The Association of Obesity with Knee Osteoarthritis in a Rural Population

OBJECTIVE: To investigate the cross-sectional association of the obesity with the knee osteoarthritis (OA) in a rural population. METHOD: We studied the cross-sectional asssociation between the obesity and the knee OA by analysis of data (Juam-Study based data) from an epidemiologic survey of a population of 1,100 adults who resided around the Juam lake in Chonnam. The recruited sampling were 475 adults above 40 years old. We diagnosed knee OA by typical clinical features such as bony swelling, crepitus and pain on movement and divided the subjects into non-OA group (143 males:148 females) and OA group (60 males:124 females). There is no difference in the mean ages of two groups. The body mass index (BMI) was calculated from a weight and height (kg/m2) and body fat percent (BFP) was measured by bioelectric impedance fatness analyzer (BIA). We defined obesity as a BMI over 30 kg/m2 in both sex or a BFP over 25% in male and over 30% in female. The BMI and BFP were 23.2 +/- 3.2 kg/m2, 24.0 +/- 7.5% in non-OA group and 23.5 +/- 3.4 kg/m2, 26.0 +/- 7.0% in OA group and were compared in two groups. RESULTS: 1) Prevalence odds ratio (POR) for risk factors of knee OA was high in seventh decade, female, a high cholesterol group, and a high BFP group, and was not high in BMI group. 2) There was no association between BMI and knee OA. 3) There was no association between BFP and knee OA. CONCLUSION: We were not able to prove the cross-sectional association between obesity and knee OA. The results suggested that knee OA was a heterogeneous disorder and more possibly influenced by multiple other factors, such as age, sex, and various metabolic abnormalities than obesity itself.

Paralytic Disease Related to Enterovirus 71 Infection: A report of 4 cases

Enterovirus 71 (E-71) infection was first described in 1974 after isolation studies of specimens from a series of patients who had severe neurological disease. One important feature of E-71 is its ability to cause paralytic disease. In the summer of 1997, we identified 4 children with E-71 infection. The striking feature of this outbreak is the occurrence of all cases with polio-like paralytic disease. Other disease associated with E-71 infection included aseptic meningitis, meningoencephalitis, respiratory disease, gastroenteritis, and hand-foot-mouth disease. The spectrum of illness observed in our cases was compared to that seen in other outbreaks. It is suggested that the significance of E-71 infection lies in its neuropathogenic potential. There is no specific, therapeutic modality of E-71 infection but its prognosis is good except some cases.

Diagnostic Value of Tendon Reflex in Diabetic Peripheral Neuropathy

OBJECTIVE: To investigate the role of tendon reflex test in the diagnosis of diabetic peripheral neuropathy. METHOD: Patellar tendon reflex (PTR) and achilles tendon reflex (ATR) were recorded in forty six diabetic patients and thirty seven normal adults by delivering tendon taps with an electric reflex hammer. Forty six diabetic patients were divided into two groups based on nerve conduction study and diabetic neuropathy score: group 1 consisted of nineteen patients with peripheral neuropathy, group 2 consisted of twenty seven patients without peripheral neuropathy. Multiple regression equations using latency as a variable dependent on age and height were used and upper crossing of the 3 standard deviation level with regression on height and age was considered abnormal. RESULTS: Mean latencies of PTR and ATR were prolonged in the diabetic patients in comparison with the controls (p<0.01) and were prolonged in group 1 compared to group 2. In group 1, PTR was abnormal in 14 cases (sensitivity: 73.6%, specifity: 88%) and ATR was abnormal in 13 cases (sensitivity: 68.4%, specifity: 85.1%). In group 2, PTR was abnormal in 3 cases and ATR was abnormal in 4 cases. CONCLUSION: Tendon reflex test would be a valuable supplement to conventional nerve conduction studies for detection of diabetic peripheral neuropathy, especially in the proximal segment.

Cystic Entrapment of Infraspinatus Branch of Suprascapular Nerve Confirmed by Ultrasonography: Case report

Cystic entrapment of infraspinatus branch of suprascapular nerve is a rare cause of shoulder pain with infraspinatus atrophy. We discuss the ultrasonographic diagnosis and ultrasonography- guided aspiration of the cyst as a treatment. Case: A 37-year-old, ship-yard laborer had experienced left shoulder discomfort and pain without trauma history. Physical examination showed profound selective atrophy of left infraspinatus muscle. Simple X-ray of shoulder showed normal findings. Electrodiagnostic examination revealed delayed motor latency of infraspinatus branch of suprascapular nerve and denervation potentials of infraspinatus muscle exclusively. Ultrasonographic finding showed 13.5X21.5 mm sized cystic mass around left infraspinatus notch. Ultrasonography-guided aspiration was done, and then electrical stimulation therapy and strengthening exercise of left shoulder were performed. Symptoms were improved. We report a rare case of cystic entrapment of infraspinatus branch of suprascapular nerve in a patient without traumatic insult.

Measurement of Skin Temperature Alteration Caused by Smoking Using Digital Infrared Thermal Imaging

Digital infrared thermal imaging(DITI) has been proposed as a diagnostic aid in patient with many disease entities, such as the cardiovascular, the neurologic, the musculoskeletal diseases and so on. Supporters of thermography state that normal patients have the normal thermograms and abnormal patients have the abnormal thermograms. The purpose of this study was to determine how much a cigarette will affect skin temperature change in the course of normal day's smoking. Twenty one healthy smokers(mean age, 27.4+/-5.1 years old) and fourteen nonsmokers(mean age, 24.4+/-1.6 years old) took parts in the study. All were male. The cigarette consumption averaged 14.0 per day. Smokers maintained their smoking habit in the ambient temperature before on initial measurement and smoked a cigarette in the controlled laboratory room. Measurements were taken for 5 minutes, 1 hour and 2 hours afterward. The skin temperature of the face, the both palms and the both soles was measured using Dorex digital infrared thermal imaging system. In all sessions, the skin temperature was higher on the face and lower on the sole. There were no significant differences of skin temperature on both sides of body in all subjects(p>0.05). The skin temperature of all measured parts was significantly lower in the smoking group before and 5 minutes after smoking(p0.01).

Electrodiagnostic Evaluation of Diabetic Central Neuropathy: Electrophysiologic diagnosis of diabetic central neuropathy by using MEP and SEP

We studied diabetic central neuropathy(DCN) that is not well-known neurologic disorder. for confirming its existence and then presenting objective diagnostic criteria and methods. Thirtysix diabetics(NIDDM: 30, IDDM: 6), men age 53.1 years, 21 males and 15 females, were com pared with 36 controls, mean age 51.5 years, 18 males and 18 females, electrophysiologically. First, we diagnosed peripheral polyneuropathy(PN) in diabetics by means of Diabetic Neuropathy Staging(DNS) developed at the University of Michigan and classified diabetics into two group; group I indicates diabetics with PN. group II diabetics without PN. Second, we studied central(cortico-cervical and cortico-lumbar) motor conduction time(CMCT) by means of magnetic motor-evoked potential (MEP) and central somatosensory conduction time by means of somatosensory-evoked potentials(SEP) stimulating on median and posterior tibial nerves. There were no significant differences(P>0.05) statistically in cortico-cervical CMCT between diabetics and controls. There were significantly more prolonged(P<0.01) in cortico-lumbar CMCT between diabetics and controls. In median nerve-evoked 3-channel SEP, N13-N20 (cortico-cervical) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In tibial nerve-evoked 2-channel SEP, P38-N22(cortico-lumbar) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In 30 patients(83.3%) of 36 diabetics, the study revealed central conduction delay in view of that above 2 or more abnormalities representing central conduction delay, that is, central neuropathy. In 10 patients(33.3%, M: 7, F:3) of diabetics with central neuropathy(30 patients), even though they had no PN, central conduction delay was revealed. Conclusively, in view of representing central conduction delay in 83.3% of patients, we believer that more active evaluations are needed in diabetics representing nonspecific central neurologic symptoms, for example, psychomotor slowing or cognitive dysfunctions, and MEP and SEP are useful in diagnosing DCN.

Spontaneous Thoracolumbar Spinal Cord Infarction: A case report

Vascular disease of the spinal cord occurs less frequently than of the brain, and its incidence is not known. Case reports of spinal cord infarction are uncommon, especially ones with spontaneous causes. We experienced one case with a spontaneous spinal cord infarction in the territory of the Adamkiewicz artery. In this case, the clinical pictures were characterized by sudden onset of paraplegia, bilateral radicular pain, dissociated sensory loss below the level of infarction and sphincter dysfunction. Neuroradiological investigation and CSF analysis ruled out compressive or infectious lesions. Selective spinal angiography revealed an occlusion of the Adamkiewicz artery. The patient had a substantial recovery over a period of weeks with intensive rehabilitation treatments.

Nerve Conduction Studies after Surgical Release of Carpal Tunnel Syndrome / 대한정형외과학회잡지

Nerve Conduction studies are used not only in diagnosis of compression neuropathy, but also as a prognostic evaluation after is treatment. Authors analyzed the changes of nerve conduction studies in the 21 hands of 19 patients of carpal tunnel syndrome which was confirmed by clinical and electrodiagnostic methods, and treated by surgical release of transverse carpal ligament. The changes of nerve conduction and clinical studies were completed just before surgery, and at 2-week, 1-month, 3-month and 6-month of postoperative periods, and summarized as follows; 1. The distal sensory and motor latencies were significantly(P < 0.05) improved at the 3-month of postoperative periods, respectively. 2. The sensory conduction velocities across the carpal tunnel was significantly(P < 0.05) improved at the 6-month of postoperative periods. 3. The distal motor amplitude was significantly(P < 0.05) improved at the 6-month of postoperative periods. 4. The changes in sensory conduction studies were more sensitive value for evaluation of patients with carpal tunnel syndrome. 5. The distal latencies reflected the progress of clinical improvement, accurately. These conduction studies are considerable value in the evaluation of the post-carpal tunnel release patient.

Osteoporosis in normal Korean and fractures of the proximal femur: bone quality analysis by Singh index

No abstract available.