The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

Detorque values of abutment screws in a multiple implant-supported prosthesis / 대한치과보철학회지

PURPOSE: This study evaluated the detorque values of screws in a multiple implant-supported superstructure using stone casts made with 2 different impression techniques. MATERIAL AND METHODS: A fully edentulous mandibular master model and a metal framework directly connected to four implants (Branemark System(R); Nobel Biocare AB) with a passive fit to each other were fabricated. Six experimental stone casts (Group 1) were made with 6 non-splinted impressions on a master cast and another 6 experimental casts (Group 2) were made with 6 acrylic resin splinted impressions. The detorque values of screws (TorqTite(R) GoldAdapt Abutment Screw; Nobel Biocare AB) were measured twice after the metal framework was fastened onto each experimental stone cast with 20 Ncm torque. Detorque values were analyzed using the mixed model with the fixed effect of screw and reading and the random effect of model for the repeated measured data at a .05 level of significance. RESULTS: The mean detorque values were 7.9 Ncm (Group 1) and 8.1 Ncm (Group 2), and the mean of minimum detorque values were 6.1 Ncm (Group 1) and 6.5 Ncm (Group 2). No statistically significant differences between 2 groups were found and no statistically significant differences among 4 screws were found for detorque values. No statistically significant differences between 2 groups were also found for minimum detorque values. CONCLUSION: In a multiple external hexagon implant-supported prosthesis, no significant differences between 2 groups were found for detorque values and for minimum detorque values. There seems to be no significant differences in screw joint stability between 2 stone cast groups made with 2 different impression techniques.

The effects of polishing technique and brushing on the surface roughness of acrylic resin / 대한치과보철학회지

PURPOSE: This study evaluated the effect of polishing techniques on surface roughness of polymethyl methacrylate (PMMA), as well as the influence of light-cured surface glaze and subsequent brushing on surface roughness. MATERIALS AND METHODS: A total of 60 PMMA specimens (10x10x5 mm) were made and then divided into 6 groups of 10 each according to the polymerization methods (under pressure or atmosphere) and the surface polishing methods (mechanical or chemical polishing) including 2 control groups. The mechanical polishing was performed with the carbide denture bur, rubber points and then pumice and lathe wheel. The chemical polishing was performed by applying a light-cured surface glaze (Plaquit(R); Dreve-Dentamid GmbH). Accura 2000(R), a non-contact, non-destructive, optical 3-dimensional surface analysis system, was used to measure the surface roughness (Ra) and 3-dimensional images were acquired. The surface roughness was again measured after ultrasonic tooth brushing in order to evaluate the influence of brushing on the surface roughness. The statistical analysis was performed with Mann-Whitney test and t-test using a 95% level of confidence. RESULTS: The chemically polished group showed a statistically lower mean surface roughness in comparison to the mechanically polished group (P = .0045) and the specimens polymerized under the atmospheric pressure presented a more significant difference (P = .0138). After brushing, all of the groups, except the mechanically polished group, presented rougher surfaces and showed no statistically significant differences between groups. CONCLUSION: Although the surface roughness increased after brushing, the chemical polishing technique presented an improved surface condition in comparison to the mechanical polishing technique.

The Association between Unexplained Second-Trimester Human Chorionic Gonadotropin Elevations and Pregnancy Outcome / 대한산부인과학회잡지

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.

Carcinoma of the Cervix: Usefulness of Dynamic and Contrast-Enhanced T1-weighted MR Imaging in Assessing theDepth of Stromal Invasion

PURPOSE: The purpose of this study was to evaluate the usefulness of contrast enhancement in assessing thedepth of stromal invasion in patients with uterine cervical tumors by comparing dynamic and late contrast-enhancedT1-weighted MR imaging with T2-weighted MR imaging. MATERIALS AND METHODS: Of 58 surgically proven uterinecervical cancer patients, 31 in whom tumors were seen on MRI were included in this study. Using a 1.5 T magnet,T2-weighted contrast-enhanced dynamic, and T1-weighted MR imaging were performed. In each MR imaging sequence,tumor visualization, margin delineation, enhancement pattern and depth of stromal invasion were evaluated onsagittal images and were correlated with pathological findings of resected uterus, focusing on the depth ofstromal invasion. RESULTS: Surgical FIGO stages were IB1 in 20 patients, IB2 in three, IIA in six, and IIB intwo. A tumor was detected in 29 (94%) patients on T2-weighted images, in 26 (84%) on dynamic contrast enhancedimages, and in 28 (90%) on contrast enhanced T1-weighted images. The tumor demonstrated a clear margin in 22 (71%)patients on late contrast-enhanced T1-weighted images, in 21 (68%) on dynamic images, and in 13 (42%) onT2-weighted images. Correlated with pathologic findings, the depth of stromal invasion was overestimated onT2-weighted images in eight (26%) patients, and on dynamic and late contrast-enhanced T1-weighted images in three(10%) and three (10%) respectively. CONCLUSION: Tumor margins are clearer and the extent of tumors may be moreaccurately evaluated on dynamic MR and late contrast-enhanced T1-weighted imaging. These sequences thas seem to beuseful, and superior to T2-weighted imaging, for assessing the depth of stromal invasion in patients with cervicalcarcinoma.

A Clinical Study of Extraperitoneal Cesarian Section / 대한산부인과학회잡지

The safety and effectiveness of extraperitoneal C/S are controversial, so it has been performed for the purpose of training for selected cases . But we think this procedure have some benefit in selected cases. This study was based on retrospective investigation of 300 cases of extraperitoneal cesarean section among 332 cases at Eul Ji Medical hospital, during from January, 1995 to December, 1996. The results were as follows: 1. The most prevalent age distribution was seen in the age group of 26~30. 2. The indication for extraperitoneal cesarean section were dystocia(38.3%), previous cesarean section(32.6%), elderly primigravida(12.6%) in orders. 3. In the type of the anesthesia, general anesthesia was 70.7%, epidural anesthesia was 15% and spinal anesthesia was 14.3%. 4. The most common group of operation time was 36~40minute(34.3%). 5. The post operative complications and maternal morbidities were breast engorgement(21%), peritoneal opening(19.6%), endometritis(4.3%) in orders. 6. Of all cases, the blood transfusion rates was 6%. 7. The most common group of hospital stay was 5~6 days(82%). 8. In the body weight distribution of infants, the group of 3,000~3,499gm was the most common(80.7%). 9. Of extraperitoneal cesarean sections, cases of the 5minute Apgar score more than 7 were the most common(99%). 10. The most common failure factor was abdominal and pelvic 11. There was no maternal death case.

Lymphangitic Carcinomatosis of the Lung: Serial Changes on High-Resolution CT

PURPOSE: To present initial and follow-up HRCT findings of lymphangitic carcinomatosis of the lung. MATERIALS AND METHODS: Both initial and follow-up HRCT scans were obtained in 18 patients with lymphangitic carcinomatosis of the lung. After dividing the patients into two groups (with anticancer chemotherapy (n=12) and without chemotherapy (n=6), changes of pulmonary parenchymal abnormalities (percentile increase or decrease in the extent of each pattern) were assessed and compared on initial and follow-up HRCTs. RESULTS: Findings on initial CT were interlobular septal thickening (n=18) (smooth in 15 and mixed smooth and nodular in three), thickening of bronchovascular bundles (n=17), areas of ground-glass opacity (n=15), polygonal lines (n=15), and nodules (n=10). With chemotherapy, the finding of polygonal lines decreased by 20/3%, while findings of ground-glass opacity, bronchovascular bundle thickening, septal thickening, and nodules remained stable. Without chemotherapy, all CT patterns of abnormalities except nodules increased by 45-88%. In three patients who did not undergo chemotherapy, smooth interlobular septal thickening changed to nodular thickening. CONCLUSION: Lymphangitic carcinomatosis of the lung manifests initially as smooth thickening of the interlobular septae, bronchovascular bundle thickening,areas of ground-glass opacity, and polygonal lines, as seen on HRCT. Without chemotherapy, the extent of CT findings increases and there is a tendency for smooth septal thickening to change to nodular thickening. Chemotherapy induces improvement or cessation of the progression of CT findings.

Placement of Peripherally Inserted Central Catheters (PICC): The Upper Arm Approach

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.

Placement of Peripherally Inserted Central Catheters (PICC): The Upper Arm Approach

PURPOSE: To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access. MATERIALS AND METHODS: Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava. RESULTS: Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place. CONCLUSION: The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.