect of laterally wedged insole on static balance of patients with degenerative osteoarthritic knees. METHOD: Eighteen female patients were diagnosed with medial compartment knee degenerative osteoarthritis (OA) based on symptoms and simple X-rays. Patients were studied while they stood wearing shoes with the 5 degrees or 10 degrees lateral wedged insoles compared with a bare foot. Patients chose a comfortable stance with feet spread apart, slightly turned outwards, and were asked to look straight ahead at a fixed point in a quiet room. Postural sway and weight load asymmetry were recorded while the patients were standing on two adjacent force platforms during a 30 second trial. RESULTS: Postural sway and weight load asymmetry for 30 seconds were not significantly changed by wearing laterally wedged insoles with varying elevations (p>0.05). CONCLUSION: The degree of the postural sway and weight load asymmetry for 30 seconds with the insole were not affected by the tilt of the lateral wedge.

Increased Blood Pressure and Loss of Consciousness after Stellate Ganglion Block: A case report

A 59 year-old female patient suffered from complex regional pain syndrome in left hemiplegia, was managed to stellate ganglion block (SGB) with 5 ml of 1 % lidocaine. The SGB was performed twice previously, with no side effects. And the third SGB was done in the same manner after negative aspiration testing. Two minutes later, she developed respiratory difficulty with increased blood pressure. Immediately airway management was performed by mask ventilation with oxygen. But ten minutes later, she developed respiratory arrest with unconsciousness and intubation was performed. Soon she recovered spontaneous respiration and the blood pressure returned to the former level. Despite taking all precautions during SGB, complications such as respiratory arrest and hypertension may occur even in the hands of an experienced physician. Therefore, before starting SGB, all resuscitation drugs and equipment must be ready for use in case any emergency develops.

The Relation between Radiologic and Electromyographic Findings in Patients with Low Back Pain

OBJECTIVE: To determine the relations of spinal measurements on magnetic resonance imaging (MRI), myelography and electromyography (EMG) in patients with low back pain. METHOD: We investigated forty four patients who were underwent both imaging and electrodiagnostic evaluation. Spinal geometric measurements in axial MRI included anteroposterior (AP) diameters of canal and thecal sac, interlaminar distance, width of lateral recess, thickness of ligamentum flavum, and the findings of a root deviation. This study investigated: 1) correlation of MRI disc herniation types with EMG and myelogram findings, 2) correlation of EMG findings with axial MRI spinal measurements and myelogram findings, 3) correlation of myelogram with axial MRI spinal measurements. RESULTS: The MRI disc herniation types did not relate to EMG and myelogram findings. Findings of the root compression on myelogram related to the width of lateral recess and thecal sac AP diameter only (p<0.05). There were nonparametric correlations between myelogram findings and the findings of root deviation on MRI (p<0.05). CONCLUSION: There were little correlations between EMG findings and other imaging studies. In addition, we suggest not only the disc herniation type, but also the width of lateral recess and thecal sac AP diameter is helpful in interpreting the axial spinal MRI.

Duchenne Muscular Dystrophy in a Girl with Turner Syndrome: A case report

Duchenne Muscular Dystrophy (DMD) is an X-linked, recessive disorder characterized by progressive muscular weakness, Gower sign, waddling gait and pseudohypertrophy of the calf muscles. Little is reported about DMD manifestations in females because of its' X-linked, recessive inheritance. The authors described a 12-year-old female with gait disturbance. Her symptoms were diminished muscle power, decreased deep tendon reflexes, Gower sign and pseudohypertrophy of calf muscle. Serum creatinine kinase level was elevated to 1, 674 U/ml. Electromyographic findings were compatible with myopathy. Histopathologic examination of the muscles confirmed the diagnosis of DMD. The result of karyotyping was 45X, but multiplex PCR (Polymerase Chain Reaction) analysis showed normal findings.

Changes of Intraarticular Temperature in the Knee Joint according to the Application Method of Cold Jet-stream

OBJECTIVE: To investigate the changes of intraarticular temperature in the knee according to the application methods of cold jet-stream and to find the more effective method which reduces the intraarticular temperature. METHOD: Fifteen healthy subjects were examined. We recorded both skin and intraarticular temperature of the knee for 120 minutes. We compared two different cooling methods using -30 degrees C cold jet-stream by CRAis(R) (Century, Korea). The first was the intermittent cold jet-stream application method (ICA) which applied cold jet-stream to the knee joint every other minute for 5 minutes and the second was the continuous cold jet-stream application method with infrared (CCAI) for 5 minutes. RESULTS: In ICA, the intraarticular temperature maximally dropped as 1.7+/-0.6 degrees C (p<0.01) and it took 28.7+/-18.9 minutes. Intraarticular temperature dropped 0.6+/-0.5 degrees C after 2 hour (p<0.05). In CCAI, the intraarticular temperature maximally dropped as 2.8+/-0.7 degrees C (p<0.01) and it took 38.0+/-24.6 minutes, intraarticular temperature after 2 hour dropped as 1.36+/-0.75 degrees C (p<0.05). According to the two methods, CCAI showed more reduction in the lowest and after 2 hour intraarticular temperature compared with ICA in the knee joint (p<0.05). CONCLUSION: CCAI is better for reducing the intraarticular temperature than ICA.

Change of Foot Measurements with Weight Bearing by 3-D Foot Scanner

OBJECTIVE: To evaluate the influence of weight-bearing on foot shape measured by 3-D foot scanner. METHOD: Forty-two feet of twenty-one normal subjects were studied. The foot length, width, girth and arch parameters under non weight-bearing and weight-bearing conditions were measured by 3-D foot scanner (Nexcan(R), K & I, Korea), analysis software (EnFOOT(r), K & I, Korea) and 3-D foot arch measurement program. RESULTS: The foot length, ball width, ball girth, waist girth, instep girth, short heel girth, long heel girth and length from heel point to proximal arch point significantly increased under weight-bearing condition (p<0.01). However, vamp height, waist height, instep height, length of arch, height of arch, width of arch, length from heel point to distal arch point, maximal arch height and volume of arch were significantly decreased under 50% weight-bearing condition (p<0.01). CONCLUSION: Foot parameters associated with length, width and girth increased but volume, width, length, and height of medial longitudinal arch decreased under weight bearing condition. We suggest that these findings under weight- bearing condition result from the pronation of subtalar joint and the decrement of heights of transverse and longitudinal arch heights.

Comparison of Peak Plantar Pressure between Bare Foot and In-shoe in Diabetic Patients

OBJECTIVE: To investigate the efficiency of custom-made diabetic shoes through the measurement of peak plantar pressure, compared between bare foot and in-shoe in diabetic patients METHOD: Seventeen diabetic patients participated in this study. It used diabetic shoes manufactured by Apex and P.W. minor & son. The foot was divided into 6 different areas, and peak plantar pressures of bare foot and in-shoe were measured during walking by EMED system and PEDAR , respectively. RESULTS: There were significant decreases in peak plantar pressures of all plantar areas in all types of diabetic shoes. Especially, peak plantar pressures of diabetic shoes manufactured by P.W. minor & son in medial metatarsal and big toe areas were more decreased than by Apex. CONCLUSION: The custom-made diabetic shoes can effectively reduce plantar pressures in all palntar areas of the foot, and also can prevent the development or recurrence of foot ulcers at specific areas according to the variable physical constitution of diabetic shoes.

Differential Skeletal Response to Ovariectomy in Young and Old Rats

OBJECTIVE: The purpose of this study is to evaluate the loss of bone mineral density on ovariectomized (ovx) rat in young and old rats. METHOD: Total 110 Sprague-Dawley female rats which composed of 3 months aged 88 rats and 12 months aged 22 rats were used. They were divided randomly into 5 ovx groups (15 rats for each group) and 5 sham operation group (7 rats for each group). The bone mineral density was measured by Hologic 4,500 Fan Beam bone densitometry at the time of second postoperation week, 4th week, 8th week, and 16th week in young aged group and 4th, 8th week in old aged group. RESULTS: The bone mineral density in young ovx rats was decreased measured at 2 week, 4 week and 8 week, but not 16 week compared with that of sham operation rats (p0.05). CONCLUSION: For the purpose of osteoporosis inducing experiment, young aged rat is more reliable for the detection of bone density change than old aged rat and the bone mineral density change will be continued at least 16 week postovariectomy period.

A Survey of the Prevalence of Physically Disabled in the Community: Comparison of a key-person method with the census method

OBJECTIVE: To compare the efficiency of a key-person method with the census method on the prevalence of physically disabled. METHOD: The residents of K-myeon, A-kyun, Kyungido were surveyed in May 1996 with a census method and of D-myeon in August 1997 with a key-person method. The enlisted people in this survey included 2563 persons in D-myeon and 2138 persons in K-myeon on Identification Number. RESULTS: The prevalences of the physically disabled were 2.61% of the population in D-myeon and 5.00% in K-myeon (chi-square test: P0.500). This result suggests that there is no meaningful difference in the prevalence of severely disabled between the two survey methods. CONCLUSION: The key-person method is as effective as the census method to survey the prevalence of severely disabled in rural communities and requires a less cost and man power.