During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

Aplastic anemia is characterized by a failure of blood cell production resulting in varying degrees of pancytopenia with a markedly hypocellular bone marrow. Most cases of aplastic anemia are acquired, but the disease may also occur as the result of inherited abnormalities. In 50-65% of cases, however, the etiology is unknown. For acquired forms of aplastic anemia, a variety of causative factors, including radiation, viruses, chemicals and drugs, have been implicated. Antithyroid drugs(Carbimazole, Methimazole, Propylthiouracil) are usually listed among agents associated with the development of agranulocytosis, but aplastic anemia rarely follows their use. The first case of aplastic anemia followmg propylthiouracil was reported by Marte~lo et al. in 1967 and the second case was by Aksoy and Erdem in 1968. Recently, we experienced two cases of aplastic anemia following propylthiouracil therapy due to Graves disease, so we report here these cases with literature review.
Agranulocytosis ; Anemia, Aplastic* ; Blood Cells ; Bone Marrow ; Graves Disease ; Methimazole ; Pancytopenia ; Propylthiouracil*

PURPOSE: The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF). METHODS: Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program. RESULTS: After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment. CONCLUSION: The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.
Anxiety ; Female ; Fertilization in Vitro ; Humans ; Imagery (Psychotherapy) ; Infertility ; Outpatients

This study was carried out to establish normal values and to compare the pattern reversal and light emitting diodes(LED) stimulating visual evoked potential(VEP) in 30 healthy volunteers (20 men and 10 women, age ranged from 24 to 56 years, with a mean age of 34 years). The result summarized in table 1, 2 and 3. VEP wave patterns were similar and easily reproducible with those different types of visual stimulation. As compared of normal values of pattern reversal and LED stimulating visual evoked responses, there are no significant variations of absolute latencies, amplitudes, absolute amplitude differences between two eyes, proportional amplitude differences between eyes, and duration differences between two eyes. Only differences were significant in latency differences between two eyes and duration of p. 100. These results suggest that pattern reversal and LED stimulating VEP test will be useful in clinical test according to various patient's conditions.
Evoked Potentials, Visual* ; Female ; Healthy Volunteers ; Humans ; Male ; Photic Stimulation ; Reference Values

PURPOSE: This study was done to examine the effects of abdominal breathing on VAS-Anxiety (VAS-A), blood pressure, peripheral skin temperature and saturation oxygen in pregnant women in preterm labor. METHODS: The study design was a matched control group interrupted time series. Forty-six women matched to gestational age were assigned to either the experimental group (26) or control group (20). Data were collected between March 2007 and May 2008. For the experimental treatment the women performed abdominal breathing 30 times, which took 5 minutes, and did one set of 5-minute abdominal breathing daily for three days. Data collection was done before and after the abdominal breathing to measure VAS-A, blood pressure, peripheral skin temperature and oxygen saturation. Descriptive, chi-square, Mann-Whitney U tests were used to analyze the data with the SPSS/PC+Win 15.0 program. RESULTS: For the experimental group there were significant decreases in VAS-A (Z=-4.37, p=.00), systolic blood pressure (Z=-3.38, p=.00), and an increase in skin temperature (Z=-4.50, p=.00) and oxygen saturation (Z=-3.66, p=.00). CONCLUSION: These findings suggest that abdominal breathing in pregnant women in preterm labor results in decreases in anxiety(VAS-A) including biological evidences such as systolic blood pressure, and increases in peripheral skin temperature and oxygen saturation. Further longitudinal study is needed on the lasting effects and obstetric and neonatal outcomes following abdominal breathing.
Anxiety ; Arginine Vasopressin ; Blood Pressure ; Data Collection ; Female ; Gestational Age ; Humans ; Obstetric Labor, Premature ; Oxygen ; Pregnancy ; Pregnant Women ; Respiration ; Skin ; Skin Temperature

Airway management is important during general anesthesia. Difficulty with a direct laryngoscopy can be routinely successfully managed using a laryngeal mask airway. However, a laryngeal mask airway may not be suitable for the patients having a small oral cavity volume or narrow interincisor distance. A 19-year-old man, scheduled for right clavicular fracture had no specific underlying medical problems. However, he had difficultly opening his mouth, and was Mallampati class IV. Also, he had difficultly in extending his neck. Airway management was successfully performed using a laryngeal tube instead of a laryngeal mask airway. The patient was successfully managed, without complications, until the end of the surgery.
Airway Management ; Anesthesia, General ; Humans ; Intubation* ; Laryngeal Masks ; Laryngoscopy ; Mouth ; Neck ; Young Adult

BACKGROUND: The aim of this experimental study was to investigate the expression of nNOS following ischemia/reperfusion injury in rat spinal cord. METHODS: Spraque-Dawley rats (250-300 gm) were classified into two groups according to experimental methods. Control group (n = 5) received sham operation. Ischemia in experimental group (n = 5) was induced by clamping the abdominal aorta just below the left renal artery and the abdominal aorta just above the aortic bifurcation for 20 minutes followed by 20 minutes reperfusion. The spinal cord was obtained 7 days after operation. The expression of nNOS was examined in gray and white matter with confocal microscope and Image Analyzer. RESULTS: There is no difference in nNOS expression of nNOS between gray and white matter in control group. Comparing to control group, experimental group showed higher levels of nNOS expression (P < 0.05). CONCLUSIONS: nNOS expression increased in the rat spinal cord after ischemia/reperfusion injury. We suggest that overproduction of NO may play a role in progressive nerve cell damage.
Animals ; Aorta, Abdominal ; Constriction ; Ischemia ; Neurons* ; Nitric Oxide Synthase Type I* ; Rats* ; Renal Artery ; Reperfusion ; Spinal Cord*

Although shoulder surgery is usually performed during general anesthesia, the use of an interscalene block alone or in combination with other anesthetic procedures is increasing. Blockade of the suprascapular nerve is used in the diagnosis and treatment of shoulder pain and to provide temporary relief from muscle spasm or strain in the supraspinatus or infraspinatus muscle We report a case of a patient that presented with severe shoulder pain who underwent surgery for traumatic humeral head fracture. Anesthesia was provided by an interscalene block follwing suprascapular nerve block.
Anesthesia ; Anesthesia, General ; Brachial Plexus* ; Diagnosis ; Humans ; Humeral Head* ; Nerve Block* ; Shoulder ; Shoulder Pain ; Spasm ; Supine Position*

No abstract available.
Acute Kidney Injury* ; Hemoglobinuria, Paroxysmal*

Intramuscular Stimulation (IMS) is a refined technique of traditional oriental acupuncture, and IMS has proved effective for relieving chronic pain of a neuropathic origin. IMS is currently seen to be quite a safe procedure with minimal complications having been reported to date. Various complications have been documented for acupuncture, but few complications or adverse effects have been reported in relation to the relatively new technique of IMS. We report here on a case of cervical spinal epidural hematoma that manifested as a cause of delayed hemiparesis. The safety of this procedure in unpracticed hands seems to be questionable.
Acupuncture ; Chronic Pain ; Hand ; Hematoma ; Hematoma, Epidural, Spinal ; Paresis