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The Effects of Glenohumeral Abduction Motion and Intra-articular Movement after Passive Caudal Gliding Mobilization in Frozen Shoulder Patients (상완와관절의 수동하방활주운동이 오십견환자의 외전운동과 관절 내 움직임에 미치는 영향)

  • Seo Jong-Hak;Bae Sung-Soo;Kim Chul-Yong
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.126-152
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    • 2003
  • The purpose of this study was to evaluate the value of passive caudal gliding mobilization of the glenohumeral joint on the range of motion (ROM) of active and passive abduction; to evaluate the value of pain relief through visual analogue scale (VAS); to evaluate the correlation between improvement of shoulder abduction and intra-articular movement measured by fluoroscopy in frozen shoulder patients. The subjects consisted of twenty-one patients with clinically diagnosed frozen shoulder (11 males, 10 females) between 40 and 63 years of age (mean age : 52.7 years). The traction and caudal gliding mobilization based on the convex-concave rule in the resting position and at end range of abduction was peformed for 15 minutes per day and was repeated 10 times during a 2 week period. The ROM of abduction was measured by goniometer and pain was measured by VAS. The intra-articular movement was measured by fluoroscope, Neurostar Plus TOP (Siemens, Germany). ROM measurements of each patient was acquired at pre-treatment, immediate post-treatment and 2 week post-treatment. Statistical analysis was performed using SPSS 10.0 for Windows software and data was analyzed using the paired-test and the pearson correlation. The results of this study are as follows: 1. There was a significant decrease of VAS between pre-treatment data and 2 week post-treatment data (P<.05) but no significant difference between pre-treatment and immediate post-treatment data (P>.05). 2. There was a significant increase in ROM of active and passive abduction in the pre-treatment data, immediate post-treatment data, and in 2 week post-treatment data (P<.05). 3. With regard to results of the joint play test, there was a significant difference in the grade of traction between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05). 4. With regard to results of the joint play test, there was a significant difference in the grade of caudal gliding between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05), 5. With regard to the results of fluoroscopic findings, there was a significant change of the glenohumeral joint space between pre-treatment data and immediate post-treatment data and between immediate post-treatment data and 2 week post-treatment data (P<.05). There was no significant change of the glenohumeral joint space between immediate post-treatment data and 2 week post-treatment data (P>.05). 6. With regard to the results of fluoroscopic findings, there was a significant change of acromiohumeral joint space between the three data (pre-treatment data, immediate post-treatment data, 2 week post-treatment data) (P<.05). 7. Mobility grade by joint play test was significantly increased and was correlated to improved ROM of active and passive abduction (P<.05). In this study of frozen shoulder, passive caudal gliding techniques of the glenohumeral joint results in statistically significant changes in active and passive abduction as well as in VAS. There is also a significant correlation between joint play test and ROM of abduction.

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The Effect of School Dental Service on Dental Health Knowledge, Beheaviors and Dental Health Status Among Elementary School Students (학교 구장보건실 운영이 초등학생들의 구강보건지식, 행태 및 건강상태에 미치는 영향)

  • Lee, Tae-Yong;Yun, Go-Eun;Kim, Kwang-Hwan
    • The Journal of Korean Society for School & Community Health Education
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    • v.10 no.1
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    • pp.87-104
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    • 2009
  • Objective: In this study, the dental health care knowledge, dental health behaviors and dental health status of elementary school students were compared and analyzed in the cases of their schools having dental health care center or not one. Methods: The target groups were 167 students of A school (experimental group) where pit-and-fissure sealants, fluoride mouthrinsing, and fluoride gel application were carried out with all grades of students by school dental health care center and 158 students of B school (control group) where fluoride mouthrinsing, for all grades students and pit-and-fissure sealants for the first grade students are carried out but have no the school dental health care center. Results: This study was carried out through the answer sheets and recordings of dental inspection. The findings of this study are as follows: 1. The dental health care knowledge was compared and the results showed that on average 14.2$\pm$2.1 in experimental group and 14.0$\pm$1.9 in the control group were no significantly different (p>0.05). 2. The dental health behaviors were compared and the results showed that the experimental group was significantly different(p<0.05) in terms of the number of times of dental brushing a day, the method of tooth brushing, the time of tooth brushing, the experience of tooth brushing with fluorine, the kinds of snacks and tooth brushing in school after lunch. But there was no significant difference(p>0.05) in the time of tooth brushing and the tooth brushing after eating snacks. 3. The DMF rate was compared and the results showed the significantly difference between the average experimental group and 53.8$\pm$5.0 in the control group(p<0.05). 4. The DMFT index was compared and the results showed the significantly difference between the average 0.6$\pm$2 in the experimental group and 1.4$\pm$1.6 in the control group(p<0.05). 5. The DMFI rate was compared and the results showed the significantly difference between the average 4.2$\pm$8.3 in the experimental group and 9.5$\pm$11.0 in the control group. (p<0.05). 6. The DT rate were compared and the results showed the significantly difference between the average 10.2$\pm$29.5 in the experimental group and 32.4$\pm$44.0 in the control group(p<0.05). 7. The FT rate were compared and the results showed the significantly difference between the average 88.5$\pm$31.0 in the experimental group and 67.5$\pm$44.0 in the control group(p<0.05). Conclusions: Based on the results, above there was no significant difference in dental health care knowledge between both the experimental and the control group. But we discovered that the experimental group is better than the other one in dental health care behaviors and dental health status. Therefore, we could conclude that the school dental health care center efficiently carried out the dental care and treatment. As school dental health care centers did not work out efficiently in terms of their educating on the dental health acre knowledge, the related programs to be developed and supported.

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The Role of Video-Assisted Thoracic Surgery in the Diagnosis and the Treatment of a Mediastinal Mass (종격동 병변의 진단 및 치료와 비디오 흉강경의 역할 -흉강경에 의한 종격동 병변 진단 치료-)

  • Baek, Hyo-Chae;Park, Han-Gi;Bae, Gi-Man;Lee, Du-Yeon
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.769-776
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    • 1996
  • The application of video-assisted thoracic surgery (VATS) in the examination of the thoracic cavity can be a new option in patients with mediastinal tumor because it provides outstanding visibility of the structures of the mediastinum. By clear viewing through the thoracoscope, a mediastinal tumor can be biopsied or resected, depending on the findings during an operation. We reviewed all patients who underwent curative or diagnostic operations from March 1990 to August 1995 under the impression of a mediastinal mass. The total number of patients were 113 with 59 males and 54 females. Group A underwent resection of tu or by thoracotomy(38 patients: 18 males, 20 females), and group B underwent resection of tumor by VATS (36 patients : 20 males and 16 females). Seven patients in group B were excluded because they underwent thoracotomy due to pleural adhesion or intra-operative bleeding ; therefore, the true VATS group numbered 29 cases. Group C underwent Iymph node biopsy by VATS(33 patients'16 males, 17 females), and group D(6 patients: 5 males, 1 female) underwent Iymph node biopsy through anterior mediastinotomy. The mean age in group A was 36.2 years compared to 41.3 years In group B. We compared operation time, frequency of injection for pain control, duration of chest tube insertion, postoperative hospital stay, and diagnostic yield. In group A, they were 164 minutes, 3.4 times, 5.2 days, and 11.3 days, respectively, in comparison to 152 minutes, 2 times, 4.7 days, and 8.3 days, respectively, in group B. These data revealed that the day of discharge was significantly shorter in group B (p valu : 0.03). In group C, the mean age was 45.8 years (range 1 ∼70). The operation time was from 30 to 335 minutes (mean 105), pain control was required from 0 to 15 times(mean 3.2), and a chest tube was needed for 1 to 36 days (mean 6.1). In group D, mean age was 53.3 years, operation time 121 minutes, pall control injec- tion frequency 2.6 times, and mean chest tube duration 10.5 days. The diagnostic yield in group C was 8 oyo compared to 100 oyo in group D although the number of patients in group D is small.

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Hospice and Palliative Care for Cancer Patients with Brain Metastases (전이성 뇌암 환자의 호스피스 완화의료)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.30-36
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    • 2005
  • Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

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Effect of cytokines in breast milk on infant during the first two-years of life (모유 내 사이토카인 함량과 2 년간 추적관찰 후 알레르기 발생)

  • Kim, Woo Kyung;Yoon, Hae-Sun
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.912-918
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    • 2007
  • Purpose : Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. Allergic disease (AD), including atopic eczema, asthma, allergic rhinitis, and food allergy is characterized by an imbalance between cytokines produced by distinct T-helper cell subtypes. The aim of the study was to investigate the concentrations of cytokines and chemokines that were involved in allergic reactions in breast milk from allergic and nonallergic mothers and then analyse the effect of breastfeeding duration on the prevalence of allergic disease in the age of two. Methods : The breast milk samples were collected from mothers with AD (n=88) and without AD (n=47). Breast milk was collected at the second day (colostrum) and four weeks later (mature milk).The level of Interlukine (IL)-4, IL-5, IL-6, IL-8, IL-10, IL-13, $TGF-{\beta}1$, $TGF-{\beta}2$, RANTES in breast milk were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits according to the manufacturer's instructions. Results : Mothers with AD had a higher concentration of IL-8 in colostrum compared with those without AD (P=0.021). But, $TGF-{\beta}1$ and $TGF-{\beta}2$ were higher concentrated in colostrum of mother without AD (P=0.013, P=0.001). Whereas concentrations of other cytokines were not significantly different between the two groups. There was no association between levels of cytokines and chemokines in the breast milk and allergic development during the first 2 years of life in the infants. Conclusion : The higher concentration of $TGF-{\beta}1$ and $TGF-{\beta}2$ in colostrum from non-allergic mothers may explain the protective effect. But, the higher concentrations of IL-8 in colostrum from allergic mothers may in part explain the controversial results on the protective effect of breastfeeding against allergic diseases. We conclude that there is no convincing evidence form a relation between cytokines in breast milk and allergic diseases in infants. Longer follow-up are necessary to evaluate the effects of breast milk components on AD.

Effects of 166Holmium and 166Holmium-chitosan Complex(166Ho-CHICO) on Normal Brain of Rats (홀뮴 및 홀뮴-키토산 복합체가 정상 백서 뇌에 미치는 효과에 대한 연구)

  • Sun, Jing He;Joh, Chul W;Ahn, Young Hwan;Park, Chan Hee;Shim, Chull;Park, Kyung Bae;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1309-1315
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    • 2000
  • Objectives : We performed an in vivo experiment to investigate the effect of $^{166}Holmium$ and $^{166}Holmium$-chitosan complex($^{166}Ho$-CHICO) on the normal brain of rats and to determine the sublethal dose of $^{166}Ho$-CHICO. Materials and Methods : $^{166}Ho$ is a beta and gamma ray emitter. $^{166}Ho$-CHICO is a novel radio-pharmaceutical complex with chitosan to facilitate the transport of $^{166}Ho$ obtained from Korea Atomic Energy Research Center(Taejon, Korea). It is in acidic form and becomes gel state at alkaline pH. One hundred and seventy consecutive rats were divided into four groups : $^{166}Ho$ treated(n=50), $^{166}Ho$-CHICO treated(n=57), saline treated(n=5) and chitosan treated(n=5) groups. $^{166}Ho$ and $^{166}Ho$-CHICO were injected into the rat brain stereotactically with various doses of 0.1mCi/$20{\mu}l$, 0.2mCi/$20{\mu}l$, 0.3mCi/$20{\mu}l$, and 0.4mCi/$20{\mu}l$ using an automated microinjector. Nuclear imaging, histopathological and hematological studies were performed in 10 rats in each group at 1 day, 3days, 7 days, 1 month and 3 months after the injections. Results : An infiltration of inflammatory cells and necrotic changes were noted in $^{166}Ho$ treated group at 1 week after the injection. A wedge-shaped tissue defect due to necrosis, lined with infiltrated glial cells in $^{166}Ho$ treated group and a cystic defect lined with reactive astroglial cells in $^{166}Holmium$-CHICO treated group at 3 months after the injection were observed. $^{166}Ho$ alone without chitosan leaked out and caused necrotic lesion on the cerebral surface but $^{166}Holmium$-CHICO treated group did not show this feature. As the dose of $^{166}Ho$ increased, the mortality rates were also increased. The mortality rate of the $^{166}Holmium$-CHICO group was higher than the $^{166}Ho$ treated group at a dose of 0.4mCi/$20{\mu}l$/300g. There was no detectable radioactivity due to the leakage or extravasation from the injected site of the brain on the scintigraphy performed at 1 hour, 24 hours and 48 hours after the injection. There was also no detectable activity of $^{166}Holmium$-CHICO in other organs including spleen, liver and kidney. Conclusions : $^{166}Ho$-CHICO did not leak out to the critical cortical surface of the brain from the injection site and induced radiation changes of the parenchyma around the injection site without cortical damage. The sublethal dose of $^{166}Ho$-CHICO for the normal brain in rats was determined to be 0.2mCi/$20{\mu}l$/300g.

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Medical Care Expenditure of Residents in Urban Poor Area (도시 영세지역의 가계 의료비지출)

  • Hwang, In-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.91-102
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    • 1993
  • This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered questionnaires completed by housewives. The survey was conducted from March 1 to May 31, 1992. The mean age was 31.1 years in the poor area and 37.1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The average monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%), while hospital and clinic(37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2.800 Won in the poor area and 6,300 Won in the control area.

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Predictive value of cobalt chloride solution for hypohidrosis with topiramate (약물 유발 소한증에서 cobalt chloride solution의 임상적 유용성)

  • Lee, Hyuk;Lee, Seung Hyun;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1180-1185
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    • 2006
  • Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children (과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계)

  • Kim, In-Kyoung;Kang, Jae-Heon;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.736-744
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    • 2007
  • Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Comparison of Nutritional Status of the Daejeon Metropolitan Citizens by Frequency of Eating Out (외식 빈도에 따른 대전시민의 영양상태 비교)

  • Suh, Yoon-Suk;Kang, Ji-Hyun;Kim, Han-Sook;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.171-180
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    • 2010
  • This study aims at investigating the health and nutritional status of the adults according to frequency of eating out. One day food intake data were collected by 24 hr recall dietary survey and body size, blood pressure and some blood lipids and other constituents were measured on 137 Daejeon metropolitan citizens 20 yrs old and above who visited Chungnam National University Hospital for physical examination during the period of December 6, to December 15, 2008. The frequency of eating out were categorized into four levels: less than once a week, once a week, 2-3 times a week, 4 times a week and above. Body mass Index, waist circumference, blood pressure, blood lipid, blood glucose, GPT and GOT did not showed any significant difference according to the frequency of eating out of the subjects. Though, systolic blood pressures and serum levels of total cholesterol and LDL-cholesterol showed a little tendency to be high in the subjects eating out 2-3 times a week. In the contrary, serum triglyceride level tended to be low in the same group. The subjects eating out 4 times a week and over took more total protein, animal protein, animal fat, phosphorus and vitamin $B_2$ than any other group. Also protein energy ratio was the highest in the group eating out 4 times a week and above and they took more animal food group, other food group, beverages teas and alcohols than other groups eating out. These results showed that higher frequency of eating out leads to higher intake of protein, fat, phosphorus, animal food groups and other food groups (oils, beverages, seasonings) and to lower intake of vitamin C and plant food groups. It, thus, suggested that the strategy for restaurant business is required to provide the menu substituted animal food by more plant food.