No abstract available.
Electrocardiography* ; Hyperbaric Oxygenation*

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

Gastric volvulus is an uncommon condition which is difficult to diagnose and treat. It designates abnormal rotation of the stomach along its longitudinal (organoaxial) or transverse (mesenteroaxial) axis. When the rotation exceeds 180 degrees, gastric obstruction or strangulation may occur. The classical presentation of acute gastric volvulus is the triad of severe epigastric pain, vomiting followed by retching without the ability to vomit, and difficulty or inability to pass a nasogastric tube. Delay in diagnosis and treatment of gastric volvulus can lead to fatal complications such as gastric ischemia, perforation, and hemorrhage. Gastric volvulus is a true emergency which should be treated immediately either surgically or by upper endoscopy. We report a case of an acute incarcerated gastric volvulus due to a left-sided diaphragmatic hernia in an adult male patient, which was treated successfully by operation.
Acute Disease ; Hernia, Diaphragmatic/*complications ; Humans ; Male ; Middle Aged ; Stomach Volvulus/diagnosis/*etiology

BACKGROUND: We investigated relationships between generalized joint laxity and primary lumbar disc herniation occurrence and compared clinical outcomes after conservative treatment in lumbar disc herniation patients with and without generalized joint laxity. METHODS: The study group included 128 men, and the control group included 276 men matched for age and body mass index with the study group. The primary outcome measure was the presence or absence of generalized joint laxity using the Beighton scale. Clinical outcomes measured by the visual analog scale and the Oswestry disability index 2 years after conservative treatment were the secondary outcome measure. RESULTS: Generalized joint laxity prevalence was 13.2% in the study group and 5.1% in the control group, a significant difference (P=0.01). Spearman correlation analysis revealed that weight (r=0.162, P=0.03), body mass index (r=0.131, P=0.03), and generalized joint laxity (r=0.372, P<0.01) significantly correlated with lumbar disc herniation occurrence. In multivariate regression analysis, generalized joint laxity was the only significant lumbar disc herniation predictor (P=0.002; 95% confidence interval, 1.08 to 5.26). Generalized joint laxity in lumbar disc herniation patients was associated with worse clinical outcomes after conservative treatment measured by visual analog scale scores for lower extremity pain (P=0.02), lower back pain (P=0.03), and Oswestry disability index scores (P=0.03). CONCLUSION: Generalized joint laxity might be associated with lumbar disc herniation occurrence and might also be a negative predictor of worse clinical outcomes after conservative treatment.
Body Mass Index ; Humans ; Intervertebral Disc Displacement ; Joint Instability* ; Low Back Pain ; Lower Extremity ; Lumbar Vertebrae ; Male ; Outcome Assessment (Health Care) ; Prevalence ; Treatment Outcome* ; Visual Analog Scale

We present a retrospective study on 63 patients who underwent decompressive craniectomy from April 1985 to June 1990. All patients were comatose(Glasgow Coma Score;3-8) at the time of operation. There were 42 males and 21 females with an age range of 7 to 80 years(mean age, 43 years). Bifrontal craniectomy was performed in 15 patients(23.8%) and frontotemporoparietal craniectomy was done in 48 patients(76.2%). Pupils were abnormal in 41 patients(65.1%) on arrival. However, those became abnormal in 60 patients(95.2%) preoperatively. Fourty nine of the 63 patients died within the first 30 days of surgery (operative mortality, 77.8%). Late mortality was 3.2%, making the total mortality for this series 81.0%. Only eight patients(12.7%) could have favorable outcome(good recovery and moderate disability). The operative method did not affect on the prognosis. The most common primary mass lesion was acute subdural hematoma(35 patient;55.6%). Skull fracture was found in 48 patients(76.2%). Postoperative CT scanning were obtained in 18 patients(28.6%). Moderate to marked degree of edema was found in 14 patients(77.8%). Delayed lesions were found in 13 patients(72.2%). Intracerebral hematoma was the most common delayed lesion. In nine patients(50.0%), the degree of midline shift was more severe than the preoperative CT scans. These results stroly suggested that the WDCE was not an effective surgical method due to its high mortality, morbidity and possible harmful effect such as enhanced edema formation and hastened delayed lesions.
Coma ; Craniocerebral Trauma* ; Decompressive Craniectomy* ; Edema ; Female ; Head* ; Hematoma ; Humans ; Male ; Mortality ; Prognosis ; Pupil ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed

OBJECTIVE: The lack of anatomical knowledge for the anterior cervical microforaminotomy is liable to injure the neurovascular structures. The surgical anatomy is examined with special attention to the ventral aspect exposed in anterior cervical microforaminotomy. METHODS: In 16 adult formalin fixed cadaveric cervical spine, the author measured the distances from the medical margin of the longus colli to the medical wall of the ipsilateral vertebral artery and the angle for the ipsilateral vertebral artery. The distances from the lateral margin of the posterior longitudinal ligament to the medial margin of the ipsilateral medial wall of the vertebral artery, to the ipsilateral dorsal root ganglion was measured too. RESULTS: The distance from the medial margin of the longus colli to the ipsilateral vertebral artery was 13.3~14.7mm and the angle for the ipsilateral vertebral artery was 41~42.5 degrees. The range of distance from the lateral margin of the posterior longitudinal ligament to the ipsilateral vertebral artery was 11.9~16.1mm, to the ipsilateral dorsal root ganglion was 11.6~12.9mm. CONCLUSION: These data will aid in reducing neurovascular injury during anterior cervical approaches.
Adult ; Cadaver ; Formaldehyde ; Ganglia, Spinal ; Humans ; Longitudinal Ligaments ; Spine ; Vertebral Artery

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.
Biopsy ; Chungcheongnam-do ; Gynecology ; Humans* ; Mass Screening* ; Obstetrics ; Papilloma* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

OBJECTIVE : The purpose of this study was to characterize the Rolandic fissure(Rf) and was to identify the Rf using the surface bony landmarks which can be usually exposed on craniotomy. METHODS : After morphological evaluation of the Rfs using 21 Korean adult formalin fixed cadavers, craniometric measurement was carried out from the surface bony landmarks of nasion, glabella, bregma, and lambda. RESULTS : The Rfs of both hemispheres did not show the mirror image. The Rfs ran forward and downward toward the sylvian fissure keeping the mean angle of 67degrees from mid-sagittal line as elongated S-shape in left and the elongated reverse S-shape in right hemisphere. Connections between the Rf and the longitudinal fissure and between the Rf and the sylvian fissure were found in 3 (7.1%) and 2 (4.8%) of 42 hemispheres, respectively. Most Rfs extended superiorly to 2-3mm lateral to the most superomedial surface of hemispheres and extended inferiorly to 3-5mm superior to the sylvian fissures. The mean distances from the nasion, glabella, bregma, and lambda to the most superomedial aspect of the Rf were 18.8+/-0.9cm, 16.6+/-0.8cm, 5.2+/-0.6cm, and 6.9+/-1.0cm, respectively. The mean distance measured between the Rf and the nasion using traditional method was 18.4+/-0.6cm. CONCLUSION : The distance between the Rf and the nasion roughly correspond within the range of mean 4 mm compared with that measured by the traditional measurement. These data may be more helpful to delineate the Rf after the placement of drapes for craniotomy.
Adult ; Cadaver ; Craniotomy ; Formaldehyde ; Humans

OBJECTIVE: Morphometric data for the sympathetic ganglia (SG) of the upper thoracic spine was investigated to identify the exact location of the SG in order to reduce normal tissue injury in the thoracic cavity during thoracoscopic sympathectomy. METHODS: In 46 specimens from 23 formalin-fixed adult cadavers, the authors measured the shortest distance from the medial margin of the T1, T2 and T3 SG to the most prominent point and medial margin of the corresponding rib heads, and to the lateral margin of the longus colli muscle. In addition, the distance between the most prominent point of the rib head and the lateral margin of longus colli muscle and the width of each SG were measured. RESULTS: The shortest distance from the medial margin of the SG to the prominent point of corresponding rib head was on average 1.9 mm on T1, 4.2 mm, and 4.1 mm on T2, T3. The distance from the medial margin of the SG to the medial margin of the corresponding rib head was 4.2 mm on T1, 5.9 mm, and 6.3 mm on T2, T3. The mean distance from the medial margin of the SG to the lateral margin of the longus colli muscle was 6.7 mm on T1, 8.8 mm, 9.9 and mm on T2, T3. The mean distance between the prominent point of the rib head and the lateral margin of the longus colli muscle was 4.8 mm on T1, 4.6 mm, and 5.9 mm on T2, T3. The mean width of SG was 6.1 mm on T1, 4.1 mm, and 3.1 mm on T2, T3. CONCLUSION: We present morphometric data to assist in surgical planning and the localization of the upper thoracic SG during thoracoscopic sympathectomy.
Adult ; Cadaver ; Ganglia, Sympathetic ; Head ; Humans ; Muscles ; Ribs ; Spine ; Sympathectomy ; Thoracic Cavity ; Thoracic Vertebrae ; Thoracoscopy