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.
Brain Stem* ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Infant*

No abstract available.
Spine*

No abstract available.
Talus*

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

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

The continuous perineural, perivascular compartment surrounding the brachial plexus from the tip of the cervical transverse process to the axilla may be entered at virtually any level, and the extent of anesthesia depends upon the level of entry and volume of local anesthetics injected. Various approaches of brachial plexus block were introduced to produce a successful block with the least complications. In this study, 25 ml of 0.5% bupivacaine hydrochloride solution was injected by subclavian perivasular approach to illustrate the effect of various locations of paresthesia on the distribution of analgesia in 50 patients who had an operation of the hand or forearm. The location of paresthesia evoked by insertion of a 23-gauge scalp needle during performance of brachial plexus block was checked at the distribution of the superior, middle, and inferior trunks. A pin prick test was performed at 15 min, 30 min and 45 min after injection of bupivacaine hydrochloride to evaluate the distribution of analgesia in the superior, middle and inferior trunk of the brachial plexus. The incidence of analgesia in all three trunks was the highest when paresthesia of the middle trunk distribution was elicited. The incidence of analgesia in the superior trunk distribution was significantly lower when inferior trunk paresthesia was elicited than when superior trunk paresthesia was elicited. Superior trunk paresthesia was the most frequently elicited. Complications were arterial puncture (32%), Horner's syndrome (8%) and hematoma (2%). The results indicates that brachial plexus block by supraclavicular subclavian perivascular approach is a relatively safe technique. Injection of local anesthetics following the confirmation of middle trunk paresthesia is desirable to obtain the successful block. Especially when analgesia of superior trunk distribution is required, the direction of needle insertion should be adjusted to avoid the inferior trunk paresthesia elicited.
Analgesia ; Anesthesia ; Anesthetics, Local ; Axilla ; Brachial Plexus* ; Bupivacaine ; Forearm ; Hand ; Hematoma ; Horner Syndrome ; Humans ; Incidence ; Needles ; Paresthesia ; Punctures ; Scalp

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*