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MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • 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.

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Capstone Design Trail in Nursing Education and Its Outcome (간호학에 적용한 캡스톤 디자인의 적용사례 및 결과)

  • Moon, Kyoung-Ja
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.194-202
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    • 2017
  • This study is a methodological study analyzing the results of applying capstone design to nursing education. Among the nursing college students who completed the fundamental nursing subject, the students who agreed to participate in the research were composed of the project team and proceeded as team activities. It was conducted through knowledge - team composition - topic selection / analysis - design / development - simulation - evaluation / feedback process starting from knowledge learned through fundamental nursing class. The research period was from January 1, 2015 to October 30, 2015 for 6 months. BBS (Bed Sore Socks) was developed for the prevention of pressure ulcers, and BBS was applied for seven days to randomly selected patients in the long term care facility. The incidence and pressure ulcer risk scores were assessed. The results of the pilot study showed that the intervention group had an effect on the incidence of pressure ulcer ($x^2=.40$, p = .500) and the pressure ulcer risk score (z = -.45, p = .690), but it was not statistically significant. Capstone design was trailed in the field of nursing education and produced the bed sore socks. In the nursing education, not many capstone design trails appeared yet, this study might be the first trail in the field of nursing, and it could be challenging for expanding of nursing education.

A Study on the Patient's Attitude of Korean Medicine by Social Classes (계층별 한방의료 이용 실태에 관한 연구)

  • Lee, Han-Wool;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.71-86
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    • 2007
  • This study aims at looking into the use of oriental medical services in treating disease and patient's attitude of oriental medicine by social classes. The first to be explored through this study is medical accessibility, classifying them by age, gender and job. Second is to examine kinds of oriental medical services and expenses incurred in treating the disease. Third is to compare satisfaction for the services offered and investigate into relations between disease and oriental medicine through cross-analysis by class, and provide fundamental materials for enhancing accessibility to oriental medical centers for treating chronic diseases. The 1,376 households for the period of time from Apr. to Jun. 2005, were asked to answer to the questionnaires offered. The conclusion from the survey can be summarized as follows. Medical services for the onset of disease were less offered to females, older group, low schooling, and low-income bracket. It is attributable to an economic cause, in both genders. The in- and outpatients' rate were found higher in groups of female, older age, low-income and blue-color workers. Use of oriental medical centers were higher in outpatients than inpatients probably for low-income brackets were less frequently put on regular physical checkups, more exposing to diseases. Each hospitalization was found over six days longer in average; 19.7 days for oriental medical hospitals, 12.5 for hospitals. The hospital charges that patients should pay for one hospitalization showed 909,000 won in oriental medical hospitals, much higher than 518,000 won in hospitals. Outpatients were also found to pay more for oriental medical services; 55,000 won for oriental medical hospitals, 19,000 for hospitals. As to outpatients' satisfaction, oriental medical hospitals were generally found to be a little more satisfactory than general hospitals; 11.2% of respondents answered Very Satisfactory. Satisfaction to services offered to outpatients showed 82.2% of respondents responded to Over Satisfactory for herb clinics, 76% for general hospitals. For future intention to use oriental medical services, females, over 51 years old, lower education and income, and blue color workers showed more intention to use them. To be more competitive in treating chronic diseases, it is necessary that oriental medical services become more accessible through extending its coverage of insurance into more medical herbs and their prepared packs, as well as mapping out extensive publicity strategies to make known to the public about high efficacy of medical herbs and their safety.

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Enhanced Expression of TREK-1 Is Related with Chronic Constriction Injury of Neuropathic Pain Mouse Model in Dorsal Root Ganglion

  • Han, Hyo Jo;Lee, Seung Wook;Kim, Gyu-Tae;Kim, Eun-Jin;Kwon, Byeonghun;Kang, Dawon;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Biomolecules & Therapeutics
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    • v.24 no.3
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    • pp.252-259
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    • 2016
  • Neuropathic pain is a complex state showing increased pain response with dysfunctional inhibitory neurotransmission. The TREK family, one of the two pore domain $K^+$ (K2P) channel subgroups were focused among various mechanisms of neuropathic pain. These channels influence neuronal excitability and are thought to be related in mechano/thermosensation. However, only a little is known about the expression and role of TREK-1 and TREK-2, in neuropathic pain. It is performed to know whether TREK-1 and/or 2 are positively related in dorsal root ganglion (DRG) of a mouse neuropathic pain model, the chronic constriction injury (CCI) model. Following this purpose, Reverse Transcription Polymerase Chain Reaction (RT-PCR) and western blot analyses were performed using mouse DRG of CCI model and compared to the sham surgery group. Immunofluorescence staining of isolectin-B4 (IB4) and TREK were performed. Electrophysiological recordings of single channel currents were analyzed to obtain the information about the channel. Interactions with known TREK activators were tested to confirm the expression. While both TREK-1 and TREK-2 mRNA were significantly overexpressed in DRG of CCI mice, only TREK-1 showed significant increase (~9 fold) in western blot analysis. The TREK-1-like channel recorded in DRG neurons of the CCI mouse showed similar current-voltage relationship and conductance to TREK-1. It was easily activated by low pH solution (pH 6.3), negative pressure, and riluzole. Immunofluorescence images showed the expression of TREK-1 was stronger compared to TREK-2 on IB4 positive neurons. These results suggest that modulation of the TREK-1 channel may have beneficial analgesic effects in neuropathic pain patients.

The Incidence Rate of Coronary Heart Disease in City Area (도시지역의 관상동맥질환 발생률 조사)

  • Chun, Byung-Yeol;Kim, Kwon-Bae;Kim, Kee-Sik;Kim, Young-Jo;Kim, Yoon-Nyun;Kim, Chang-Yoon;Park, Wee-Hyun;Shin, Dong-Gu;Shim, Bong-Sub;Lee, Jong-Joo;Lee, Choong-Won;Chang, Sung-Gug;Jun, Jae-Eun
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.395-403
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    • 1998
  • To estimate the incidence rate of coronary heart disease in Korea, of all residents in Taegu city aged 25 or above, those who had an acute MI or a fatal coronary event between 1 July 1996 and 30 June 1997 were registered. Seven hundreds and eight patients were registered during the study period(685 were identified at hospital and 23 were autopsy cases). Age-standardized annual incidence rate of men in city area was 93 per 100,000(95% CI; 61-142) and 35% CI; 16-67) in women(100 in men and 20 in women aged 35-64). The incidence was rapidly increased after age 40 in men, however, in women after age 60. Twenty-eight-days case fatality rate was 45% in men and 47% in women. However, in the age group of 45-59 case fatality rate in women was two times higher than that in men. In conclusion, crude annual incidence rate of CHD in city area was 73 per 100,000 in men and 33 in women. The age-standardized annual incidence of CHD in men(93 per 100,000) was 2 times higher than that in women (33 per 100,000) in Korea.

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Present Status and Future Aspects of Radiation Oncology in Korea (방사선 치료의 국내 현황과 미래)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.211-216
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    • 2006
  • $\underline{Purpose}$: An analysis of the infrastructure for radiotherapy in Korea was performed to establish a baseline plan in 2006 for future development. $\underline{Materials\;and\;Methods}$: The data were obtained from 61 radiotherapy centers. The survey covered the number of radiotherapy centers, major equipment and personnel. Centers were classified into technical level groups according to the IAEA criteria. $\underline{Results}$: 28,789 new patients were treated with radiation therapy in 2004. There were 104 megavoltage devices in 61 institutions, which included 96 linear accelerators, two Cobalt 60 units, three Tomotherapy units, two Cyberknife units and one proton accelerator in 2006. Thirty-five high dose rate remote after-loading systems and 20 CT-simulators were surveyed. Personnel included 132 radiation oncologists, 50 radiation oncology residents, 64 medical physicists, 130 nurses and 369 radiation therapy technologists. All of the facilities employed treatment-planning computers and simulators, among these thirty-two percent (20 facilities) used a CT-simulator. Sixty-six percent (40 facilities) used a PET/CT scanner, and 35% (22 facilities) had the capacity to implement intensity modulated radiation therapy. Twenty-five facilities (41%) were included in technical level 3 group (having one of intensity modulated radiotherapy, stereotactic radiotherapy or intra-operative radiotherapy system). $\underline{Conclusion}$: Radiation oncology in Korea evolved greatly in both quality and quantity recently and demand for radiotherapy in Korea is increasing steadily. The information in this analysis represents important data to develop the future planning of equipment and human resources.

CD11b as a Biomarker for Canine Systemic Inflammatory Response Syndrome and Sepsis (개 전신성염증반응증후군 및 패혈증의 진단적 표지자로서 CD11b의 활용)

  • Yu, Do-Hyeon;Noh, Dong-Ho;Song, Ru-Hui;Kim, Jun-Hwan;Lee, Da-Mi;Kim, Sue-Hee;Park, Chul;Park, Jin-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.627-630
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    • 2010
  • The aim of this study is to investigate neutrophil activation markers among canine ICU (intensive care unit) control, systemic inflammatory response syndrome (SIRS) and sepsis. These markers include WBC (white blood cells), platelets counts, blood film examination (neutrophilic band to segmentation ratio and neutrophilic degenerative changes), and flow cytometric analysis (CD11b expression of neutrophils). As a result, the mean CD11b fluorescence intensity of neutrophils and the neutrophilic degenerative change scores were both significantly higher in sepsis group (P<0.05). In addition, mortality was also found to be correlated with the up-regulation of CD11b expression in circulating neutrophils. This study demonstrates that CD11b expression of neutrophils could be more a reliable biomarker to predict prognosis in ICU patients than traditional blood film examination according to this study.

Statistics of Poison Exposure in Korea (국내중독현황)

  • Hwang Jung-Yun;Ko Jae-Ook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.59-64
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    • 2003
  • Objective: This study was conducted for the nationwide statistical survey of poison exposure to provide the rationale for establishing and developing the poison control center (PCC) in Korea. Design: Study group for Korea PCC in National Medical Center reviewed the medical literature on poison exposure of Korea from death reports of National Statistical Office (NSO), the toxic exposure statistics from the report of National Health Insurance Corporation (NHIC), and poison related data from 119 ambulance services (FD) for the purpose of obtaining the poison and its related data. We also conducted questionnaire from the expert who work in emergency medicine department at the designated 320 emergency medical centers in Korea for the preparedness and acknowledgement about necessity of PCC and their need for that. Results: We reviewed the reliable data from the death report of NSO, poison exposure data from NHIC, and running report from FD. Poisoning death occured at home ($36.7\%$) and hospital ($46.3\%$). Poisoning are more common in rural area than the city area. Patients were seen more frequently in the local clinics than in any hospital. The drugs ($45.7\%$) and pesticide ($18.1\%$) are common poison. Common place to poison exposure were residential area ($39.9\%$), industry ($9\%$). mass residential area ($7\%$). and farm ($6\%$). The education level were primary school ($33.2\%$), high school ($23.7\%$), and middle schol ($21.3\%$) in order. We have to provide the poison guideline for lay public to understand easily, and for medical experts. The medical facilities need to be invested and have more interest for toxicology. All medical staff who work in the designated emergency medical center want PCC to establish. They want to have poison information from hospital ($91.3\%$), regional poison information center ($45.0\%$), regional poison control center ($52.5\%$), nationwide poison information center ($48.8\%$), nationwide poison control center ($46.25\%$), as a role of poison control center. They also want that pcc have poison epidemiologic study and statstics, training program for the experts, registration of rare case of posion on website, reflection of policies to activities for antidote production etc., speedy consultation system for poison analysis, public education, establishment of both regional and national pee, etc. Conclusion: Poison center must be established to provide poison information for all the public and medical experitise, focusing rural area and private clinic, to detoxify, to reduce the cost, time, morbity, and mortality through the whole country.

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Changes of Risk factors of Metabolic Syndrome among the Elderly in the Rural Area after Two Years (농촌지역 노인에서 대사증후군 위험인자의 2년 후 변화)

  • Oh, Suk-Hee;Kim, Ha-Jeong;Sohn, Seok-Joon;Sim, Jeong-Sin
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.36-45
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    • 2010
  • Objectives: This study was performed to examine the healthy lifestyle influenced on the metabolic syndrome among the elderly in the rural area. We examined the changes of risk factors of metabolic syndrome after two years. Method: Out of 134 who did health screening at the J county health center from July 1 to August 31, 2006, 65 aged people confirmed to metabolism syndrome were selected as subjects. For the final analysis, 62 aged people who revisited after two years were selected our subjects. The data were analyzed using SPSS PC+ 12.0 program for descriptive, Chi-square test, t-test and ANOVA analysis. Result: The result of this study indicated that 62 metabolic syndrome patients in 2006 decreased into 53, and women were higher than men. The difference in the metabolic syndrome came from level of education, smoking, health practices, and past illness history. Conclusion: Therefore, the change of lifestyle needs to be induced by the level of education, and for the group of smoking, non-exercise, and past illness history not only regular checkups to prevent metabolic syndrome but also education to have interest on themselves may need intensively.

Tissue conditioner in edentulous patients, depending on the time and the thickness of the changes affect the dimensional stability (무치악 환자에서 조직양화제(tissue conditioner)가 시간과 두께에 따라 체적안정성의 변화에 미치는 영향)

  • Shim, Youn-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3794-3801
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    • 2010
  • This study evaluated the linear dimensional changes with the factor of time and thickness using of three commercially available tissue conditioners (Coe-Comport, Visco-Gel, Soft-Liner). The thickness of materials were changed (1.5mm, 3.0mm) and the percentage changes in dimension were measured at 1h(baseline), 12h, 24h, 3 days and 7days after specimen preparation. The obtained data were analyzed by ANOVA with the SAS/PC statistical package. From the results, large differences appear between the various tissue conditioners. The results suggested that the period recommended for forming functional impression would be 36h to 3days after insertion in the mouth. Depending on the type of tissue conditioner over time, as there were significant differences in the elastic change(p<0.05). Tissue conditioner of the 1.5mm, 3.0mm thickness were significantly different by the dimensional stability(p<0.05). Elastic deformation of the ideal itself, and resilient when compared only the look, Visco-Gel 3.0mm group, stability was the most stable volume. In addition, it is important to select tissue conditioners suitable for functional impression because of the wide range of dimensional stability among the materials.