No abstract available.
Tenosynovitis*

BACKGROUND: Using c-fos expression one of the immediate early gene, as a marker of altered neuronal response, we investigated the effect of superior cervical ganglion block (SCGB) exhibiting the same effect of SGB of human on the activity of several brain regions which are considered as located on autonomic neural pathway and neuroendocrine axis in rat. METHOD: The 48 Sprague-Dawley strain rats were divided into 4 groups, as saline/stress (control) group, SCGB/stress (tested) group, saline group, SCGB group. Superior cervical ganglion block was conducted in the SCGB/stress group and SCGB group while saline/stress and saline group were sham operated. After then restraint stress was imposed on the animals of SCGB/stress group and saline/stress group. And 2 hour after injection (saline, SCGB group) or restraint stress (saline/stress, SCGB/stress group), c-fos protein (Fos) was localized by immunocytochemistry. RESULTS: Much stronger Fos immunoreactivity was induced in the several brain region of control group rats compared to other three groups and the numbers of Fos positive cell count of tested group were significantly decreased in paraventricular hypothalamic nucleus (p<0.01), A5 (p<0.01), raphe pallidus (p<0.05), nucleus tractus solitaius (p<0.01) compared to control group. CONCLUSION: This study demonstrate that superior cervical ganglion block attenuates stress induced neuronal activities of paraventricular hypothalamic nucleus, A5, raphe pallidus, nucleus tractus solitarius.
Animals ; Axis, Cervical Vertebra ; Brain* ; Cell Count ; Genes, vif ; Humans ; Immunohistochemistry ; Neural Pathways ; Neurons ; Paraventricular Hypothalamic Nucleus ; Rats* ; Rats, Sprague-Dawley ; Solitary Nucleus ; Superior Cervical Ganglion*

No abstract available.
Arthritis, Rheumatoid* ; Humans

Pre-eclampain or eclampain is a cause of maternal morbidity and mortality. It is characterized by the triad of maternal hypertension, proteinuria and generlized edema. The etiology of pre-eclampain or eclampsia is thought to be a decreased placental perfusion which results in an increased production of renin, angiotensin, aldosteron, thrombolplastin and a decreased production of prostaglandin. Anesthesiologists have to perform anesthesia technic for high-risk toxemia of pregnancy, and make proper choices of anesthesia method and drugs. Advantages of general anesthesia for Cesarian-section in cases of eclampsia include rapid induction, less hypotension, control of ventilation and fetal oxygenation. Disadvantages include myocardial depression from the anesthetic drugs, hypertension during light anesthesia, the interacion between manesium sulfate and muscle relaxante which might lead to prolonges respiratory paralysis and neonatal depression associated with the general anesthesia. The author used general anesthesis for the Cesarian-section in two severe toxemic patients who had pulmonary edema and bloody sputum because of congestive heartfailure. One patient had cardiac arrest upon arrival at the emergency room and after cardiopulmonary resuscitation the cesarian-section was performed. The mother had complets recovery, but the baby expired in twenty-ninehours. The Mother and twin babies in the other case had complete recovery.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Angiotensins ; Cardiopulmonary Resuscitation ; Depression ; Eclampsia ; Edema ; Emergency Service, Hospital ; Estrogens, Conjugated (USP) ; Female ; Heart Arrest ; Humans ; Hypertension ; Hypotension ; Mortality ; Mothers ; Oxygen ; Perfusion ; Pre-Eclampsia ; Pregnancy* ; Proteinuria ; Pulmonary Edema ; Renin ; Respiratory Paralysis ; Sputum ; Twins ; Ventilation

BACKGROUND: When using the data based on history, ECG and cardiac enzyme, two to eight percent of patients with acute chest pain are incorrectly perceived as being at low risk and therefore sent home mistakenly. It is known that changes of Doppler parameters appear first, before regional asynergy in 2D-echocardiography, electrocardiographic change and chest pain. however, the clinical application of Doppler information in the diagnosis of acute myocardial infarction remains uncertain, especially in elderly patients. METHODS: From March 1998 to March 1999, pulsed wave Doppler echocardiography was performed in patients with acute myocardial infarction within 6 hours, and Doppler parameters were evaluated. Each Doppler parameters were compared between elderly (age > or =65) and young(age < 65) groups. RESULT: E peak velocity & E/A ratio showed significant differences between two groups(p<0.05). especially, Stroke volume, isovolumic relaxtion time & myocardial performace index showed marked difference(p<0.01). CONCLUSION: Diastolic Doppler parameters of elderly group were significantly changed than younger group. however systolic Doppler parameters were relatively preserved. Among Doppler parameters, myocardial performance index is a conceptrally new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it may be useful as screening test for patients with AMI in elderly patients.
Aged ; Chest Pain ; Diagnosis ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Mass Screening ; Myocardial Infarction* ; Stroke Volume

Many reports have been made concerning underlying and associated conditions causing pseudomembranous colitis and it has been documented that occurrence of pseudomembranous colitis is related with antibiotics administration. Recent study showed that Clostridium difficile produced enterotoxin by colonization in intestinal wall and leading into pseudomembranous colitis. Diagnosis is based on positive culture of Clostridium difficile, positive test of Clostridium difficile toxin and specific histological findings after observation of whitish plaque on colonoscopic or sigmoidoscopic examination. Authors have experienced one case of pseudomembranous colitis developing after long term ampicillin administration in a case with colon cancer associated with diarrhea and diagnosis was confirmed by typical pseudomembrane on biopsy following classical whitish plaque absevation on sigmoidoscopic examination. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metron-idazole in four days and disappearance of whitish plaque on repeated sigmoidoscopic examination and improvement of clinical symptoms after 9 days of medication.
Ampicillin ; Anti-Bacterial Agents ; Biopsy ; Clostridium difficile ; Colon ; Colonic Neoplasms ; Diagnosis ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Enterotoxins

OBJECTIVE: Patients with Parkinson's disease (PD) frequently experience depression associated with voice problems. Singing involves the use of similar muscles and the neural networks associated with vocal function and emotional response. The purpose of this study is to enhance vocal quality and depressive symptoms of patients with PD using individual singing program. METHODS: The Individual Therapeutic Singing Program for PD (ITSP-PD) was conducted by a certified music therapist. In total, nine PD patients with a subjective voice problem or depression participated in 6 sessions over 2 weeks. We measured the Maximum Phonation Time (MPT) via the Praat test, the Voice Handicap Index (VHI), the Voice-Related Quality of Life (V-RQOL) and the Geriatric Depression Scale (GDS). RESULTS: In total, 8 out of 9 patients completed all the sessions; 6 out of 8 patients participated in the follow-up test after 6 months. A statistically significant change in MPT (p = 0.011) was observed between the pre- and post-tests. The VHI (p = 0.035) and the GDS (p = 0.018) were significantly lower in the post-test. In the pre-, post-, and follow-up tests, the MPT (p = 0.030), V-RQOL (p = 0.008), and GDS (p = 0.009) were significantly changed. CONCLUSION: The ITSP-PD based on neurological singing therapy for PD showed therapeutic possibility for vocal function and depression in patients with PD. Our findings suggest the need for a randomized study to examine the continuing positive effects of the ITSP-PD over a longer period of time.
Depression ; Follow-Up Studies ; Humans ; Muscles ; Music ; Music Therapy ; Parkinson Disease ; Phonation ; Quality of Life ; Singing ; Voice

PURPOSE: The purpose of this study was to look at prevalences of abnormal serum aminotransferase levels and abnormal serum total cholesterol levels among adolescents with obesity in Seoul area. METHODS: Body mass index[BMI(kg/m2)], serum aspartate aminotransferase(AST) alanine aminotransferase(ALT), and total cholesterol levels were measured in 26,876 adolescents(male : 13,287, female : 13,589) of first grade of high school in Seoul between the ages of 15 and 16 years, enrolled in a large health examination survey by Seoul School Health Center(SSHC) in 2001. Obesity was defined as BMI more than 95th percentile for age and sex and normal weight was defined as BMI between 25th percentile and 75th percentile for age and sex. Abnormal levels of AST, ALT and total cholesterol were defined as more than 95th percentile for age and sex. RESULTS: The BMI at 95th percentile was 28.7 in males and 26.9 in females. The prevalence of abnormal AST levels was higher in obesity group than in normal weight group. In males, those were 23.7% and 3.7%, respectively(P<0.01, x2-value : 529.2). In females, those were 11.8% and 4.9 %, respectively(P<0.01, x2-value : 56.3). The prevalence of abnormal ALT levels was significantly higher in the obesity group compared with the normal weight group. In males, those were 33.9% and 1.7%, respectively(P<0.01, chi2-value : 1,693.4). In females, those were 22.3% and 3.9%, repectively(P<0.01, x2-value : 397.6). The prevalence of abnormal total cholesterol levels was higher in the obesity group than in the normal weight group. In males, those were 16.8% and 3.5%, respectively(P<0.01, x2-value : 268.3). In females, those were 9.0% and 5.4%, respectively(P<0.01, x2- value : 14.2). CONCLUSIONS: This study revealed that the prevalences of abnormal AST, ALT and total cholesterol level were higher in the obese group than in the normal weight group.
Adolescent* ; Alanine ; Aspartic Acid ; Cholesterol* ; Female ; Humans ; Male ; Obesity* ; Prevalence ; School Health Services ; Seoul

Due to improvements in medical care, the socioeconomic level and public health, life expectancy has dramatically increased. Thus, advances in the development of life-support systems and the control of infection have resulted in many surgical and anesthetic procedures being performed on extremely elderly patients. In contrast to younger patients, elderly patients may manifest more than one pathologic process associated with progressive degenerative changes in various organs of the aged, especially in the heart, brain, and kidney. Since both progressive degenerative change occurring in the elderly population and the cumulative incidence of disease in that population result in death intraoperatively or during the immediate postoperative period, the anesthesiologist must be particularly alert to the possibility of anesthetic risks in the elderly. The elderly patient is more likely to have hypertension, congestive heart failure, cardiac dysrhythmias, chronic pulmonary disease, and diabetes. Preoperative evaluation and treatment of those conditions must be extensively reviewed prior to the induction of anesthesia. To evaluate geriatric anesthetic experiences, 539 cases of patients aged over 60 years of 4,266 anesthetic cases admitted to P.M.C. from January to December, 1986 were analyzed according to age, sex, physical status, anesthetic technique an6 agents, surgical department, preoperative chest X-ray findings, preoperative E.C.G findings, and postoperative complications. The results are as follows. 1) Of 4,266 anesthetic patients 539(12.6%) were over 60 3ears of age and 322(59.7%) were males and 217(40.3%) females. 2) In the classification of physical status, the most common evidence was class 2 in 303 cases. Emergency surgery comprised 27.1%. 3) The anesthesia technique employed was usually general anesthesia and this suggested that balanced anesthesia used with narcotics offers several advantages to geriatric patients. 4) In the surgical department, 310 cases(57.5%) were for general surgery, 75 cases(13,9%), orthopedic surgery; 57 cases(10.6%), urology; and 49 cases(9.1%), neurosurgery, respectively. Cancer was present in 198 cases(36.7%), 5) Preoperative chest X-ray findings: The most common finding was pulmonary tuberculosis in 44 cases(8.2%). Pneumonia, pulmonary emphysema, and so forth were also observed. 6) Preoperative E.C.G findings: The most common findings was myocardial ischemia in 48 cases(8.9%). Also myocardial infarction observed in 8 cases(1.5%) 7) Postoperative complications were as follows: The most common incidence was wourid infection in 29 cases(5.4%) followed by pneumonia. There were a number of miscellaneous complications. but postoperatively, they did not present any significant problems. 8) The overall mortality rate was 3.5%(19 cases). The difference in the mortality rate related to age was not statistically significant(p>0.1), but the mortality rate related to physical status was statistically significant(p<0.001). 9) Optimizing a patient's preoperative condition by the anesthesiologist, consultants, and other physicians was assumed to reduce perioperative morbidity and mortality.
Aged ; Anesthesia* ; Anesthesia, General ; Arrhythmias, Cardiac ; Balanced Anesthesia ; Brain ; Classification ; Consultants ; Emergencies ; Female ; Heart ; Heart Failure ; Humans ; Hypertension ; Incidence ; Kidney ; Life Expectancy ; Lung Diseases ; Male ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Narcotics ; Neurosurgery ; Orthopedics ; Pneumonia ; Postoperative Complications ; Postoperative Period ; Public Health ; Pulmonary Emphysema ; Thorax ; Tuberculosis, Pulmonary ; Urology

Adenocarcinoma ; Biopsy ; Biopsy, Fine-Needle ; Deglutition Disorders ; Dyspnea ; Hemoptysis ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Periodontal Cyst ; Thyroid Gland ; Thyroid Neoplasms ; Ultrasonics