Peroneal Tendinopathy in Chronic Lateral Ankle Instability / 대한스포츠의학회지

In patients complained of lateral ankle pain, the peroneal tendinopathy is frequently overlooked because relatively rare. In this study, types of lesion, frequency, and clinical results were analyzed in patients with peroneal tendinopathy associated in chronic ankle instability. This study reviewed the result of 22 patients. The average age was 35.1 years with an average follow-up of 20.1 months. Modified Brostrom procedure was done and peroneal tendon was explored. Peroneal tendinopathy was composed of 9 tear, 2 dislocation, 4 tendinitis, 7 low-lying muscle belly, 1 peroneal quartus. Depending on the type of peroneal tendinopathies, tubularization, groove deepening and retinaculum repair, and debridement were done. All patients had a history of repeated sprains, positive anterior drawer test, lateral ankle pain. After the last follow-up, the visual analogue scale score and American Orthopaedic Foot and Ankle Society score were evaluated. Also, almost of all patients were satisfied and anterior drawer test was improved. If the patients have chronic ankle instability and pain around the retromalleolar area, we keep in mind that the lesions are peroneal tendinopathy.

Reliability of MRI Findings of Peroneal Tendinopathy in Patients with Lateral Chronic Ankle Instability

BACKGROUND: Patients with chronic lateral ankle instability also have peroneal tendinopathy often. However, preoperative MRIs of these patients are vague in many cases. Our study was performed to see the reliability of MRI findings of peroneal tendinopathy in patients with chronic lateral ankle instability. METHODS: MRI images for 82 patients who had chronic lateral ankle instability, and had received surgical treatment between March 2006 and November 2009 were compared with impressions from operating rooms. The mean age of patients was 36.4 years (range, 15 to 64 years), 82 ankles were studied, and patients with rheumatoid diseases were excluded from the study. RESULTS: Of the 82 cases, 26 were true positives, 38 true negatives, 13 false positives and 5 false negatives. Of 39 cases of peroneal tendinopathy diagnosed from MRI, 14 had peroneal tendon partial tears, 15 tenosynovitis, 3 dislocations, 17 low-lying muscle bellies, and 6 peroneus quartus muscles. Of 31 cases of peroneal tendinopathy observed in surgery 11 had peroneal tendon partial tears, 4 tenosynovitis, 5 dislocations, 12 low-lying muscle belliess, and 1 peroneus quartus muscle. Sensitivity and specificity of peroneal tendinopathy were 83.9% and 74.5%, respectively. Positive predictive value was 66.7%. Negative predictive value was 88.4%. Accuracy rate was 78.0%. CONCLUSIONS: MRI is a useful diagnostic tool for detecting peroneal tendinopathy in patients with chronic lateral ankle instability. However, MRI is vague in many cases. Therefore, a thorough delicate physical examination and careful observation is needed.

Virtual Reality Alcohol Treatment : Craving and EEG Responding to Multi-Sensory Stimulation in Patient with Alcohol Dependence / 신경정신의학

OBJECTIVES : In our previous report, alcohol dependent patients (ADP) with virtual reality treatment showed a greater decrease in cravings for alcohol and increase in alpha power of the frontal lobe, compared to ADP who underwent general treatment. For the showing different responsibility on alcohol consumption situation between ADP and healthy comparisons, we compared the change in cravings and alpha waves in frontal lobe during virtual reality treatment for alcohol dependence (VRT). METHODS : Thirty seven alcohol-dependent male inpatients diagnosed using DSM-IV, and 25 ageand education-matched healthy adult males were recruited. We measured the changes in cravings and Electroencephalogram (EEG) activity between alcoholic patients and healthy control subjects during VRT. RESULTS : During the VRT, ADP reported higher craving for alcohol during the high risk situation and lower craving for alcohol during aversive situation, compared to healthy controls. The alpha wave of frontal lobe activity in ADP was decreased while that in healthy subject was increased from relaxation to high risk situation (HRS). In ADP, the changes of EEG {Fp1-A1 (r=-0.48, p=0.04), F7-A1 (r=-0.49, p=0.03), Fp2-A2 (r=-0.46, p<0.05), and F8-A2 (r=-0.54, p=0.02)} in the frontal lobe were negatively correlated with the change of craving for alcohol. CONCLUSION : The present study demonstrated that the ready availability and the affinity of alcohol cues in ADP appear to be correlated with decreased function of the frontal lobe.

Virtual Reality Alcohol Treatment : Craving and EEG Responding to Multi-Sensory Stimulation in Patient with Alcohol Dependence / 신경정신의학

OBJECTIVES : In our previous report, alcohol dependent patients (ADP) with virtual reality treatment showed a greater decrease in cravings for alcohol and increase in alpha power of the frontal lobe, compared to ADP who underwent general treatment. For the showing different responsibility on alcohol consumption situation between ADP and healthy comparisons, we compared the change in cravings and alpha waves in frontal lobe during virtual reality treatment for alcohol dependence (VRT). METHODS : Thirty seven alcohol-dependent male inpatients diagnosed using DSM-IV, and 25 ageand education-matched healthy adult males were recruited. We measured the changes in cravings and Electroencephalogram (EEG) activity between alcoholic patients and healthy control subjects during VRT. RESULTS : During the VRT, ADP reported higher craving for alcohol during the high risk situation and lower craving for alcohol during aversive situation, compared to healthy controls. The alpha wave of frontal lobe activity in ADP was decreased while that in healthy subject was increased from relaxation to high risk situation (HRS). In ADP, the changes of EEG {Fp1-A1 (r=-0.48, p=0.04), F7-A1 (r=-0.49, p=0.03), Fp2-A2 (r=-0.46, p<0.05), and F8-A2 (r=-0.54, p=0.02)} in the frontal lobe were negatively correlated with the change of craving for alcohol. CONCLUSION : The present study demonstrated that the ready availability and the affinity of alcohol cues in ADP appear to be correlated with decreased function of the frontal lobe.

A Study on the Standardization of the Hospital Anxiety and Depression Scale for Koreans: A Comparison of Normal, Depressed and Anxious Groups / 신경정신의학

OBJECTIVE: The Purpose of this study was to standardize the Hospital Anxiety and Depression Scale for Koreans(HAD-K). METHOD: HAD-K, Beck Depression Inventory(BDI), and Self-Rating Anxiety Scale(SAS) were administered to 66 anxious and 74 depressed patients and 189 normal controls. RESULTS: The median correlation between items of the HAD-A and corrected item total score was 0.55 and HAD-D was 0.47. The values of Cronbach's alpha coefficient were 0.89 and 0.86. The results of testing the validity of the HAD examined by t-test proved that anxious and depressed groups were significantly different from normal controls. The construct validity of HAD-D with BDI was r=0.80, and HAD-A with SAS was r=0.79. The result of examining the sensitivity and specificity of HAD-D revealed that cut-off point of 8 yielded 89.2% sensitivity rate and 82.5% specificity rate. And those of HAD-A revealed that cut-off point of 8 yielded 78.8% sensitivity rate and 82.5% specificity rate. The result of the factor analysis found 3 factors in HAD, which were anxiety(factor 1) and depression (factor 2). The total percent of two factors were 59.6%. CONCLUSION: The HAD-K was proven to measure the anxiety and depression validly. Primary physicians and non-psychiatrists also can easily measure anxiety and depression of patients within a short time with HAD-K.

Life Event Stress and Coping Strategy in the Patients with Coronary Artery Disease / 신경정신의학

OBJECTIVES: This study was aimed to investigate and compare the life event stress unit, coping strategy and other risk factors in coronary artery disease patients who visited Cardiovascular Division of Dept. of Internal Medicine Chung-Ang University Hospital. METHODS: Review of medical chart, semi-structured interview, Scale of Life Events and Multidemensional Coping Scale were applied to patients group(No.=26) who were diagnosed as cardiovascular disease at Cardiovascular Division Dept. of Internal Medicine, Chung-Ang University Hospital and control group(No.=37) who were screened as normal at Health Screening Center. The data were processed by T test and Chi-square test using SPSS version 7.0. RESULTS: 1) The scores of life event stress of patient group were significantly higher(372.34+/-172.81) than those of normal control group(228.27+/-116.37)(p<0.05). 2) In the aspect of coping strategies, the patients' group was significantly higher than normal control group at the fatalism, accomodation and self-criticism(p<0.05), while in the normal control group, the positive comparison and religious seeking tended to be higher than in the patients group, with no statistical significance. 3) Comparing other risk factors of coronary artery disease, the patients group was higher than the normal control group at the incidence of diabetes, hypo-HDL-cholesterolemia and hypertension(p<0.05). But the incidence of smoking, hypertriglyceridemia and hypercholesterolemia did not differ significantly. CONCLUSIONS: The life event stress was found to be one of the risk factors of coronary artery disease. The passive-negative coping strategies, such as the fatalism, accomodation and selfcriticism, were also another risk factors.