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Treatment of Refractory Lateral Epicondylitis with Platelet-Rich Plasma (불응성 주관절 외상과염에 대한 혈소판 풍부 혈장 주입 치료의 임상적 결과)

  • Ko, Sang-Hoon;Lee, Chae-Chil;Kang, Byeong-Seong;Lee, Ki-Jae;Lee, Seon-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.58-63
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    • 2010
  • Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.

Chest X-ray Findings and Serum Tumor Necrosis Factor-αLevels in Patients with Kawasaki Disease (가와사끼병 환아에서 흉부 X-선 검사의 변화와 혈중 Tumor Necrosis Factor-α에 대한 연구)

  • Kim, Ji Young;Kwon, Jung Hyun;Kim, Kyung Hyo;Yu, Jung Hyun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.534-538
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    • 2005
  • Purpose : Kawasaki disease(KD) is a multisystemic inflammatory vasculitis of unknown etiology. Many complications other than cardiovascular involvement have been recognized in KD. However, there have been few reports published concerning involvement of the lungs in this disease. The purpose of this study was to examine the relationship between serum TNF-${\alpha}$, the degree of coronary artery dilatation and chest X-ray(CXR) findings. In addition, we have investigated serum anti-Mycoplasma antibody(AMA) titers in patients with KD who have abnormal CXR findings. Methods : Eighty four patients with KD were included in this study(group I; 41 patients with normal CXR fndings, group II; 43 patients with abnormal CXR findings). Serum levels of TNF-${\alpha}$ and AMA titer were measured. Results : We reviewed the CXR findings and clinical courses of 84 patients with Kawasaki disease and found abnormal CXR findings in 43 patients(51.2 percent). Peribronchial cuffing was the most frequent abnormality(22.4 percent). In the group with abnormal CXR findings(group II), a statistical difference was not noted in age, sex, duration of fever, hemoglobin, WBC, platelet, ESR, and CRP levels and incidence of coronary arterial lesions as compared with the group having normal CXR findings(group I). No difference was noted in serum TNF-${\alpha}$ level between group I and group II. 2 patients(12.5 percent) of 16 KD patients with abnormal CXR findings have positive AMA titer(above 1 : 320). Conclusion : Most of the abnormal CXR findings in KD patients were peribronchial cuffing. The abnormal CXR findings in KD patients did not mean severe inflammations. It is difficult to consider that CXR abnormalities are related to coronary arterial lesions. In addition, further study on the relationship between Mycoplasma infection and Kawasaki disease is needed.

The Related Factors of Safety Behaviors and Accident in Elementary School Children (초등학생의 안전행동 및 사고 관련 요인)

  • Kim, Kyung-Sook;Lee, Moo-Sik;Hong, Jee-Young;Hwang, Hye-Jeong;Bae, Seok-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.288-293
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    • 2011
  • This study was conducted to investigate the elementary school students' consciousness of safety, activities to prevent their accidents and factors causing such accidents. For this aim, a research was conducted from Nov. 19 through Dec. 22, 2007 by means of questionnaires distributed to 800 students enrolled in the 5th and 6th grades of 4 elementary schools in a urban-rural combined city. Out of the questionnaires distributed, 785 were collected and put to analysis by using SPSS 13.0 program to determine t-test, ANOVA, logistic regression, etc. 1. The maximum scores of safety consciousness revealing relatively high level of safety consciousness. There was, however, statistically significant difference by grade, type of residence, school life and academic achievements. In detail, 5th graders featured higher level of safety consciousness and those who live in apartments, lead a pleasant life at school and get better academic scores tended to keep higher level of safety consciousness. 2. The subjects of the high scored of activities to prevent accidents, with a statistically significant difference by gender, grade and individual personality. Females, 5th graders and active students were found to be more conscious of preventive activities for accidents. 3. In general, 6th graders and active students turned out to have experienced more accidents. 4. The main factors exerting influence on occurrence of accidents on the part of elementary school students are known to be preventive actions and consciousness of traffic safety in the category of safety consciousness. The significant variable in preventive actions was preventive actions of traffic accidents, burns and intoxication by category of accidents, but individual personality by category of general characters. Sixth graders and male students experienced more accidents, without significantly significant difference, though. As a result, From the above findings, prevention of safety accidents is found to be very important for elementary school students. It is therefore suggested that schools as well as homes should continue to conduct practical education to prevent accidents with priority placed on familiarizing students with preventive activities in daily life in consideration of their personal characters.

The Job Consciousness for Radiological Technologists in Korea, Canada, and Australia (한국, 카나다 및 호주 방사선사의 직업의식)

  • Han, Eun-Ok;Kwon, Deok-Mun;Park, Kwang-Hun;Choi, Seung-Yoon;Jung, Chung-Hyun;Bae, Sang-Il;Oh, Chang-Woo
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.225-234
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    • 2009
  • This study attempts to provide basic information on overseas employment to the radiological technologists and students majoring in radiology in Korea who consider the overseas employment by investigating the job consciousness for radiological technologists in Canada and Australia which have a high level of interest for overseas employment and want to compare their status with that of Korean radiological technologists. This study was performed by visiting hospitals such as Prince George Regional Hospital, 1475 Edmonton Street, Prince George, BC, Canada on August 13, 2007, Alfred Hospital, Commercial Road Melbourne 3004, Australia on August 4, 2008, and other Korea hospitals that show the similar scale as Canada and Australia on September 10, 2007. The results were summarized as follows : 1. Differences were observed in this sexual composition, such as 18 males (90%) in Korea, 14 females (73.7%) in Canada, and 25 females in Australia (86.2%). 2. The item of 'aptitude' which is one of the most important criteria, showed the highest level in Korea, Canada, and Australia, and the second most considered item was 'salary'. 3. In the values in jobs, the items of 'economic self-sufficiency', 'recognized by others', and 'establishing a social position' represented high levels in Korea, and the items of 'like the job itself', 'establishing self-actualization', 'feel the meaning of life', and 'make new friends' showed high levels in Canada and Australia. 4. Regarding the item of 'a job is important as much as a marriage', 'Yes' showed high level in Korea, and 'No' showed high levels in Canada and Australia. 5. Radiological technologists in Korea demonstrated a low level in the job consciousness compared to those of Canada and Australia. Although this study shows some limitations for showing whole idea of radiological technologists due to the lack of the scope in samples for each country as a practical manner, this study can be regarded significant to compare some countries that have interests in overseas employment.

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Clinical Characteristics of Tuberculosis in North Korean Refugees (북한이탈주민에서의 결핵의 임상적 고찰)

  • Choi, Chang-Min;Jeong, Woo-Kyoung;Kang, Cheol-In;Kim, Doh-Hyung;Kim, Young-Keun;Heo, Sang-Taek;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.285-289
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    • 2006
  • Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.

Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy (미만형 색소 융모 결절성 활액막염의 관혈적 활막 전 절제술 후 경과)

  • Lee, Mo-Ses;Lee, Soo-Hyun;Suh, Jin-Suck;Yang, Woo-Ik;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.27-36
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    • 2010
  • Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

A Clinical Observation on Children with Transient Small Bowel Intussusception (일과성 소장형 장중첩증의 임상적 고찰)

  • Hur, Nam-Jin;Ryu, Min-Hyuk;Lee, Dong-Jin;Kwon, Jung-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.160-168
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    • 2000
  • Purpose: The purpose of this study was to evaluate the clinical and abdominal ultrasonogra- phic(US) features of spontaneously reduced transient small bowel intussusception in chlidren. Methods: We retrospectively reviewed the clinical and US findings of 98 children with intussusception who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Mar. 1999 to Feb. 2000. Results: 1) Among 98 cases, there were 12 cases (12.3%) of transient small bowel intussusception(TSBI) and 86 cases (87.7%) of classic intussusception (CI). 2) The peak incidence of age in TSBI was over 3 years, which was older than that in CI. With regard to sex distribution, male predominated in both type. 3) Clinical symptoms and signs including cyclic irritability, vomiting, bloody stool, and abdominal mass in TSBI group were less common than those in CI group (41.7%, 33.4%, 0.0%, 0.0% vs 91.9%, 59.3%, 41.9%, 26.7%, respectively) but persistent abdominal pain was more common in TSBI group than in CI group (58.5% vs 11.2%). 4) The size of total target sign and surrounding peripheral hypoechoic rim of TSBI group on US were smaller than those of CI group ($11.95{\pm}2.61$ mm, $2.08{\pm}1.15$ mm vs $26.91{\pm}5.98$ mm, $7.86{\pm}2.77$ mm, respectively). 5) Concomittant illness was found more frequently in TSBI group than in CI group (66.7% vs 26.7%). 6) All case of TSBI group were reduced spontaneouly, which were confirmed by US, but none of CI group. Conclusion: Transient small bowel intussusception is probably more common than generally thought and its clinical and US findings is quite different from classical obstructing intussus-ception. Because all of our cases resulted in spontaneous reduction, we recommend careful observation and repeat examination rather than an immediate operation in transient small bowel intussusception.

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The Clinical Characteristics According to the Risk Factors of Idiopathic Nonhemolytic Hyperbilirubinemia (신생아 특발성 비용혈성 고빌리루빈혈증의 위험 요인에 따른 임상 양상)

  • Park, Sook-Hyun;Kang, Ji-Hyun;Kwon, Soon-Hak;Kim, Heng-Mi;Kim, Yong-Sun
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.224-231
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    • 2010
  • Purpose: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. Methods: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. Results: The mean gestational age was $38^{+3}{\pm}1^{+4}$ weeks, and the mean age on admission was 8.8$\pm$4.0 days. The mean body weight (3,105$\pm$479 g) was decreased by 2.8$\pm$6.4 percent compared to the mean birth weight (3,174$\pm$406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. Conclusion: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

Evaluation of Hemodynamic Failure with Acetazolamide Challenged $^{123}I-IMP$ Brain SEPCT and PET (PET과 Acetazolamide 부하 $^{123}I-IMP$ 뇌혈류 SPECT를 이용한 혈역학적 부전의 평가)

  • Chun, Kyung-Ah;Cho, In-Ho;Won, Kyu-Jang;Lee, Hyung-Woo;Hayashida, Kohei
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.94-102
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    • 2003
  • Purpose : Cerebral blood flow (CBF) reactivity to acetazolamide (ACZ) is useful to select patients with hemodynamic failure. However, it is still a matter of speculation that varying degrees of regional CBF increases after ACZ administration represent the severity or stage of regional hemodynamic failure as assessed by positron emission tomography (PET). We studied to elucidate whether ACZ challenge $^{123}I-IMP$ brain single photon emission tomography (SPECT) can accurately grade the seventy of regional hemodynamic failure. Materials and Methods: Eighteen patients (M: 16, F: 2, average age: 61 years) with unilateral occlusive disease of the internal carotid artery or the trunk of the middle cerebral artery (MCA). Patients undewent $^{123}I-IMP$ brain SPECT study with acetazolamide challenge and PET study was carried out within 2 weeks before and after SPECT study. Five healthy volunteers with a mean age of 48 years (range: 28-73 yr, M: 3, F: 2) underwent PET studies to determine normal values. In SPECT study, an asymmetry index (Al)-the percentage of radioactivity of region of interest (ROI) in the occlusive cerebrovascular lesion to the contralateral homologous ROI-was used for numerical evaluation of relative $^{123}I-IMP$ distribution. In PET study, regional CBF, oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen ($CMRO_2$) and cerebral blood volume (CBV) values were measured with $^{15}O-labeled$ gas inhalation method and the values were used for comparison with Al (Al during acetazolamide challenge-Al of basal study) on the SPECT study. ROls were classified by severity into three groups (normal, stage I and stage II). Results: Mean values of Al in areas with normal, stage I and stage II hemodynamic failure were $6.25{\pm}7.77%\;(n=107),\;-10.38{\pm}10.41%\:(n=117)\;and\;13.30{\pm}10.51%\;(n=140)$, respectively. Al significantly differed with each groups (p<0.05). Correlation between Al and CBF, OEF and CBV/CBF in hemisphere with occlusive cerebrovascular lesion was 0.20 (p<0.01), -0.28 (p<0.01) and -0.28 (p<0.01), respectively. Conclusion: We concluded that $^{123}I-IMP$ brain SPECT with acetazolamide challenge could determine the severity ad stage of regional hemodynamic failure as assessed by PET.

Relationship Between Insertion Torque, and Pullout Strength Depending on the Size of the Pilot Hole and Biodegradable Suture Anchor in Osteoporotic Humeral Head (골다공증이 있는 상완골 골두의 파일럿 홀 (Pilot Hole)과 흡수성 나사못의 크기에 따른 토크 (Torque)와 뽑힘 강도 (Pullout Strength) 간의 관계)

  • Chun, Yong-Min;Lee, Young-Han;Kim, Sung-Hwan;Park, Yoo-Jung;Kim, Sung-Jae
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.8-15
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    • 2012
  • Purpose: The object of this study was to investigate the difference in torque and pullout strength between the standard anchor insertion (5.0 mm) with a small awl (3.7 mm) and larger anchor insertion (6.5 mm), with a standard awl (5.0 mm) in osteoporotic humeral head. Materials and Methods: The embalmed 24 paired cadaveric shoulders were assigned to either Group A or B. After measuring the bone mineral density (BMD) of the ROI (region of interest) in the humeral head, 5.0 mm suture anchors were inserted using a 3.7 mm awl in Group A1, and the same 5.0 mm anchors were inserted using a 5.0 mm awl in Group A2. The 5.0 mm anchors were inserted using a 5.0 mm awl in Group B1, and 6.5 mm anchors were inserted using a 5.0 mm awl in Group B2. We measured the torques at the time of the anchor insertion and pullout strengths. Results: There was no significant difference in the BMD between the groups. The torque of A1 (20.6 $cN{\cdot}m$) was significantly higher than that of A2 (13.2 $cN{\cdot}m$), and the torque of B2 (20.8 $cN{\cdot}m$) was significantly higher than that of B1(12.1 $cN{\cdot}m$). However, the difference in the increased torque between group A and B was not significant. The pullout strength of A1 (204.2 N) was significantly higher than that of A2 (152.9 N), and the pullout strength of B2 (210.9 N) was significantly higher than that of B1 (149.5 N). However, the difference in the increased pullout strength between Group A and B was not significant. Conclusion: In severe osteoporosis, the use of a larger suture anchor with a standard awl increased the torque and pullout strength significantly, in comparison to the use of the same sized suture anchor and awl. If there is an inadequate interval between the anchors on the greater tuberosity, the use of a 3.7 mm awl and 5.0 mm anchor will be beneficial compared to that of a 5.0 mm awl and 6.5 mm anchor, considering that an increase in the pullout strength does not depend on the awl size.