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

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

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*

When the non-union gap in a long bone is more than half of the diameter of the bone at that level, it presents a significant challenge to traditional bone grafting technique. Even if there are several good ways for this problem, such as shortening, traditional various bone grafting, electrical stimulation and free vascularized bone graft, most of these techniques have some difficulties to maintain the stability of fracture post-operatively, and we have to keep their extremities into a cast or external fixator so long. So we have attempted to treat the large osseus gap non-union in long bone with fixation of heavy duty or condylar plate on one side of fracture for fracture stability, a long tibial corticocancellous strut graft on the other side of fracture for fracture stability and rapid bony union, and extensive cancellous chip bone graft between the plate and tibial graft to enhance the bony union. We have experienced 9 cases of large osseus gap non-union in long bone with this technique from March 1981 to September 1986 at the department of orthopaedic surgery, St. Mary's hospital, Catholic University Medical College. 1. Their, 7 males and 2 females, average age was 38 years old, with a range of 24 to 53 years old. The distribution of the involved bone was 6 femur, 2 humerus, 1 radius and ulna with 1.4 years of average duration of non-union, ranged from 7 months to 2.4 years. The average gap from normal bone to normal bone was 4.8cm, with a range of 2.7cm to 7.4cm. The average number of previous surgical procedures was 4, with a range of 2 to 7. Four of the nine patients had quiescent osteomyelitis. 2. Post-operative immobilization with splint or cast was applied for 6 weeks for upper extremity and 8 weeks for lower extremity followed by active R.O.M. exercise and non-weight bearing crutch walking. 3. Five of the nine cases(55.6%) had completely bony union. This occured on an average 8 months post-operatively and was faster in the forearm bones and femur than in the humerus. An additional cancellous bone graft was done in two. But other two of the patients had subsequent amputation because of recurrent and uneontrollable osteomyelitis stirred up by the surgery. 4. This procedures was proved to be one of valuable adjuvant method in treatmqnt of large osseous gap non-union of long bones.
Amputation ; Bone Transplantation ; Electric Stimulation ; External Fixators ; Extremities ; Female ; Femur ; Forearm ; Humans ; Humerus ; Immobilization ; Lower Extremity ; Male ; Methods ; Osteomyelitis ; Radius ; Splints ; Transplants ; Ulna ; Upper Extremity ; Walking

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

Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

Injuries and pains of musculoskeletal joint in human body is common onset in industrialized world. However, muscle fatigue plays a very significant role in contributing causes of many pains associated with musculoskeletal joints. Based on this hypothesis, degree of muscle fatigue was investigated using electromyography measurement technique during isometric and concentric/eccentric muscle contractions. Different response of the muscle fatigue between two different muscle contractions (isometric and concentric/eccentric contractions) was examined by comparison of parameters which were median frequency, median power and RMS value. Healthy 16 young persons without previous musculoskeletal diesease history were tested with Noraxon Myosystem 2000 EMG measurement system. In this study, two different exercises were performed. First exercise was concentric/eccentric exercise. Second exercise was isometric muscle contraction. In the case of the isometric exercise, median frequency was decreased, but median power and RMS were increased. However, during the concentric/eccentric exercse, median frequency was increased, but median power and RMS were decreased. Both of those revealed that the pattern of the median frequency was W type, but median power and RMS were M type as time passed. In this study, the patterns of the muscle fatigue during concentric/eccentric exercise as well as isometric exercise were identified. It will be helpful to prevent musculoskeletal injury from over-working andexercising.
Electromyography* ; Exercise ; Human Body ; Humans ; Joints ; Muscle Contraction ; Muscle Fatigue*