ABSTRACT
OBJECTIVE: In the management of spasticity, intramuscular neurolysis with small amount of dilute aqueous phenol has proved to be a useful measure. But, considerable problem has taken place in utilization of phenol. This study was attempted to compare the effect of phenol and alcohol for the peripheral nerve blocking in the management of spasticity. METHOD: Intraneural injection of 5% phenol, 50% alcohol and 90% alcohol solution carried out in each group of 10 rats. A total of 30 rat were injected and examined electrophysiologically before and after blocking the nerve (24 hour, 1 weeks, 2 weeks, 4 weeks, 8 weeks). The randomized one rat of each group was sacrificed for the histological examination of the sciatic nerve at every examined day. RESULTS: There was no difference of the distal latencies and amplitudes of compound muscle action potentials among the groups before injection. The latencies were prolonged at 24 hours post-injection and shortened at 1 week post-injection in all the groups. The amplitudes were markedly decreased at 24 hours post-injection and increased at 1 week post- injection and reached the pre-injection value at 8 week post-injection in all the groups. Histologic studies showed necrosis at 1 week post-injection and regeneration at 2 week post- injection in 50% and 90% ethanol groups. Phenol injection group showed necrosis at 4 week post-injection and regeneration after 8 weeks. CONCLUSION: Our preliminary experience with alcohol for peripheral nerve blocking with encouraging result has been described.
Subject(s)
Animals , Rats , Action Potentials , Ethanol , Muscle Spasticity , Necrosis , Nerve Block , Peripheral Nerves , Phenol , Regeneration , Sciatic NerveABSTRACT
OBJECTIVE: To evaluate the effectiveness of nonsurgical treatment and to evaluate the usefulness of ultrasonographic assessment in postburn hypertrophic scar. METHODS: The subjects were twenty-seven burn patients with hypertrophic scar. Hypertrophic scars were treated by four different methods: triamcinolone acetonide injection (Group I), pressure garment application (Group II), combination treatment of triamcinolone acetonide and garment (Group III) and no treatment (Group IV). To assess the effectiveness of each treatment method, ultrasonographic measurement of scar thickness and punch biopsy of scar were done before and after treatment. RESULTS: After 4 weeks treatment, the scar thickness decreased by 14.9 9.4% in Group I, 4.7 8.4% in Group II and 20.5 13.2% in Group III. However the scar thickness increased by 10.0 13.5% in Group IV (no treatment). The pathologic findings didn't show significant change. CONCLUSION: The TA solution injection therapy and pressure garment therapy were effective methods for the treatment of the postburn hypertrophic scar, but the combinations of both therapies was more effective than each single therapy. The ultrasonography can be used as objective measure to assess effectiveness of therapy.
Subject(s)
Humans , Biopsy , Burns , Cicatrix , Cicatrix, Hypertrophic , Triamcinolone Acetonide , UltrasonographyABSTRACT
OBJECTIVE: To investigate the relationship between activities of daily living (ADL) dependence and psychological parameters in the adult hemiplegic stroke patients. METHODS: The subjects were total 122 stroke patients who underwent rehabilitation therapy. Patients were surveyed with questionnaires for anxiety, stress, and depression. Cognitive functions were assessed by mini-mental status examination and their ADL functions were evaluated by modified Barthel index. The correlation between ADL function and psychological parameters was statistically analyzed by Pearson's correlation test. RESULTS: Results were as follows: The average stress score of stroke patients was 76.7 which was relatively high. Fourty-seven percent of stroke patients suffered from depression, and it was more frequent in the left hemiplegics. As the result of the Pearson's correlation test, ADL function is closely correlated with intrapersonal stress level, but not with the level of anxiety or depression. The cognitive function has correlation with intrapersonal stress level, but not with depression. CONCLUSION: Understanding of the relationship between psychological status and ADL function in the stroke patients will be helpful to the physician for conducting efficient rehabilitation of these patients.
Subject(s)
Adult , Humans , Activities of Daily Living , Anxiety , Depression , Surveys and Questionnaires , Rehabilitation , StrokeABSTRACT
OBJECTIVE: To investigate the current status and the basic information of cumulative traumatic disorder among workers. METHOD: The subjects were 198 workers, consisted of 100 shipspublisher workers, 155 telephone operators and 43 light workers. Workers were surveyed with a standardized self- administered questionnaire and examed by the occupational medicine doctors and physiatrists for the cumulative traumatic disorders. Laboratory tests, nerve conduction studies and X-rays of the C-spine and shoulders were performed in all subjects. RESULT AND CONCLUSION: Myofascial pain syndrome was the most frequent problem in the shipspublisher and telephone operators. As a result of the multiple logistic regression analysis, cycle time, palm pinch, lumbar and neck flexion were the significant variables accounting for the musculoskeletal symptoms.
Subject(s)
Logistic Models , Myofascial Pain Syndromes , Neck , Neural Conduction , Occupational Medicine , Prevalence , Surveys and Questionnaires , Shoulder , TelephoneABSTRACT
OBJECT: To find out the anatomical changes of adhesive capsulitis of the shoulder by the ultrasonography. METHOD: We examined 20 patients with a adhesive capsulitis of the shoulder. Ultrasonographic findings were analysed by a radiologist who measured the synovium thickness of anterior, posterior and axillary plane and coracohumeral ligament length of the shoulder. RESULTS: Synovium thickness of the shoulder was measured with a mean value of 1.4+/-0.3 mm in the anterior plane, 1.4+/-0.4 mm in posterior plane and 1.8+/-0.5 mm in axillary plane of the unaffected sides and a mean value of 1.7+/-0.5 mm in the anterior, 1.8+/-0.4 mm in posterior and 3.2+/-1.0 mm in axillary planes of the affected sides. Coracohumeral ligament length was measured with a mean value of 27.8+/-7.9 mm in the unaffected side and 26.3+/-8.1 mm in the affected side. CONCLUSION: The characteristic appearance of the adhesive capsulitis of the shoulder by ultrasonography was an increased synovium thickness in the axillary plane compared to the unaffected side. This study demonstrates that the ultrasonography is a valuable tool for the evaluation and follow up for the adhesive capsulitis of shoulder.
Subject(s)
Humans , Adhesives , Bursitis , Ligaments , Shoulder , Synovial Membrane , UltrasonographyABSTRACT
Thirty-eight patients with a musculoskeletal chest wall syndrome were evaluated for the musculoskeletal findings of chest wall. All patients had the chest wall tenderness and the typical chest pain could be reproduced by the palpation. There was no significant difference in the diagnostic features of the pain for the onset, location, characteristics, duration, radiation, and area of references for chest pain among the different groups of the patients. However, a reproduction of pain by palpation and the pressure threshold difference between the lesion and control points by using pressure algometry was a reliable and specific diagnostic tool. Pressure threshold difference was correlated with numerical rating scale by the correlation coefficient 0.96. The common causes of the chest wall syndrome were the myofascial pain syndrome, chostochondritis, sternalis syndrome, rib-tip syndrome, xiphodynia in order. Six patients had chest wall disorders in conjunction with other associated intrathoracic condition. Thirty-two patients had an isolated chest wall syndrome. Chest wall syndrome should be considered in all patients with the chest pain, as its recognition could help the patient management.
Subject(s)
Humans , Chest Pain , Myofascial Pain Syndromes , Palpation , Reproduction , Thoracic Wall , ThoraxABSTRACT
Medial femoral cutaneous nerve(MFCN), a sensory branch of the femoral nerve, supplies the skin over the anteromedial aspect of the thigh and knee. Posterior femoral cutaneous nerve(PFCN), comprised of fibers originating from the anterior and posterior divisions of the first three sacral segments, supplies the skin over the posterior aspect of the thigh. Forty nerves of twenty healthy adults, ages from 20 to 58, were tested. The onset and peak latencies of MFCN were 2.3+/-0.2 ms and 2.9+/-0.2 ms respectively. The baseline to peak amplitude was 6.5+/-2.3 V. The onset and peak latencies of PFCN were 2.4+/-0.2 ms and 2.9+/-0.2 ms respectively. The baseline to peak amplitude was 7.1+/-1.7 V.
Subject(s)
Adult , Humans , Equipment and Supplies , Femoral Nerve , Knee , Skin , ThighABSTRACT
Fall is a major threat to the stroke patients. The purpose of this study is to find out the potential risk factors for recurrent falls in the stroke patients. The subjects were sampled 20 hemiplegic fallers who experienced at least one fall at the stroke center of Hangkang Sacred Heart hospital. Balance subscale and gait scale of Tinetti was used as a screening test for referral to mobility fuction. The potential contributing factors for fall were social activity, impulsivity, congnition, motivation. These factors were correlated with falls. The authors also surveyed the places, postures of activities, and injurires from falls. The falls occurred 2.5 times average in studied subjects and is most of subjects the first fall occurred in their first month of standing and gait training. 58.3% of falls occurred indoor(33.3% in room), 29.2% at hospital, 12.5% outdoor. The activities related to fall were walking 36.8%, rising from a chair 36.8%, sitting 10.5%. Although, most(75%) of injuries were soft tissue contusions or strains, the other 25.1% of falls accompanied fractures. The femur fracture was 18.8%, and compressed spine fracture was 6.3%. The social activity was most strongly correlated with falls with high correlation coefficent of 0.72. The other factors were not significant with lower coefficient values, balance scale of 0.35, gait scale of 0.24, motivation of 0.40, congnition of 0.26, impulsivity of ?0.19. It was suggested that activity plays an important mediating risk factor for falls in the stroke patients. These data support the concept of preventive strategy for falls in the stroke patients who are at risk.
Subject(s)
Humans , Contusions , Femur , Gait , Heart , Impulsive Behavior , Mass Screening , Motivation , Negotiating , Posture , Referral and Consultation , Risk Factors , Spine , Stroke , WalkingABSTRACT
Visual Perception in stroke patients is very important in the respect of prognosis and functional recovery. Therefore understanding and knowledge of the visual perceptual dysfuction should be the base for the training in activities of daily living. The present study was designed to test the disturbance of visual perceptions, espescially for error in visual perception of verticality or horizontality of rod in hemiplegic patients. In additions, we assessed the hemiplegic and control groups, for the balance index, the duration of disease onset, and the lateralization and localization of lesions by computerized tomography or magnetic resonance image respectively with analysis of an each factor. The vertical average error angles of hemiplegic patients are greater than those of controls. The error angles of the left hemiplegic patients are greater than those of the right hemiplegia. Correlation between the vertical average error angles and the balance index has the reversed coefficient factors. Verticality recovers mostly in 2-3 months of onset.
Subject(s)
Humans , Activities of Daily Living , Hemiplegia , Prognosis , Stroke , Visual PerceptionABSTRACT
Burn patients with associated limb amputations present demanding rehabilitation problems, many of which might lead them to chronic issues. The authors studied 77 male and 9 female burn patients with amputations. Most amputations occurred with high voltage electrical burns. The fingers were the most frequent target for amputations. The most frequent site of amputation was the entrance at the right side and multiple amputation in nature. The prosthetic fittings were delayed because of burn wounds and grafts and fragile skin at the stump. Also, limited range of motion, decreased strength, hypertrophic scar contracture, heterotopic ossification and bony overgrowth were additional limiting factors. We conclude that early rehabilitation intervention would be critical to prevent complications and to improve rehabilitation outcome of burn amputee patients.
Subject(s)
Female , Humans , Male , Amputation, Surgical , Amputees , Burns , Cicatrix, Hypertrophic , Contracture , Extremities , Fingers , Ossification, Heterotopic , Prostheses and Implants , Range of Motion, Articular , Rehabilitation , Skin , Transplants , Treatment Outcome , Wounds and InjuriesABSTRACT
BACKGROUND: The gaitaids are helpful for the patients of gait disturbance, but there was no study about the quantitative assessment of the effectiveness of gaitaids of several different types. But proper use of gaitaids is important for the disabled who is suffered from falls with or without trauma. The appropriate prescription of gaitaids is coming from the objective assessment for gaitaids. METHODS: We evaluated the 'balance index(BI)', which is originally suggested assessment scale by author, for the five different gaitaids :mono-cane, quad-cane, forearm crutch, axillary crutch, walker We assessed the difference of B.1 with or without using each gaitaids examined by 50 healthy adults and 20 stroke patients. RESULTS: The BI in the normal adult was 34.5+/-2.7, and 21.0+/-6.9 in the stroke patients. The balance index o( walker user was 37.6+/-1.4, which was the highest score. The BI of quad-cane was 30.1 +/-4.8, which was the next highest score and the BI of mono-cane, forearm crutch, axillary crutch were 25.5+/-5.6, 25.5+/-5.7, 25.5+/-5.4, which were lower than that of quad-cane. CONCLUSION: It can be suggested that the walker is the most effective for the support balance on gait and the quad-cane is more effective than mono-cane or crutches for balance support.
Subject(s)
Adult , Humans , Canes , Crutches , Forearm , Gait , Prescriptions , Stroke , WalkersABSTRACT
Cumulative trauma disorders were surveyed in a cross-sectional study of 100 male ship yard workers and 43 male office workers. And baseline checklist for risk assessment of cumulative trauma disorders was applicated in a ship making process. Cases of cumulative trauma disorders were defined using physical examinations and electronic diagnostic methods. Data on demographics, individual factors (medical condition), work organization and psychosocial aspects of work were obtained by questionnaire. Association between the above factors and cumulative trauma disorders were assessed by multiple logistic regression models. 29(29 %) participants of male shipyard workers and 4(9.2 %) study subjects of male office workers met our case definitions for cumulative trauma disorders. The myofascial pain syndrome of neck muscles(12 % of participants) and carpal tunnel syndrome(5 % of participants) were the major two medical conditions in shipyard workers. The odds of male shipyard workers for cumulative trauma disorders to male office workers was 3.15 after adjustment of age(95 % C.I. :2.25-5.44). And the variables such as duration of present job, HIVD condition, and surges in workload were associated at least one of the cumulative trauma disorders in the final models (p<0.05) . This study indicates that work related upper extremity musculoskeletal disorders are relatively common among shipyard workers, and shows that the psychosocial factors is not likely to be related to the occur rences of these disorders in heavy workers. Also we developed baseline checklist for risk assessment of cumulative trauma disorders. The checklist was unique in that its expected users were industrial hygienists and occupational healthing nurses who did not have much ergonomic background and in that it was targeted to Korean workers in various types. As the first application of the checklist, shipyard workers were evaluated.
Subject(s)
Humans , Male , Checklist , Cross-Sectional Studies , Cumulative Trauma Disorders , Demography , Logistic Models , Myofascial Pain Syndromes , Neck , Occupational Health , Physical Examination , Psychology , Surveys and Questionnaires , Risk Assessment , Ships , Upper ExtremityABSTRACT
Cumulative trauma disorders were surveyed in a cross-sectional study of 100 male ship yard workers and 43 male office workers. And baseline checklist for risk assessment of cumulative trauma disorders was applicated in a ship making process. Cases of cumulative trauma disorders were defined using physical examinations and electronic diagnostic methods. Data on demographics, individual factors (medical condition), work organization and psychosocial aspects of work were obtained by questionnaire. Association between the above factors and cumulative trauma disorders were assessed by multiple logistic regression models. 29(29 %) participants of male shipyard workers and 4(9.2 %) study subjects of male office workers met our case definitions for cumulative trauma disorders. The myofascial pain syndrome of neck muscles(12 % of participants) and carpal tunnel syndrome(5 % of participants) were the major two medical conditions in shipyard workers. The odds of male shipyard workers for cumulative trauma disorders to male office workers was 3.15 after adjustment of age(95 % C.I. :2.25-5.44). And the variables such as duration of present job, HIVD condition, and surges in workload were associated at least one of the cumulative trauma disorders in the final models (p<0.05) . This study indicates that work related upper extremity musculoskeletal disorders are relatively common among shipyard workers, and shows that the psychosocial factors is not likely to be related to the occur rences of these disorders in heavy workers. Also we developed baseline checklist for risk assessment of cumulative trauma disorders. The checklist was unique in that its expected users were industrial hygienists and occupational healthing nurses who did not have much ergonomic background and in that it was targeted to Korean workers in various types. As the first application of the checklist, shipyard workers were evaluated.