• Title/Summary/Keyword: Chronic Patients

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The Diagnostic Usefulness of Stress Radiography in Chronic Lateral Ankle Instability (만성 발목 관절 외측 불안정성의 진단에서 스트레스 방사선검사의 유용성)

  • Kim, Yong-Min;Cho, Byung-Ki;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Park, Kyoung-Jin;Kim, Dong-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.35-40
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    • 2011
  • Purpose: This study was performed to evaluate the diagnostic usefulness of ankle stress radiograph for evaluation of chronic lateral ankle instability. Materials and Methods: Among patients undergoing the modified-Brostrom procedure, 42 cases with complete rupture of the anterior talofibular ligament were enrolled in this study. Sixty Korean adults (120 cases) were recruited as the control group. Radiologic measurement of talar tilt and anterior talar translation was performed through stress radiographs using Telos device. We obtained the normal range of Korean adults, and used as a standard value for judgment of mechanical instability. We analyzed the sensitivity, specificity, positive and negative prediction value of ankle stress radiograph. Results: On ankle stress radiograph, normal range of talar tilt angle and anterior talar translation was below $8.3^{\circ}$, below 7.6mm. Talar tilt angle on varus stress radiograph showed 57% of sensitivity, 97% of specificity, 89% of positive and 86% of negative prediction value. Anterior talar translation on anterior drawer stress radiograph showed 69% of sensitivity, 97% of specificity, 91% of positive and 90% of negative prediction value. Conclusion: Ankle stress radiograph had a good specificity, positive and negative prediction value for the evaluation of mechanical instability. However it underestimated the mechanical instability of ankle joint. It must be remembered that normal stress radiograph does not exclude ankle instability.

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Clinical research of Aqua-acupuncture effects on Rheumatoid arthritis (약침을 이용한 류마토이드 관절염에 대한 임상적 연구)

  • Park, So-Young;Koh, Kang-Hoon;Yoon, Min-Young;Jin, Kyong-Sun;Chang, Byoung-Sun;Km, Il-Du;Cho, Nam-Geun;Lee, Byong-Chul;Lee, Sam-Ro;Moon, Hyung-Cheol;Hwang, Woo-Jun;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.135-146
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    • 2002
  • Background and Purpose : This study shows the clinical effects on treatment with Rheumatoid arthritis using Aqua-acupuncture such as Ursi Fel Bovis Calculus and Cathami Flos that are known for which have anti-inflammatory and analgesic effects. Objective and Methods : This study has been carried out Aqua-acupuncture treatment such as Cathami Flos and Ursi Fel Bovis Calculus twice or three times a week with patients diagnosed as rheumatoid arthritis on 7 criteria of US Rheumatism Academy. Results : 1. If you see the sexual distribution, it shows the rates of male and female 1: 1.83. Age distribution shows as age ascend it shows high. 2. If you see the duration distribution, it shows chronic tendency in order of more than 6 months(63.3%), 2 to 5 months, and I month. 3. If you see the invaded distribution, it shows chronic tendency in order of hand(37 cases), wrist joint(34 cases), knee joint(32 cases), ankle joint(21 cases), elbow joint(16 cases), shoulder joint(14 cases), feet(14 cases), hip joint(9 cases), low back(6 cases), neck(4 cases). 4. Seeing the mean post-therapeutic index among groups on RA factor level distinction, it shows that 0-18(normal range) scored 89.0, 19-50 scored 94.8, 51-80 scored 101.2, 81-100 scored 97.3, 101-140 scored 102.4, above 141 scored 97.5. 5. Seeing the mean post-therapeutic index among groups on CRP level distinction, it shows that 0-0.4(normal range) scored 100, 0.5-1.0 scored 48.6, 1.1-2.0 scored 34.9, 2.1-3.0 scored 35.7, 3.1-4.0 scored 37.1, 4.1-5.0 scored 53.8, above 5.0 scored 70.4. 6. Seeing the mean post-therapeutic index among groups on ESR level distinction, it shows that 0-20(normal range) scored 48.6, 21-40 scored 57.5, 41-60 scored 59.2, 61-80 scored 59.2, above 81 scored 66.0. 7. If you see the satisfactory assesment after Aqua-acupuncture treatment such as Cathami Flos and Ursi Fel Bovis Calculus, Excellent is 11 cases, Good is 14 cases, and Moderate 5 cases. Conclusion : It will be better effects, if herbal medicine, moxibustion, and acupuncture are used together with Cathami Flos and Ursi Fel Bovis Calculus on rheumatoid arthritis as chronic inflammatory disease.

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The Effect of Kinesio Taping on the Change of Muscle Strength and Endurance in Trunk Flexion and Extension in Chronic Low Back Pain(CLBP) (만성요통 환자의 테이핑 적용 시체간의 굴곡과 선전의 근력과 지구력의 변화 측정)

  • Kim, Su-Hyung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.40-48
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    • 2005
  • In this study, the muscle strength and endurance of the lumbar at flexion and extension were determined using an isokinetic muscle strength meter (Biodex) in patients with chronic lumbar go (10 male and 10 females), and the changes in muscle strength and endurance of the lumbar at flexion and extension after application of Y-shaped sacrospinalis muscle taping, typically used for patient with lumbar go, were studied. In addition, the sacrospinalis muscle taping of a different shape (I-shaped taping) was applied bilaterally centering on the spine, and the muscle strength and endurance of the lumbar at flexion and extension were determined and compared with those before taping. In addition, the results after application of Y-shaped taping and I-shaped taping were also compared. 1. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio taping and after application of Y-shaped taping did not show the level of significance. 2. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and application of Y-shaped taping did not show the level of significance. The extensor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping did not show the level of significance. 3. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 4. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio taping and after application of I-shaped taping showed the level of significance. The extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 5. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $60^{\circ}$/ sec showed the level of significance (p<.05). 6. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not showed the level of significance (p<.05).

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A Case of Progressive FSGS and Chronic Kidney Disease in Congenital Chloride Diarrhea with SLC26A3 Mutation (선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 만성 신장병으로 발전한 사례)

  • Seo, Young-Jun;Cheong, Han Bin;An, Seok Min;Sin, Woo Cheol;Bae, Eun Joo;Yoon, Jong Hyung;Jeong, Hwal Rim;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.87-94
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    • 2018
  • We present the case of long-term observation of a patient with chronic kidney disease (CKD) caused by advanced focal segmental glomerulosclerosis (FSGS) resulting from underlying congenital chloride diarrhea (CLD). A 20-year-old woman was admitted for prolonged proteinuria despite conservative treatment for CLD. She was diagnosed with CLD and started taking KCl salt supplementation from the time of birth. Mild proteinuria was first found at 12 years of age, which progressed to moderate proteinuria at 16 years of age. At 16 years of age, CKD stage 2 with FSGS was diagnosed based on the initial assessment of the glomerular filtration rate (GFR) and kidney histology. On admission, we re-assessed her renal function, histology and genetic analysis. GFR had deteriorated to CKD stage 4 and renal histology revealed an advanced FSGS combined with tubulointerstitial fibrosis. A homozygous mutation in the SLC26A3 gene (c.2063-1G>T) was found by diagnostic exome sequencing and may have been inherited from both parents. CLD patients can be more vulnerable to renal injury, which may also cause progression of renal failure. Therefore, even if there is an early diagnosis and adequate salt supplementation, close monitoring of renal function and tailored treatment should be emphasized for renal protection and favorable CLD prognosis.

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A clinical study of systemic lupus erythematosus in children (소아에서 전신성 낭창의 임상적 고찰)

  • Kim, Ji Tae;Nam, Young Mee;Lee, Jae Seung;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.74-78
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    • 2007
  • Purpose : Systemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disease with complex clinical manifestations. It probably involves genetic, environmental and immunologic factors. In this study, we investigated the clinical manifestations, laboratory findings and prognosis of pediatric SLE to aid clinical care of pediatric SLE. Methods : The data of 45 patients who were diagnosed as pediatric SLE in Severance Children's Hospital from Jan. 1996 to Dec. 2005 were analysed retrospectively. Results : The mean age at diagnosis was 10.8 (0-15) years old. And the ratio of male to female patients was 1:4. The initial manifestations were facial edema (51.1 percent), malar rash (44.4 percent), and fever (28.9 percent). The ANA (97.8 percent), anti-ds DNA antibody (82.2 percent), lupus nephritis (71.1 percent), malar rash (71.1 percent), and cytopenia (66.7 percent) were the most common findings among the classification criteria by ACR (American College of Rhematology, 1997). Conclusion : Clinical manifestations and prognosis are various in pediatric SLE. Intensive studies of SLE in children should be continued for more effective treatment.

Clinical Analysis of Arteriovenous Fistula Using Perforating Vein on Antecubital Fossa (팔 오금에서 시행한 관통정맥을 이용한 동정맥루 조성술의 임상적 고찰)

  • Choi, Kwang-Ho;Yoon, Young-Chul;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.642-647
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    • 2010
  • Background: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. Material and Method: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. Result: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. Conclusion: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.

Comparison of the effect of Action Observational training and Task-oriented training on Upper Limb Function and activities of daily living in People with Chronic stroke (만성 뇌졸중환자의 상지 기능 및 일상생활동작에 동작관찰훈련과 과제지향훈련의 효과 비교)

  • Bang, Dae-Hyouk;Kang, Tae-Woo;Oh, Duck-Won
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.409-416
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    • 2012
  • This study aimed to compare the effectiveness of action-observational training and task-oriented training on upper limb function and activities of daily living in patients with post-stroke hemiparesis. This study included 12 voluntary participants with post-stroke hemiparesis. Subjects were randomly assigned to either group 1 or group 2, with 6 in each group. Each subject completed the crossover experiment that comprised of action-observational training (A) and task-oriented training (B). The intervention sequence was A-B for the group 1 and B-A for the group 2. Each training was performed for 30 min a day, 5 times a week for 2 weeks (total experimental period of 4 weeks). Assessments were made using the Wolf Motor Function Test (WMFT) and Modified Barthel Index (MBI) thrice: at baseline, after 2 weeks of intervention, and after 4 weeks of intervention. The results showed that the WMFT and MBI scores significantly improved after the completion of each training (p<.05). Therefore, a determination of the superior training method was difficult. The effect sizes of both groups were greater when performed the action-observational training. The findings suggest that both the action-observational training and task-oriented training may be helpful in improving the upper limb function and activities of daily living for patients with post-stroke hemiparesis, and support the clinical feasibility of the action-observational training.

Crosstalk between EGFR and p53 in Hepatocellular Carcinoma

  • Cioca, Andreea;Cimpean, Anca;Ceausu, Raluca;Fit, Ana-Maria;Zaharie, Teodor;Al-Hajjar, Nadim;Puia, Vlad;Raica, Marius
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8069-8073
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    • 2014
  • Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers worldwide, with a high mortality. Most patients present with late stage disease, when the treatment options are limited to systemic chemotherapy. The purpose of our study was to evaluate the significance of p53 and EGFR expression in HCC, and to determine whether these two markers correlate with conventional parameters of prognosis. Materials and Methods: Our study included a total of 45 patients, diagnosed histopathologically with HCC. Clinicopathological data including sex, age, tumor necrosis, tumor size, histologic grading, tumor stage, the presence of cirrhosis and chronic hepatitis, were recorded from the Institute database. Three independent microscopic fields were selected for each sample and all the tumor cells within each microscopic field were counted, and then the positive percent of p53 cells were calculated. Three staining patterns were recognized: diffuse, heterogenous and focal. The intensity of EGFR staining was scored on a scale of 0-3+: 0 no staining; 1+ when a weak membrane staining was observed; 2+ when membrane staining is more intense than in 1+, but less than 3+, and 3+ when intense dark brown staining delineated the membrane. To determine the relationship between EGFR expression and p53, we performed double staining in the same HCC specimens. Results: By immunohistochemical staining, p53 protein was detected in tumor cell nuclei in 20 HCCs (44%). We found a significant correlation between the intensity of p53 expression and the histological grade (p=0.008). EGFR expression was detected in 17 (38%) cases, linked to histological grade (p=0.039). Moreover, the intensity of p53 expression was significantly correlated with EGFR intensity (p=0.014). Conclusions: Our results suggest that overexpression of p53 and EGFR plays an important role in hepatocarcinogenesis and contributes to more advanced disease. These markers are not only valuable predictors of prognosis in HCC, but they are also rational targets for new anti-tumor strategies.

A Case of a 2-year-old Girl with Type I Gaucher Disease Presenting with Growth Retardation and Leg Pain (2세 여아에서 성장 부진과 다리 통증을 동반한 1형 고셔병 증례)

  • Park, Yesul;Hwang, Jae-Yeon;Hwang, Eun Ha;Cheon, Chong Kun;Lee, Beom Hee;Yoo, Han-Wook;Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.2
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    • pp.63-68
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    • 2017
  • Gaucher disease (GD) is caused by the deficiency of glucocerebrosidase. In pediatric patients with GD, especially Type I GD, enzyme replacement therapy (ERT) can reduce the hepatosplenomegaly and improve the hematologic finding and growth velocity. Herein, we report a 2-year-old girl with Type I GD presented with hepatosplenomegaly, bone pain and growth retardation. A 2 year-old-girl was referred to our hospital due to severe hepatosplenomegaly and growth retardation. She suffered from both leg pain and chronic fatigue. Simple x-ray showed widened distal long bones like that of an 'Erlenmeyer flask' which is associated with GD. The laboratory test showed anemia and thrombocytopenia. The enzyme activity was markedly reduced and the direct sequencing of the GBA gene showed the compound heterozygous mutations, p.G46E and p.L444P. As the G46E have been considered as the protective gene against neuronopathic genotype, we could assess the Type I GD in this patient. After one year of ERT, the growth velocity became 11 cm per year. Bone pain and fatigue disappeared. The volume of liver and spleen was reduced from $683cm^3$ and $703cm^3$ to $590cm^3$ and $235cm^3$, respectively. Although GD is an extremely rare disease in Korea, growth retardation and bone pain in children are the important signs which lead to early detection of GD and a simple radiologic finding is helpful to assess the GD at outpatient clinic. We highlight that the early diagnosis and early ERT is important for good growth and outcome for pediatric patients with GD.

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The effect of chlorhexidine on reduction of viable organisms in aerosol produced by ultrasonic scaler (클로르헥시딘이 초음파 치석제거기에 의해 발생된 에어로졸 내 세균 수에 미치는 영향)

  • Son, Woo-Kyung;Shin, Seung-Yun;Kye, Seung-Beom;Yang, Seung-Min
    • Journal of Periodontal and Implant Science
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    • v.39 no.3
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    • pp.303-310
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    • 2009
  • Purpose: The aerosol generated by ultrasonic scaler can contain bacteria or virus which can penetrate into body through respiratory systems of dentists, dental hygienist or patients. The aim of this study is to evaluate the effect of chlorhexidine digluconate as preoperative mouthrinse or lavage for ultrasonic scaler on the reduction of viable organisms in aerosol produced during periodontal treatment using ultrasonic scaler. Methods: 30 patients with moderate chronic periodontitis were included and divided into 3 groups: Control (no preoperative mouthrinse and tap water as lavage), CHG (preoperative mouthrinse with 0.1% chlorhexidine digluconate and tap water as lavage), CHL (no preoperative mouthrinse and 0.1% chlorhexidine digluconate as lavage). Each patient received scaling or subgingival curettage for 30 min. In CHG group, mouthrinse with chlorhexidine digluconate was performed for 1 min. before treatment. Before, during and after scaling or subgingival curettage, air sampling was performed for 7 min. each (1000 L/7 min.) with trypticase-soy agar plate. Agar plates were incubated in $37^{\circ}C$ aerobically. The numbers of colony-forming units (CFU) were counted and compared. Results: The numbers of CFUs of the samples obtained during treatment were $97{\pm}14.0$ in control, $73.1{\pm}14.9$ in CHG group and $44.5{\pm}9.0$ in CHL group. The difference among the 3 groups was determined to be statistically significant (one-way ANOVA with Bonferroni's correction, p-value: 0.0003). In contrast, the numbers of CFU of samples obtained before and after treatment were not significantly different among the groups. Conclusions: Chlorhexidine digluconate used as preoperative mouthrinse or lavage for ultrasonic scaler can reduce the microorganisms in aerosol produced during periodontal treatment using ultrasonic scaler. Less number of microorganisms were detected when chlorhexidine was used as lavage for ultrasonic scaler.