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OBJECTIVE: The purpose of this study is to evaluate the balance training effects of balance system in hemiplegic stroke patients. METHOD: The study consisted of 14 male and 6 female hemiplegic patients, aged 48 to 70 years, time postattack ranged from 6 to 17 months. Balance training was done by conventional method (control group) and using balance system (Chattanooga Group, Inc., training group) and the effect were evaluated by balance system. RESULTS: Body sway index and moving target accuracy rate were not significantly different between training group and control group before training, but were significantly different after training. Training group showed significantly decreased sway index and increased moving target accuracy rate at four weeks after training compared to the status before training. CONCLUSION: The hemiplegic patients trained by balance system showed significantly improved static and dynamic postural balance control. Therefore, the balance system is considered to be a valuable training modalitiy for the hemiplegic patients.
Female ; Humans ; Male ; Postural Balance ; Stroke

BACKGROUND: Nalbuphine is one of the opioid agonist-antagonists and is used frequently in the anesthetic field. Usage is focused on potent analgesic action and the adjuvant of narcotics because of less complications with preserved analgesia. The most common routes of administration for postoperative pain control are epidural and intravenous, so we compared both pharmacokinetic profiles. METHODS: Twelve patients were randomly divided into two groups. All patients were given a spinal anesthesia with tetracaine hydrochloride. One group (n = 6) received nalbuphine 10 mg via epidural route and another group (n = 6) received the same dose via intravenous route. Venous blood was drawn at 0, 0.25, 0.5, 1, 2, 4, 6 and 8 hours to measure plasma nalbuphine concentrations. Analysis was performed by high performance liquid chromatography with an electrochemical detector. RESULTS: At 0.25 hour, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (49.48 +/- 4.98 ng/ml) than in the intravenous administration group (40.44 +/- 1.64 ng/ml). At 6 and 8 hours, the plasma concentration of nalbuphine was significantly higher in the epidural administration group (5.98 +/- 1.86 ng/ml, 3.85 +/- 0.94 ng/ml) than in the intravenous administration group (3.80 +/- 0.33 ng/ml, 2.43 +/- 0.32 ng/ml). Clearance, elimination half life, volume of distribution and AUC were not significantly different between the two groups. CONCLUSIONS: The plasma concentrations of nalbuphine via epidural route and intravenous route were similar in both groups after 0.25 hour to 6 hours. At 0.25 hour and after 6 hours, the epidural administration group had a higher plasma concentration of nalbuphine than the intravenous administration group.
Administration, Intravenous* ; Analgesia ; Anesthesia, Spinal ; Area Under Curve ; Chromatography, Liquid ; Half-Life ; Humans ; Nalbuphine* ; Narcotics ; Pain, Postoperative ; Plasma* ; Tetracaine

BACKGROUND: The hemodynamic responses to endotracheal intubation are associated with sympathoadrenal activity. Polymorphisms in the beta1-adrenergic receptor (beta1AR) gene can alter the pathophysiology of specific diseases. The aim of this study is to investigate whether the Ser49Gly and Arg389Gly polymorphism of the beta1AR gene have different cardiovascular responses during endotracheal intubation under sevoflurane anesthesia. METHODS: Ninety-one healthy patients undergoing general anesthesia were enrolled. Patients underwent slow inhalation induction of anesthesia using sevoflurane in 100% oxygen. Vecuronium 0.15 mg/kg was given for muscle relaxation. Endotracheal intubation was performed by an anesthesiologist. The mean arterial pressure (MAP), heart rate (HR), and the corrected QT (QTc) interval were measured before induction, before laryngoscopy, and immediately after tracheal intubation. Genomic DNA was isolated from the patients' peripheral blood and then evaluated for the beta1AR-49 and beta1AR-389 genes using an allele-specific polymerase chain reaction method. RESULTS: No differences were found in the baseline values of MAP, HR, and the QTc interval among beta1AR-49 and beta1AR-389, respectively. In the case of beta1AR-49, the QTc interval change immediately after tracheal intubation was significantly greater in Ser/Ser genotypes than in Ser/Gly genotypes. No differences were observed immediately after tracheal intubation in MAP and HR for beta1AR-49 and beta1AR-389. CONCLUSIONS: We found an association between the Ser49 homozygote gene of beta1AR-49 polymorphism and increased QTc prolongation during endotracheal intubation with sevoflurane anesthesia. Thus, beta1AR-49 polymorphism may be useful in predicting the risk of arrhythmia during endotracheal intubation in patients with long QT syndrome.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; DNA ; Genotype ; Heart Rate ; Hemodynamics ; Homozygote ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Long QT Syndrome ; Methyl Ethers ; Muscle Relaxation ; Oxygen ; Polymerase Chain Reaction ; Vecuronium Bromide

PURPOSE: To evaluate the correlation between lower urinary tract symptoms (LUTS) and premature ejaculation (PE) in Korean men older than 40 years. MATERIALS AND METHODS: In total, 258 men older than 40 years completed the International Prostate Symptom Score (IPSS; total score, storage symptoms [ST], and voiding symptoms [VD]), a 5-item version of the International Index of Erectile Function (IIEF-5), and the Premature Ejaculation Diagnostic Tool (PEDT). The study examined the relationship between LUTS and PE. In the PEDT, PE is defined as a score > or =11. RESULTS: The prevalence of PE was 29.1% with the PEDT versus a self-reported value of 49.5%. The prevalence of PE was 30.9% in 40 to 59-year-old men (21.3%) and 28.1% in 60 to 79 year-old men (78.7%). In men 40 to 59 and 60 to 79 years old, the mean PEDT, IPSS, and IIEF-5 scores were 8.65 and 7.88, 13.5 and 12.38, and 15.83 and 13.69, respectively. No significant correlations were observed between the total and subscale scores of the IPSS (p=0.204) and the PEDT (p=0.309) with increasing age, whereas a significant negative correlation was detected between the IIEF-5 and age (p=0.002). The PEDT score was significantly correlated with the IPSS-ST (r=0.326, p<0.001), IPSS-VD (r=0.183, p=0.005), IPSS-total (r=0.310, p<0.001), and IIEF-5 total (r=-0.248, p<0.001). CONCLUSIONS: LUTS, especially storage symptoms, were related to PE. In elderly men, control of both erectile dysfunction and LUTS may play an important role in managing PE.
Aged ; Ejaculation ; Erectile Dysfunction ; Female ; Humans ; Lower Urinary Tract Symptoms ; Male ; Middle Aged ; Premature Ejaculation ; Prevalence ; Prostate ; Quality of Life

Transient tachypnea of the newborn(TTN) is a benign self-limited disease characterized by early onset and rapid recovery of tachypnea although it may occasionally have a more prolonged and protracted course. A retrospective clinical study was mad on 29 neonates with TTN admitted to NICU of Pohang St. Mary's Hospital from January 1992 to June 1993. The results were as follows: 1) TTN(36.2%) was the most common cause of respiratory distress in the neonate followed by idiopathic respiratory distress syndrome(23.8%), pneumonia(18.8%), meconium aspiration syndrome(6.2%), perinatal asphyxia(6.2%), polycythemia(3.8%), anemia(1.2%), persistent fetal circulation(1.2%), paroxysmal supraventricular tachycardia(1.2%) and tracheoesophageal fistula(1.2%) 2) TTN was more frequent in the male term infants but can occur in premature(41.4%) and low birth weight infants(34.5%). 3) The associated perinatal conditions were oxytocin-induction(8 cases, 27.6%), Cesarean delivery(10 cases, 34.5%) and asphyxia(7 cases, 24.2%) 4) Arterial blood gas analysis showed respiratory acidosis in 3 cases and metabolic acidosis in 3 cases but none of TTN showed hypoxia unresponsive to oxygen 5) Chest X-ray showed hyperaeration in 10 cases(34.5%), increased pulmonary vascularity in 8 cases(27.6%), hyperaeration and increased pulmonary vascularity in 6 cases(20.6%) and cardiomegaly in 12 cases(53%). 6) Tachypnea usually appeared within 6hours and abated by 48-72hours but sustained more than 73hours in 7 cases(24.1%) 7) In majority of cases, maximal respiratory rates were below 100 rates/min and administered oxygen concentrations were 20-40%, and their mean values were 81 rates/min, 37.6% respectively. 8) TTN with more prolonged course(> or=48hours) was associated with low birth weight infants, prematurity and higher respiratory rates(> or=100 breaths a minute)(p<0.05).
Acidosis ; Acidosis, Respiratory ; Anoxia ; Blood Gas Analysis ; Cardiomegaly ; Gyeongsangbuk-do ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Meconium Aspiration Syndrome ; Oxygen ; Respiratory Rate ; Retrospective Studies ; Tachypnea ; Thorax ; Transient Tachypnea of the Newborn*

Transient tachypnea of the newborn(TTN) is a benign self-limited disease characterized by early onset and rapid recovery of tachypnea although it may occasionally have a more prolonged and protracted course. A retrospective clinical study was mad on 29 neonates with TTN admitted to NICU of Pohang St. Mary's Hospital from January 1992 to June 1993. The results were as follows: 1) TTN(36.2%) was the most common cause of respiratory distress in the neonate followed by idiopathic respiratory distress syndrome(23.8%), pneumonia(18.8%), meconium aspiration syndrome(6.2%), perinatal asphyxia(6.2%), polycythemia(3.8%), anemia(1.2%), persistent fetal circulation(1.2%), paroxysmal supraventricular tachycardia(1.2%) and tracheoesophageal fistula(1.2%) 2) TTN was more frequent in the male term infants but can occur in premature(41.4%) and low birth weight infants(34.5%). 3) The associated perinatal conditions were oxytocin-induction(8 cases, 27.6%), Cesarean delivery(10 cases, 34.5%) and asphyxia(7 cases, 24.2%) 4) Arterial blood gas analysis showed respiratory acidosis in 3 cases and metabolic acidosis in 3 cases but none of TTN showed hypoxia unresponsive to oxygen 5) Chest X-ray showed hyperaeration in 10 cases(34.5%), increased pulmonary vascularity in 8 cases(27.6%), hyperaeration and increased pulmonary vascularity in 6 cases(20.6%) and cardiomegaly in 12 cases(53%). 6) Tachypnea usually appeared within 6hours and abated by 48-72hours but sustained more than 73hours in 7 cases(24.1%) 7) In majority of cases, maximal respiratory rates were below 100 rates/min and administered oxygen concentrations were 20-40%, and their mean values were 81 rates/min, 37.6% respectively. 8) TTN with more prolonged course(> or=48hours) was associated with low birth weight infants, prematurity and higher respiratory rates(> or=100 breaths a minute)(p<0.05).
Acidosis ; Acidosis, Respiratory ; Anoxia ; Blood Gas Analysis ; Cardiomegaly ; Gyeongsangbuk-do ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Meconium Aspiration Syndrome ; Oxygen ; Respiratory Rate ; Retrospective Studies ; Tachypnea ; Thorax ; Transient Tachypnea of the Newborn*

This study was done for identifying the factors which affect psychologic symptoms of low back(LBP) patients. The study subjects were 43 work-related low back pain patients, 28 work-related non-low back pain patients and 47 general low back injury patients. The study material is SCL 90-R for checking psychologic symptoms and questionnaire for obtaining general information about the subjects. The data were analyzed by model of analysis of covariance adjusted by several variables such as gender, age, education and marital status and then compared the least square means of symptom score between groups. To identify the factors that affect psychologic symptom, duration of suspension, return to work and interaction factor of these two variables were analyzed by multivariate model and we calculated partial correlation coefficient of these variables. As a result, work-related LBP patients showed higher score of symptoms in somatization, depression and psychosis than work-related non-LBP and non-work-related LBP. Duration of suspension and return to work were significant explanatory variables for psychologic symptom score of work-related LBP. Then, we may conclude that the treatment and rehabilitation programe for work-related LBP should cover the strategy of early return to work.
Back Injuries ; Back Pain ; Depression ; Education ; Humans ; Low Back Pain* ; Marital Status ; Psychometrics* ; Psychotic Disorders ; Surveys and Questionnaires ; Rehabilitation ; Return to Work

Coronary arteriovenous fistula is relatively rare disease and originates more commonly in the right than in the left cononary artery. We report one case of cononary arteriovrnous fistula which we have experienced recently in 22 years old female, who has complained of dyspnea on exertion and intermittent anterior chest pain radiating to the left shoulder for several years. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. In this case, the fistula was originated from the right coronary artery and drained into the posterior wall of the right ventricle, the coronary artery was dilated(diameter=1.5cm) and tortuous and significant shunt was measured(Qp/Qs=2.31). The opening of the fistula draining into right ventricle was obliterated with sutures.
Arteries ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dyspnea ; Echocardiography* ; Echocardiography, Transesophageal ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Shoulder ; Sutures ; Young Adult

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.
Calcium ; Epilepsy* ; Foot ; Goiter ; Humans ; Hypogonadism ; Hypoparathyroidism* ; Hypothyroidism* ; Intellectual Disability ; Male ; Parathyroid Hormone ; Tetany ; Young Adult