No abstract available.
Gynecology* ; Laparoscopy*

We experienced two cases of convulsive seizure, accompanied with tachycardia and hypertension following spinal anesthesia for inguinal herniorrhaphy and skin graft. Spinal anesthesia was performed with teracaine, 10% dextrose solution and epinephrine. Tranexamic acid was used instead of 10% dextrose solution inadvertently. About 2 hours after spinal anesthesia, the patients developed spastic rigidity at the upper extremities and chest wall that progressed to episthotonus and seizure preceded by tachycardia and hypertension. About 40 hours after vigorous symptomatic treatment using mechanical ventilator, oxygen, short acting barbiturate, antihypertensive drugs and anticonvulsants, the patients had recovered completely with clear mental state. And they didn't show any other neurologic deficits except amnesia.
Amnesia ; Anesthesia, Spinal ; Anticonvulsants ; Antihypertensive Agents ; Epinephrine ; Glucose ; Herniorrhaphy ; Humans ; Hypertension ; Muscle Spasticity ; Neurologic Manifestations ; Oxygen ; Seizures* ; Skin ; Subarachnoid Space* ; Tachycardia ; Thoracic Wall ; Tranexamic Acid* ; Transplants ; Upper Extremity ; Ventilators, Mechanical

The authors present a very rare case of an intrasellar cavernous hemangioma that mimick a pituitary macroadenoma radiologically. A 63-year-old male patient was admitted with visual field defect and clinical manifestations of pituitary failure. MR image revealed intrasellar gadolinium-enhancing tumor with parasellar extension suggesting pituitary macroadenoma. But pathology was cavernous hemangioma. It was suggested that cavernous hemangioma should be included in the differential diagnosis of pituitary mass.
Diagnosis, Differential ; Hemangioma, Cavernous* ; Humans ; Male ; Middle Aged ; Pathology ; Pituitary Neoplasms ; Sella Turcica ; Visual Fields

OBJECTIVE: To investigate the effects of mirror therapy using a tablet PC for post-stroke central facial paresis. METHODS: A prospective, randomized controlled study was performed. Twenty-one post-stroke patients were enrolled. All patients performed 15 minutes of orofacial exercise twice daily for 14 days. The mirror group (n=10) underwent mirror therapy using a tablet PC while exercising, whereas the control group (n=11) did not. All patients were evaluated using the Regional House–Brackmann Grading Scale (R-HBGS), and the length between the corner of the mouth and the ipsilateral earlobe during rest and smiling before and after therapy were measured bilaterally. We calculated facial movement by subtracting the smile length from resting length. Differences and ratios between bilateral sides of facial movement were evaluated as the final outcome measure. RESULTS: Baseline characteristics were similar for the two groups. There were no differences in the scores for the basal Modified Barthel Index, the Korean version of Mini-Mental State Examination, National Institutes of Health Stroke Scale, R-HBGS, and bilateral differences and ratios of facial movements. The R-HBGS as well as the bilateral differences and ratios of facial movement showed significant improvement after therapy in both groups. The degree of improvement of facial movement was significantly larger in the mirror group than in the control group. CONCLUSION: Mirror therapy using a tablet PC might be an effective tool for treating central facial paresis after stroke.
Facial Paralysis* ; Humans ; Mouth ; National Institutes of Health (U.S.) ; Outcome Assessment (Health Care) ; Prospective Studies ; Smiling ; Stroke*

OBJECTIVES: Copper and Zinc, the trace elements of a living body, take a part in immunologic mechanism and induce the pulmonary fibrosis which is the pathologic progress of pneumoconiosis. This study was performed to assist the identification of the pathologic process of pulmonary fibrosis in pneumoconiosis. METHODS: The subjects of this study was 200 diagnosed persons as pneumoconiosis, of whom 100 persons was the visitors in the outpatients departments of pneumoconiosis and 100 admissive pneumoconiosis patients. The serum copper and zinc are measured and com pared. RESULTS: The mean serum copper concentration of visitor group was significantly higher than that of control group, and that of stage V3 subgroup of visitor group was highest because of their advanced fibrosis. But, there was not the difference of serum copper concentration between patient and control group. We thought that the reason was poor nutritional and health status of the patient. The mean of serum zinc concentration of visitor and patient control was lower than that of control group. As the degree of pulmonary fibrosis was more severe from stage Vl, V2, V3 of visitor to stage Pl, P2, P3 of patient, the mean of serum zinc concentration was lower. The ratio of serum copper/zinc of visitor and patient was higher than that of control, and that of patient was higher than that of visitor. Those results showed that the ratio of serum copper/zinc ratio more greatly expressed the degree of progression of pneumoconiosis than only copper or zinc concentration by adjustment of nutritional and health status of the patient. CONCLUSIONS: As above study results, the degree of pulmonary fibrosis of pneumoconiosis could be estimated by means of serum copper/zinc ratio.
Copper* ; Fibrosis ; Humans ; Outpatients ; Pneumoconiosis* ; Pulmonary Fibrosis ; Trace Elements ; Zinc*

Low back pain in computer terminal operators is a very common but important symptom. While the occupational risk factors of low back pain were approved obscurely, there have been few studies on analysis or understanding of occupational risk factors. Therefore, we studied occupational risk factors of low back pain, especially for ergonomic factors as well as general characteristics of workers. We selected 98 subjects for this study, computer terminal operators ordinary using computers in Pusan. We calculated the subjective severity of low back pain of each operator by the Low Back Pain Scoring System. The relation of low back pain score to general characteristics of worker was also analyzed. We analyzed the relationship between low back pain score and individual efforts to prevent low back pain. We measured the ergonomic factors of each computer terminal operator - Trunk Jnclination(TI), Arm Flexion(AF), Elbow Angle(EA), Head Tilting(HT), Knee Angle(KA), using of foot plate and gap between the popliteum and chair. The correlations between these ergonomic factors and low back pain score were then analyzed. And the results are as follows: 1. The prevalence rate of low back pain in computer terminal operators was 39.8% in this study, when low back pain score was converted by the low back pain scoring system. 2. According to general characteristics of workers related to low back pain, the scores were higher in the older age group, the married and the longer work carriers. (p < 0.05) 3. In the analysis of the relationship between low back pain score and individual effort to prevent low back pain, regular exercise, history of schooling for prevention of low back pain, and declaration of intention to participate in low back pain education or exercise were stastistically significant(p < 0.05). And the more severe the low back pain, the higher the intention to participate in low back pain education they had in this study. 4. In the analyses of relationships or correlations between low back pain score and each of the 7 categories of ergonomic factors, only head tilting had a weak reverse correlation with low back pain(r=-0.2999, p < 0.01). From now on, cohort studies for the risk factors of low back pain of workers, who have been forced to work in non-ergonomical positioning at the work site, will be necessary. On the background of these ergonomic studies, the occupational health profession should be required to manage ergonomic working conditions.
Arm ; Busan ; Cohort Studies ; Computer Terminals* ; Education ; Elbow ; Foot ; Head ; Human Engineering ; Humans ; Intention ; Knee ; Low Back Pain* ; Occupational Health ; Prevalence ; Risk Factors* ; Workplace

PURPOSE: Nuclear factor-kappa B(NF-kappa B) is now recognized as playing a potential role in programmed cell death and the adaptive response to various stress. Cellular hypoxia is a primary manifestation of many cardiovascular diseases. It seems that vascular endothelial growth factor (VEGF) and insulin like growth factor-I(IGF-I) have a function as a protective molecule in the heart against several stress including hypoxia. In this study, the role of NF-kappa B to the cellular response and regulation of protective molecules against the acute hypoxia in the heart was studied. METHODS: To cause acute hypoxic stress to the heart, Sprague Dawley rats were exposed to hypoxic chamer(N2 92% and O2 8%). After the hypoxic exposure, nuclear proteins, total proteins and mRNA were isolated from heart. Translocation of the transcription factors NF-kappa B, NF-ATc, AP-1 and NKX-2.5 were evaluated by electrophoretic mobility shift assay(EMSA). The expression of IGF-I and VEGF were studied before and after the hypoxic stress by competitive-PCR, Northern hybridization and Western hybridization. To confirm the role of the NF-kappa B in the heart, the rats also were pretreated with diethyl-dithiocarbamic acid(DDTC) into peritoneal cavity to block NF-kappa B translocation into nucleus. RESULTS: The expression of NF-kappa B, AP-1 and NF-ATc were increased by the hypoxic stress. Increased expression of the VEGF and IGF-I were also observed by the hypoxic stress. However, the blocking of the NF-kappa B translocation reduced those expressions of VEGF and IGF-I. CONCLUSION: These results suggest that NF-kappa B has a protective role against the acute hypoxia through several gene expression, especially VEGF and IGF-I in heart muscle.
Animals ; Anoxia* ; Cardiovascular Diseases ; Cell Death ; Cell Hypoxia ; Gene Expression ; Heart* ; Insulin ; Insulin-Like Growth Factor I ; Myocardium ; NF-kappa B* ; Nuclear Proteins ; Peritoneal Cavity ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Transcription Factor AP-1 ; Transcription Factors* ; Vascular Endothelial Growth Factor A

The authors found that the fourth author's affiliation had been inadvertently omitted.

OBJECTIVE: The informed consent, in literal sense, is a medicolegal process that requires full explanation and clear disclosure about the illness, and thorough comprehension and autonomous consent to the respective medical services of the competent recipient. The authors review the theoretical background of the informed consent and investigate pertinent problems encountered in medical practice. METHODS: We gathered 153 consecutive cases of written form of the informed consent regarding diagnosis and treatment from Mar 2001 to Jun 2002. The authors evaluate the completeness of the process by looking into the possible omitted components in whole cases and degree of recall for the explained risk by telephone questionnaire in 128 available cases. RESULTS: In a total 153 cohort, 21 emergency operation cases invariably showed structural deficiencies of free-ended discussion due to short of time. Thorough past history taking and physical examination was necessary to perform reoperation for the postoperative hematoma in 3 cases and solid intimate relationship was necessary to treat previously disclosed complication in 7 cases of invasive diagnostic and minimum operative procedures, respectively. Among the available 128 patients, only 33(25%) ones could recall the given risks addressed at the consent approximately 6 weeks later. CONCLUSION: The informed consent is a process that dictates the free dialogue between the patient and the physician, not a simple paper expressed in published characters. However, to enhance the effectiveness of the consent process, both free discussion and writing down contents are prerequisite.
Cohort Studies ; Comprehension ; Diagnosis ; Disclosure ; Emergencies ; Hematoma ; Humans ; Informed Consent ; Physical Examination ; Surveys and Questionnaires ; Reoperation ; Surgical Procedures, Operative ; Telephone ; Writing

No abstract available.