Yoon Kyoo Kang

Full genome analysis of a novel adenovirus from the South Polar skua (Catharacta maccormicki) in Antarctica

Abstract Adenoviruses have been identified in humans and a wide range of vertebrate animals, but not previously from the polar region. Here, we report the entire 26,340-bp genome of a novel adenovirus, detected by PCR, in tissues of six of nine South Polar skuas (Catharacta maccormicki), collected in Lake King Sejong, King George Island, Antarctica, from 2007 to 2009. The DNA polymerase, penton base, hexon and fiber genes of the South Polar skua adenovirus (SPSAdV) exhibited 68.3%, 75.4%, 74.9% and 48.0% nucleotide sequence similarity with their counterparts in turkey hemorrhagic enteritis virus. Phylogenetic analysis based on the entire genome revealed that SPSAdV belonged to the genus Siadenovirus, family Adenoviridae. This is the first evidence of a novel adenovirus, SPSAdV, from a large polar seabird (family Stercorariidae) in Antarctica.

Referred pain pattern of the pronator quadratus muscle.

&NA; Pain patterns of the myofascial trigger points (TrP) for most muscles of the forearm have been documented. However, there are no published reports on the referred pain patterns for the pronator quadratus (PQ) muscle. The purpose of this study was to determine the referred pain pattern of the TrP in the PQ. Thirty‐five arms of 35 healthy adult volunteers with no history of neck pain, arm pain or paresthesia were studied. Following skin sterilization, a Teflon‐coated syringe needle was inserted into the PQ of the non‐dominant forearm under electromyographic guidance, and 0.3 mL of 6% hypertonic saline was injected. Subjects drew in their pain areas on a pain diagram, and this drawing was transferred into the Pain Chart System® for analysis. Two main pain patterns were observed. The most common pattern involved pain spreading both distally and proximally from the injection site, along the medial aspect of the forearm (57%). In half of these cases, the pain area extended to the medial epicondyle proximally and the fifth digit distally. The second main pattern revealed pain spreading distally to the third and/or fourth finger (29%). The pain patterns originating from the PQ resemble the C8‐T1 dermatomes, and ulnar and median nerve sensory distributions. Thus, myofascial pain of the PQ should be considered as a possible cause of pain in the medial forearm and hand, especially when no other neurological abnormalities are present.

Referred pain pattern of the abductor pollicis longus muscle.

Hwang M, Kang YK, Shin JY, Kim DH: Referred pain pattern of the abductor pollicis longus muscle. Am J Phys Med Rehabil 2005;84:593–597. Objective:To determine the referred pain pattern of the abductor pollicis longus muscle. Design:Intramuscular hypertonic saline was injected into the abductor pollicis longus of 15 healthy adults to induce muscle pain. Subjects completed pain drawings depicting the pain distribution. The drawings were transferred into the Pain Chart System for analysis. Results:Referred pain distributions were as follows: the radial aspect of the wrist (61.9%), the dorsal aspects of the third and fourth fingers (14.3%), and a combination of the two distribution patterns (23.8%). Conclusion:Referred pain patterns of the abductor pollicis longus resemble the C6, 7, and 8 dermatomes, the superficial radial sensory nerve distribution, and are very similar to the area of pain experienced in de Quervain’s tenosynovitis. Thus, identification of the abductor pollicis longus trigger point should be considered in pain of the radial aspect of the wrist and thumb, especially when no other neurologic abnormalities or inflammatory conditions are present.

Reference values of fractionated neurography of the ulnar nerve at the wrist in healthy subjects

OBJECTIVE This study is designed to derive a normative database for nerve conduction values of the ulnar nerve in the wrist. METHODS Ulnar nerve study at the wrist (UNSW) was performed in 204 hands of 102 control subjects. The UNSW was composed of motor and sensory tests. Motor UNSW was done with first dorsal interosseous muscle recording. Sensory UNSW was performed antidromically with fifth finger recording. The 3 stimulation points were 2 cm proximal to the pisiform, just lateral to pisiform, and 3 cm distal to the pisiform. RESULTS Mean latency differences in the proximal and distal segments were 0.4 +/- 0.1 and 0.5 +/- 0.1 ms in motor UNSW and 0.4 +/ -0.1 and 0.5 +/- 0.1 ms in sensory UNSW. The 95th percentile values for motor and sensory UNSW were 0.5 ms in the proximal segment and 0.7 ms in the distal segment. CONCLUSIONS When the 95-percentile value was considered as the normal upper limit, the criteria of abnormality for motor and sensory UNSW were greater than 0. 5 ms in the proximal segment and greater than 0.7 ms in the distal segment. SIGNIFICANCE The normative values of UNSW may be useful in screening for ulnar neuropathy at the wrist.

Intramuscular hemangioma mimicking myofascial pain syndrome: a case report.

Intramuscular hemangioma, an infrequent but important cause of musculoskeletal pain, is often difficult to establish the diagnosis clinically. This report describes a case of a 32-yr-old woman who presented with severe left calf pain for 10 yr. Initial conservative treatments consisting of intramuscular electrical stimulation, herb medication, acupuncture, and intramuscular lidocaine injection under the diagnosis of myofascial pain syndrome in other facilities, failed to alleviate the symptoms. On physical examination, there was no motor weakness or sensory change. Conventional radiography of the leg revealed a soft tissue phlebolith. Conventional angiography study showed hemangioma. Intramuscular hemangioma within the soleus muscle was confirmed by magnetic resonance imaging. Following surgical excision of the hemangioma, the patients symptom resolved completely. Intramuscular hemangioma is a rare cause of calf pain and should be considered in the differential diagnosis if a patient with muscle pain, particularly if associated with a soft tissue mass, fails to respond to conservative treatment.

Localization of ulnar neuropathy at the elbow using new stimulator for the inching test.

OBJECTIVE To evaluate the usefulness of the TenElectrodes, a new stimulator for inching test, in the diagnosis and localization of ulnar neuropathy at the elbow (UNE). METHODS Sixty-two ulnar nerves in 40 control subjects and 24 ulnar nerves in 23 patients with typical symptoms and signs of UNE were studied. The inching test of ulnar motor nerve using TenElectrodes was done along 8 cm across the elbow in the extended position. RESULTS In the inching test of the control group, the mean segmental latency difference was 0.19+/-0.08 ms. Maximal latency difference over a 1 cm segment did not exceed 0.40 ms in any of the controls but exceeded 0.5 ms or more in all clinical UNE patients. In all UNE patients, the lesion sites were identified by the inching test using TenElectrodes: the retroepicondylar groove (54.2%), the humeroulnar arcade (29.2%), and dual compression (16.6%). CONCLUSIONS TenElectrodes is a useful stimulator for the inching test in the diagnosis of UNE. The precise localization of compression was possible in all patients with UNE and the most common site was the retroepicondylar groove.

Electrodiagnosis support system for localizing neural injury in an upper limb

Needle electromyography (EMG) is used for the diagnosis of a neural injury in patients with a cervical/lumbar radiculopathy, plexopathy, peripheral neuropathy, or myopathy. Needle EMG is a particularly invasive test and thus it is important to minimize the pain during inspections. In this paper, we introduce the Electrodiagnosis Support System (ESS), which is a clinical decision support system specialized for neural injury diagnosis in the upper limb. ESS can guide users through the diagnosis process and assist them in making the optimal decision for minimizing unnecessary inspections and as an educational tool for medical trainees. ESS provides a graphical user interface that visualizes the neural structure of the upper limb, through which users input the results of needle EMG tests and retrieve diagnosis results. We validated the accuracy of the system using the diagnosis records of 133 real patients.

Development of Korean Academy of Medical Sciences Guideline for Rating Physical Disability of Upper Extremity

While the lower extremities support the weight and move the body, the upper extremities are essential for the activities of daily living, which require many detailed movements. Therefore, a disability of the upper extremity function should include a limitation of all motions of the joints and sensory loss, which affects the activities. In this study, disabilities of the upper extremities were evaluated according to the following conditions: 1) amputation, 2) joint contracture, 3) diseases of upper extremity, 4) weakness, 5) sensory loss of the finger tips, and 6) vascular and lymphatic diseases. The order of 1) to 6) is the order of major disability and there is no need to evaluate a lower order disability when a higher order one exists in the same joint or a part of the upper extremity. However, some disabilities can be either added or substituted when there are special contributions from multiple disabilities. An upper extremity disability should be evaluated after the completion of treatment and full adaptation when further functional changes are not expected. The dominance of the right or left hand before the disability should not be considered when there is a higher rate of disability.

A novel computer-assisted algorithmic method for differential diagnosis of dermatological diseases.

To deal with human surface locations electronically, it is essential to establish a designation method to code the sites. For the development of site designation methods and databases, dermatological textbooks, atlantes and clinical photographs were collected and reviewed. The sites were systematically named, numbered, and mapped on human models. The whole human surface was divided into 484 segments, and then assembled into 15 groups and 29 subgroups. After establishing the site designation method, we constructed a database of the sites of occurrence of dermatological diseases, and a database of age, sex, signs and symptoms. More than 700 diseases were analyzed and coded into the database. To gather information on the site of a particular disease, not only textbooks, and atlantes of dermatology, but also photographs obtained during clinical practices were reviewed, as clinical photos of patients can be more delicate than the descriptions in textbooks. The prototype of a computer assisted dermatological diagnosing system was made using site a designation method and the databases. This interactive computer program worked relatively well as a helpful guide or dermatological diagnosing tool. Further diseases are being added to the databases.