Many different kinds of anorectal physiologic studies were performed for the evaluation of defecation disorders. Some of these studies are anorectal manometry and pudendal nerve conduction study. In pudendal nerve conduction study, pudendal nerve terminal motor latency (PNTML) was considered to be very useful for the evaluation and management of these patients. However, evaluation of amplitude in pudendal nerve conduction study has been clinically seldom used. Therefore, the aim of this study was to evaluate the clinical significane of amplitude in pudendal nerve conduction study in patients with defecation disorders by comparing to manometric profiles. MATERIAL AND METHODS: Between February, 1997 and February, 1998 all patients who underwent pudendal nerve conduction study and anorectal manometry for the evaluation of defecation disorders (constipation and fecalincontinence) were analyzed. Latency as well as amplitude in pudendal nerve conduction study were compared in both groups to the pressure profiles in manometric study according to the subgroups of these patients. Statistical analysis were performed by a Chi-square or Student's t-test and significance was assumed when p<0.05. RESULTS: A total of 80 patients, forty constipation with a mean age of 55.3+/-14.5 (GI: range; 24~86) years and forty fecal incontinence with a mean age of 61.1+/-10.3 (GII: range; 37~74) years and a male to female ratio of 25:15 (GI), 28:12 (GII), were studied. PNTML in both sides in GI were significantly decreased in comparision to those of GII (GI: Rt, 2.17+/-0.7 ms Lt, 2.03+/-0.5 ms, GII: Rt, 2.50+/-0.7 ms, Lt 2.64+/-0.8 ms, p<0.05), However, there were no differences between the two groups in terms of amplitudes (GI: Rt 399.0+/-348 uV, Lt 426.8+/-403 uV, GII: Rt, 406.9+/-273 uV Lt, 392.9+/-291 uV, NS) in pudendal nerve conduction study. In manometric findings, even though maximal resting, mean, minimum and maximal pushing pressures were no differences in both groups, mean resting and maximal squeezing pressure were significantly increased in GI than those of GII (GI: 82.4+/-31 cmH20, GII: 60.5+/-25 cmH20 in mean resting pressure, GI: 213.1+/-108 cmH20, GII: 178.7+/-66 cmH20 in maximal squeezing pressure, p<0.05) When we analyzed the overall values of amplitudes according to the diagnosis, age, gender, and the value of PNTML, there were no statistically significant differences between the two groups. But, when the one side of PNTML shorter than the other side, it tended to have a high amplitude in that side than that of the other side in the same patient (the probability for trend was 74%). CONCLUSION: Constipation patient has a shorter PNTML, higher mean resting, and maximal squeezing pressure than fecal incontinene patient. The amplitude in pudendal nerve conduction study had a trend of inverse correlation to the latency in the same patient. Therefore, amplitude in pudendal nerve conduction study might be useful to monitor or predict the outcome after treatment in patients with defecation disorders.
Constipation ; Defecation* ; Diagnosis ; Fecal Incontinence ; Female ; Humans ; Male ; Manometry ; Pudendal Nerve*

No abstract available.
Acidosis, Renal Tubular*

No abstract available.
Knee* ; Menisci, Tibial*

Herein we report a case of subungual osteochondroma in a male patient. Although there have been several reports about cases of subungual exostosis in Korea, a case of subungual osteochondroma had not been reported until now. Osteochcndromas are clearly different disease entities from exastosis in that they have diagnostic hyaline cartilaginous caps instead of the fibrocartilages in subungual exostosis. Additioaally, subungual osteochondroma is a very rare type having an incidence rate of less than 1% among all osteochondromas. Our patient was an 18-year-old male with a solitary woody mass on his right great toe that was painfuL A surgical excisional biopsy following a nail plate avulsion showed the characteristic hyaline cattilaginous caps enclosing bony trabecula connected with the inferior cortical bone.
Adolescent ; Biopsy ; Exostoses ; Humans ; Hyalin ; Incidence ; Korea ; Male ; Osteochondroma* ; Toes

No abstract available.
Anterior Cruciate Ligament* ; Patellar Ligament*

No abstract available.
Continuous Positive Airway Pressure* ; Ventilation*

Separation of the symphysis pubis in association with delivery is very rare. The Korean orthopedic and obstetrical literature pertaining to this syndrome is absent. The physiological widening is small and asymptomatic, but a separation of more than one centimeter may occur and in usually symptomatic. A twenty-six-year-old woman of separation of symphysis pubis associated with delivery was treated successfully with the treatment of reduction and pelvic band, with absolute bed rest in the lateral decubitus position.
Bed Rest ; Female ; Humans ; Orthopedics ; Pubic Bone*

Multiple factors including gastroesophageal reflux disease (GERD) were evaluated for a case-control study in Chonnam area to investigate the causative entity of COPD. Data on the multiple causative factors from hospital records and interview survey were analyzed in three groups of COPD(64 cases as case group), normal lung (83 cases as control group 1) and non-COPD lung disease (45 cases as control group 2). Smoking status, history of adulthood pulmonary infection and frequent history of URI, socioeconomic status, and GERD were significantly different between COPD group and control group 1. Drinking status, physical height of the subjects and GERD were significantly different between COPD group and control group 2. If control group 1 was used, odds ratio of GERD and COPD was 5.68(95%confidence interval, 95% CI:2.59-12.45) and 4.81 (95% CI:1.89-10.53) when adjusted by age and smoking status. If control group 2 was used. Odds ratio of GERD and COPD was 4.22 (95% CI:1.69-10.56) and 4.59 (95% CI:1.64-12.86) when adjusted by alcohol and adulthood respiratory infection status. In summary, there results suggested that GERD might play a causative role in the development of COPD.
Case-Control Studies ; Drinking ; Gastroesophageal Reflux* ; Hospital Records ; Jeollanam-do ; Lung ; Lung Diseases ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Social Class

Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

Renal dysplasia results from aberrant metanephric histogenesis caused fundamentally by a defect in inducer tissue or responding tissue. Dysplastic kidneys vary tremendously in gross and microscopic appearance but are characterized by abnormal organization and a mixed population of primitive structures, such as fetal or immature cartilage, dysplastic ducts, immature tubules, and undifferentiated mesenchyme. We report a case of unilateral multicystic renal dysplasia associated with an ipsilateral ectopic ureteral orifice entering a seminal vesicle cyst in a 33-year-old man. He was admitted due to primary infertility which had developed three years ago. The his semen analysis revealed oligospermia. No evidence of a family history of renal dysplasia was reported. Microscopic examination showed that the entire kidney was composed of cysts lined by flattened cells, dysplastic ducts and immature tubules surrounded by collars of spindle cells, primitive mesenchyme, and a few aberrantly formed glomeruli.
Adult ; Cartilage ; Humans ; Infertility ; Kidney ; Male ; Mesoderm ; Multicystic Dysplastic Kidney* ; Oligospermia ; Semen Analysis ; Seminal Vesicles* ; Ureter*