MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)
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- Annals of Clinical Neurophysiology
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- v.4 no.2
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- pp.114-118
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- 2002
Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.
Objectives: This study was performed to review the research trends regarding the treatment of Postpartum Depression (P.P.D) in the Traditional Chinese Medicine (TCM). Methods: We searched articles in CNKI (China National Knowledge Infrastructure) from 2004 to 2013. Search key words were "产后抑郁症", "Postpartum Depression", and we selected 27 studies except for non-clinical studies, insufficient number of studies, unrelated studies and tests on animals. Results: We selected 27 articles with following results: 1) One study of Jadad Quality Assessment Scale score showed 3 points, 4 studies showed 2 points and 22 studies showed less than 1 point. Overall, the quality of the studies was low. 2) DSM - IV was frequently used as a diagnostic criteria and HAMD was mostly used as evaluation criteria. Diagnostic criteria and evaluation criteria were the same in HAMD and EPDS. 3) In TCM, there are various ways, such as herbal medicine, acupuncture, electro acupuncture, auricular acupuncture and/or massage to treat the postpartum depression. 4) The roots of Bupleurum falcatum Linne, Glycyrrhiza uralensis Fisch, Angelica gigas Nakai and Paeonia lactiflora Pall, the rhizome of Atractylodis macrocephala Koidz, the semen of Zizyphus jujuba Mill, the radix of Curcuma aromatica Salisb, the sclerotium of Poria cocos Wolf and the rhizomas of Cyperus rotundus L and of Cnidium officinale Makino are mainly used in the herbal medicine. BaekHoi (GV20) and Yindang (Ex-HN3) are mainly used in acupuncture points. 5) Most of the studies showed effective results. Some of the results were similar to those of the control groups which were cured by western medicine. Other results were better than those of control groups. Conclusions: Research on postpartum depression has been actively conducted in TCM and all studies showed effective results in the study group patients. Therefore, with this study, we hope to activate more clinical research on the treatment of patients in Korean traditional medicine.
There have been studies reporting the increase in student confidence in mathematics when using technology. However, past studies indicating a positive correlation between technology and confidence in mathematics do not explain why they see this positive outcome. With increased availability and easy access to the Internet in schools and the development of free online virtual manipulatives, this research was interested in how the use of virtual manipulatives in mathematics can affect students confidence in their mathematical abilities. Our hypothesis was that the classes using virtual manipulatives which allows students to connecting dynamic visual image with abstract symbols will help students gain a deeper conceptual understanding of math concept thus increasing their confidence and ability in mathematics. The participants in this study were 46 fifth-grade students in three ability groups: one high, one middle and one low. During a two-week unit on fractions, students in three groups interacted with several virtual manipulative applets in a computer lab. Data sources in the project included a pre and posttest of students mathematics content knowledge, Confidence in Learning Mathematics Scale, field notes and student interviews, and classroom videotapes. Our aim was to find evidence for increased level of confidence in mathematics as students strengthened their understanding of fraction concepts. Results from the achievement score indicated an overall main effect showing significant improvement for all ability groups following the treatment and an increase in the confidence level from the preassessment of the Confidence in Learning Mathematics Scale in the middle and high ability groups. An interesting finding was that the confidence level for the low ability group students who had the highest confidence level in the beginning did not change much in the final confidence scale assessment. In the middle and high ability groups, the confidence level did increase according to the improvement of the contest posttest. Through interviews, students expressed how the virtual manipulatives assisted their understanding by verifying their answers as they worked and facilitated their ability to figure out math concept in their mind and visually.
The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are(1) the problems encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purposes above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS : PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as 'pain control, OPD visits, diet-control problems' among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, 'OPD visits and knowledge deficit' would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under 50. 0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was 'very necessary' and 'somewhat necessary'. 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as