Postural Control Measures of Patients with Lower Back Pain Using Balance Master(R) System

OBJECTIVE: To evaluate that lower back pain would influence postural control ability. METHOD: Thirty-eight adults (18 men, 20 women) participated and were divided into two groups; the study (patients with lower back pain) group and the control (healthy adults) group. Postural control ability of participants was evaluated through the Balance Master(R) system. A total of seven measurements were analyzed to determine the difference between the study and control group. RESULTS: Patients with lower back pain demonstrated weight bearing patterns on the non-tender side, wider area of sway (degrees) under conditions (unilateral stance on firm surface with eye closed) in modified clinical test sensory interaction on balance (p<0.05). Wider area of turn sway (degrees) and long turn time (sec) during step/quick turn were demonstrated in patients with lower back pain (p<0.05). CONCLUSION: The results showed that patients with lower back pain was reduced in the postural control ability. Further studies about the effect of back exercise on postural control ability of patients with lower back pain should be carried out.

The Comparision of Effects between Stellate Ganglion Block and Oral Corticosteroid Therapy in Post-stroke Complex Regional Pain Syndrome

OBJECTIVE: To compare the therapeutic effects between stellate ganglion block and steroid therapy in post-stroke complex regional pain syndrome. METHOD: In this controlled study, thirty-eight patients with post-stroke complex regional pain syndrome were randomly divided into two groups. One group received a total of five repeated stellate ganglion block every three days and the other group received an oral corticosteroid therapy. Therapeutic effects were assessed before treatment, after fifteen days and thirty days in the each group and evaluated via volume of the involved hand, circumference of the middle finger, shoulder and hand pain score. RESULTS: In both groups, hand edema and circumference of middle finger were decreased after fifteen days and thirty days of treatment. However, the stellate ganglion block group showed more significant improvement in mean change of hand edema and circumference compared to the steroid therapy group. The hand and shoulder pain were also decreased significantly after fifteen days in both groups. In stellate ganglion block group, patients' pain kept decreased even after thirty days had passed since the treatment. However, in the other group who got the steroid therapy, there was no further decrease from the fifteenth day after the therapy. CONCLUSION: Although both treatment were effective in relieving symptoms of post-stroke complex regional pain syndrome, the stellate ganglion block was more effective. However, further controlled study is required.

Clinical Study of Acute Renal Failure / 대한내과학회지

OBJECTIVE: Acute Renal Failure is a clinical syndrome characterized by a sudden decrease in renal function which was previously normal. Despite advances in medical care, prognosis in ARF is variable according to the influence of demographic factors, severity of ARF, nature of disease causing ARF, coexisting disease, treatments applied, and complications. We studied the recent changes of clinical feature of ARF. METHODS: We studied retrospectively 245 patients with ARF who had been hospitalized at Kyung Hee University Hospital between February 1988 and March 1993. RESULTS: 1) Male to female sex ratio was 1.8 : 1, and the incidence was high in above fifth decade (67.8%). 2) Acute renal failure was classified, according to clinical background, into medical group 79.6% (195 cases) and surgical group 20.4% (50 cases), and oliguric group 40.8% (100 cases) and non-oliguric group 59.2% (145 cases). 3) Acute renal failure due to medical causes included ARF by hemorrhagic fever with renal syndrome (25.6%), drugs and chemicals (17.9%), sepsis (17.4%) and systemic infection (7.7%) etc. ARF due to surgical causes included ARF by multiple trauma (34%), various surgical procedures (30%), surgical sepsis (14%), burn (12%) etc. 4) During admission, the expired patients had more severe biochemical and clinical characteristics including high BUN and serum potassium (p<0.01), lower serum albumin (p<0,01) than those of survivor. 5) Infections as the cause of ARF were 107 cases (43.7%), which included hemorrhagic fever with renal syndrome 50 cases, sepsis 31 cases, urinary tract infection 7 cases and respiratory tract infection 6 cases etc. The most common infecting organism was Hantavizus (50.5%). There was a greater number of gram-negative organisms than gram-positive organisms (34.1% vs 9.9%). 6) The overall mortality rate in patients with ARF was 31.4Fo. The presumptive causes of death were underlying disease (59.7%) such as sepsis, acute poisoning, cardiogenic and hypovolemic shock, and respiratory failure (14.3%), hyperkalemia (9.1%), pulmonary edeme (6.5%), and metabolic aidosis (2.6%) in order of frequency. 7) The highest mortality rate was 42.6% in patients above 50 years old. Mortality rate in patients with ARF due to surgical causes (52.0%) was significantly high than that of medical causes (26.2%) (p<0.05). Among the expired patients, oliguric group was 72.7%. In conclusion, there have been major trends in the clinical features of acute renal failure in this study. Especially, significant increase in the number of elderly patients, non-oliguric patients, and medical causes such as hemarrhagic fever with renal syndrome or sepsis were observed. Survival rate significantly decreased with increasing age, in acute renal failure by surgical causes, in oligurie patients, and in the presence of complicating factors such as sepsis or shock.

A Case of Fascioliasis Diagnosed by ERCP / 대한소화기내시경학회지

Fascioliasis is a zoonotic disease caused by Fasciola hepatica, a liver fluke, for which human acts as an accidental host. Fascioliasis, while common in some tropical countries, is rare in Korea. Endoscopie retrograde cholangiopancreatography(ERCP) has been described in only a very few cases as a useful technique for the diagnosis of fascioliasis. We report a case of fascioliasis diagnosed by ERCP, after endoscopic sphinchterotomy adult worms were removed by Dormia basket.

Clinical Significance of Serum Concentration of Intercelluar Adhesion Molecule-1 in Patients with Acute and Chronic Liver Disease / 대한간학회지

BACKGROUND/AIMS: Recent studies, have examined the expression of adhesion molecules in liver inflammation, and the existence of soluble ICAM 1 in serum could be proved by ELISA. We maeasured s-ICAM 1 in patients with acute and ehronic liver disease to see the level of s-ICAM 1 can reflect degree of necroinflammation or progress of disease. METHOD: Serum levels of soluble forms of intercellular adhesion molecule 1(sIGAM 1) in 78 patients with acute and chronic liver disease including acute hepatitis B, CAH, C.'PH, post-necrotic and alcoholic liver cirrhosis, hepatoceliular carcinoma, toxic hepatitis were measured by enzyme-linked immunosorbent assays. RESULTS: 1) ICAM 1 semm levels in acute and chronic liver disease including acute hepatitis B(709.6+/-321.7 ng/L, p<0.001), C:AH(582.2+/-312.4 ng/L, p<0.001), CPH(357,8+/-135.0 ngL, p<0.044), postnecrotic livercirrhosis(716.2+/-348.0 ng/L, p<0.0001), alcoholic liver cirrhosis(763.3+/-48l.5 ng/L, p<0.009). Hepatocellular carcinoma(728.2+/-329.0 ng/L, p<0.002), toxic hepatitis(817.3+/-324.4 ng/l, p<0.0001) were signiticantly higher than that of healthy controLs(234.5+/-67.5 ng/L).2) In comparison with CPH we found significantly increased ICAM- 1 serum levels in CAH.(p=0.027) A significant correlation was found between the ICAM-1 serum level and the histologically graded inflammatory activity in CAH. 3) No correlation was found be1ween the ICAM l serum level aml the Child- Pugh classification in liver cirrhosis. 4) In comparison with chronic hepatitis we found signitcantly increased 1CAM 1 serum levels in liver cirrhosis(p = 0.001) , and in hepatocellular carcinoma(p = 0.0001). CONCLUSION: Soluble ICAM I serum level correlated well with ongoing necrointlammatory activity in acute and chronic hepatitis and also slCAM 1 can reflect disease severity in various chronic 1iver disease groups.