PURPOSE: The purpose of this study was to investigate the effects of upper extremity exercise training on the motor activity, the ADL and the health related quality of life. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were conveniently selected 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who had been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of motor activity(amount, quality) of plegic side, DL(ADL, IADL) and health related QOL(SF-36). RESULTS: 1. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group. 2. There were no significant differences in ADL and IADL between experimental and control groups. 3. After 2 weeks of treatment. the health related QOL was significantly higher in subjects who participated in exercise training than in subjects in the control group. CONCLUSION: The above results state that the U/E exercise training could be an effective intervention for improving the motor activity and the health related QOL of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.
Activities of Daily Living* ; Biofeedback, Psychology ; Community Health Centers ; Humans ; Motor Activity* ; Quality of Life ; Upper Extremity*

There are many controversies concerning therapeutic guidelines for the treatment of Kienbock's disease. We experienced 17 cases of stage II or III Kienbock's disease(Lichtman's classification), which were treated with triscaphe fusion from March 1983 to March 1992. The mean Follow-up peri- od was 25 months. The purpose of this study is to evaluate the clinical and radiological result of triscaphe fusion of 17 cases of Kienbock's disease. 1. The pain was relieved in all cases, but range of motion was not improved after operation. 2. The postoperative results of triscaphe fusion were evaluated by Licthman's method. 9 cases (53%) were rated as satisfactory and 8 cases as unsatisfactory. 75%(3 cases of 4) were rated sat isfactory in IIIA a group and 22%(2 casaes of 9) were rated satisfactory in IIIB group. 3. The psudoarthrosis was noted in 2 cases of 17.
Follow-Up Studies ; Methods ; Osteonecrosis ; Range of Motion, Articular

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

The aim of this study was to assess the effect of 6-week vegetable juice supplementation (360 ml/day) on serum lipid profiles and antioxidant activity in college women. Twenty women (mean age: 21) with normal life style and dietary pattern and who are free of any specific diseases were recruited among the student in S women's university. The subjects consumed vegetable juice to take part in an uncontrolled clinical trial for a 6-week intervention period. While there was no difference in the concentration of total cholesterol and HDL-cholesterol, serum concentrations of TG and HDL/LDL ratio were significantly reduced by 22% (p = 0.013) and 6% (p = 0.007) respectively. Significant decrease in malondialdehyde (p = 0.000) was accompanied by an increase in the activity of serum antioxidant enzymes, such as GSHPx (p = 0.000), SOD (p = 0.007). It was also found that total antioxidant status was improved by 5.4% (p = 0.009). Serum parameters were all changed without affecting body mass index, waist and hip circumferences, or nutrient intakes after six week of supplementation. This study demonstrated that the supplementation regular meals with vegetable juice can favorably affect serum lipid profiles and antioxidant systems, and hence could contribute to reduce the risks of chronic diseases in college women.
Body Mass Index ; Cholesterol ; Chronic Disease ; Female ; Hip ; Humans ; Life Style ; Lipid Peroxidation ; Malondialdehyde ; Meals ; Vegetables*

PURPOSE: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the U/E motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality). RESULT: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. CONCLUSION: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

OBJECTIVE: In order to confirm the local production of total and specific IgE antibodies in the nasal polyp tissues. MATERIAL AND METHOD: We measured total IgE and house dust mite(Dermatophagoides pteronpssinus .' DP)-specific IgE antibody using enzyme-linked immunosorbent assay(ELISA) in the supernatant of nasal polyp homogenates from 72 subjects undergoing nasal polypectomy. The subjects were divided into three groups according to skin reactivity to DP: 20 strongly atopic subjects to group I(mean wheal diameter) 3mm), 19 weakly atopic subjects to group II (mean wheal diameter 1-3mm) and 33 negative skin responders to group III. RESULT: Group I showed significantly higher levels of total and DP-specific IgE levels in the nasa
Antibodies ; Dust* ; Immunoglobulin E* ; Nasal Polyps* ; Pyroglyphidae* ; Skin ; United States National Aeronautics and Space Administration

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures