The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

No abstract available.
Cough* ; Humans ; Hydrogen-Ion Concentration*

Recently, the Korean Neuropsychiatric Association expelled one of its members on grounds of multiple ethical violations, which included a sexual boundary violation between doctor-patient relationships. However, the lack of understanding of why this is an ethical issue was found among the general population as well as psychiatric professionals. In this review article, we introduce the basic concepts of psychotherapy and psychiatrist-patient relationships, including therapeutic structure and transference/countertransference, and elaborate the reasons why boundary violations, and especially sexual boundary violations, are unethical and potentially harmful to the patient and to the psychiatric community.
Ethics ; Humans ; Psychiatry* ; Psychotherapy

A case of amelia, which affected upon both lower extremities, was experienced at the Taegu Presbyterian Hospital. We report this case because of rarity of amelia and an addition of the case with brief review of literatures.
Daegu ; Ectromelia ; Lower Extremity ; Protestantism

It has been emphasized that the treatment of choice for the trochantric fracture of the femur is open reduction and rigid internal fixation to reduce complications by early ambulation. The incidence of trochanteric fracture of the femur in the young age group has been considerably increased in recent years because of increased traffic and industrial accidents. The author treated 38 cases of trochanteric fracture of the femur in the year 1974 through 1979, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. In sex distribution, 24 out of 38 were males and 14 were females. 16 cases out of 24 male patients were in the age group 20-40 and 9 cases out of 14 female were over 60 years of age. Over all mortality was 7.9%. 2. The numbers of patients of type I and III were 11 cases in each type out of 38 trochanteric fracture. 3. 26 cases out of 38 cases were treated by open reduction and internal fixation and the others were by traction and cast. 4. The applied metal devices were 3 types: Smith-Peterson nail and Thornton or McLaughlin plate, compression hip screw, and multiple pinning. 5. Mean duration of bony union is shorter in the group of open reduction and internal fixation (13 weeks) than the group of traction and cast (15 weeks). The cause of difference is that the 6 out of 9 cases of type IV and V were included in conservative group. 6. The incidece of the complications such as coxa vara, slipping screw, long nail and traction palsy occurred higher in the group fixed with Smith-Peterson nail and plate than the group fixed with compression hip screw.
Accidents, Occupational ; Coxa Vara ; Early Ambulation ; Female ; Femur ; Hip ; Humans ; Incidence ; Male ; Mortality ; Paralysis ; Sex Distribution ; Traction

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

BACKGROUND AND OBJECTIVES: Little information about the surgical anatomy and technique for retropharyngeal node dissection has been published. The purpose of this study was to review our surgical technique and results of retropharyngeal lymph node dissection. MATERIALS AND METHODS: Eleven advanced oropharyngeal and hypopharyngeal squamous cell carcinoma patients who had been treated with resection of primary tumor and standard neck dissection including retropharyngeal lymph node dissection from 1994 to 1999 were evaluated retrospectively. RESULTS: One of 11 patients had positive retropharyngeal lymph node. The surgical technique used for retropharyngeal lymph node dissection were total laryngopharyngectomy, mandibular splitting or mandibulectomy approach. There was no specific complication of retropharyngeal lymph node dissection except one case of Horner's syndrome. CONCLUSION: Retropharyngeal lymph node dissection was a safe procedure, bet it required total laryngopharyngectomy, madibular splitting or mandibulectomy approach. It was possible to remove retropharyngeal lymph made en-bloc with primary tumor in most cases.
Carcinoma, Squamous Cell ; Horner Syndrome ; Humans ; Hypopharyngeal Neoplasms ; Lymph Node Excision* ; Lymph Nodes* ; Neck Dissection ; Oropharyngeal Neoplasms ; Retrospective Studies

No abstract available.
Hernia, Inguinal* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging*

After extracapsular cataract extraction and posterior chamber intraocular lens implantation on 62 high myopic patients(79 eyes) whose axial lengths were more than 26.0mm, the authors investigated the differences between the calcualted, predicted, peroperative values and measured postoperative values retrospectively. The patients were divided into 2 groups according to their axial lengths; Group C is 35 patients (44 eyes) with 26.0-28.4mm. Group D is 27 patients(35 eyes) with more than 28.4mm. Group A, as control group, is 70 patients(81 eyes) with 22.0-24.4mm and group B, as control group, is 37 patients(44 eyes) with 24.5-25.9mm. Autorefractive examination and manifest refraction was done at 1week, 1month, 3 months postoperatively. Preoperative intraocular lens diopter was calculated by SRK-II and SRK/T formula. After the scleral incision, continuous circumlinear capsulorhexis, and phacoemulsification, one-piece PMMA lens was implanted in the bag. At postoperative 3 months, all patients had the tendency of myopic shift and the shift calculated by SRK-II was much more than that by SRK/T. The difference was statistically significant. In conclusion, it is better to apply SRK/T formula when axial length is more than 26.0mm, in order to acheive goal diopter postoperatively.
Capsulorhexis ; Cataract Extraction ; Cataract* ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Retrospective Studies

BACKGROUND: An adequate uteroplacental and fetal blood flow during labor and cesarean delivery is of prime importance for fetal well-being and neonatal outcome. METHODS: Using the vascular smooth muscle of the human isolated umbilical arteries, this study was performed to see whether commonly used local anesthetics (bupivacaine, lidocaine and 2-chloroprocaine) and opioids (morphine,fentanyl and meperidine) could induce contracion or relaxation of these resting and precontracted vessels. Rings from human umbilical arteries were prepared by microdissection. The vessel rings were mounted in tissue baths for an isometric recording of the contractile activity. For resting muscles, the reactivity to drugs is expressed as a percentage of a maximal KCl-induced contraction, and for precontracted muscle, it is expressed as a percentage of a submaximal KCl-induced contraction. RESULTS: Bupivacaine, lidocaine and 2-chloroprocaine all induced contractions. Bupivacaine showed a maximal contraction (46.7 +/- 10.5%) at concentrations of 43 micrometer, lidocaine 19.7 +/- 4.8% at 0.11 mM. and 2-chloroprocaine showed 14.6 +/- 2.9% at 0.65 mM. Morphine, fentanyl and meperidine all induced contractions. Morphine showed a maximal contraction (19.6 +/- 7.1%) at a concentration of 10 4 M, meperidine at 17.2 +/- 8.4% at 3 x 10 5 M, and fentanyl at 1.7 +/- 2.0% at 3 x 10(-6)M. When umbilical arteries were induced to contract with a submaximal concentration of KCl, bupivacaine and lidocaine showed an ability to increase the magnitude of the sustained contraction, but 2-chloroprocaine showed a relaxation of the sustained contraction. Morphine, fentanyl and meperidine showed no change in the sustained contraction. CONCLUSIONS: This study demonstrates these local anesthetics and opioids as vasoactive on human umbilical arteries. If applicable in vivo, these drugs might have some influence on umbilical vessel tone and thus might reduce umbilical blood flow.
Analgesics, Opioid* ; Anesthetics, Local* ; Baths ; Bupivacaine ; Fentanyl ; Fetal Blood ; Humans* ; Lidocaine ; Meperidine ; Microdissection ; Morphine ; Muscle, Smooth, Vascular ; Muscles ; Relaxation ; Umbilical Arteries*