Sonographic evaluation of the 23 patients with herniated lumbar disc was carried out via anterior approach. The most important sonographic finding of the herniated disc was posterior displacement of the ventral echogenic line. Twenty patients(87%) were coincided in the result of the preoperative sonography and myelography. Of them, 19 patients were well correlated with surgical findings. A 19 of the 20 patients with satisfactory outcome found changes on the postoperative sonogram. In conclusion, disc sonography may be the modality evaluating patients with low back pain and radiculopathy. And also, sonography will become the supplementary study of the patient who has the persistent radiculopathy following discectomy.
Diskectomy ; Humans ; Intervertebral Disc Displacement ; Low Back Pain ; Myelography ; Radiculopathy ; Ultrasonography*

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Bilirubin* ; Humans ; Infant, Newborn*

INTRODUCTION: Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Sleep deprivation can have significant effects on athletic performance. However, there are few published data related to the amount of sleep obtained by elite athletes. We investigated sleep patterns of Korean women golfers using sleep-related questionnaires. METHODS: For this study, 98 Korean university women golfers and 46 age- and sex-matched controls were recruited. All subjects were asked to complete the self-administered sleep questionnaire consisting of questions about habitual sleep patterns (sleep onset time, sleep latency, awakening time in the morning, day time napping time), exercise habits, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Pittsburgh Sleep Quality Index (PSQI), validation of the Perceived Stress Scale (PSS), and Beck Anxiety Inventory (BAI). RESULTS: The sleep onset time was significantly earlier (pm 23 : 05 +/- 00 : 52 and 00 : 14 +/- 00 : 51 ; t = 5.287, p < 0.001), the waking time was later (am 07 : 21 +/- 01 : 09 and 6 : 35 +/- 00 : 32; t = -2.715, p = 0.008), the weekday total sleep time was greater (417.77 +/- 78.18 minute and 351.52 +/- 77.83 minute ; t = 4.406, p = 0.001), and the daytime nap time was greater (77.73 +/- 41.28 minute and 20.22 +/- 33.03 minute ; t = 7.623, p < 0.001) in the golf athletes compared to the controls. The PSQI scores were significantly lower, but estimated sleep latency and ESS, ISS, PSS, and BAI scores were not different among the two groups. CONCLUSION: This study suggests that Korean university women golfers have good sleep patterns resulting in no difference in sleep-related stress compared to age- and sex-matched control students.
Anxiety ; Athletes ; Athletic Performance ; Female ; Golf ; Humans ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

No abstract available.
Rectum*

BACKGROUND: The heart rate adjusted ST segment criteria(Delta ST/HR index and rate-recovery loop or R-R loop) compared to standard ST segment criteria may improve the ability of the exercise electrocardiogram for the prediction of severe coronary artery disease and future cardiac events in patients with chronic angina pectoris, but the predictive value of these criteria for predicting these issues has not been studied in patients with acute myocardial infarction. METHODS: 64 patients with first uncomplicated myocardial infarction were studied. All patients performed predischarge(mean 8+/-4 days) symptom-limited exercise test and coronary angiography(mean 11+/-15 days). During the follow-up period(mean 449+/-273 days), the occurrence of the major cardiac events(death, reinfarction, coronary artery bypass surgery) and minor cardiac event(angina, heart failure) were recorded, and then univariate and multivariate analysis of several clinical and exercise variables known to be as prognostic markers were performed. RESULTS: The results are as follows : 1) The sensitivities of Delta ST/HR index and R-R loop(92%, 83% respectively) for predicting multivessel disease showed no significant difference compared to that of standard ST segment criteria(83%). 2) Major cardiac events occurred in 12(20%) of 64 patients and only single independent predictive factor for its prediction was multivessel coronary artery disease(p=0.0001), whereas total cardiac event occurred in 32(50%), multivessel disease(p=0.003), and maximal workload <5mets(p=0.038). 3) For the prediction of total cardiac event, DeltaST/HR index and R-R loop(all 97%) were significantly more sensitive(p<0.05) than standard ST segment criteria(78%), and there was a tendency to increase in specificity in R-R loop(84%) compared to DeltaST/HR index(59%) or standard ST segment criteria(66%). 4) The negative predictive value of all negative test of three ST segment criteria for predicting total cardiac event was 100%. CONCLUSION: Although the heart rate-adjusted ST segment criteria have no advantage over standand ST segment criteria for the prediction of severe coronary artery disease, they can be more useful prognostic markers by enhancing the accuracy of the predischarge exercise electrocardiogram for the prediction of subsequent cardiac events after a first acute myocardial infarction.
Angina Pectoris ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Exercise Test* ; Follow-Up Studies ; Heart ; Heart Rate ; Humans ; Multivariate Analysis ; Myocardial Infarction* ; Prognosis ; Sensitivity and Specificity

Cauda equina syndrome has been described as a complex of low back psin, bilateral sciatica, saddle anesthessia and motor weakness in the lower extremity that progress to paraplegia with bladder and bowel incontinence. The syndrome is uncommon, accouting spproximately 1–16% of reported cases of lumbar disc herniation, but needs urgent diagnosis and surgical treatment. Clinical observations were carried out on 8 cases of cauda equina syndrome in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from June 1980 through June 1986 and the following results were obtained. 1. The highest incidence, 5 cases(63%), occured in 40 49 year old age group and the sex distribution was 5 males and 3 females. 2. Eight cases fell into two clinical groups. group 1(3 cases) presented with a sudden onset without any previous history of low back pain and group 2(5 cases) presented with a incidious onset with history of recurrent low back pain. 3. Preoperative myelogram revealed a totsl block to the flow of the contrsst medium in all cases. 4. Wide laminectomy and discectomy were performed in all cases within 2 weeks after the onset of bladder symptom and 3 cases with two levels of disc prolapse were found. 5. Among total 11 levels of disc prolapse, there was 5 levels of L5-S1, 4 levels of L4-5 and 2 levels of L3-4. 6. The duration of the preoperative bladder symptom was 3.3 days in group 1 and 6.4 days in group 2. 7. With a minimum of 6 months follow up, motor power wss fully recovered in 5 cases, sensory in 6 cases and bladder function in 4 cases.
Cauda Equina ; Diagnosis ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Lower Extremity ; Male ; Paraplegia ; Polyradiculopathy ; Prolapse ; Sciatica ; Sex Distribution ; Urinary Bladder

There are many difficulties in operative technique of total knee replacement of bony ankylotic knee, because it accompanies the deformity of the knee, contracture of soft tissue and bony ankylosis. It is said that there are poor gaining of post-operative range of motion and development of many problems in wound healing. We performed conversion TKR in seventeen patients who had fused knee between Jan. 1985 and Dec. 1991. After follow up of average three years and four months, we analyse the results. Sixteen patients were women and one was man. There were eight cases of tuberculosis knees, seven cases of septic knees and two cases of posttraumatic arthritis. Thirteen cases had previous knee surgery and in another four cases knee fusion developed spontaneously. Average age of patients were 35 years old. Operation was performed between ten months and twenty years averaging nine years after knee fusion. When blood chemistry and physical examination showed no findings of infection, operation was performed. We used bone cement in 8 cases and autogenous bone graft in 4 cases for large bone defect. For release of soft tissue contracture, in 8 cases, we lengthened quadriceps tendon with the method of V-Y advancement technique and in another 4 cases, performed patella tendon transfer from tibial tuberosity. Operative time was between three hours and four hours fifteen minutes, average three hours and fourty minutes. The results of these patients were as follows; 1. The postoperative average range of motion was 72° (20°-125°). The average extension lag was 9. 2. The average Hospital for Special Surgery knee rating score improved from 57 preoperatively to 84 postoperatively. 3. There were two patients who had pain on walking, but radiologically and clinically there were no loosening signs. 4. In three patients who had poor gaining of range of motion after operation, we performed arthroscopic adhesiolysis. There were two cases of transient peroneal nerve palsy which were recovered within 1 month and in another two case of deep infection with β-hemolytic streptococcus and pseudomonas, we performed knee fusion after one year ten months and one month after TKR. In conclusion, conversion TKR is a successful procedure which can obtain the restoration of function of the fused knee, especially in the cases that have adequate soft tissue condition, extensor mechanism and good bone stock.
Ankylosis ; Arthritis ; Arthroplasty, Replacement, Knee ; Chemistry ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Methods ; Operative Time ; Paralysis ; Patellar Ligament ; Peroneal Nerve ; Physical Examination ; Pseudomonas ; Range of Motion, Articular ; Streptococcus ; Tendons ; Transplants ; Tuberculosis ; Walking ; Wound Healing

No abstract available.
Amputees* ; Humans

BACKGROUND: Post-herpetic neuralgia is the most serious one of herpes zoster complications and its incidence becomes higher as the age of the patient increases. Nevertheless, besides considering the age and onset time of treatment, there is no more objective factor estimating the prognosis of post- herpetic neuralgia. OBJECTIVE: The aim of this study is to understand the progression of herpes zoster and estimate the prognosis of post-herpetic neuralgia by practicing electrodiagnostic tests to patients with herpes zoster. METHODS: We evaluated the pain scales in 26 patients with herpes zoster on the first visit and 2 months later. We also performed electrodiagnostic tests, more objective and reproducible methods, including somatosensory evoked potentials and motor nerve conduction studies on both the involved and uninvolved sites of 32 lesions in 26 patients with herpes zoster, and then compared the results with the change of pain scales. RESULTS: 1. The pain category scale and visual analogue scale on the second examination were significantly decreased compared with those on the first examination (P<0.05). 2. Latencies of intercostal somatosensory evoked potentials recorded on scalp and spine were significantly delayed in involved sides compared with those in uninvolved sides (P<0.05). 3. In the latencies and conduction velocities of motor nerve conduction studies, no significant differences were seen between involved sides and uninvolved sides. 4. On the second examinataion, latency differences of somatosensory evoked potentials were significantly improved compared with those on the first examination (P<0.05). 5. Among the various somatosensory evoked potentials parameters, P1 latency difference of cortical somatosensory evoked potentials between involved and uninvolved sides correlated significantly with pain category scale ard visual analogue scale on second examination (r=0.48, P<0.05; r =0.51, P<0.05, respectively). N1 latency difference of spinal somatosensory evoked potentials between involved and uninvolved sides correlated significantly with a visual analoge scale on the first examination and pain category scale on the second examination (r=0.61, P<0.05; r=0.78, P<0.05, respectively). CONCLUSION: Intercostal somatosensory evoked potentials can be a useful and reliable technique to predict the development and severity of post-herpetic neuralgia.
Evoked Potentials, Somatosensory ; Herpes Zoster* ; Humans ; Incidence ; Neural Conduction ; Neuralgia* ; Prognosis ; Scalp ; Spine ; Weights and Measures