Increased death rate resulted from cardiovascular disease called for the study on the autonomic nervous system and cardiovascular system. It is known that an HRV (heart rate variability) spectrum analysis based on ECG (electrocardiograph) signals could be used to define activity of sympathetic and parasympathetic nervous system noninvasively. However, it is important to prove whether suggested HRV analysis method could provide the useful information for observing autonomic nervous system quantitatively and objectively before clinical application. In this study, 14 rats were used and divided into two groups, sympathectomy group and vagotomy group, respectively. During the experiment, ECGs of rats were collected three times at each experimental condition. After the application of Berger's series algorithm to the ECG raw data, HRV spectrum was obtained via FFT (fast Fourier transform). Power contents for each frequency bands were calculated from HRV waveforms. Two peak values, HF (high frequency) and LF(low frequency), representing autonomic nervous system status were used to extract the parameter, HF/LF ratio. Results showed that HF/LF values were increased for the sympathectomy group and decreased for the vagotomy group. It implies that the variations in HF/LF components exhibits the information for the classification of ANS(autonomic nervous system) function quantitatively. HRV analysis algorithm developed from this study could be expanded for the observation of autonomic nervous system variations in human.
Animals ; Autonomic Nervous System ; Cardiovascular Diseases ; Cardiovascular System ; Classification ; Electrocardiography ; Humans ; Mortality ; Parasympathetic Nervous System ; Rats ; Spectrum Analysis ; Sympathectomy* ; Vagotomy*

Cardiovascular syphilis is one of the most important complications of tertiary syphilis, although its incidence is decreasing in recent years. Aortitis is the primary manifestation of cardiovascular syphilis, resulting most commonly in aortic aneurysm, aortic regurgitation and coronary artery ostial obstruction. The authors experienced 46-year-ole male with a history of chancre 20 years ago, and several bouts of right chest pain since last year. Serologic tests revealed reactive in VDRL (1:64) and in TPHA test. Chest x-ray, chest CT, echocardiogram and aortogram showed aneurysm of ascending aorta with no evidence of aortic regrugitation of coronary obstruction. Histologic findings of involved aorta revealed "tree bark" appearance in gross, and microscopically adventitial thickening with endarteritis of the vasa vasorum and destruction of elastic tissue of media, showing moth-eaten appearance. The patient was underwent excision of the aneurysm and dacron aortic prosthetic graft was replaced with success.
Aneurysm* ; Aorta* ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortitis ; Chancre ; Chest Pain ; Coronary Vessels ; Elastic Tissue ; Endarteritis ; Humans ; Incidence ; Male ; Polyethylene Terephthalates ; Serologic Tests ; Syphilis ; Syphilis, Cardiovascular ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Vasa Vasorum

The hepatic artery was embolized with absolute ethanol in 1 mongrel dogs to evaluate the embolic effect andsafety of this material. Follow up angiography and liver function test were performed at 15 minutes, 1 week and 4weeks after embolization. Retrograde cholangiography, microangiography and pathologic examination were done at 4weeks after embolization. The result was as follows: 1. Sequential angiography showed successful and persistentocclusion of intrahepatic arteries at different levels, and reconstitution of the intrahepatic arterialcirculation via collaterals. 2. Microangiography revealed avascular area in 5 cases. But in incompletely infactedare there showed tortuous hepatic arteries, decreased perfusion of sinusoid and microcolaterals through theinterlobular arteries, capsular arteries and peribiliary vascular plexus. In one case sparse peribiliary plexuswas observed. 3. Retrograde cholangiography revealed findings of cholangitis on involved segment. 4. The absoluteethanol was effective for achieving a permanent occlusion of intraheptaic arteries but caused damage on sinusoidand hepatic parenchyme, and on peribilary vasucular plexus resulting in sclerosing cholangitis. So in furtherclinical application, caution would be necessary to superselect the tumor supplying artery to avoid unnecessaryparenchymal damage.
Angiography ; Animals ; Arteries ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing ; Dogs ; Ethanol ; Follow-Up Studies ; Hepatic Artery ; Liver Function Tests ; Perfusion

OBJECTIVE: To identify the effects of isokinetic strengthening of trunk muscles on balance in hemiplegic patients after stroke. METHOD: All participants were ambulatory hemiplegic patients, injured at least 6 months prior to study. The patients (n=16) were randomly divided into two groups. The control group received neurodevelopmental treatments and gait training 3 times a week. In addition to the same treatments provided for the control group, the experimental group received trunk isokinetic strengthening exercises using isokinetic dynamometer 3 times a week. Trunk muscle peak torque and balance in the experimental group were compared with those in control group at baseline and 4 weeks after treatments. RESULTS: There were no significant differences in age, lesion of hemiplegia, time after stroke onset, trunk muscle strength and Berg balance score before treatments between two groups. In the experimental group, peak torques of trunk extensor increased significantly at 60degrees/sec and 90degrees/sec at 4 weeks (p<0.05), but there were no significant improvements in peak torques of trunk flexor at all degree and extensor peak torques at 120degrees/sec. Both the extensor and flexors showed no significant changes in the control groups. In the experimental group, a mean percent change in peak torque involving the trunk extensor was significantly increased at 60degrees/sec. In the experimental group, Berg balance scores, 10 m gait velocity, sit to stand and gait 3 m and return, and 10 seconds stair up and down were improved (p<0.05). No significant improvements were noted in the control group. CONCLUSION: Isokinetic strengthening of trunk muscles can improve balance in hemiplegic patients.
Exercise ; Gait ; Hemiplegia ; Humans ; Muscle Strength ; Muscles ; Stroke ; Torque

BACKGROUND: P300 component of the long latency auditory evoked potentials (LLAEPs) provides information on conscious and cortical funtion. The P300 wave occures only for stimuli that somehow capture the patients attention. Therefore LLAEPs implys a degree of cognitive processing. We studied sedation scale and P300 wave to determine if LLAEPs could be utilized as electrophysiologic predictors of sedation. METHODS: The P300 component of LLAEPs from vertex was recorded from 10 ASA physical status I and II patients undergoing elective surgery while they listened via headphones to a series of clicks which were interrupted unpredictably by a tone burst (2 KHz) before and after diazepam 0.04 mg/kg and 0.08 mg/kg IV. The patients were asked to concentrate on the clicks and to press a button whenever they detected a 2 KHz tone. And sedation scale also was measured. RESULTS: Amplitude of P300 was decreased and latency of P300 was increased in a dose-dependent manner with IV diazepam. Amplitude was greatest and latency was shortest in awake. And sedation scale also was increased according to increased IV diazepam adminstration. CONCLUSIONS: Both amplitude and latency may be highly related to the sedation scale with progressively increasing dose of diazepam. Therefore we conclude that P300 component of LLAEPs can be utilized as an electrophysiologic predictor of awareness and sedation.
Diazepam* ; Event-Related Potentials, P300* ; Evoked Potentials, Auditory* ; Humans

The intraoperative rupture of an intracranial aneurysm can dramatically interrupt the fine operative procedure and jeopardize the patient's chance for meaningful survival. A sudden increase of the arterial pressure and intracranial pressure during laryngoscopy and intubation is potentially dangerous and may lead to fresh bleeding from an aneurysm in patient with recent subarachnoidal hemorrhage due to aneurysmal rupture. But aneurysmal rupture during induction occurs rarely. Recently we experienced rebleeding due to sudden increased arterial blood pressure during laryngoscopy and intubation in 39 years old female patient who was scheduled for clipping of ruptured intracranial aneurysm on 11th day after ictus. And she died of cerebral death on 6th postoperative day. Here we discuss the incidence, prognosis, diagnosis, management and prophylaxis of the aneurysmal rupture during induction with a brief review of the literature.
Adult ; Anesthesia* ; Aneurysm ; Arterial Pressure ; Diagnosis ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Intracranial Pressure ; Intubation ; Laryngoscopy ; Prognosis ; Rupture ; Surgical Procedures, Operative

BACKGROUND: When patients return to the emergency department shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. But in other aspects many short term revisits may be unnecessary in the aspect of emergency care because it is known that substantial numbers of patients use emergency department for nonemergency problems. So we analysed the tendency and the cause of short term revisit patients, determined the rates and the associated demographic, clinical, disease variables as a tool of quality assurance. METHODS: We carried out a chart review of patients seen in the emergency department, who revisited within 72 hours, of Young Dong Severance Hospital retrospectively between January 1, 1998 and September 30, 1999 (period 2), and compared with result between April 1, 1990 and March 31, 1991 (period 1) respectively. RESULTS: In the period 1, the total revisits patients were 204/21,025(0.97%), in that period scheduled revisits were 15.2%, the unscheduled were 84.8%, and the frequent revisits (more than 3 times) were 6.4%. In the period 2, the total revisit patients were 4,722/72,802 (6.49%), in that period scheduled revisits were 86.3%, the unscheduled were 13.7%, and the frequent revisits were 24.8%. The most common cause of revisit during the period 2 is a drug addictor (31.2%) that frequently used the emergency room for seeking drug. CONCLUSIONS : The scheduled revisit patients for dressing, medication, re-evaluation were increased enormously, so the medical care of these patients might be a part of job that performed in emergency department. And if the health care system could support the adequate nursing care facility, the portion of avoidable revisits of emergency department can be decreased. We also found that the emergency department is an important points for the early identification and referral for the treatment of patients who revisited emergency room for seeking drug, and the analysis of physician related factor in revisits patients may be used as a tool of quality assurance in the emergency department.
Bandages ; Delivery of Health Care ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Humans ; Nursing Care ; Referral and Consultation ; Retrospective Studies

No abstract available.
Humans

Recently, as standard of living has been improving and awareness of well-being has been generalized, people's desire pursuing beauty has been spreading across the world. We made a survey with 184 graduating high school girls in December 2003. According to the survey. 57.6% of them knew about plastic surgery, 41.8% of them knew well about whole field of plastic surgery, and 60.3% of them wanted to have an aesthetic surgery. 44.6% got an information about an aesthetic surgery from general public and 27.6% from TV, respectively. Regarding the use of aesthetic surgery, 59.8% answered that it makes them more confident about themselves rather than just to be beautiful. 78.8% of them have complaints about how they look. Finally, as the personal desire to make themselves look beautiful to others increases, so does the interest in aesthetic plastic surgery. In conclusion, as the society of plastic and reconstructive surgeons, we still need more effort for the correct cognition and awareness of plastic surgery among general public.
Beauty ; Cognition* ; Female ; Humans ; Socioeconomic Factors ; Surgery, Plastic*

PURPOSE: The present study evaluated whether oral supplementation with a branched-chain amino acid (BCAA) improves the biochemical and amino acid profiles of liver tumor patients undergoing radiotherapy. MATERIALS AND METHODS: Patients were randomly assigned to one of 2 groups: a group given oral supplementation with BCAA granules (LIVACT granules; Samil Pharm Co., Korea, each granule containing L-isoleucine 952 mg, L-leucine 1,904 mg, and L-valine 1,144 mg) during radiotherapy, or a placebo group. Physical and biochemical examinations and measurements, including subjective symptoms, Child-Pugh class, body mass index, plasma albumin concentration, and plasma amino acid profiles were monitored. RESULTS: Fifty were enrolled between November 2005 and November 2006. We also analyzed data from 37 hepatocellular carcinoma (HCC) patients in order to evaluate a more homogenous group. The two groups of patients were comparable in terms of age, gender, Child-Pugh score, and underlying hepatitis virus type. Serum albumin, total protein, liver enzymes, and cholesterol showed a tendency to increase in the BCAA group. In this group, the percentage of cases that reverted to normal serum albumin levels between 3 and 10 weeks after administration of BCAA was significantly higher (41.18%) than in the placebo group (p=0.043). CONCLUSION: Oral supplementation with a BCAA preparation seems to help HCC patients undergoing radiotherapy by increasing the BCAA concentration.
Amino Acids, Branched-Chain ; Body Mass Index ; Carcinoma, Hepatocellular ; Cholesterol ; Hepatitis Viruses ; Humans ; Isoleucine ; Korea ; Leucine ; Liver ; Oxytetracycline ; Plasma ; Serum Albumin ; Valine