There are many patients who complain of shoulder pain with stiffness. Sadly these patients are often neglected by many physicians. An effective treatment is necessary in clinical practice. In our pain clinic, the fifty patients who were diagnosed frozen shoulder were randomly selected and followed up from Oct. 1992 to Mar. 1993. Important factors affecting outcome include; time from onset of pain and stiffness until treatment, initial severity of the pain and stiffness. We found that appropriate treatment led overall to improved patient satisfaction. The results are as follows. For patients treated within 3 weeks of syndrome occurrence, the recovery rate was in excess of 80%. But, if the patients had suffered for more than 6 months prior to treatment, the recovery rate was below 70%. For problems present in excess of six years only slight improvement was observed. These patients were difficult to manage. If the condition of patients was class I, the recovery rate was 94.4%. But in the cases of class III, only 25% of patients were recovered. From our results, we believe that early treatment is the best choice in management of frozen shoulder patients.
Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.
Heshmat, Ramin;shafiee, Gita;Kelishadi, Roya;Babaki, Amir Eslami Shahr;Motlagh, Mohammad Esmaeil;Arefirad, Tahereh;Ardalan, Gelayol;Ataie-Jafari, Asal;Asayesh, Hamid;Mohammadi, Rasool;Qorbani, Mostafa
Nutrition Research and Practice
/
v.9
no.4
/
pp.404-410
/
2015
BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.
Background: Korean Red Ginseng (KRG) is widely used for strengthening the immune system and fighting fatigue, especially in people with deficiency syndrome. However, there is concern that the long-term application or a high dose of KRG can cause "fireness" (上火 in Chinese) because of its "dryness" (燥性 in Chinese). The aim of this study was to assess the safety and efficacy of a 4-week treatment with KRG in participants with deficiency syndrome. Methods: This was a 4-week, randomized, double-blind, placebo-controlled clinical trial. A total of 180 Chinese participants were randomly allocated to three groups: placebo control group, participants were given a placebo, 3.6 g/d; KRG 1.8 g and 3.6 g groups. The primary outcomes were the changes in fireness and safety evaluation (adverse events, laboratory tests, and electrocardiogram). The secondary outcomes were the efficacy of KRG on fatigue, which include the following: traditional Chinese medicine (TCM) symptom scale and fatigue self-assessment scale. Results: Of the 180 patients, 174 completed the full study. After 4 weeks of KRG treatment, the Fire-heat symptoms score including Excess fire-heat score and Deficient fire-heat score showed no significant change as compared with placebo treatment, and no clinically significant changes in any safety parameter were observed. Based on the TCM syndrome score and fatigue self-assessment score, TCM symptoms and fatigue were greatly improved after treatment with KRG, which showed a dose- and time-dependent effect. The total effective rate was also significantly increased in the KRG groups. Conclusion: Our study revealed that KRG has a potent antifatigue effect without significant adverse effects in people with deficiency syndrome. Although a larger sample size and longer treatment may be required for a more definite conclusion, this clinical trial is the first to disprove the common conception of "fireness" related to KRG.
Oh, Hyun Woo;Kim, Hyun Jung;Jun, Dae Won;Lee, Seung Min
Korean Journal of Community Nutrition
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v.20
no.6
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pp.460-467
/
2015
Objectives: Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults. Methods: A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (<110 mEq/day, 110~180 mEq/day, >180 mEq/day). Results: After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group. Conclusions: The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.
Schmitz-Feuerhake, Inge;Busby, Christopher;Pflugbeil, Sebastian
Environmental Analysis Health and Toxicology
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v.31
/
pp.1.1-1.13
/
2016
Objectives To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (A-bomb) survivors. Methods To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down's syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. Results Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. Conclusions We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.
Pulse diagnosis that distinguishes internal injury from external injury by comparing the left and right of the chon pulse was formed in the process of Naegyoung's pulsation theory of ST9 and LU9 being assimilated into diagnostic method by taking chon pulse. The founder of school of internal injury, I Dong-won, expanded the horizon for this method to be widely used in clinical practice by especially explaining the specific application and theoretical background. According to him, pulse at ST9 which means chon pulse at the left hand, is bigger than the chon pulse at the right hand, it reflects external injury. Bigger "entrance pulse", a chon pulse at the right hand means internal injury. The reason is the left side of the body is a path for Yanggi so it controls the exterior part and the right side of the body is a path for Eumgi to descend so it controls the interior part. Internal injury develops as the spleen and stomach get injured. If the spleen and stomach is damaged essence derived from food cannot ascend to the stomach and will flow back to the lower part. As a result, fire of Eum type formed at the lower part will shoot up to the upper part and manifests external injury-like exterior syndromes. In this case, evidence distinguishing between internal and external injury is the fact that right hand pulse is bigger than the left hand. The important reason for distinguishing between internal and external injury is because when treating external injury caused by excess syndrome, pathogenic Gi should be dispelled. However, treating internal injury cased by deficiency syndrome, requires promoting the primordial Gi.
Objectives : Patients who visit oriental medical hospital for growth treatment are increasing. So we aimed to classify the tendency of the patients. Methods : We studied 231 patients who visited Oriental medical hospital for growth treatment from January 2004 to August 2005. We classified sex ratio, height percentile, symptom form of the Oriental medicine, age ratio and developed complication of patients. We used X-ray, endoscope for nasal cavity, blood sample, the Standard Growth Table made by the Korean Association of Pediatrics, 1998. Results : The results which were classified as follows; boys were 50.2 percentile, girls were 49.8 percentile. The classification according to age stage resulted as follows; infant stage 1.3 percentile, preschool age 13.4%, school age 28.6%, rapid growth stage 22.9 percentile, puberty 33.8 percentile. The classification according to height percentile resulted as follows; 3 percentile or under 12.1%, 25 percentile or under 48.9%, 50 percentile or under 25.6%, 75 percentile or under 10.8%, 75 percentile excess 2.6%. The classification according to disease resulted as follows; paranasal sinusitis 12.1 percentile, allergic rhinitis 10 percentile, atopic dermatitis 5.6 percentile, nocturia 3 percentile, convulsion or tic disorder 2.2 percentile, precocious puberty 1.3 percentile, Tuner syndrome 0.9 percentile, developmental disability 0.4 percentile. Conclusions : Sex ratio of children patients who visited Orienatal medical hospital were nearly the same. 13.4% of hospital visit children patients were taller than average. Most of the male children patients were school ages while the female were in puberty. 35.5% of them have developed complication as follows; paranasal sinusitis, allergic rhinitis, atopic dermatitis, nocturia, convulsion or tic disorder, precocious puberty, Tuner syndrome and developmental disability.
The chromosome 7-linked long QT syndrome (LQT2) is caused by mutations in the human ether-a- go-go-related gene (HERG) that encodes the rapidly activating delayed rectifier $K^+$ current, $I_{Kr},$ in cardiac myocytes. Different types of mutations have been identified in various locations of HERG channel. One of the mechanisms for the loss of normal channel function is due to membrane trafficking of channel protein. The decreased channel function in some deletion mutants appears to be due to loss of coupling with wild type HERG to form the functional channel as the tetramer. Most of missense mutants with few exceptions could interact with wild type HERG to form functional tetramer and caused dominant negative suppression with co-injection with wild type HERG showing variable effects on current amplitude, voltage dependence, and kinetics of activation and inactivation. Two missense mutants at pore regions of HERG found in Japanese LQT2 (A614V and V630L) showed accentuated inward rectification due to a negative shift in steady-state inactivation and fast inactivation. One mutation in S4 region (R534C) produced a negative shift in current activation, indicating the S4 serving as the voltage sensor and accelerated deactivation. The C-terminus mutation, S818L, could not express the current by mutant alone and did not show dominant negative suppression with co-injection of equal amount of wild type cRNA. Co-injection of excess amount of mutant with wild type produced dominant negative suppression with a shift in voltage dependent activation. Therefore, multiple mechanisms are involved in different mutations and functional abnormality in LQT2. Further characterization with the interactions between various mutants in HERG and the regulatory subunits of the channels (MiRP1 and minK) is to be clarified.
Objectives The purpose of this study was to investigate the correlation between gastric emptying measured by ultrasonography and Korean medical instruments of diagnosis and assessment in functional dyspepsia (FD) patients. Among the subgroups of FD, postprandial distress syndrome (PDS) is related to gastric motility disorder.Methods Ten patients with FD and particularly with PDS as well as 10 healthy controls were enrolled in the study from September to November 2015. The gastric emptying shown as the half-life of gastric volume (T1/2) was measured by ultrasonography. The severities of spleen qi deficiency and dyspepsia symptoms were assessed by a spleen qi deficiency questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K), respectively. In addition, a food retention questionnaire (FRQ), a damum questionnaire (DQ), a cold and heat questionnaire (CHQ), a deficiency and excess questionnaire (DEQ), and a visual analogue scale (VAS) of distention and fullness were completed by every participant.Results In comparison with the control group, the FD group showed significantly higher scores for the SQDQ, NDI-K, FRQ, DQ, DEQ, and VAS of distention and fullness. T1/2 was also significantly higher in the FD group than in the control group. There were significant correlations between T1/2 and the SQDQ score. However, there were no significant correlations between T1/2 and other questionnaire scores except for one item of the NDI-K.Conclusions According to these findings, it was determined that measuring gastric emptying using ultrasonography could be a quantitative indicator to diagnose spleen qi deficiency in FD patients.
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