Quantitative Sensory Test in Normal Adult

OBJECTIVE: To obtain normal data of quantitative sensory test (QST) in Korean adult. METHOD: The subjects were 85 normal adults aging from 30 to 69 years old, who had no abnormal sensory and neurologic problem. We performed following three QSTs on dominant side and one verbal questionnaire. 1) Semmes-Weinstein monofilament wire system (0.05 G, 0.2 G, 2 G, 4 G, 10 G, 300 G) for touch sensation, 2) Rydel-Seiffer Tuning Fork for vibration sensation, 3) TSA-2001 Thermal sensory analyser for thermal sensation, 4)University of Texas Subjective Peripheral Neuropathy verbal questionnaire. RESULTS: 1) Touch perception score measured with Semmes-Weinstein monofilament wire system, declined with age (p<0.01). 2) Vibration perception score measured with the tuning fork, declined with age in foot (p<0.01). 3) Warm sense and heat pain threshold measured with TSA-2001 thermal sensory analyser increased with age, and cold sense and cold pain threshold declined with age. 4) Weight showed negative correlation with vibration perception score in man's foot. CONCLUSION: Normal data of three sensory test obtained from this study could be used for the early detection of peripheral neuropathy or loss of "protective sensation".

Comparison of Gait Characteristics with Dynamic and Solid Ankle-Foot Orthoses in Children with Spastic Cerebral Palsy

OBJECTIVE: To investigate the effects of dynamic (hinged) and solid ankle-foot orthoses (AFO) on the gait characteristics in spastic cerebral palsied children and to find out which AFO has a more beneficial effect on correcting the abnormal gait pattern in those children. METHOD: The subjects were 40 children with spastic cerebral palsy (CP) who were able to walk independently without walking aids. Their ages were ranging from 2 to 12 years. Children were randomly prescribed to dynamic or to solid AFO. Twenty-four children got solid AFO and 16 children got hinged AFO. Gait characteristics were evaluated by computer based kinematic gait analysis while they were walking with AFO and on barefoot. Gait characteristics on barefoot and with hinged AFO and with solid AFO respectively were compared. RESULTS: Temporospatial parameters while walking on barefoot were not significantly different from those while walking with AFOs. While walking with hinged AFO, the maximal knee extension angle during stance phase was decreased in comparison with that on barefoot (p<0.05). Ankle dorsiflexion angle on hinged AFO was increased throughout the gait cycle (p<0.05). While walking with solid AFO, ankle dorsiflexion angle at initial contact, at 98% of gait cycle and at maximal ankle dorsiflexion angle in stance phase were increased in comparison with that on barefoot (p<0.05). There was no significant difference of changes after wearing orthoses between hinged and solid AFO. CONCLUSION: Both types of AFOs exerted a positive effect on ankle motion, not in knee or hip joints in the children with spastic cerebral palsy. The gait characteristics during walking with both AFOs were not significantly different, even if the hinged type might be more effective in preventing knee hyperextension in stance phase and in improving maximal ankle dorsiflexion during the swing phase.

Clinical Study of Nevus Anemicus / 대한피부과학회지

Nevus anemicus is a congenital anomaly characterized by pale macules of varying size and shape, and it is due to the increased sensitivity of blood vessels to catecholamines. However, the clinical features of nevus anemicus are not yet fully established. A clinical observation was made analyzing 26 cases of nevus anemicus over a 10-year period. Histopathological investigation in 6 cases, stain with Fontana-Masson in 4 cases, irradiation of ultraviolet B in 5 cases, digital infrared thermal imaging in 5 cases and color analysis using true-color imaging in 12 cases were also performed. The results were as follows: 1. The ratio of men to women was 1.2:1. The lesions were mostly(80%) present before the age of 18, but only 15% of the patients' lesions were present at birth. 2. The lesions were most frequently found on the face(33.3%) and neck(33.3%), followed by the chest(14.8%), lower extremities(7.4%) and back(7.4%). 3. Most patients(92.3%) had a single lesion. The extent of the lesions did not exceed 10% of the body surface area and the lesions did not show any progression or resolution. 4. The stainability of Fontana-Masson in nevus anemicus lesions showed no significant change compared with perilesional normal skin. 5. Irradiation of ultraviolet B ray(minimal erythemal dose to 80mJ/cm2) did not induce erythema on nevus anemicus lesions. 6. There was no significant temperature difference between nevus anemicus lesions and perilesional normal skin. 7. There was no significant correlation between chrominance and age. In conclusion, nevus anemicus in Korea shows the same incidence in both sexes, it usually arises at birth or childhood, but it may also develop later in life. Most patients show focal lesions that do not progress or resolve.

Foot screening technique in a diabetic population

Foot complications are a well known factor which contribute to the morbidity of diabetes and increases the chance of amputation. A total of 126 consecutive diabetic patients were evaluated by diabetic foot screening. Forty-one patients showed an impaired protective sense when tested with Semmes-Weinstein monofilament 5.07 (10 g), and 92% of them showed peripheral polyneuropathy in nerve conduction study (NCS). The mean vibration score of the Rydel-Seiffer graduated tuning fork in patients with peripheral polyneuropathy in nerve conduction (NCV) study was 5.38+/-2.0, which was significantly different from that of patients without polyneuropathy in NCS. Among the deformities identified on examination, callus, corn, and hallux valgus were the greatest. While checking the ankle/ brachial index (ABI), we also evaluated the integrity of vasculature in the lower extremities. After extensive evaluation, we classified the patients into eight groups (category 0,1,2,3,4A,4B,5,6). The result of this study suggested that the Semmes-Weinstein monofilament test, Rydel-Seiffer graduated tuning fork test, and checking the ankle/brachial index were simple techniques for evaluating pathologic change in the diabetic foot by office screening, and that this screening based on treatment-oriented classification helps to reduce pedal complications in a diabetic population

Effects of Therapeutic Exercise on Patients with Osteoarthritis of Knee

OBJECTIVE: To investigate the effect of therapeutic exercise on patients with osteoarthritis of knee in view of functional capacity. METHOD: The subjects were 80 patients with osteoarthritis of knee. Patients were randomly allocated to exercise or no exercise (control) group. Osteoarthritis was diagnosed on the base of clinical features, X ray findings. Therapeutic exercise was consisted of quad-setting exercise, isokinetic exercise, squatting exercise. Effects of therapeutic exercise were evaluated by muscle function, functioal performance and degree of pain. RESULTS: In exercise group, muscle function such as torque and endurance of extensor and flexor of knee were increased significantly compaired with control group (p<0.05). Increment was more apparent in extensor. In both group, pain was decreased but more apparent in exercise group (p<0.05). Functional performance was assessed in terms of dependency, difficulty and amount of pain. Exercise group showed improvement of functional performance in walking inside, climbing stairs (p<0.05) but control group did not show improvement. Seventy percent of patients with osteoarthritis of knee showed increment of body weight above 10 kg compaired with their twenties. CONCLUSION: When we manage the osteoarthritis of knee, therapeutic exercise should be included in the treatment regimen as well as physical and medical therapy.