The Pattern of Occurrence of Fractures in Children and Adolescents and Its Managements Based on the Database of the Health Insurance Review and Assessment Service

PURPOSE: The purpose of this article is to report on the pattern of medical process and relative frequencies of fractures in children and adolescents. MATERIALS AND METHODS: The authors retrospectively analyzed the database of the health insurance review and assessment service regarding children and adolescents under 20 years old treated from 2008 to 2010. Newly registered numbers of fractures in children and adolescents according to sex, month, institution, and anatomical location were also reviewed. RESULTS: A total of 1,893,416 fractures occurred during three years; approximately 630,000 cases were treated during one year (approximately 562 cases among 10,000 people during one year). During one year, the most fractures occurred in June and the least in February. Senior general hospital consisted of 5.72%, 12.30% in general hospital, 19.28% in hospital, and 62.70% in clinics. Among the fracture sites, 0.05% were cervical fractures, 0.91% in sternum and thoracic vertebra, 1.35% in lumbar vertebra and pelvis, 12.79% in shoulder and upper extremities, 26.87% in lower extremities, 38.10% in wrist and hand, 1.01% in femur, 10.40% in lower extremities including ankle, and 8.52% in foot excluding ankle. The maximal incidence was age 14 years in male and 12 years in female. CONCLUSION: The authors reviewed the pattern of medical process and relative frequencies of fractures in children and adolescents.

Surgical Treatment of Atypical Femoral Fracture / 대한정형외과학회잡지

Bisphosphonates have been used as first-line therapy to reduce the incidence of osteoporotic fractures. Several publications have recently described the occurrence of low-energy subtrochanteric and femoral shaft fractures with long-term bisphosphonate use, so called atypical femoral fracture. Atypical fracture is a rare condition, and the treatment and its effectiveness have not been adequately reported. Thus, finding appropriate treatment is difficult. In this report, the authors reviewed the treatment of atypical fracture and described helpful suggestions for surgery.

Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures

PURPOSE: To investigate the relationship between the greenstick laminar fractures and the dural tear in low lumbar burst fractures and their optimal treatment. MATERIALS AND METHODS: We enrolled 51 patients (52 cases) who had been diagnosed with low lumbar burst fracture from June 2003 to May 2007. The average age was 39 years (range, 22 to 58), 30 male patients (58.8%), and 21 female patients (41.2%). Average follow-up periods was 19 months (range, 11 to 45). Lumbar CT scan were taken 1 mm slices in precision for all patients. We judged it incomplete fracture if lumbar CT scans show loss of cortical continuity over 3 slices if there is an aggrement of two among one radiologist and two orthopaedic surgeons reached a consensus. Dural tear and entrapment of nerve root were confirmed intraoperatively by the senior surgeon. RESULTS: In 52 burst fractures, complete lamina fractures occurred in 21 cases and there were green stick laminar fractures in 14 cases. Neurologic defect has been found in 12 cases, 5 (63%) from complete laminar fractures and 3 (37%) from green stick laminar fractures. Dural tears has been detected in 9 cases (26%), 4 (19%) from complete laminar fractures and 5 (36%) from green stick laminar fractures. CONCLUSION: Dural tear and nerve root entrapment can be accompanied in patients with green stick fracture. There is necessary to consider the possibility of dural tear and nerve root entrapment before operation and to indentify carefully to the presence of nerve root entrapment during operation.

Bilateral Recurrent Thigh Abscesses for Five Years after a Transobturator Tape Implantation for Stress Urinary Incontinence

The synthetic, tension-free midurethral sling procedure using transobturator tape (TOT) was introduced in 2001 and has become the most widely used procedure for the treatment of female urinary incontinence worldwide. However, infectious complications associated with erosions have occasionally been reported because of a foreign body reaction to the polypropylene mesh. We observed a case of a bilateral recurrent thigh abscess manifesting 5 years after a TOT sling procedure. The patient had recurrent thigh abscesses with repeated incisions and drainages in the past 1 year. Five months earlier, she had undergone a procedure to remove the eroded suburethral mesh, but incompletely. The right thigh abscess recurred, and ultimately the residual mesh was completely excised with abscess drainage. Complete mesh removal is very important to prevent abscess recurrence, and it is necessary for any urologist treating women who have undergone the TOT procedure to be aware of the possibility of abscesses occurring for a long time after the operation.

Significance of S100A2 and S100A4 Expression in the Progression of Prostate Adenocarcinoma

PURPOSE: The aim of this study was to investigate the expression pattern of calcium-binding proteins S100A2 and S100A4. We also sought to determine the prognostic value of these markers for patients with prostate adenocarcinoma. MATERIALS AND METHODS: Immunohistochemical staining was performed to detect S100A2 and S100A4 expression in 26 tissue samples obtained during transurethral resection from patients with benign prostatic hyperplasia (BPH) and in 67 tissue samples obtained during prostate biopsy and radical prostatectomy from patients with prostate carcinoma. The immunoreactivity of these proteins was stratified on a scale of 0 to 3 and was correlated with the pathologic features of prostate adenocarcinoma. RESULTS: High expression of S100A2 was observed in the tissue of patients with BPH, whereas low or no expression was observed in prostate cancer (CaP) cells. The protein level of S100A4 was significantly higher in CaP than in BPH cells. The higher level of S100A4 observed in CaP tissue correlated with increasing tumor grade. CONCLUSIONS: Decreased expression of S100A2 and increased expression of S100A4 may be important in the progression of CaP. This finding could aid in identifying aggressive CaP. The simultaneous analysis of S100A2 and S100A4 expression in prostate tissues may be a useful prognostic marker for CaP.

Significance of S100A2 and S100A4 Expression in the Progression of Prostate Adenocarcinoma

PURPOSE: The aim of this study was to investigate the expression pattern of calcium-binding proteins S100A2 and S100A4. We also sought to determine the prognostic value of these markers for patients with prostate adenocarcinoma. MATERIALS AND METHODS: Immunohistochemical staining was performed to detect S100A2 and S100A4 expression in 26 tissue samples obtained during transurethral resection from patients with benign prostatic hyperplasia (BPH) and in 67 tissue samples obtained during prostate biopsy and radical prostatectomy from patients with prostate carcinoma. The immunoreactivity of these proteins was stratified on a scale of 0 to 3 and was correlated with the pathologic features of prostate adenocarcinoma. RESULTS: High expression of S100A2 was observed in the tissue of patients with BPH, whereas low or no expression was observed in prostate cancer (CaP) cells. The protein level of S100A4 was significantly higher in CaP than in BPH cells. The higher level of S100A4 observed in CaP tissue correlated with increasing tumor grade. CONCLUSIONS: Decreased expression of S100A2 and increased expression of S100A4 may be important in the progression of CaP. This finding could aid in identifying aggressive CaP. The simultaneous analysis of S100A2 and S100A4 expression in prostate tissues may be a useful prognostic marker for CaP.

Characteristics of Incidentally Detected Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: This study compared the clinicopathological features, diagnosis and prognosis of an incidental renal cell carcinoma with those of a symptomatic carcinoma. MATERIALS AND METHODS: The medical records of 140 renal cell carcinoma patients at our hospital between 1995 and 2004 were reviewed. The patients were divided into two groups: asymptomatic and symptomatic patients. The patients characteristics, radiologic studies, tumor stage, tumor size, nuclear grade, and survival rates were investigated. The data was analyzed using a chi-square test, Student's t-test and Kaplan-Meier survival curve. RESULTS: Of the 140 patients 57(41%) were asymptomatic and 83(59%) were symptomatic. The median tumor size was 5.2cm for incidental cancer and 8.1cm for symptomatic cancer. The 5-year cancer specific survival rate was significantly higher for the incidental tumors than the symptomatic tumors(78.9% versus 45.8%). When adjusted for stage, there was no difference in survival in those with stage I to IV disease between the 2 groups. Stage I, II lesions were present in 82.5% of patients in the incidental group and 39.7% in the symptomatic group. In contrast, a stage lesion was present in 17.5% of the patients in the incidental group compared with 60.3% in the symptomatic group. A higher tumor grade of symptomatic lesions was also noted. CONCLUSIONS: The incidental group showed a significantly lower stage and grade, and a higher 5-year survival rate. This result was attributed to the early detection of renal cell carcinoma before the onset of symptoms. Overall, early detection of renal cell carcinoma using radiologic tools will improve the prognosis of renal cell carcinoma.

The Two Year's Follow Up Study of Symptomatic Hands without Electrodiagnostic Evidence of Carpal Tunnel Syndrome

OBJECTIVE: The purpose of this study was to determine the natural history of symptomatic hands without electrodiagnostic evidence of carpal tunnel syndrome (CTS). METHOD: This study was comprised of 88 hands of 49 subjects with symptoms consistent with CTS without median mononeuropathy who were recruited during a community health examination and followed after two years. 88 hands of 44 people with age and sex-matched healthy controls were followed for comparison. Symptoms and electrodiagnostic findings were compared between the two groups. RESULTS: 62 hands of the symptomatic group had persistent symptoms after 2 years while 16 hands of the control group had symptoms consistent with CTS. Median motor distal latencies were significantly delayed after two years in the symptomatic group (p<0.05). Median sensory latencies were also delayed in the symptomatic group, but this was not statistically significant (p=0.064). The occurrence rate of median mononeuropathy at wrist was significantly higher in the symptomatic group than in the control group (13.6% vs. 2.3%)(p<0.05). CONCLUSION: The results of this study suggested that a significant number of symptomatic hands without electrodiagnostic evidence of CTS may have persistent symptoms and may progress to electrodiagnostically evident CTS.

Operative Treatment of Acetabular Fractures through the Ilioinguinal Approach / 대한정형외과학회잡지

PURPOSE: To evaluate the efficacy and the result of the ilioinguinal approach in the operative treatment of acetabular fractures. MATERIALS AND METHODS: A retrospective analysis was performed on 22 patients who were available for follow-up over one year. The reduction quality, clinical results, and radiographic results were analyzed based on the criteria of Matta. Complications were recorded as well. RESULTS: Anatomical reduction (0-1 mm displacement) was achieved in 18 cases (81.9%) and imperfect reduction (2-3 mm displacement) was achieved in 4 cases (18.1%). Excellent clinical and radiographic results were graded in all of the 18 anatomically reduced fractures. The clinical results were excellent in 1 case, good in 2, and poor in 1; although radiographic results were good in 4 cases with imperfect reductions. Complications included 5 cases with a transient lateral femoral cutaneous nerve injury, which resolved during the follow-up period and 1 case with a partial femoral nerve palsy. CONCLUSION: The ilioinguinal approach is effective for anterior wall, anterior column, and associated anterior and posterior hemitransverse fractures; as well as both column, transverse fracture, and T-shaped fractures. The risk of iatrogenic lateral femoral cutaneous nerve damage is relatively high, but there were no residual symptoms at the time of latest follow-up evaluation.

Prevalence and Risk Factors of Carpal Tunnel Syndrome in Diabetic Patients

OBJECTIVE: To investigate the prevalence and risk factors of carpal tunnel syndrome in diabetic patients. METHOD: Electrodiagnostic study was performed to diagnose carpal tunnel syndrome and polyneuropathy in 266 (male 151, female 115) diabetic patients. General charateristics, diabetes related factors, anthropometric factors were compared between non-carpal tunnel syndrome and carpal tunnel syndrome groups to identify the risk factors for carpal tunnel syndrome. RESULTS: Prevalence of carpal tunnel syndrome in diabetic patients was 16.2 % (43 subjects). Female, farming, wrist depth width ratio (>or=0.7) were associated with carpal tunnel syndrome in diabetic patients. In right hand, odds ratio was 12.82 (95% confidence interval: 2.97~55.3) in female, 5.15 (95% confidence interval: 1.17~22.7) in farming, 28.53 (95% confidence interval: 1.80~451.1) in wrist depth width ratio (>or=0.7). The similar results were also observed in left hand. CONCLUSION: The results suggest that occupation, sex, and anthropometric factor like wrist shape were more associated with carpal tunnel syndrome in diabetic patients than diabetes mellitus itself.

Comparison of Functional Recovery Status according to Rehabilitation Therapy in Stroke Patients

OBJECTIVE: To investigate the effect of rehabilitation therapy on functional recovery in chronic stroke patients. METHOD: Brunnstrom stage for neurologic recovery, modified Barthel index (MBI) for functional recovery, and possi bility of gait were assessed in 66 chronic stroke patients. MBI and possibility of gait were compared the patients who received rehabilitation therapy (Rehab patients) with the patients who did not receive rehabilitation therapy (non- Rehab patients) in each Brunnsrom stage. RESULTS: In Brunnstrom stage III, 13 of 15 Rehab patients could walk 10 m or more, but none of 7 non-Rehab patients could walk independently, and this difference was statistically significant. MBI score was also significantly higher in Rehab patients than non-Rehab patients (71.3 vs 18.9, p=0.000) in Brunnstrom stage III. In Brunnstrom stage IV, V, VI, MBI score and possibility of gait were higher in Rehab patients than non-Rehab patients, but not significant. CONCLUSION: We can confirm the effect of rehabilitation therapy on functional recovery, and this effect seems to be more decisive in neurologically low recovery status patients.

Carpal Tunnel Configuration Measured by Ultrasonography as a Risk Factor of Carpal Tunnel Syndrome in Motor Part Manufacturing Workers / 대한산업의학회지

OBJECTIVES: This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work. METHODS: The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later. RESULTS: Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ). CONCLUSIONS: Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.

Carpal Tunnel Configuration Measured by Ultrasonography as a Risk Factor of Carpal Tunnel Syndrome in Motor Part Manufacturing Workers / 대한산업의학회지

OBJECTIVES: This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work. METHODS: The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later. RESULTS: Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ). CONCLUSIONS: Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.

Wrist Ratio as a Risk Factor of Carpal Tunnel Syndrome / 대한산업의학회지

OBJECTIVES: To evaluate the risk factors of the carpal tunnel syndrome (CTS) and the impact of the wrist ratio on the prevalence of CTS in workers on repetitive work over a long term. METHODS: Study subjects consisted of 45 male and 16 female workers in a company that produces soundproof material in Gyeongju. We conducted a physical examination, a self-reported questionnaire survey and a nerve conduction study. CTS cases were defined as those subjects that had a positive finding in both the nerve conduction study and the physical examination done by a doctor specializing in rehabilitation medicine. RESULTS: Prevalence of CTS among the study subjects was 26.2/100 persons. The prevalence of CTS was positively associated with increasing age (p<0.01, using the chi-square test for trend) and female gender (OR=6.98, 95% CI=1.66-31.0), but was negatively associated with the educational level (p<0.01 by the chi-square for trend). Workers in the production area had a higher prevalence of CTS compared to those in the clerical area (OR=10.8 in the frame manufacturing process, OR=32.2 in the vacuum molding process). Patients with CTS had a narrower mean wrist width and a shorter mean hand and palm length, compared to those that had no disease (p<0.01 by the Student's t-test). The number of subjects who had a wrist ratio of 0.74 or more was significantly higher in cases of CTS (OR=4.0, 95% CI=1.01-16.3). However, a multiple logistic regression analysis showed only that the type of work was a significant variable after adjusting for the other variables. CONCLUSIONS: The wrist ratio, a surrogate of carpal tunnel configuration, can represent individual susceptibility to CTS. However this study shows that the use of the wrist ratio for predicting CTS risk is not adequate. The development of a new carpal tunnel configuration index based on more direct measurements of the tunnel shape will provide a better predictor of individual susceptibility to CTS.

Experimental Study on Carpal Tunnel Syndrome as a Cumulative Trauma Disorder

OBJECTIVE: To study the reaction of tissues in the carpal tunnel after repeated flexion of wrist in order to verify the pathophysiology and pathomechanism of the carpal tunnel syndrome as a cumulative trauma disorder. METHOD: Six groups of adult rabbits (5 rabbits were allocated to each groups) were exposed to repeated contractions of the wrist flexors by the median nerve stimulation at the elbow level for different durations; 2 days, 1 week, 2 weeks, 3 weeks, 4 weeks, and 5 weeks. Histological evaluation, morphometric analysis, and electrophysiological studies were carried out after the stimulation. RESULTS: There were no typical nor consistent findings in the tissues in the carpal tunnel except the median nerve. Inflammatory cell infiltration and edematous changes were noted in the epineurial tissue of median nerve. Decrease of large myelinated fibers and changes of fiber shape were observed in the median nerve. On the morphometric analysis, fiber diameter was smaller in groups of longer exposure duration. Changes were most prominent in 5 weeks group and in the periphery of the nerve fascicle in all the groups. Significant reduction of amplitude and increase of duration of compound muscle action potential were noted on electrophysiological study of the median nerve. CONCLUSION: The authors concluded that repeated experimental wrist flexion could give rise to an injury of the median nerve in the carpal tunnel. Accumulation of microtrauma of median nerve by epineurial edema and direct mechanical compression seems to be the pathomechanism of the carpal tunnel syndrome as a cumulative trauma disorder.

Prevalence of and Risk Factors for Carpal Tunnel Syndrome in a Rural Population

OBJECTIVE: The purpose of this study was to investigate the prevalence of and risk factors for carpal tunnel syndrome in a rural population in Korea. METHOD: Among the 1004 residents in a rural district who participated in the health examination, 450 (165 male, 285 female) adults aged between 30 and 79 years were randomly selected. Hand symptom questionnaire and electrodiagnostic studies were used to diagnose and classify carpal tunnel syndrome. General characteristics, female-related factors, work-related factors and anthropometric measurements were compared between normal and carpal tunnel syndrome group to identify the risk factors for carpal tunnel syndrome. RESULTS: Subjects with carpal tunnel syndrome were 76 (16.9%), symptom only subjects were 168 (37.3%), asymptomatic slowing 27 (6.0%) and peripheral polyneuropathy were 16 (3.6%). Age, farming, body mass index and wrist depth width ratio were associated with risk of carpal tunnel syndrome and odds ratio were 1.03 (95% confidence interval 1.01~1.07), 2.62 (95% confidence interval 1.17~5.86), 2.24 (95% confidence interval 1.14~4.40) and 3.13 (95% confidence interval 1.64~5.96), each. CONCLUSION: These data suggest that the prevalence of carpal tunnel syndrome is high in a rural population and physical factors like wrist shape and body mass index, occupation and aging are associated with risk of carpal tunnel syndrome.

Evaluation of Early Neurologic Abnormalities on the Workers Exposed to Acrylamide / 대한산업의학회지

OBJECTIVES: Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure. METHODS: Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done. RESULTS: The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2). CONCLUSIONS: The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.

The Significance of Anti-type I Collagen Antibody Titer in Occupational Low Back Pain

OBJECTIVE: To assess the significance of anti-type I collagen antibody titer in estimating cumulative trauma and predicting the presence of occupational low back pain. METHOD: Under the hypothesis that cumulative trauma on the spine will expose collagen and stimulate the formation of auto-antibody, we measured the serum anti-type I collagen antibody titers (IgM and IgG) in 408 male workers of a metal welding and manufacturing company. The antibody titers were measured in duplicates by ELISA. Statistical analysis was done to compare the titers according to occupational profiles (type of occupation and duration of employment) and clinical profiles (occurrence of low back pain, duration of low back pain and clinical impression). RESULTS: The anti-type I collagen IgG antibody titers were significantly increased in labor workers (n=357) in comparison with office workers (n=51)(p or =3 months)(n=8). CONCLUSION: These data suggest that anti-type I collagen IgM and IgG antibody may be useful in predicting the presence of occupational low back pain and estimating cumulative trauma, respectively.

Musculoskeletal Problems in Pregnancy

OBJECTIVE: To investigate the frequency, nature and risk factors of musculoskeletal problems in pregnancy. METHOD: We obtained the information through a questionnaire and physical examination of full-term (gestational age over 38 weeks) pregnant women. Prevalence, onset time, severity and risk factors of musculoskeletal problems were analyzed. RESULTS: Among the 70 pregnant women, 37 women (53%) complained of low back pain which was the most common musculoskeletal problem in pregnancy. Other problems were hand symptoms (31%), lower extremity joint pain (31%), leg cramp (29%), chest pain, shoulder pain and neck pain. Previous history of low back pain was significantly correlated with the occurrence of low back pain in pregnancy. Weight gain during pregnancy and amount of time of housework during pregnancy were significantly correlated with carpal tunnel syndrome. Pregnant women suffering from leg cramp were significantly old in age. CONCLUSION: Prevalence of musculoskeletal problems during pregnancy was relatively high and several risk factors were related with occurrence of those problems. So, prophylactic risk factor control would be necessary to reduce musculoskeletal problems during pregnancy.

Electrodiagnostic Study on Neuropathies in String Players

OBJECTIVE: To determine the frequency, involved nerves and sites of entrapment neuropathy in string players. METHOD: The subjects were 24 string playing musicians and age matched 24 normal controls. Questionnaire, physical examination were taken in the musicians and the electrodiagnostic study was performed in both the musician and the control groups. Electrodiagnostic study included nerve conduction study of median and ulnar nerves. The distal motor latency, segmental motor conduction velocity, distal sensory latency, and amplitude of sensory nerve action potentials were measured. Each parameter of nerve conduction study was compared in two groups and was correlated to the string playing duration. RESULTS: Three musicians (12.5%) were diagnosed as entrapment neuropathy: One, left ulnar neuropathy at the elbow and the wrist and left median neuropathy at the wrist; Two, left ulnar neuropathy at the elbow. Ulnar motor conduction velocity of right forearm segment and left elbow segment were significantly reduced in the musicians compared to those of the controls (P<0.05). The distal sensory latency of left ulnar nerve was significantly prolonged in musicians compared to that of the controls (P<0.05). The string playing duration significantly correlated with the distal motor latency of right median nerve (R=0.632, P<0.05) and the distal sensory latency of left median nerve (R=0.518, P<0.05). CONCLUSIONS: These results suggest that some entrapment neuropathies could be developed due to cumulative trauma in string players. Elbow and wrist segment of left ulnar nerve, forearm segment of right ulnar nerve are possible sites of entrapment neuropathy in string players.