No abstract available.
Accidents, Traffic* ; Depression* ; Headache* ; Memory*

The neuropsychiatric sequelae of traumatic brain injury are effects on complex aspect of cognition, emotion and behavior. They include problems with attention and arousal, concentration, executive function, intellectual changes, memory inpairments, personality changes, affective disorders, anxiety disorders, psychosis, apathy, aggression, and irritability. There are many useful therapeutic approaches available for people who have been brain injuries. Although a multifactioral, multidisciplinary, collaborative approach to treatment is proposed, for purposes of exposition the author have divided treatment into psychopharmacological, cognitive, behavioral, psychological, and social interventions.
Aggression ; Anxiety Disorders ; Apathy ; Arousal ; Brain Injuries* ; Cognition ; Executive Function ; Humans ; Memory ; Mood Disorders ; Psychotic Disorders

Traumatic Brain Injury(TBI) of any severity can result in broad and persisting biopsychosocial sequelae. Depression after TBI occur at a greater frequency than in the general population, with estimates approaching 25% to 50% for major depression, and 155 to 30% for dysthmia. Acute onset depressions are related to lesion location and may have their etiology in biological response of the injured brain, whereas delayed onset depressions may be mediated by psychosocial factors, suggesting psychological reactions as a possible mechanism. Anxious depressions are associated with right hemisphere lesions, whereas major depressions alone are associated with left dorsolateral frontal and left basal ganglia lesions. However, there is insufficient information to postulate a specific neuroanatomic model for TBI-related depression.
Basal Ganglia ; Brain ; Brain Injuries* ; Craniocerebral Trauma ; Depression* ; Psychology

Avariety of symptoms can occur following traumatic brain injury(TBI) or other types of acquired brain injury. These symptoms can include problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit. These symptoms may respond to certain drugs, such as dopaminergic agents. Amantadine may protect patients from secondary neuronal damage after brain injury as a effects of NMDA receptor antagonists and may improve functioning of brain-injured patients as a dopaminergic agonist. Clinically, based on current evidence, amantadine may provide a potentially effective, safe, and inexpensive option for treating the cognitive, mood and behavioral disorders of individuals with brain injury. The rationales for using amantadine are discussed, and pertinent literatures are reviewed.
Amantadine* ; Brain ; Brain Injuries* ; Dopamine Agents ; Dopamine Agonists ; Humans ; Impulsive Behavior ; Memory, Short-Term ; Motivation ; N-Methylaspartate ; Neurons ; Problem Solving

OBJECTIVEs: Cytogenetic investigations were carried out on 770 women with primary (n=560) and secondary amenorrhea (n=210) to determine the frequency of chromosomal or genetic causes of amenorrhea. MATERIALS AND METHODS: In 770 women with primary amenorrhea (n=560) and secondary amenorrhea (n=210), chromosomal analysis were performed. RESULTS: 1) The most prevalent age group is 16-20 years of age group with primary amenorrhea and 26-30 years of age group with secondary amenorrhea. 2) Out of 560 cases of primary amenorrhea, 343 cases (61.3%) had the normal chromosome constitution and 217 cases (38.7%) had the abnormal chromosome constitution including 46,XY. 3) In 217 cases of abnormal chromosome of primary amenorrhea, 57 cases (26.3%) had 45,X and 34 cases (15.8%) had the 46,XY, 24 cases (11.0%) had 45,X/46,X,i (Xq), 23 cases (10.6%) had 45,X/46,X,+mar and 14 cases (6.6%) had 45,X/46,XY. 4) Out of 210 cases of secondary amenorrhea, 181 cases (86.2%) had the normal chromosome constitution and 29 cases (13.8%) had 45,X/46,XX. CONCLUSION: High percentage of chromosomal abnormalities was diagnosed in primary amenorrhea and most of them were sex chromosome anomalies. In secondary amenorrhea, the prevalence was lower than primary amenorrhea, so a preselection of patients with secondary amenorrhea for cytogenetic investigations seems to be necessary.
Amenorrhea* ; Chromosome Aberrations ; Constitution and Bylaws ; Cytogenetics* ; Female ; Humans ; Prevalence ; Sex Chromosomes

No abstract available.
Plasminogen Activators* ; Plasminogen* ; Pulmonary Embolism*

A cross-sectional survey was conducted to determine the prevalence rate of scoliosis in elementary, middle and high school boys in May 1988. The study population included 1,393 male students in Pusan ; 463 students of 4th grade in two elementary schools, 543 students of 1st grade in one middle school and 387 students of 1st grade in one high school. The students of elementary school were screened with inspection by two physicians at the same time and the students of middle and high schools were screened with both inspection by the same physicians and 70mm chest X-ray. Positive students in any one of the two screening tests were measured for height and body weight and asked for the shoulder side on which he carries the school bag. The angle of curvature on X-ray film was measured by Cobb's method. The number of positive students in any one of the two tests were 15(3.2%) in elementary schools, 174(32.0%) in middle school and 92(23.8%) in high school. However, positive rates in both tests were only 2.2% for the middle school students and 2.6% for the high school students and among these students 1.1% out of total middle school students and 2.3% of high school students had a curvature equal to or greater than 5 degrees of Cobb's angle on 70mm chest X-ray film. There was a statistically significant association between the direction of spinal curve and the shoulder side on which one carries school bag among positive students in both screening tests (p<0.05). Mean height and body weight of 281 positive students in any one of two screening tests were compared with the Korean standard for the same age. Mean weight of elementary school students was nearly the same as the standard weight but the height was slightly shorter than the standard. However, both mean height and weight of the middle school students were lower than the standard while those of the high school students were higher. The prevalence rate of scoliosis for the 2nd 3rd grades of high school is presumed to be higher than that of the 1st grade of high school and the rate for girls will be even higher than the rate for boys of the same age. Thus, scoliosis seems to be an important school health problem. To prevent scoliosis, it is recommended to reduce the weight of school bag, educate the students to keep a right posture and exercise periodically.
Body Weight ; Busan* ; Cross-Sectional Studies* ; Female ; Humans ; Male ; Mass Screening ; Posture ; Prevalence* ; School Health Services ; Scoliosis* ; Shoulder ; Thorax ; X-Ray Film

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1--30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (+/-58.6) minutes; 2023(+/-50.7) minutes for the university hospitals and 164.2(+/-60.5) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the major reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430Won. Out of the total medical fee, 20,323Won(9.3%) was for the newborn nursery care. In case of C-section delivery six nights and seven days, who stayed otal medical fee was 732,578Won and out of the total fee 76,937Won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141Won for the tertiary care hospitals and 14,576Won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.
Education ; Fee Schedules ; Fees and Charges ; Fees, Medical* ; Hospitals, General ; Hospitals, University ; Humans ; Infant, Newborn* ; Insurance ; Investments ; Maintenance and Engineering, Hospital ; Nurseries* ; Nursing ; Nursing Care ; Nursing, Supervisory ; Pediatrics ; Salaries and Fringe Benefits ; Tertiary Healthcare

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

Tibial Plateau fracture is relatively common injury which often produce major disability, and their treatment has been in controversy. Recent studies suggest that early knee motion and perhaps better surgical techniques have improved clinical end results. Protection from weight bearing and length of immobilization have varied among authors and variable treatment methods. Thirty-eight tibial plateau fractures treated at Kangnam Sacred Heart Hospital from March in 1984 to December in 1988 were analized and the followings were obtained. l. Of 38 patients, 29 patients were male and 9 female. 2. The most common associated injury was an ipsilateral fibular fracture. 3. Average duration of immobilization was 4 to 6 weeks in conservative treatment and 2 to 4 weeks in operative treatment. 4. We started partial weight bearing in 24 patients within 6 weeks and full weight bearing in 28 patients between 8 and 12 weeks, and good end results were obtained.
Clinical Study ; Female ; Heart ; Humans ; Immobilization ; Knee ; Male ; Weight-Bearing