No abstract available.
Diabetic Neuropathies*

OBJECTIVE: To study the erectile response to intracavernosal injection of prostaglandin E1 in 33 spinal cord injured men with neurogenic erectile dysfunction. METHOD: The erectile response was assessed by the penile palpation. Thirty three subjects (mean age, 35.5 years) were studied. They received a testing dosage starting from 2.5 microgram with increasing dosage (maximum 40 microgram) to achieve an erection. The positive response accounts for the sufficient erection lasting for more than 30 minutes. RESULTS: After the injection, 30 subjects (90.9%) achieved the positive response and the mean duration of erection was 59.2 minutes. Of the 30 positive responders, the mean dosage needed to induce positive response was 5.8 microgram in the patients with cervical cord injury (12 subjects), 13.1 microgram in the patients with thoracic cord injury (12 subjects), and 33.3 microgram in the patients with lumbar cord injury (6 subjects). The mean dosage required for the positive response was different according to the pre-injection erectile function of the subjects. For the positive response, it required 7.7 microgram in a full erection with short duration group (14 subjects), 9.4 microgram in a partial erection group (8 subjects), and 30.6 microgram in no erection group (8 subjects). No systemic side effect or complication was noted except for the prolonged erection in 1 subject. CONCLUSION: The intracavernosal injection of prostaglandin E1 appears to be a safe and effective treatment for the treatment of erectile dysfunction in spinal cord injured men. The dosage depends on the level of spinal cord injury and pre-injection erectile function.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Palpation ; Spinal Cord Injuries ; Spinal Cord*

The author investigated on the ratio of central serous retinopathy (C.S.R.) cases among total out patients, the distribution of age and sex, and sites of affected eye in 214 cases of C.S.R. from March 1st 1977 to February 28th 1981. Fluorescein angiography was performed in 132 eyes of 108 cases among them. Each type according to the leaking pattern on fluorescein angiography were characteritically classified as followings: Type A; Leaking point is unremarkable (C.S.R. clinically). Type B; Leaking point appears at early arterial phase and increases in density gradually but the size of leaking area is not enlarged. Type C; Leaking point appears at early arterial phase and increases concentrically in its size and density. Type D; Leaking point appears at early arterial phase and increases vertically (mushroom shaped) in its size and density. Type E; Leaking point appears at early arterial phase and gradually fades out (scar formation). The results were obtained as follows: 1) The eyes of C.S.R. were observed in 0.83% among total out patients. 2) As to the distribution of age, 5th decade was most frequantly affected in 37.3%. 3) As to the distribution of sex. male was observed in 80.8%. 4) Among 214 cases, unilateral involvement was observed in 85.1% without difference of both eyes and binocular involvement was nbserved in 14.9%. 5) Type C in leaking pattern was most frequantly observed in 25.8%. 6) A single leakage was observed in 59. 1% of all eyes. 7) The site of leaking point of fluorescein was found most frequantly in the upper area. 8) The direction of diffusion in leaking pattern was most frequantIy upward in type C, and outward in type D. 9) The detached size of type C and D were more larger than other types. 10) Comparing the onsets of each type, type A, B, C and D could be seen within 3 months, and type E could be found over 3 months. 11) In general, the visual acuity was severely disturbed in type D rather than the other types. And the visual disturbance was remarkable in the case of large serous detachment.
Central Serous Chorioretinopathy* ; Diffusion ; Fluorescein Angiography ; Fluorescein* ; Humans ; Male ; Outpatients ; Telescopes ; Visual Acuity

No abstract available.
Spine*

No abstract available.
Talus*

No abstract available.
Brain Stem* ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Infant*

Early diagnosis of persistent abnormal reflexes may be of great significance to a more effective functioning of the cerebral palsied child. It is important to know the normal and abnormal reflex responses and their effect upon motor development for providing a basis for evaluation in the diagnosis and treatment of the cerebral palsied child. We studied 28 cerebral palsied children, between 1 to 12 years old, who were treated at Sam Yook Childrens Rehabilitation Center from May 1975 to December 1977. The pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1. The following were the most important pathologic reflexes in non-walking fgroup: a. Positive supporting reaction b. Protective extensor thrust c. Moro reflex 2. If they are present, the prognosis for walking ambulation was bad and surgery will not improve for the chances of walking.
Child ; Diagnosis ; Early Diagnosis ; Humans ; Prognosis ; Reflex ; Reflex, Abnormal ; Reflex, Startle ; Rehabilitation Centers ; Walking

In contrast to younger patients, geriatric patients are generally considered to be a poor risk for anesthesia and surgery and greater care should be taken in anesthetic management, because many have chronic systemic diseases in addition to a decrease in physiologic function. To evaluate geriatric anesthetic experiences, we received clinical records of 1,062 patients aged over 65 out of 21,656 surgical cases performed at Korea University Hye-Wha Hospital from January 1980 to December 1986. The cases were analysed according to age, sex, department, preoperative physical status, anesthetic techniques and agents, duration of anesthesia, operation site, length of hospital stay, laboratory data(Chest X-ray, EKG), associated diseases, postoperative complications and mortality. The results are as follows: 1) Of the 1,062 geriatric surgical patients, 516 cases(48.6%) were 65~69 years of age. 2) The number of geriatric surgical cases was 1,062 of which 672(63.3%) were male and 390(36.7%) were female. 3) Most surgical cases were general surgery(401 cases, 37.8%). 4) The rate of elective and emergency surgery was 78.0%(829 cases) and 22.0%(233 cases), respectively. The ratio of insurance patients (737 cases, 69.4%) versus noninsurance patients(325 cases, 30.6%) was approximately 2:1. 5) The number of general anesthesia cases was 777 (73.2%), spinal anesthesia 244( 23.0%), epidural anesthesia, 21(.20%), and brachial plexus block, 5( 0.5%). The anesthetics were thalamonal and meperidine hydrochloride(238 cases, 22.4%), halothane(204 cases, 19.2%) and tetracaine(244 cases, 23.0%). 6) The duraion of anesthesia was within 1hour in 88 cases( 8.3%), 1~2 hours in 421 cases(39.6%), and 2~3 hours in 291 cases(27.4%). 7) The number of lower abdominal surgery cases was 497 (46.8%) and the number of upper abdominal surgery cases was 188(17.7%). 8) Preoperative laboratory findings were as follows: The findings of preoperative chest X-rays revealed that 219 cases(21.4%) were within normal mits. 182 cases(17.8%) had hypertensive heart, and 208 cases(20.4%) had atherosclerosis. The EKG, which was done on 90.8% of the patients, revealed that 333 cases (34.5%) were within normal limits, 77 cases(8.0%) showed left ventricular hypertrophy, 65 cases(6.7%) showed sinus bradycardia, and 27 cases(2.8%) showed myocardial ischemia. 9) Hypertension(88cases, 49.4%) was the most commonly associated disease. 10) The total number of postoperative complication cases was 73(6.9%). Seventeen cases showed wound infection and delayed skin closure, 19 cases showed pneumonia, and 7 cases showed atelectasis. 11) The total number of postoperative deaths was 18 cases(1.7%).
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Anesthetics ; Atherosclerosis ; Brachial Plexus ; Bradycardia ; Electrocardiography ; Emergencies ; Female ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Insurance ; Korea ; Length of Stay ; Male ; Meperidine ; Mortality ; Myocardial Ischemia ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Skin ; Thorax ; Wound Infection

Hwa-Byung(HB) has been categorized as a Korean culture-bound syndrome that is prevalent in married women of low socioeconomic status. PURPOSE: The Purpose of the study was to search for the essence of HB and a caring-healing process of HB. Then the research result discusses whether the Transpersonal Caring-Healing Model has been congruent with it. METHOD: Case examples resulted from in-depth telephone counseling over a period of time at the Women's Hot Line with a client who is a housewife with HB. The counseling content was analyzed through Giorgi's method of descriptive phenomenology. RESULT: The core meaning of the essence of HB was 'injustice'; and essential themes were 'lack of reciprocity', 'infidelity' 'suppressed aggression and powerlessness' and 'need for recognition'. The core meaning of the essence of the caring-healing process was 'caring-healing experience(maintaining a trust relationship)'; and essential themes were 'active listening', 'empathy' and 'forming a therapeutic relationship'. According to Watson, 'active listening', 'empathy' and 'forming a therapeutic relationship' were identified as intentionality, intersubjectivity and transpersonal. CONCLUSION: Transpersonal caring can release inner power and strength and help the person to gain a sense of inner harmony. Transpersonal caring is as important to healing as are conventional treatment approaches and even more powerful in the long run.
Somatoform Disorders/*nursing ; Poverty ; Nurse-Patient Relations ; Marriage ; Korea ; Humans ; Female ; Culture ; Counseling

BACKGROUND:Outpatient surgery has recently grown in popularity. This trend has affected the practice of anesthesia and has also led to an increasing interest in the development and use of short-acting anesthetic and analgesic agents. METHODS: One hundred fifty patients scheduled for outpatient surgery were randomly allocated to receive propofol, sevoflurane or isoflurane anesthesia with tracheal intubation. Clinical recovery times were analyzed as emergence, recovery, cognition and discharge. All adverse events were noted. RESULTS: Sevoflurane resulted in significantly shorter times to emergence (2.9 min), recovery (4 min), cognition (5.5 min) and discharge (13.4 min) than isoflurane. Propofol resulted in shorter times to emergence (2 min), recovery (2 min), cognition (3 min) and discharge (6.6 min) than isoflurane, but these were not significant. Also, sevoflurane resulted in shorter times to emergence, recovery, cognition and discharge than propofol, but not significantly. Among the adverse events noted, the percentages of postoperative nausea and vomiting (PONV) after anesthesia were 8%, 20% and 24% for the those who received propofol, sevoflurane and isoflurane, respectively. Propofol resulted in a significantly lower incidence of PONV than sevoflurane or isoflurane. There was no significant difference between sevoflurane and isoflurane in this respect. CONCLUSIONS: Sevoflurane and propofol are better anesthetics than isoflurane for outpatient anesthesia because of their rapid recovery times and a lower incidence of postoperative nausea and vomiting.
Adult* ; Ambulatory Surgical Procedures* ; Analgesics ; Anesthesia* ; Anesthetics ; Cognition ; Humans ; Incidence ; Intubation ; Isoflurane* ; Outpatients* ; Postoperative Nausea and Vomiting ; Propofol*