Work-Related Risk Factors of Knee Meniscal Tears in Korean Farmers: A Cross-Sectional Study

Background@#Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. @*Methods@#The participants included 486 farmers (238 men and 248 women), aged 40–69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. @*Results@#A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000–19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. @*Conclusion@#This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

Factors related to femoral bowing among Korean female farmers:a cross-sectional study

Background@#Female farmers have a high prevalence of knee osteoarthritis (KOA) in South Korea. Femoral bowing has been reported to be related to KOA by increasing load on the mechanical axis. This study aimed to investigate factors related to femoral bowing in Korean female farmers. @*Methods@#We analyzed the legs of 264 female farmers registered with the Korea farmers' knee cohort of Jeonnam Center for Farmers' Safety and Health. A structured questionnaire was used to determine sociodemographic variables, agricultural career, cumulative squatting working time (CSWT), and cumulative heavy lifting working time. Femoral bone density was measured and Kellgren-Lawrence (KL) grades were obtained from the knee radiographs.Mechanical axis angle (MAA), femoral bowing angle (FBA), anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA), and condylar-plateau angle (CPA) were measured. We examined the relationship between the FBA and related factors by using multiple linear regression. @*Results@#The proportion of individuals with radiographic KOA (≥ KL grade 2) in this study was 37.9%. As KL grades increased, MAA, FBA, and CPA increased, whereas aLDFA and aMPTA decreased. FBA increased with age. Multiple linear regression analyses using FBA as a dependent variable showed relationship with higher age, lower height, higher BMI, lower bone mineral density, longer CSWT, and longer agricultural careers. @*Conclusions@#The results of this study suggest that external factors related to agricultural work in female farmers was associated with femoral bowing, in addition to internal factors such as age, bone density, height, and obesity.

Work-Related Risk Factors of Knee Meniscal Tears in Korean Farmers: A Cross-Sectional Study

Background@#Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. @*Methods@#The participants included 486 farmers (238 men and 248 women), aged 40–69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. @*Results@#A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000–19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. @*Conclusion@#This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

Factors related to femoral bowing among Korean female farmers:a cross-sectional study

Background@#Female farmers have a high prevalence of knee osteoarthritis (KOA) in South Korea. Femoral bowing has been reported to be related to KOA by increasing load on the mechanical axis. This study aimed to investigate factors related to femoral bowing in Korean female farmers. @*Methods@#We analyzed the legs of 264 female farmers registered with the Korea farmers' knee cohort of Jeonnam Center for Farmers' Safety and Health. A structured questionnaire was used to determine sociodemographic variables, agricultural career, cumulative squatting working time (CSWT), and cumulative heavy lifting working time. Femoral bone density was measured and Kellgren-Lawrence (KL) grades were obtained from the knee radiographs.Mechanical axis angle (MAA), femoral bowing angle (FBA), anatomical lateral distal femoral angle (aLDFA), anatomical medial proximal tibial angle (aMPTA), and condylar-plateau angle (CPA) were measured. We examined the relationship between the FBA and related factors by using multiple linear regression. @*Results@#The proportion of individuals with radiographic KOA (≥ KL grade 2) in this study was 37.9%. As KL grades increased, MAA, FBA, and CPA increased, whereas aLDFA and aMPTA decreased. FBA increased with age. Multiple linear regression analyses using FBA as a dependent variable showed relationship with higher age, lower height, higher BMI, lower bone mineral density, longer CSWT, and longer agricultural careers. @*Conclusions@#The results of this study suggest that external factors related to agricultural work in female farmers was associated with femoral bowing, in addition to internal factors such as age, bone density, height, and obesity.

Atypical Traumatic Pneumorrhachis Accompanied by Paraparesis

Pneumorrhachis, caused by intraspinal air, is an exceptional but important radiographic finding that is accompanied by different etiologies. Pneumorrhachis, by itself, is usually asymptomatic and gets reabsorbed spontaneously. Therefore, the patients with pneumorrhachis are mostly managed conservatively. We encountered a unique case of atypical traumatic pneumorrhachis accompanied by paraparesis.

Paraplegia due to Spinal Epidermoid Cyst Rupture at Asthma Attack

Spinal epidermoid cyst is less than 1% of the entire spinal cord tumor and a rare tumor. It is a slowly proliferating benign tumor and can be a result of either congenital or acquired factors. In particular, reports of acute paraplegia due to spinal epidermoid cyst rupture are very rare. Since authors experienced paraplegia resulting from congenital spinal epidermoid cyst rupture during an asthma attack, it is reported with a review of literature.

The Effect of Extracorporeal Shock Wave Therapy on Pressure Ulcer

OBJECTIVE: To investigate the effect of extracorporeal shock wave therapy (ESWT) on pressure ulcers which is a major, functionally-limiting medical problem impairing quality of life for many people each year. METHOD: Seven patients who had stage 3 pressure ulcers were enrolled for the study. Each patient was treated with 6 sessions of low-energy (0.10~0.15 mJ/mm2, 1,000 impulses) ESWT. The length, width, depth and soft tissue biopsy of pressure ulcers were evaluated every 2 weeks for 6 weeks. RESULTS: The length, width and depth decreased significantly after 2 weeks of ESWT application. Healthy granulation tissue was formed. Soft tissue biopsy revealed increased the number and size of capillaries and decreased inflammatory cells in treated case. CONCLUSION: ESWT promoted wound healing and revealed favorable histological changes in pressure ulcers. We suggest that ESWT can be used for the safety and effective management of pressure ulcer.

A Clinical Study of Intercostal Neuropathy after Rib Fracture / 대한흉부외과학회지

BACKGROUND: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. MATERIAL AND METHOD: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. RESULT: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. CONCLUSION: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

Useful Laboratory Protocols for Screening Test for Chronic Low Back Pain Patients

OBJECTIVE: To estimate association between laboratory findings such as serum lipid panel, urine pH, alkaline phosphatase, lactic acid and chronic low back pain patients. METHOD: A sample (n=112) of blue color employees in an engineering company were divided into three groups, degenerative herniated disc patients, degenerative spondylosis patients and radiculopathy patients. Each group was examined for the correlation between several factors and chronic low back pain. Several factors including laboratory findings with serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, urine PH, alkaline phosphatase, lactic acid and smoking were analysed. RESULTS: There was no association between the baseline total cholesterol, HDL-cholesterol, LDL-cholesterol, alkaline phosphatase, urine pH, lactic acid and chronic low back pain. However, the triglyceride levels were significantly higher in degenerative herniated disc patients, degenerative spondylosis patients and smokers. CONCLUSION: High serum triglyceride predicted incident degenerative chronic low back pain.

Ape1/Ref-1 Stimulates GDNF/GFR alpha1-mediated Downstream Signaling and Neuroblastoma Proliferation

We previously reported that glial cell line-derived neurotropic factor (GDNF) receptor alpha1 (GFR alpha1) is a direct target of apurinic/apyrimidinic endonuclease 1 (Ape1/Ref-1). In the present study, we further analyzed the physiological roles of Ape1/Ref-1-induced GFRalpha1 expression in Neuro2a mouse neuroblastoma cells. Ape1/Ref-1 expression caused the clustering of GFR alpha1 immunoreactivity in lipid rafts in response to GDNF. We also found that Ret, a downstream target of GFRalpha1, was functionally activated by GDNF in Ape1/Ref-1-expressing cells. Moreover, GDNF promoted the proliferation of Ape1/Ref-1-expressing Neuro2a cells. Furthermore, GFR alpha1-specific RNA experiments demonstrated that the downregulation of GFR alpha1 by siRNA in Ape1/Ref-1-expressing cells impaired the ability of GDNF to phosphorylate Akt and PLC gamma-1 and to stimulate cellular proliferation. These results show an association between Ape1/Ref-1 and GDNF/GFR alpha signaling, and suggest a potential molecular mechanism for the involvement of Ape1/Ref-1 in neuronal proliferation.

(-)-Epigallocatechin Gallate Inhibits the Pacemaker Activity of Interstitial Cells of Cajal of Mouse Small Intestine

The effects of (-)-epigallocatechin gallate (EGCG) on pacemaker activities of cultured interstitial cells of Cajal (ICC) from murine small intestine were investigated using whole-cell patch-clamp technique at 30degrees C and Ca2+ image analysis. ICC generated spontaneous pacemaker currents at a holding potential of -70 mV. The treatment of ICC with EGCG resulted in a dose-dependent decrease in the frequency and amplitude of pacemaker currents. SQ-22536, an adenylate cyclase inhibitor, and ODQ, a guanylate cyclase inhibitor, did not inhibit the effects of EGCG. EGCG-induced effects on pacemaker currents were not inhibited by glibenclamide, an ATP-sensitive K+ channel blocker and TEA, a Ca2+-activated K+ channel blocker. Also, we found that EGCG inhibited the spontaneous [Ca2+]i oscillations in cultured ICC. In conclusion, EGCG inhibited the pacemaker activity of ICC and reduced [Ca2+]i oscillations by cAMP-, cGMP-, ATP-sensitive K+channel-independent manner.

Evaluation of Cardiopulmonary Function and Serum Lipid Profile in Spinal Cord Injured Patients

OBJECTIVE: To help cardiopulmonary rehabilitation and prevention of cardiovascular disease in spinal cord injured patients. METHOD: Twenty spinal cord injured patients were divided into 3 groups according to level of injury - cervical, thoracic and lumbar level groups. Exercise stress test was initiated at a velocity of 1.5 mph for 1 minute and was increased 0.5 mph for each subsequent minute. To evaluate blood lipid profiles, we measured total cholesterol, HDL (high density lipoprotein)-cholesterol, LDL (low density lipoprotein)-cholesterol and triglyceride levels in the fasting state. RESULTS: Oxygen consumption, oxygen consumption ratio of maximal oxygen consumption and minute ventilation were significantly higher in the thoracic and lumbar cord level groups compared to the cervical cord level group (p<0.05). There was a significant difference between all 3 groups in respect to total duration of exercise (p<0.05). The HDL- cholesterol level showed significant correlation with total exercise time (p<0.05). CONCLUSION: Cardiopulmonary evaluation by specialized wheel chair system in spinal cord injured patients may be more safe and accurate method compared to the previous examination.

Visual Evoked Potential Study in Amblyopia and Normal Groups

OBJECTIVE: The purpose of this study was to evaluate the relationship between the visual acuity and visual evoked potentials of the amblyopia patients and normal persons for the demonstration of the visual disability. METHOD: We performed visual evoked potential study, in 49 eyes of the 43 amblyopia patients and in 76 eyes of 38 normal young adults. Our study was carried out to evaluate the relationship of the visual acuity with N1, P1, N2, P2 latency, P1-N2 amplitude and to compare the latency of N1, P1, N2, P2, and P1-N2 amplitude in amblyopia patients and normal young adults. RESULTS: The mean values of N1, P1, N2, P2 latency were prolonged in amblyopia patients compared to normal young adults (p 0.05), but significant correlation was noted between the visual acuity and P1-N2 amplitude (p <0.05). CONCLUSION: These results showed prolonged latency of N1, P1, N2, P2 in amblyopia group as well as significant correlation between visual acuity and P1-N2 amplitude in both groups. So, P1 latency and P1-N2 amplitude are good parameters in evaluating the visual disability.

The Study about the change of Fetal Adrenal Gland Hormone during Pregnancy and Labor / 대한산부인과학회잡지

OBJECTIVE: Fetal adrenal gland hormone was known to have close association with fetal weight and labor pain in response to fetal stress. Our purpose was to analyze the correlation between cortisol, DHEA-S in cord blood and obstetric status of fetuses. METHODS: We collected cord blood samples from 60 neonates immediately after delivery of baby. Six cases were complicated by intrauterine growth restriction and fourteen patients were complicated by preeclampsia. We measured cortisol, DHEA-S levels by using the RIA commercial Kits for the ELISA. We performed statistic analysis of the data on the SPSS computer program. RESULTS: Cortisol was significantly higher in intrauterine growth restriction (23.4 +/- 16.2 microgram/dL) statistically than control group (13.7 +/- 9.5 microgram/dL) (P=0.022). Cortisol and DHEA-S had negative correlation each other (P=0.025). DHEA-S was significantly lower in intrauterine growth restriction (1202.2 +/- 1005.9 ng/ mL) than control group (1714.8 +/- 978.6 ng/mL) (P=0.01). DHEA-S had increased with advancing gestational age (P=0.03) and fetal weight (P=0). CONCLUSION: Cord blood cortisol level and DHEA-S level has close association with intrauterine growth restriction and negative correlation with each other.

Isokinetic Evaluation of Shoulder Joint Strength in College Handball Players and General College Students

OBJECTIVE: To obtain the comparison data of the shoulder strength between handball players of college and general college students. METHOD: Fifteen subjects from each group, college handball players and general college students groups were tested. Peak torque, peak torque ratio of internal rotator to external rotator, peak torque to body weight ratio and average work during isokinetic exercise were studied. RESULTS: All of the parameters tested in handball players of college were greater than those of general college students. The peak torque in handball players was greater than that of general college students at 60o/sec, 180o/sec, which was statistically significant (p<0.05). The peak torque ratio of internal rotator to external rotator in dominant side of handball players was greater than the college group (p<0.05). The peak torque to body weight ratio at 60o/sec did not show significant differences between handball players of college and general college students. The average power at 60o/sec did not show significant differences between the two groups. CONCLUSION: The values of peak torque ratio of internal rotator to external rotator of the shoulder joint in dominant side of handball players were greater than those of the general college students. So it was suggested this result have to be considered in selecting handball players and exercise prescription.

Comparison of Isokinetic Strength of Knee and Pulmonary Function between Collegians and Hockey Players in College

OBJECTIVE: The purpose of this study was to examine the strength of the knee and pulmonary function comparing collegians and hockey players in college. METHOD: KINdegreeCOM isokinetic dynamometer and medigraph were used to evaluate strength of the right lower extremity and pulmonary function to 30 male students comprising 15 hockey players and 15 collegians with no significant difference in age, weight, and height between the two groups. All subjects used their right lower limb as dominant limb. RESULTS: 1) The significant differences between collegians and hockey players were found in the peak torque at 60o/sec,180o/sec. 2) The siginficant differences between collegians and hockey players were found in forced vital capacity, forced expiratory volume in one second and expiratory reserve volume on the pulmonary function. 3) The significant correlation between isokinetic strength and pulmonary function were found in peak torque. CONCLUSION: It is turned out that hockey players in college have much better isokinetic strength and pulmonary function than collegians, so it is suggested this result have to be considered in selecting hockey players and exercise prescription.

Changes of Cardiopulmonary Response and Serum Lipid Level after Backward Walk Training

OBJECTIVE: The purpose of this study was to examine the changes of cardiopulmonary response and serum lipid level after backward walking training in healthy male college students. METHOD: Subjects were ten healthy male college students. Maximal heart rate and VO2max were determined for each subject by administering a Bruce treadmill exercise test after backward walking training during eight weeks. Wilcoxon signed rank test was used to evaluate the changes of the backward walk training. RESULTS: The study showed that maximal heart rates were 163.7 beat/min in pre-training and 175.8 beats/min in post- training; in contrast, resting heart rates were 72 beat/min in pre-training and 67 beat/min in post-training. The maximal oxygen consumptions were 2111 ml/min in pre-training and 2521 ml/min in post-training. There were significant differences (p<0.05) in maximal heart rate, heart rate ratio of maximal heart rate (% HR), oxygen consumption, and oxygen consumption ratio of maximal oxygen consumption (% VO2max) between the pre and post-training. The HDL cholesterol level was 42.8 mg/dl in pre-training and 58.0 mg/dl in post-training. There was significant increased of HDL cholesterol in post-training. CONCLUSION: We concluded that 5 km/hr backward walk training for eight weeks was an effective exercise program to increase in aerobic capacity of the male college students.

Comparison of Heart Rate and Oxygen Consumption between Forward and Backward Walking

OBJECTIVE: The purpose of this study was to investigate the changes of oxygen consumption and heart rate at forward and backward treadmill walking in healthy male college students. METHOD: Subjects were composed of twenty healthy male college students. The oxygen consumption, oxygen consumption ratio of maximal oxygen consumption (VO2max%) and heart rate, heart rate ratio of maximal heart rate (HRmax%) were measured for each subjects by administering a treadmill exercise test at 5 km/hr speed of forward and backward walking. Paired t-test was used to evaluate the difference of the forward and backward walking. RESULTS: The study showed that heart rate and HRmax% were 120.9 beat/min, 61.6% in forward walking, and 166.1 beats/min, 84.3% in backward walking, respectively. The oxygen consumption and VO2max% were 15.9 ml/kg/min, 37.3% in forward walking, and 23.6 ml/kg/min, 55.8% in backward walking, respectively. CONCLUSION: We concluded that 5 km/hr backward walking was more effective exercise program than forward walking to promote health in the college students.

Cervical Range of Motion in Korean Adults

OBJECTIVE: The purpose of this study was to determine the normal value of cervical motion in Korean adults. METHOD: Five hundred healthy subjects, 250 men and 250 women between third decades and seventh decades completed this study. The Cervical Range of Motion (CROM) instrument was used to measure six cervical motions and horizontal head motion. RESULTS: The elderly group had significantly less motion than the younger group for all six motions and horizontal head motions (p<0.05). Women had greater range of cervical motions than men in all cervical motions (p<0.05). CONCLUSION: The method using the CROM instrument seems to be useful for primary and follow up test of cervical disease.

Effect of Passive Leg Range of Motion Exercise in Hemiplegic Patients

OBJECTIVE: The purpose of this study was to examine the change of heart rate, mean arterial pressure, respiration rate, and spasticity at passive leg range of motion exercise for one month in hemiplegic patients. METHOD: Subjects were composed of twenty hemiplegic patients who had spasticity above two grade in modified Ashworth scale. Passive leg range of motion exercise was performed with passive cycle leg exerciser (Autocybex) at the speed of 40 rpm. Training program consisted of two sessions a day, and each session was done for twenty minutes. The heart rate, mean arterial pressure, and respiration rate were checked for each subject before and after passive leg range of motion exercise at initial state and after one month. Spasticity was measured at knee joint of the affected side at initial state and after one month. RESULTS: The resting heart rate, mean arterial pressure and respiration rate were significantly decreased after one month (p<0.05). The changes of heart rate, mean arterial pressure, and respiration rate after passive leg range of motion exercise were significantly decreased after one month (p<0.05). The grade of spasticity was decreased after one month (p<0.05). CONCLUSION: We concluded that passive leg range of motion exercise during one month stabilized heart rate, mean arterial pressure, and respiration rate, and reduced spasticity.