OBJECTIVES: The sensitivity and accuracy of thermistor airflow signal has been debated. The purposes of this study were to compare apnea-hypopnea index(AHI) detected from a conventional thermistor signal and a nasal pressure transducer of airflow(NPT), to evaluate the value of NPT for the diagnosis of upper airway resistance syndrome (UARS), and to measure airway pressure fluctuations which produced respiratory arousals in UARS by naso-oro-esophageal manometer catheter. The subjects were 30 patients with obstructive sleep apnea syndrome [mild(540), 10), and 6 UARS patients. Airway resistance arousal in this study was defined as arousals which were not associated with apnea or hypopnea of thermistor signal, but showed significant decrease of nasal airflow pressure just before arousal and a prompt recovery of nasal airflow pressure after arousal, The airway pressure fluctuations were measured during 260 airway resistance arousals observed in 10 patients with OSAS, 2 with UARS. RESULTS: Mean AHIs of patients with OSAS were 33.4 by thermistor and 48.4 by NPT. The AHIs of mild, moderate and severe OSAS group were 10.2, 32.1, 65.4 respectively by thermistor and 23.1, 45.9, 76.4 by NPT. The mean AHI of patients with UARS was 3.2 by tehrmistor and 108 by NPT. The mean AHI of patients with nonspecific arousals was 2.7 by thermistor and 4.4 by NPT. The mean airway pressure changes during resiratory arousals of different groups were 8.7 cmH2O in mild OSAS, 11.4 cmH2O in moderate OSAS, 24.7 cmH2O in severs OSAS and 6.6 cmH2O in UARS. CONCLUSION: The nasal pressure transducer of airflow was more sensitive and accurate for assessing respiratory disturbances of patients with OSAS and was extremely helpful for the diagnosis of UARS without esophageal pressure monitoring. From the results, we would like to propose carefully the NPT diagnostic criteria for sleep disordered breathing as follows : NPT-AHI 5-15->UARS, 15-35->mild OSAS, 35-55->moderate OSAS and >55 ->severe OSAS.
Airway Resistance* ; Apnea ; Arousal ; Catheters ; Diagnosis ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Transducers, Pressure

BACKGROUND: Combined spinal epidural anesthesia (CSE) is used for obtaining adventages of both spinal and epidural anesthesia. But it might be suspected that epidural volume load affect spinal sensory blockade level during CSE. METHODS: Eighty patients undergoing lower abdominal and lower extremity operation were involved in our study. Subarachnoid block with 12mg of tetracaine was established in all patients. Four groups were studied. Group 1 (n=20), the control, received only spinal anesthesia. Group 2 (n=20), group 3 (n=20) and group 4 (n=20) received 10, 15 and 20 ml of epidural saline immediately after spinal anesthetic administration. Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes. Blood pressure, heart rate and incidence of complications such as hypotension, bradycardia, nausea and high block were measured. RESULTS: The sensory blockade level of groups 3 and 4 was higher than group 1 (p<0.05). Blood pressure and heart rate were not different compared with each other. The incidence of complications, except that higher block above T4 in group 4 was more than in group 1 (p<0.05), were not different when compared with each other. CONCLUSIONS: Epidural saline above 15 ml may affect sensory blockade level of spinal anesthesia during CSE.
Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bradycardia ; Heart Rate ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Nausea ; Tetracaine

No abstract available.
Activities of Daily Living* ; Humans ; Stroke*

The present study was designed to identify the sequential electrophysiological findings ant to determine the prognostic values of electrophysiological and clinical pararneters in patients with Guillain-Barre syndrome (GBS). Severely affected 42 subjects (Grade D,E). Who fulfilled the diagnostic criteria of GBS were selected. Twentynine patients were followed up at least 6 months (range 6-24 months) from the onset of neurologic syrnptorns. We analyzed 83 electrodiagnostic studies from 42 subjects. The sequential electrophysiological abnorrnalities were most marked at 3-4 weeks after the onset. At that time the most significant change was a decrease of CMAP amplitude. By stepwise discriminant analysis of several electrophysiological parameters, the three variables, of CMAP amplitude, distal conduction velocity; and F-wave latency were deterrnined to be significant pararneters. The accuracy of predicting the prognosis at 6 months was 82. 8%, when the classification functions were applied. Nlerefore the findings of early electrophysiological studies would be irnportant in understanding the serial pathophysiological changes and assessing the clinical outcorne of Guillain-Barre syndrorne.
Ants ; Classification ; Guillain-Barre Syndrome* ; Humans ; Prognosis

In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
Anxiety* ; Appetite ; Asian Continental Ancestry Group ; China* ; Depression* ; Divorce ; Dyspepsia ; Education ; Ethnopsychology ; Family Relations ; Female ; Flushing ; Hospitalization ; Humans ; Libido ; Literacy ; Marital Status ; Mouth ; Paresthesia ; United Nations ; Weight Loss

Severe limitation of knee motion is a complication of operative procedures or trauma about the knee. Physical therapy and occasionally manipulation of knee with anesthesia may improve results when performed soon after the onset of motion limitation. When performed later, these have been proven less useful. This is a review of 15 patients who had severe limitation of knee motion following open operative procedures or trauma about knee and were treated by percutaneous release of adhesions under arthroscopic control. There were eleven males and four females, ranging in age from 23-67years(mean 38 years). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from three and half months to four years(mean 11.5 months). The interval between arthroscopic adhesiolysis and final follow-up evaluation ranged from 6 months to 3 years(mean 1.5 years). Average preoperative knee motion was 38.2 degrees. After arthroscopic adhesiolysis, maximum knee motion under anesthesia was 120.3 degrees and average final motion at follow-up was 101.2 degrees. The results of treatment of treatment of Tbc knee sequalae with secondary osteoarthritis and pyogenic arthritis were less favorable for motion improvement. Arthroscopic adhesiolysis seems to be a useful method of treatment in knee ankylosis. Morbidity was low, complications were few and the duration of hospital stay was short.
Anesthesia ; Ankylosis ; Arthritis ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee ; Length of Stay ; Male ; Methods ; Osteoarthritis ; Surgical Procedures, Operative

Voice changes developing after endotracheal intubation during right hemicolectomy with endotracheal intubation have been found to be due to a right recurrent laryngeal nerve palsy in 43-years-old male patient. It was likely that the inflated cuffed tube rode up to the level of the cricoid cartilage during the course of surgery as traction was placed on the endotracheal tube because the condenser humidifier and breathing circuit weighed heavy. Cuff overexpansion, in addition to muscle relaxation and decreased tracheal elasticity were considered as contributing factors of vocal cord palsy. We believe that tube traction and cuff overexpansion were the mechanism of vocal cord palsy in our patient. So we recommend the routine use of tube stand so that weigh of the breathing circuit does not transmit traction to the endotracheal tube. Concurrently, filling the cuff with a sample of the inspired mixture of gases, saline and 4% lidocaine in special cases or regular deflation of the cuff must be considered.
Cricoid Cartilage ; Elasticity ; Gases ; Humans ; Intubation, Intratracheal* ; Lidocaine ; Male ; Muscle Relaxation ; Respiration ; Traction ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

A clinical experience with management was made on 65 cases of posterior urethral injury in the Department of Urology, Jeonbug National University Hospital during the period. From January, 1978 to December, 1982. The results were as follows: 1. The number of the posterior urethral injury was 65 cases. 2. Age distribution of the posterior urethral injury was the high test in the age 20-49 (66%). 3. The most common cause of the posterior urethral injury was industrial injury in 44 cases and traffic accident in 21 cases. 4. Initial managements of posterior urethral injury were Foley catheter indwelling in 8cases, cystostomy only in 20 cases and primary realignment in 37 cases. 5. Of 65 cases, urethral stricture after initial management developed in 34 cases. 6. Among 34 cases of the urethral stricture, various delayed managements were performed, including sounding in 19 cases, transpubic urethroplasty in 5 cases, urethral end-to-end anastomosis by perineal approach in 9 cases and cystostomy in 1 case.
Accidents, Traffic ; Age Distribution ; Catheters ; Cystostomy ; Jeollabuk-do ; Urethral Stricture ; Urology

PURPOSE: Bilateral high signal intensity in basal ganglia on Tl-weighted images is unusual. the purpose of this study is to describe the pattern of high signal intensity and underlying disease. METHODS AND MATERIALS: During the last three years, 8 patients showed bilateral high signal intensity in basal ganglia on Tl-weighted image, as compared with cerebral white matter. Authors analized the images and underlying causes retrospectively. Of 8 patients, 5 were male and 3 were female. The age ranged from 15 days to 79 years. All patient were examined by a 0.5T superconductive MRI. Images were obtained by spin echo multislice technique. RESULTS: Underlying causes were 4 cases of hepatopathy, 2 cases of calcium metabolism disorder, and one case each of neurofibromatosis and hypoxic brain injury. These process were bilateral in all cases and usually symmetric. In all cases the hyperintense areas were generally homogenous without mass effect or edema, although somewhat nodular appearence was seen in neurofibromatosis. Lesions were located in the globus pallidus and internal capsule in hepatopathy and neurofibromatosis, head of the caudate nucleus in disorder of calcum metabolism, and the globus pallidus in hypoxic brain injury. CONCLUSION: Although this study is limited by its patient population, bilateral hyperintense basal ganglia is associated with various disease entities. On analysis of hyperintense basal ganglia lesion, the knowledge of clinical information improved diagnostic accuracy.
Basal Ganglia* ; Brain ; Brain Injuries ; Calcium Metabolism Disorders ; Caudate Nucleus ; Edema ; Female ; Ganglia ; Globus Pallidus ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Male ; Metabolism ; Neurofibromatoses ; Retrospective Studies

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
Acceleration ; Adolescent ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Hyperplasia* ; Hyperprolactinemia ; Hypothyroidism* ; Magnetic Resonance Imaging ; Pituitary Gland ; Thyroid Gland