OBJECTIVES: Chronic pain is one of the most common experiences of humans and a typical psychophysiological disorder. The aim of this study was to measure the psychophysiological responses in chronic pain patients using a biofeedback system, and to compare them with the results from normal healthy subjects. METHODS: Forty two patients with chronic pain (17 males and 25 females, average age 44.67+/-11.10 years) and 42 normal healthy controls (17 males and 25 females, average age 45.17+/-10.46 years) participated in this study. Electromyography (EMG), skin conductance (SC), and skin temperature (ST) were recorded using biofeedback system during the 3 phases (baseline, stress, and recovery) of stress reactivity test, and average values of them were calculated. Difference of values between two groups in each corresponding phase was analyzed with independent t-test, and change of values across phases of stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). RESULTS: Compared to normal controls, chronic pain patients had higher value of EMG (baseline : 8.10+/-5.97 micronV vs 4.72+/-1.52 micronV, t=-3.56, p<0.01 ; stress : 11.25+/-6.89 micronV vs 8.49+/-4.78 micronV, t=-2.13, p<0.05 ; recovery : 7.12+/-3.77 micronV vs 4.78+/-1.59 micronV, t= -3.70, p<0.01) and SC (baseline : 1.06+/-1.0 micronS vs 0.42+/-0.29 micronS, t=-4.0. p<0.01 ; stress : 1.87+/-2.05 micronS vs 1.03+/-0.86 micronS, t=-2.47, p<0.05 ; recovery : 1.74+/-1.77 micronS vs 0.64+/-0.59 micronS, t=-3.8, p<0.01) in all the 3 phases. But, skin temperature comparison did not reveal significant differences in all the 3 phases between two groups. CONCLUSION: Psychophysiological responses of chronic pain patients in stress reactivity test were different from those of normal healthy controls. These results suggest that sympathetic nervous system is more activated in chronic pain patients.
Biofeedback, Psychology ; Chronic Pain ; Electromyography ; Female ; Humans ; Male ; Psychophysiologic Disorders ; Psychophysiology ; Skin ; Skin Temperature ; Sympathetic Nervous System

Five cases of tennis elbow seen during the time period from Jaunary 1983 to January 1985 had operative treatment. Of the five clinical cases, four elbows in three patients were treated with Nirschl and Pettrone operation. This operative technique included exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The following results were obtained. 1. Correct analysis of the patient's emotional stability was essential prior to undertaking surgical procedure for tennis elbow. 2. The results of Nirschl and Pettrone operation were graded as excellent in three elbows and fair in one.
Elbow ; Humans ; Mortuary Practice ; Tennis Elbow ; Tennis

BACKGROUND: The physical environment (noise, temperature & humidity, microwaves, and jet lag) in the cockpit of air-transportation airplane is well known to have adverse effects on flight crew. But due to airplane security reasons and so on, the true environment could not be fully assessed up to now. The object of this study was to measure the status, to examine the effects of the environment, and to suggest the protection from them. METHODS: The status except jet lag was measured from the first officer seat in the B747-400/ B737-400/500 cockpit at several flight stage (pre-flight, after engine start, take off, climb, cruise, descent). Jet lag was examined through a flight crew schedule for 45 days. RESULTS: Noise level (74-84 dB), humidity (19%), microwaves(well above the caution and dangerous range), and jet lag (not enough to adjust from flight) were measured. The physical environment was examined which had considerable adverse effects on flight crew. CONCLUSION: The flight crew should be aware of the status which increase work load and physical load during flight. They must leave the cockpit as much as possible while they are off duty and be isolated from such status during rest.
Aircraft* ; Appointments and Schedules ; Humidity ; Microwaves ; Noise

PURPOSE: The population of metabolic syndrome is increasing in Korea. The prevalence is related to lifestyle, such as lack of physical activity and irregular diet. Most patients with metabolic syndrome know that lifestyle intervention is important to managing the condition. However, they do not always follow the intervention for various reasons, including lack of knowledge on how to change their lifestyle and lack of accessibility to that knowledge. The purpose of this study was to test the web-based health promotion program we developed. METHODS: Fifty-six adult workers from eight areas of business were recruited. They all had a confirmed metabolic syndrome diagnosis after being registered at a university hospital for annual health checkups. Twenty-nine workers were assigned to the experimental group, and the others were assigned to the control group. The web-based program was applied to the experimental group as an intervention for 8 weeks.Waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, and blood pressure were measured before and after the program. Data were analyzed using chi-square test, Fisher's exact test, and t test. RESULTS: There were statistically significant differences between the two groups in waist circumference and high-density lipoprotein cholesterol (t = -4.43, p < .001; t = 2.22, p = .031, respectively). Of the 29 participants, 13 (44.83%) in the intervention group had less than two indices for metabolic syndrome. CONCLUSIONS: This study suggests that a web-based program is useful for patients with metabolic syndrome to improve physiologic parameters related to metabolic syndrome. The web-based program may be easily applicable to community as well as clinical setting.
Adult ; Blood Glucose/metabolism ; Case-Control Studies ; Female ; *Health Behavior ; Health Promotion/*methods/standards ; Humans ; *Internet ; *Life Style ; Lipoproteins, HDL/blood ; Male ; Metabolic Syndrome X/*rehabilitation ; Middle Aged ; Triglycerides/blood ; Waist Circumference ; Young Adult

BACKGROUND: The purpose of this study is to assess the ability of dipyridamole99mTc-MIBI SPECT to identify and localize coronary artery disease(CAD). METHODS: The study population consists of 60 patients(37 males, 23 females : mean age 57+/-10 years) including 30 with prior myocardial infarction who underwent both dipyridamole99mTc-MIBI SPECT and coronary angiography for the evaluation of chest pain. RESULTS: The sensitivities for detection of CAD(> or =50% and > or =70% coronary stenosis by angiography) by dipyridamole99mTc-MIBI SPECT are 96% and 98% respectively, and specifities are 71% and 73% respectively. The sensitivities for detection of individual diseased vessels(> or =50% and > or =70%) are 79% and 90% for left anterior descending artery(LAD), 53% and 59% for left circumflex artery(LCX), 45% and 53% for right coronary artery(RCA), 64% and 77% for LCX/RCA, 63% and 72% for total. The specificities for detection of individual diseased vessels(> or =50% and > or =70%) are 62% for LAD, 98% and 98% for LCX, 92% and 89% for RCA, 91% and 89% for LCX/RCA, 87% and 86% for total. The concordances for ditection of individual didseased vessels beteen coronary angiography and dipyridamole99mTc-MIBI SPECT are all fair for SAD(Kappa=0.4 in > or =50% stenosis, 0.54 in > or =70% stenosis)LCX(Kappa=0.56,0.63),RCA(Kappa=0.4,0.44) and LCX/RCA(Kappa=0.56,0.67). CONCLUSION: Dipyriddamole99mTc-MIBI SPECT appers to be an useful noninvasive test for both identification and localization of coronary artery disease.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Female ; Humans ; Male ; Myocardial Infarction ; Tomography, Emission-Computed, Single-Photon*

According to the electromyographic study, the superior and inferior heads of lateral pterygoid, one of the masticatory muscles, are known to perform the reciprocal actions in mandibular movements; the superior head is active in closing movement, whereas the inferior head is active in opening of the jaw. Through these two reciprocal actions of these two heads, the articular disk of TMJ is seated in its resting position. Many reports regarded the superior and inferior heads of the lateral pterygoid as functionally independent muscles, but from a morphological point of view, the origin of the independent nerve innervation and intramuscular branching patterns of the mandibular nerve are unclear. Twenty -four adult hemi -sectioned heads were dissected to clarify the topography of the nerve distribution on two heads of lateral pterygoid and also to determine the anatomico -clinical relevance related with temporomandibular disorder. Most buccal nerves were found to run between the superior and inferior heads of the lateral pterygoid (21 cases, 87.5 %). In 3 cases, buccal nerves passed through the inferior head of the lateral pterygoid (12.5%). In front of the ascending ramus region, most buccal nerves ran in front of the temporalis without being entrapped within the temporalis (16 cases, 66.7%). However, in 8 cases buccal nerve passed in front of the temporalis being entrapped within the anterior fiber of the temporalis (33.3%). In this study, the mandibular nerve trunk was located intimately to the lateral pterygoid. Both heads of the lateral pterygoid muscles were innervated from the mandibular nerve branches, but the patterns of nerve distribution were various. Nerves innervated to the superior head of the lateral pterygoid had different origin. Only in 45.8% (11 cases), they originated from the buccal nerve. In 16.7% (4 cases) the nerve branches originated from the anterior deep temporal nerve only, and in 12.5% (3 cases) from the buccal and anterior deep temporal nerve. In contrast, nerves innervated to inferior head of the lateral pterygoid showed different pattern of distribution. In 58.3 %, nerves distributed on the inferior head originated from both the buccal and mandibular nerve trunk. In 20.8%, they originated from the buccal nerve only, in 12.5% from the mandibular nerve trunk only. In seven categories of the distribution of mandibular nerve branches, in only 20.8% (5 cases), both the superior and inferior heads of the lateral pterygoid had the common source of nerve innervation, the buccal nerve. In contrast, in 45.9% (11 cases) additional nerve twigs from the mandibular nerve trunk were distributed on the inferior head of the lateral pterygoid muscle. Author observed the pterygoid loop (ansa pterygoidea) located between the mandibular nerve trunk and the nerve innervating to the lateral pterygoid in 4 cases. In addition, the intramuscular nerve loop within the inferior head of lateral pterygoid was observed in 5 cases. Summarizing these results, besides the buccal nerve mentioned in an anatomical textbook, nerve twigs originating directly from the mandibular nerve trunk innervated to the lateral pterygoid and the ones originating from the anterior and middle deep temporal nerves distributed on the lateral pterygoid muscle in various manners. Considering the various patterns of nerve distribution on the lateral pterygoid, author concluded that the two heads of the lateral pterygoid are controlled by independent innervation. Furthermore, we found out that nerve entrapments and nerve communications are related with symptoms of temporomandibular disorder and with possible collateral route of motor innervation to the facial expression muscles, respectively.
Adult ; Facial Expression ; Head ; Humans ; Jaw ; Mandibular Nerve* ; Masticatory Muscles ; Muscles ; Nerve Compression Syndromes ; Pterygoid Muscles* ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Klippel-Feil syndrome(KFS) consists of short neck, low posterior hairline and restriction of motion of the neck due to fusion of cervical vertebrae. The typical disorder results from a failure of the normal segmentation of mesodermal somites during 3-8 weeks of gestation. In 1912, the first complete clinical description of this syndrome was given by Klippel and Feil. Feil reported additional cases in 1919 and distinguished between three morphologic groups. The incidence of KFS has been estimated to be approximately 1 : 40,000-42,000 births. A slight female predilection has been noted. Although the disorder is sporadic, there are examples of familial occurrence; how ever, no clear mechanism of inheritance has been accepted. Since the disturbance producing a short neck occurs early in embryogenesis, defects in other organ systems may occur at the same time. Common musculoskeletal anomalies that accompany KFS include scoliosis, as well as Sprengel's deformity in as many as one-third of cases. Neurologic, cardiovascular, and urinary tract anomalies are associated with KPS. We report a case of Klippel-Feil syndrome with associates anomalies include Sprengel's deformity.
Cervical Vertebrae ; Congenital Abnormalities ; Embryonic Development ; Female ; Humans ; Incidence ; Klippel-Feil Syndrome* ; Mesoderm ; Neck ; Parturition ; Pregnancy ; Scoliosis ; Somites ; Urinary Tract ; Wills

Priapism has been classified as primary (idiopathic)and secondary according to etiology. Hemodynamically, it can be separated into two distinct types: low-flow (ischemic) and high flow (non-ischemic). In the latter type, the most common cause is blunt genital trauma, and selective cavernosal artery embolization has been the most effective therapeutic method. Two cases of high-flow arterial priapism are presented. Both cases were post-traumatic and were managed with selective cavernosal artery embolization, with excellent return of premorbid levels of erectile function.
Arteries ; Male ; Penile Erection ; Priapism*

Priapism has been classified as primary (idiopathic)and secondary according to etiology. Hemodynamically, it can be separated into two distinct types: low-flow (ischemic) and high flow (non-ischemic). In the latter type, the most common cause is blunt genital trauma, and selective cavernosal artery embolization has been the most effective therapeutic method. Two cases of high-flow arterial priapism are presented. Both cases were post-traumatic and were managed with selective cavernosal artery embolization, with excellent return of premorbid levels of erectile function.
Arteries ; Male ; Penile Erection ; Priapism*

PURPOSE: Epidemiologic studies have demonstrated that rhinitis and asthma commonly coexist in the same patients and that a temporary relationship exists between the onset of rhinitis and asthma, with rhinitis frequently preceeding the development of asthma. Despite the compelling evidence that rhinitis has a remarkable impact on asthma, it has been controversial how the presence of rhinitis causes asthma to be worsen. We studied to know the effect of coexistence of allergic rhinitis on lower airway eosinophilic inflammation in mild persistent bronchial asthma. METHODS: A total of 129 mild persistent asthmatics were enrolled and divided into three different groups as follows: 37 cases with asthma only; 40 cases with mild allergic rhinitis; and 52 cases with moderate to severe allergic rhinitis. Methacholine challage test and sputum induction were performed and sputum ECP, sputum eosinophils and bronchial hyperresponsiveness (BHR) were compared in each group. RESULTS: In mild asthmatics with moderate to severe allergic rhinitis, the BHR to methacholine increased compared to those with mild or no allergic rhinitis. Eosinophils and ECP in induced sputum were significantly higher in more severe allergic rhinitis groups. We also found a significant correlation between BR index and sputum eosinophils. (gamma=0.578, P< 0.05) CONCLUSION: Our results demonstrated that the severity of allergic rhinitis was related to lower airway eosinophilic inflammation and bronchial hyperresponsiveness in mild persistent asthmatics with allergic rhinitis.
Asthma* ; Child ; Eosinophils* ; Epidemiologic Studies ; Humans ; Inflammation* ; Methacholine Chloride ; Respiratory System ; Rhinitis* ; Sputum