• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.82-86
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• 2018

Background: Although a common shoulder disease, there are no accepted classification criteria for frozen shoulder (FS). This study therefore aimed to evaluate the accuracy of the conventionally used FS classification system. Methods: Primary FS patients (n=168) who visited our clinic from January 2010 to July 2015 were included in the study. After confirming restrictions of the glenohumeral joint motion and absence of history of systemic disease, trauma, shoulder surgery, shoulder muscle weakness, or specific x-ray abnormalities, the Zuckerman and Rokito's classification was employed for diagnosing primary FS. Following clinical diagnosis, each patient underwent a shoulder magnetic resonance imaging (MRI) and blood tests (lipid profile, glucose, hemoglobin A1c, and thyroid function). Based on the results of the blood tests and MRIs, the patients were reclassified, using the criteria proposed by Zuckerman and Rokito. Results: New diagnoses were ascertained including blood test results (16 patients with diabetes, 43 with thyroid abnormalities, and 149 with dyslipidemia), and MRI revealed intra-articular lesions in 81 patients (48.2%). After re-categorization based on the above findings, only 5 patients (3.0%) were classified having primary FS. The remaining 163 patients (97.0%) had either undiagnosed systemic or intrinsic abnormalities (89 patients), whereas 74 patients had both. Conclusions: These findings demonstrate that most patients clinically diagnosed with primary FS had undiagnosed systemic abnormalities and/or intra-articular pathologies. Therefore, a modification of the Zuckerman and Rokito's classification system for FS may be required to include the frequent combinations, rather than having a separate representation of systemic abnormalities and intrinsic causes.

• The Korean Journal of Physiology
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• 제26권1호
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• pp.55-68
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• 1992

The effects of changes in extracellular $Na^+\;and\;Ca^+$ concentration on the membrane potential and contractility were studied in the antral circular muscle of guinea pig stomach in order to elucidate the existence and the nature of $Na^+/Ca^{2+}$ exchange mechanism. All experiments were performed in tris buffered Tyrode solution which was aerated with 100% $O_2$ and kept at $35^{\circ}C.$ The treatment of $10^{-5}$ ouabain was performed to induce intracellular $Na^+$ loading prior to the start of experiment. The results were as follows: 1. $Na^+$-free Tyrode or high $Ca^{2+}$-Tyrode solution hyperpolarized the membrane potential and induced contracture. The time course of contracture was similar to that of change in membrane potential. 2. The degree of hyperpolarization and the amplitude of contracture decreased in accordance with the increase of extracellular $Na^+$ concentration. 3. $Na^+$-free contracture was developed even after blocking the influence of intrinsic nerves by the pretreatment with atropine, guanethidine and TTX. 4. $Ca^{2+}$-channel blockers(D-600 or $Mn^{2+}$) and the blocker of intracellular $Ca^{2+}$ release from sarcoplasmic reticulum(ryanodine) did not suppress the development of $Na^+$-free contracture. And also, dinitrophenol had no effect on $Na^+$-free contracture. 5. Dose-response relationship between extracellular $Na^+$ concentrations and the magnitude of contractures showed a sigmoid pattern. The slope of straight line from Hill plot was 2.7. 6. In parallel with the increase of extracellular $Ca^{2+}$ concentration, the amplitude of contracture increased dose dependently and was maximum at 8 mM $Ca^{2+}$-Tyrode solution. 7. The relationship between extracellular $Ca^{2+}$ concentrations and the magnitude of contractures showed hyperbolic pattern. The slope of straight line from Hill plot was 1.1. From the above results, it is suggested that $Na^+/Ca^{2+}$ exchange mechanism exists in the antral circular muscle of guinea pig stomach and this mechanism affects the membrane potential electrogenically.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.9-18
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• 2017

Background: Short foot exercise (SFex) is often prescribed and performed in the sport and rehabilitation fields to strengthen intrinsic foot muscles. However, SFex is difficult to perform because of lack of feedback methods. Objects: The aim of this study was to compare the effects of SFex with and without electromyography (EMG) biofeedback on the medial longitudinal arch (MLA) of healthy individuals who maintained a static standing position. Methods: All participants (14 males and 12 females) were randomly divided into two groups (biofeedback and non-biofeedback groups). The EMG activity of the abductor hallucis (AbdH) and tibialis anterior (TA) and the MLA angle on the dominant leg side were measured with the participant in the standing position in the pre- and post-intervention conditions. The intervention session consisted of 15 minutes of SFex with (biofeedback group) or without (non-biofeedback group) EMG biofeedback. The groups were compared using two-way repeated measures analysis of variance. Results: The post-intervention activities of the AbdH muscle (p<.05) and the AbdH/TA ratio (p<.05) were significantly greater in the biofeedback group than in the non-biofeedback group. The activity of the TA (p<.05) and the MLA angle (p<.05) in the biofeedback group were significantly lower in the post-intervention condition than in the pre-intervention condition. Conclusion: The present findings demonstrate that the combination of SFex and EMG biofeedback can effectively facilitate the muscle activity of the AbdH and strengthen the medial longitudinal arch.

• The Korean Journal of Physiology
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• 제16권1호
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• pp.1-11
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• 1982

Force development of smooth muscle cells is directly regulated by the concentration of free calcium ions in the sarcoplasm, and the sarcoplasmic concentration of calcium ion can be modulated by electrogenic Na-K pump. The role of Na-K pump on vascular tone was studied in isolated rabbit renal artery. Helical strips of arterial muscle were prepared from left renal arteries. All experiments were performed in $HCO_3^--buffered$ Tyrode solution which was aerated with $3%CO_2-97%\;O_2$ mixed gas and kept at $35^{\circ}C$. In some experiments, rabbit was injected intraperitoneally $18{\sim}24$ hours prior to the experiments, with a large dose(5 mg/kg body wt) of reserpine, in order to eliminate the catecholamines present in intrinsic adrenergic nerve terminate. Treatment used in this experiment that inhibits Na-K pump was the exposure of strips to K-free Tyrode solution. Contractile response to K free Tyrode solution developed slowly and the time required for maximum contracture was $20{\sim}30$ minutes. This K-free contracture was rapidly relaxed by the addition of potassium to the bathing solution. No K-free contracture occurred in a Ca-free Tyrode solution. But contraction developed rapidly when calcium ion was added to the bathing solution after 30 minute exposure of the strip to Ca-free Tyrode solution. This contracture was completely inhibited by Ca-antagonist, verapamil. The K-free contracture was abolished by ${\alpha}-adrenergic$ blocker, phentolamine, as well as by the catecholamine depletion from adrenergic nerve terminals. Even in reserpinized strip, the exogenous norepinephrine-induced contraction in K-free Tyrode solution was rapidly suppressed by the addition of potassium ion. The results of this experiment suggest that K free contracture develops by norepinephrine release from adrenergic nerve terminals, while the relaxation of K-free contracture is induced by the activation of electrogenic Na-K pump.

• PNF and Movement
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• 제18권1호
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• pp.97-106
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• 2020

Purpose: This study aimed to determine the most effective way to facilitate the abductor hallucis muscle during PNF leg pattern-emphasized hallux abduction. Methods: The study recruited 18 healthy adults. All participants agreed voluntarily to take part in the study following an explanations of its purpose and procedures. They randomly performed the PNF leg pattern-emphasized hallux abduction variations in a hook-lying or sitting position. Activation of the abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and tibialis anterior (TA) muscles, and the ratio of AbH/AdH, were measured during PNF exercises using electromyography. One-way repeated ANOVA was used to compare the activation of foot intrinsic and extrinsic muscles during the four PNF exercises. Results: PNF leg pattern-emphasized hallux abduction using normal timing was significantly higher in TA compared to PNF leg pattern-emphasized hallux abduction using timing for emphasis, regardless of the starting position. The PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position was significantly higher in AbH than in other exercises. Although there was no statistically significant difference in the ratio of AbH/AdH, it was higher in the hook-lying position. Conclusion: PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position can be recommended as a method to optimize the activation of AbH and the ratio of AbH/AdH.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.219-223
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• 2014

During surgical procedures, unexpected material, including surgical instruments and tissue segments, may get lost in the surgical field. Most of these should be immediately removed to prevent further complications, such as vital organ irritation, infection, and inflammatory pseudo-tumor formation. However, it is not always easy to define the exact location of the foreign body, especially if the item is very small and/or it is embedded in the soft tissue of the head and neck region. Intraoperative real-time radiological imaging with C-arm fluoroscopy can be useful to trace the three-dimensional location of small and embedded foreign bodies in the oral and maxillofacial area. We describe an unusual case of an embedded micro-screw in the intrinsic tongue muscle that had been dropped into the sublingual space during a lower alveolar bone graft procedure. The lost foreign body was accurately identified with C-arm fluoroscopy and safely removed without any further complications.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.95-101
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• 1998

From march 1993 to march 1998, twenty consecutive transmetacarpal replantations and revascularizations were reviewed retrospectively. Nine patients sustained severe and diffuse crush injuries, four patients had local crush injuries, and seven suffered guillotine type amputation. Six replantations and fourteen revascularizations were performed. 76 of 81 replantable digits(93%) were salvaged. 15 patients required secondary surgery, 10 patients for tendon and joint scarring and 5 for nonunions or malunions. Intrinsic muscle function and pinch and grip strengths were weak or absent. According to Chen's grading system of functional return, 2(10%) were grade I, 6(30%) were grade II, 10(50%) were grade III, and 2(10%) grade IV. The follow-up period ranged from 6months to 46 months. Only 3 patients resumed his prior occupation(one as a supervisor); 2 were permanently disabled, 4 pursued new occupations as a manual worker, 1 were still in therapy. Only two of the manual laborers were able to return to their preinjury occupation. Despite these unacceptable functional results, all patients were satisfied with the surgery.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1990년도 춘계학술대회
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• pp.47-50
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• 1990

In this study, the degree of spectral transfer to lower frequency caused by accumulation of Latic acid inside the muscle is estimated the convintional dip analysis, zero-crossing method and FFT method have intrinsic errors and estimation problems in case of severe noise. The new spectral analysis method using "$2^{nd}$ order Maximum Entropy Method" was applied to estimate mean frequency and we confirmed that this new method yields fast and reliable estimation over the FFT method.

• Annals of Clinical Neurophysiology
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• 제13권2호
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• pp.87-92
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• 2011

Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy that occurs in the ankle. Previous studies reported that this disease was due to physiologic factors and structural lesions in the ankle or foot. The authors investigated the causative factors of TTS and their frequency via operative findings. The diagnostic value of MRI was also evaluated based on the concordance between the operative findings and the MRI findings. Methods: This study was performed in retrospective by using medical record of the patients who underwent operations with TTS from August 2003 to May 2010. Physical examination, nerve conduction study, and MRI were conducted on patients who visited department of neurology or orthopedic surgery due to pain and sensory abnormality of their ankle and foot. Results: 34 patients underwent the operation. Ganglion accounted for the largest portion of the operative findings. In addition, varicose veins, intrinsic foot muscle hypertrophy, tenosynovitis, and fascia thickening were mainly observed. Of the 34 patients, 33 patients underwent pre-operative MRI, of whom 18 patients showed MRI findings consistent with the operative findings. Conclusions: Space-occupying lesions accounted for the majority of the causative factors in TTS patients who underwent the surgical treatment. In this study, the MRI appeared useful for identifying causes of TTS.

• PNF and Movement
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• 제20권3호
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• pp.409-416
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• 2022

Purpose: This study compared and analyzed the contractility of the abductor hallucis (AbdH), an intrinsic foot muscle, between flat feet and normal feet during a movement control test (single-leg small knee band test) using ultrasonography. Methods: A total of 23 subjects with (n = 11) and without (n = 12) flatfoot were included in the study. Each subject performed the short foot exercises (SFE) with a single-leg small knee bend (SLSKB) test, which is a functional movement. An ultrasound device was used to collect data regarding the changes in the contractility of the AbdH. Results: Intergroup comparison showed that dorsoplantar thickness was significantly reduced at baseline and during the SFE with SLSKB in the flatfoot group (p < 0.05). Intragroup comparison showed that the cross-sectional area significantly improved when the SFE was performed with SLSKB in the control group (p < 0.05). Conclusion: In this study, it was observed that the AbdH had inadequate contractility during the SLSKB test in subjects with flatfoot; therefore, it is important to train the contraction of the AbdH via functional movements during clinical interventions for subjects with flatfoot.