PURPOSE: Generally, the constipation is a medical disease, but recently, there are many reports showing the good results after correction of rectocele in constipated patients. The authors try to show the effect of surgery in rectocele cases and also analyse the relationship between the anatomical distortion and clinical symptoms by using anorectal physiologic study before and after operation. METHODS: 31 cases of rectocele are surgically corrected from June 1998 to August 2001. 31 cases of them could be followed up and with them, pre- and post-operative anal ultrasonography, anorectal manommetry and defecography were tried. Personal interview was also done to each patient. RESULTS: After trasanal rectocele repair, the rectocele size decreased and clinical symptoms improved remarkably. In defecography, anorectal angle (pre-op; 105.9+/-6.0 degrees vs. post-op; 109.5+/-3.7 degees) and perineal descent (1.6+/-0.7 cm vs. 2.4+/-1.2 cm) increase in pushing state after operation. In anorectal manometry, mean resting anal pressure (29.2+/- 3.4 mmHg vs. 17.9+/-4.6 mmHg) and maximal squeeze pressure (84.5+/-20.8 mmHg vs. 47.6+/-12.1 mmHg) decreased and rectal sensation improved after operation. CONCLUSIONS: Current results suggest that the surgical correction aims not only the decrement of the rectocele size but changing the vector power on pushing more physiologically and also improving the rectal sensibility.
Constipation ; Defecography ; Humans ; Manometry ; Prospective Studies* ; Rectocele* ; Sensation ; Ultrasonography

No abstract available.
Drug Therapy*

PURPOSE: Rectoceles are often associated with anorectal symptoms. Various surgical techniques have been described to repair rectoceles, but the surgical results vary. The aim of this study was to compare transanal repair (TAR) and transanal repair with posterior colporrhaphy (TAR+PC). METHODS: The records of 58 patients operated on during a 56-month period were reviewed. Of those 26 patients had a TAR, and 32 patients had a TAR+PC. Interviews and anorectal physiologic studies were performed preoperatively and postoperatively. RESULTS: The recurrence rate after a TAR+PC was lower than the recurrence rate after a TAR (TAR 19.2% vs. TAR+PC 3.1%). The rectal sensation (sensory threshold: TAR 64.8+/-18.9 ml vs. TAR+PC 56.1+/-23.67 ml; earliest defecation urge: TAR 116.4+/-29.5 ml vs. TAR+PC 104.8+/-31.2 ml) was more improved after a TAR+PC. CONCLUSIONS: A TAR+PC for treatment of a rectocele is safe and effectively corrects obstructed defecation. The improvement probably relates, at least in part, to rectal sensational factors other than the dimensions of the rectocele.
Defecation ; Humans ; Rectocele* ; Recurrence ; Sensation

No abstract available.
Cardiomyopathies* ; Peripartum Period*

OBJECTIVE: The purpose of this study was to evaluate the effect of interferential current therapy (IFT) of swing pattern frequency alteration on the RIII nociceptive reflex. METHOD: Ten healthy volunteers received IFT of both constant (100 Hz) and swing (20~100 Hz) pattern frequency. Before and after the IFT application RIII nociceptive reflex was evoked by stimulation of sural nerve and recording at biceps femoris muscle. Twenty nine patients with low back pain were treated with IFT of constant or swing pattern frequency and degrees of pain relief were evaluated by Visual Analogue Scale (VAS) and Present Pain Intensity (PPI). RESULTS: The threshold of RIII reflex was increased immediately after both constant and swing frequency, but the increased threshold was lasted for 15 minutes only after swing pattern frequency alteration. Pain relieving effect of IFT evaluated by PPI was also lasted for 15 minutes only after swing frequency alteration. CONCLUSION: These results suggest that IFT of swing pattern frequency alteration had longer lasting effect on the inhibition of RIII nociceptive reflex and the relief of pain than that of constant frequency.
Electric Stimulation Therapy ; Healthy Volunteers ; Humans ; Low Back Pain ; Reflex* ; Sural Nerve

In spite of recent development in fixation technique we still have lots of complication including avascular necrosis of femoral head. For many years, orthopaedic surgeon have been searching for a simple, safe, accurate and reliable clinical test to asses the vascular status of the femoral head. In early detection of viability of the femoral head, nothing is more certain than bone scan at the moment. Bone scan can detect or predict the viability of the femoral head. Subramanian and McAfee introduced 99mTc-Sn-polyphosphate as a bone seeking agents. We applied serial bone scan in 19 cases of femur neck fractures from 1982 to 1985 at the department of orthopaedic surgery, National Medical Center. The results were as follows; 1. The uptake ratio of displaced and undisplaced group based on preoperative radiography was 1.ZO, 1.46, 1.52, 1.55, and 0.63, 1.23, 1.81, 1.58 in average in postoperative bone scan interval 1–2 wks, 3 months, 6 months, 12 months. The bone scan uptake ratio was lower in the former than the latter, but after 3 months, there was no remarkable difference between them. 2. At the time of 1 to 2 weeks, 3 months, 6 months and 12 months, uneventful group was 0.74, 1.27, 1.72, 1.62 and avascular necrosis group 0.13, 0.18, 0.30, 0.67 in the uptake ratio. In 2 cases of avascular necrosis, the uptake ratio was markedly decreased. 3. There was no difference between the group operated within 48 hour after injury and the group delayed later.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Necrosis ; Radiography

PURPOSE: The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS: Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS: The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P > or = .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION: Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.
Mandrillus ; Ribs ; Salicylates ; Torque

Obsessive-compulsive disorder (OCD) has a lifetime prevalence of approximately 2-3%. Until relatively recently, effective treatments for OCD were lacking. Fortunately, over the past decades, the availability of serotonin reuptake inhibitors (SRIs) and behavioral treatments using exposure-response prevention techniques has altered the outlook for patients suffering from OCD. But, treating OCD with medication still requires a blend of science and art. SRIs provide clinically significant relief to most patients, but they are not effective in all patients. Because significant number of patient with OCD do not respond to adequate trials of SRIs, other treatment options such as augmentation, switching, combination, or neurosurgical and device-based approaches may be needed. In this paper, the first-line treatment options and several alternative treatment options for OCD were reviewed. Finally, we reviewed several treatment guidelines and algorithm for OCD introduced previously by other researchers. We have a plan to develop Korean treatment algorithm for OCD based on expert's opinions. Also, we hope to use this algorithm for OCD in the clinical setting in near future.
Hope ; Humans ; Obsessive-Compulsive Disorder* ; Prevalence ; Serotonin Uptake Inhibitors

The spinal cord is part of the central nervous system, and its caudal end is named as the conus medullaris. Many researchers have reported the tip level of the conus medullaris by magnetic resonance imaging studies; others by cadaver dissection. The tip level of magnetic resonance imaging studies seemed to be higher than that of cadaver studies. We evaluated the tip level the conus medullaris with magnetic resonance imaging and cadaver dissection in Korean adult population. MR data were scanned with T1-weighted, mid-sagittal magnetic resonance imaging of 248 living persons (mean age, 42.3±16.0 years; range, 12-85 years) and cadaver data were collected by dissections of 118 cadavers (mean age, 56.0±14.9 years; range, 16-94 years). The mean level of conus tip was found to be at the middle third of 1st lumbar vertebra (range, lower third T12 - lower third L2) from magnetic resonance imaging study and the upper third of 2nd lumbar vertebra (range, lower third T12 - lower third L3) from cadaver dissection study. The tip level of conus medullaris from magnetic resonance imaging study was higher than that from cadaver dissection study (p<0.05).
Adult* ; Cadaver* ; Central Nervous System ; Conus Snail* ; Humans ; Magnetic Resonance Imaging* ; Spinal Cord* ; Spine

Bipotent progenitors for T and natural killer (NK) lymphocytes are thought to exist among early precursor thymocytes or liver lymphocytes. The identification of such a progenitor population or mature NK cells in such organs remains undefined. Here we report the identification of a novel receptor of NK cells, p58 (HLA class I-specific inhibitory receptors), in fetal thymocytes and fetal liver lymphocytes. Our finding suggests the NK cells mature in the developmental stage during feta1 ontogeny. Flow cytometric analysis revealed p58 positive cells in thymocytes or in fetal liver lymphocytes and reverse transcription PCR also showed amplification of p58 RNA. The result of single stranded conformational polymorphism (SSCP) showed it discriminates one or two base pair differences of the p58 gene. Although the question still remains as to whether the expression of p58 is due to the NK cells or natural T cells, it is clear the p58 is expressed in fetal thymocytes or liver lymphocytes. And SSCP analysis using appropriate sets of primers used in this study, is helpful to study the diversity of p58.
Base Pairing ; Killer Cells, Natural ; Liver* ; Lymphocytes* ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Reverse Transcription ; RNA ; T-Lymphocytes ; Thymocytes*