ABSTRACT
BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Subject(s)
Humans , Adrenal Cortex Hormones , Compliance , Elbow , Follow-Up Studies , Prospective Studies , Range of Motion, Articular , Rehabilitation , Shoulder Joint , Shoulder , Triamcinolone , UltrasonographyABSTRACT
BACKGROUND: Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. METHODS: A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. RESULTS: The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 +/- 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. CONCLUSIONS: The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Range of Motion, Articular , Retrospective Studies , Shoulder Joint/physiopathology , Synovitis/diagnostic imaging , Tendons/diagnostic imagingABSTRACT
BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Subject(s)
Humans , Adrenal Cortex Hormones , Compliance , Elbow , Follow-Up Studies , Prospective Studies , Range of Motion, Articular , Rehabilitation , Shoulder Joint , Shoulder , Triamcinolone , UltrasonographyABSTRACT
PURPOSE: We compared the clinical and radiological outcomes of total hip arthroplasty (THR) using Summit and Bencox stems. MATERIALS AND METHODS: The patients who underwent cementless total hip arthroplasty were recruited with a satisfactory condition of a minimum three years of follow-ups after THR. Those patients were divided into two groups, those with Summit stems and those with Bencox stems. Summit stems were in 36 patients(40 hips), and Bencox stems in 36 patients(48 hips). Summit and Bencox stems had 78 months and 42.2 months as a mean follow-up, respectively. The clinical and radiological evaluations of femoral components were performed. RESULTS: There was no difference in clinical results between the two groups. Under the radiological findings, there were no osteolytic changes or loosening. Osseointegration was detected at an average of 6.4 months(3-12 months) in the Bencox stem on the distal portion of the femoral stem, and cortical hypertrophy was detected on 6 hips with a Summit stem. CONCLUSION: The clinical and radiological evaluations in both systems showed excellent outcomes at the three year follow-ups, and there was no statistical difference on the clinical and radiological results between the two groups. Thigh pain and cortical hypertrophy were not detected in the Bencox stem, and that wound would be caused by surface treatment methods of the femoral stem, and morphological differences.
Subject(s)
Humans , Arthroplasty , Follow-Up Studies , Hip , Hypertrophy , Osseointegration , Osteonecrosis , ThighABSTRACT
BACKGROUND AND OBJECTIVES: We assessed olfactory function change in patients with chronic sinusitis who received endoscopic sinus surgery. By comparing the olfactory test results of two different age groups, we determined whether age affected postoperative olfactory function. SUBJECTS AND METHOD: Twenty patients with chronic sinusitis (2 age groups, with 10 patients in the forties and 10 patients in the seventies), who underwent endoscopic sinus surgery were selected. We used preoperative OMU CT and nasal endoscopy examination to evaluate the severity of sinusitis and polyp. Preoperative and postoperative nasal symptoms were assessed by questionnaires. The improvement of olfactory function after endoscopic sinus surgery was evaluated by olfactory function tests (T & T olfactometer and CCCRC test) preoperatively and postoperatively. RESULTS: There was no significant difference in the severity of chronic sinusitis in both groups. Significant improvement of olfactory function was seen in both groups. There was no significant differences in the improvement of olfactory function between younger and older groups. CONCLUSION: Though old aged patients with chronic sinusitis have olfactory dysfunction, active surgical treatment is effective in the improvement of olfactory function.
Subject(s)
Aged , Humans , Endoscopy , Olfaction Disorders , Polyps , Surveys and Questionnaires , SinusitisABSTRACT
BACKGROUND AND OBJECTIVES: To predict postoperative pulmonary complication in patients with conservative laryngectomy, variable factors such as pulmonary function test (PFT) have been reported. Therefore, we reviewed the relationships between postoperative pulmonary complications and preoperative risk factors including the parameters of PFT. PATIENTS AND METHOD: From 1997 Jun. to 2005 July., conservative laryngectomy was performed under diagnosis of laryngeal cancer in 36 patients. The factors related to age, history of lung diseases, the parameters of PFT (FEV1, FEV1/FVC and FVC), and the types of surgery were analyzed to evaluate the postoperative pulmonary complication. We used a retrospective analysis of medical records and Fisher exact method to verify the relationships between preoperative risk factors and the pulmonary complications. RESULTS: 8 patients had postoperative pulmonary complication. Age, history of lung diseases and PFT parameters had no statistical significance. Among them, 7 patients and 1 patient had takensupracricoid laryngectomy and supraglottic laryngectomy, respectively. Supracricoid laryngectomy cases had more significant postoperative pulmonary complications than vertical partial laryngectomy cases. CONCLUSION: Age, the history of lung diseases, and parameters of PFT had no predictable value for postoperative lung complications. In the comparison between the surgery types, only supracricoid laryngectomy cases had statistical increase of postoperative pulmonary complications.
Subject(s)
Humans , Diagnosis , Laryngeal Neoplasms , Laryngectomy , Lung , Lung Diseases , Medical Records , Respiratory Function Tests , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study was to determine the otolithic effects of galvanic vestibular stimulation on the perception of subjective visual vertical in normal subjects. SUBJECTS AND METHOD: Fifteen normal subjects were selected on the basis of medical history and neurological examination. We measured subjective tilt of a central vertical line during galvanic vestibular stimulation (0, 1.0, 2.5, 4.0 mA). Binaural and monaural electric current was applied to each subject's mastoid and forehead for vestibular stimulation. RESULTS: Anodal stimulation of the right mastoid led to clock-wise subjective visual vertical. Anodal stimualtion of the left mastoid led to counter clock-wise subjective visual vertical. There was a correlation between the amount of the measured parameter and the strength of the applied current. More consistent parameters were obtained from the binaural stimulation than the monaural stimualtion. CONCLUSION: Galvanic vestibular stimulation had effects on the vestibular functions, making changes in the subjective visual vertical. Since the galvanic stimulation had consistency with the direction of the stimulation and was proportionate to the intensity, it is thought to be a useful method for assessing otolith functions.
Subject(s)
Electric Stimulation , Forehead , Mastoid , Neurologic Examination , Otolithic MembraneABSTRACT
Normal C3WHeN strain mice exposed to topical 8inethoxypsomlen plus long wave ultraviolet (PUVA) showed a reduction in contact hypersensitivity, (CH) which was localized to the skin in the area of PUVA treatment (local suppression), whereas systemic PUVA treatment caused diffuse suppression of CH reaction, regardless of the application site of 2,4-dinitro-1-fluorobenzene (DNFB). There seem to be two different mechanisms responsible for CH reduction by PUVA. Local suppression by topical PUVA treatment was thought to be a result of blocking the afferent phase of immune response, it was associated with a lack of CH effector cells in the peripheral lymph nodes and could not be reversed by indomethacin treatment. Diffuse suppression induced by systemic PUVA treatment seemed to be associated with blocking of egress of effector cells from the regional lymph nodes, this depressed CH response was prevented when indomethacin was administered before PUVA treatment.