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

OBJECTIVE: Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. METHODS: Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. RESULTS: All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed > or =2 times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. CONCLUSION: Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.
Cavernous Sinus ; Central Nervous System Vascular Malformations* ; Fistula ; Humans ; Meningeal Arteries ; Punctures ; Superior Sagittal Sinus

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

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 purpose of this study was to determine the normal morphometric landmarks of the uniting and dividing points of the brachial plexus (BP) in the periclavicular region to provide useful guidance in surgery of BP injuries. METHODS: A total of 20 brachial plexuses were obtained from 10 adult, formalin-fixed cadavers. Distances were measured on the basis of the Chassaignac tubercle (CT), and the most lateral margin of the BP (LMBP) crossing the superior and inferior edge of the clavicle. RESULTS: LMBP was located within 25 mm medially from the midpoint in all subjects. In the supraclavicular region, the upper trunk uniting at 21 +/- 7 mm from the CT, separating into divisions at 42 +/- 5 mm from the CT, and dividing at 19 +/- 4 mm from the LMBP crossing the superior edge of the clavicle. In the infraclavicular region, the distance from the inferior edge of the clavicle to the musculocutaneous nerve (MCN) origin was 49 +/- 1 mm, to the median nerve origin 57 +/- 7 mm, and the ulnar nerve origin 48 +/- 6 mm. From the lateral margin of the pectoralis minor to the MCN origin the distance averaged 3.3 +/- 10 mm. Mean diameter of the MCN was 4.3 +/- 1.1 mm (range, 2.5-6.0) in males (n = 6), and 3.1 +/- 1.5 mm (range, 1.6-4.0) in females (n = 4). CONCLUSION: We hope these data will aid in understanding the anatomy of the BP and in planning surgical treatment in BP injuries.
Adult ; Brachial Plexus ; Cadaver ; Clavicle ; Female ; Humans ; Male ; Median Nerve ; Musculocutaneous Nerve ; Pectoralis Muscles ; Ulnar Nerve