The number of survivors after hypoxic-ischemic encephalopathy has been increasing due to recent progress in medical system and care. Impairment after injury ranges from mild memory deficit to vegetative state or death. Cognitive impairment is particularly common in the survivors, because the hippocampus and medial temporal lobe are vulnerable to ischemic insult. Medication and cognitive rehabilitation should be initiated to minimize the impact of various cognitive deficits. Instead of Glasgow-Pittsburgh Cerebral Performance Categories, which is insensitive to functional change, standardized functional assessment tools should also be used in research as well as in rehabilitation settings.
Brain Injuries ; Hippocampus ; Humans ; Hypoxia-Ischemia, Brain* ; Memory Disorders ; Mild Cognitive Impairment ; Persistent Vegetative State ; Rehabilitation ; Survivors ; Temporal Lobe

Fractures of the proximal humerus occur more frequently in older patients but are seen in all ages and emerge epiphyseal separations. The objectives of treatment are restoration of all involved structures to normal anatomical state and a completely functional limb in the shortest time possible. One part and two part fractures were indicated in conservative treatment and surgical treatment in most of three, four part fractures. The results of treatment of forty four cases according to Neer's classification were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital from Mar. 1978 to Dec.1985. The results were as follows. 1. The prevalent age distribution was third and fifth decade(48%) . 2. The most common cause of injury was slip down(14 cases, 32%). 3. The most frequent cases of the fractures in Neer's classification were two part fractures(22 cases, 50%). 4. Thirty one cases(71%) were treated by conservative treatment, twelve cases(27%) by open reduction and 1 case(2%) by prosthesis. 5. Good results were in 23 cases(52%) of one and two part fractures, fair in 17 cases(39%) and poor in 4 cases(9%) of two, three and four part fractures.
Age Distribution ; Classification ; Clinical Study ; Extremities ; Humans ; Humerus ; Jeollabuk-do ; Orthopedics ; Prostheses and Implants ; Shoulder Fractures

Chronic obstructive pulmonary diseases are being increased every year by many factors. But there are two important factors. First of all the atmospheric contamination is due to modern civilization, secondarily, the increase of old age population which is the result of prolonged life span by contribution of modern medicine. For these reasons increasing chronic obstructive pulmonary disease, anesthesiologists have had increased problems to administer anesthesia, because these patients are most difficult to manage for anesthesia. Author have studied for if it could be diminished these problems by comparing of the complications during period of anesthesia induction, maintenance, recovery and 5 postoperative days, with IPPB therapy and other physical therapy. The results of the study are as follows: 1) Pre and postoperative IPPB therapy is more useful to diminish anesthesia problems compared with other physical therapy. 2) Other physical therapy is useful when compared with controlled group. 3) IPPB therapy is the choice of treatment for postoperative atelectasis. Statistical significance was assessed by using student t test.
Anesthesia ; Civilization ; History, Modern 1601- ; Humans ; Intermittent Positive-Pressure Breathing* ; Lung Diseases, Obstructive ; Pulmonary Atelectasis ; Pulmonary Disease, Chronic Obstructive

No abstract available.
Drinking Behavior* ; Drinking* ; Humans

The endocrinologic complications such as adrenal insufficiency and hypopituitarism are common after traumatic brain injury (TBI) portending poor rehabilitation outcome. Anterior pituitary dysfunction presents as hypothyroidism, hypogonadism, growth hormone deficiency, adrenal insufficiency and hyperprolactinemia, whereas posterior pituitary dysfunction includes syndrome of inappropriate antidiuretic hormone and central diabetes insipidus. Careful history taking and physical examination are essential to detect these abnormalities early. Laboratory tests such as serum/urine sodium and osmolality, thyroid hormone, testosterone, estradiol, cortisol, prolactin, growth hormone or IGF-1 are also necessary. Screening of endocrinologic functions is recommended especially in patients with moderate or severe TBI, skull base fracture or diffuse axonal injury 3 to 6 months after injury. Further studies are needed to reveal the effect of early correction of endocrinologic abnormality on long-term functional outcome.
Adrenal Insufficiency ; Brain Injuries ; Diabetes Insipidus, Neurogenic ; Diffuse Axonal Injury ; Endocrine System Diseases ; Estradiol ; Growth Hormone ; Humans ; Hydrocortisone ; Hyperprolactinemia ; Hypogonadism ; Hypopituitarism ; Hypothyroidism ; Insulin-Like Growth Factor I ; Mass Screening ; Osmolar Concentration ; Physical Examination ; Prolactin ; Skull Base ; Sodium ; Testosterone ; Thyroid Gland ; Treatment Outcome

It has been known that the prevalence and the etiology of headache in the elderly are different from these in the general population. Nevertheless studies of headache in the elderly have been rare. Under these backgrounds, prospective study was performed to find the clinical characteristics of headache in the Korean elderly. The subjects consisted of 237 patients (male:femal = l.0:1.7). A detailed and relevant history was gathered by headache history force, and specific headache diagnosis was based on diagnostic criteria of the International Headache Society (1988). This study revealed that episodic/chronic tension-type headache (43%) was the meet common diagnosis, followed by headache not classifiable (8%), headache from substance withdrawal (6%), occipital neuralgia (5%), idiopathic stabbing headache (4%), and migraine(40%). Relatively because many patients with tension type headache had oromandibular dysfunctions, somewhat high proportion of the patients reported unilateral predominance in the location of pain. The proportion of symptomatic headache that start in the elderly were higher than that of idiopathic headache. When comparing with the general population, the importance of migraine and cluster headache declined, while the important of symptomatic headaches increased. Idiopathic headache was more common in woman than in men, but symptomatic headache had no definite sex difference. In conclusion, the etiologies and types of headache in the elderly are more complex and diverse, so that thorough diagnostic workups are needed.
Aged* ; Cluster Headache ; Diagnosis ; Female ; Headache Disorders, Primary ; Headache* ; Humans ; Male ; Migraine Disorders ; Neuralgia ; Prevalence ; Prospective Studies ; Sex Characteristics ; Tension-Type Headache

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

OBJECTIVE: This study was performed to assess the possible involvement of the dopamine D5 receptor gene(DRD5) in the etiology of schizophrenia. METHODS: We identified the distribution of the T978C varient of the dopamine D5 receptor gene in 100 schizophrenics and 100 normal controls in Korean population, and evaluated the association between two groups. RESULTS: There were no significant differences in genotype frequency of T978C variation and genotype prevalence of homozygotes between schizophrenic and control groups. There was no significant difference in T978C allele frequencies between schizophrenic and control groups. CONCLUSION: We present evidence of a lack of allelic association between the exonic common polymorphism of the dopamine D5 receptor gene and Korean schizophrenic patients. The assumption that the T978C varient of the dopamine D5 receptor gene has a genetic role in the development of schizophrenia was not examined by this case-control study. However, because it is considered that DRD5 may act as the expression factor for the symptoms of schizophrenia or affect the difference in an individual's susceptibility to the disease, future studies to investigate the influence of other variations of DRD5 are needed.
Case-Control Studies ; Dopamine* ; Exons ; Gene Frequency ; Genotype ; Homozygote ; Humans ; Prevalence ; Receptors, Dopamine D5* ; Schizophrenia

BACKGROUND: The concept of "double crush syndrome (DCS)"-a proximal compressive lesion making the distal nerve more vulnerable to injury-is an intriguing hypothesis. However, recent studies did not show unitary results. This study was preliminarily undertaken in order to clarify the causal relationship of proximal compressive lesion and carpal tunnel syndrome (CTS) in an electrophysiologic aspect. METHODS: In the period between June 1998 and June 1999 there were 24 patients with CTS(33 limbs with CTS). With these CTS patients, thorough electrodiagnostic studies were performed to discover coexisting proximal compressive lesions along the median nerve and its corresponding cervical root lesions. RESULTS: In 10 of these limbs (30%), there was a electrodiagnostically-proven coexisting proximal compressive lesion(all cervical radiculopathies). But only 1 limb (3%) had an anatomically responsible association. Finally only 1 limb (3%) with CTS had a possibility of DCS. CONCLUSIONS: CTS and cervical radiculopathy are common disorders, so there is a high possibility of coexisting as a double primary lesion without a pathophysiological relationship. Our results do not support the double crush hypothesis. However, the possibility of a reversed double crush syndrome is suggested.
Carpal Tunnel Syndrome* ; Crush Syndrome* ; Extremities ; Humans ; Median Nerve ; Radiculopathy