No abstract available.
Humans ; Mitral Valve* ; Tricuspid Valve*

OBJECTIVES: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. METHODS: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. RESULTS: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. CONCLUSIONS: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.
Compliance* ; Continuous Positive Airway Pressure* ; Humans ; Interviews as Topic ; Korea ; Polysomnography ; Seoul ; Sleep Apnea, Obstructive*

No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

BACKGROUND: The relationship between whole body vibration and awkward neck posture to cervical herniated intervertebral disc (HIVD) has been rarely reported. In this report, we present the case of an overhead crane operator, that had no known history of neck injury, but had long-term exposure to whole body vibration and improper neck posture, who developed cervical HIVD, which raises concerns over the possibility of occupational causation. CASE: A patient, operating an overhead crane since Dec 26th 1986, began to suffer from a neck pain and developed cervical HIVD in 1998. He had been frequently treated in an outpatient clinic, but the symptom was not improve. Eventually, he got HIVD surgery in Sep 6th 2007, and then the symptom was relieved. There were 4 groups and 3 shift system in the patient's overhead crane operation. He worked eight hours a day and 5 days a week. Actual crane work time was about 6 hours a day. The crane was located at 20 meters above the work field so that the crane operator had to look downward and the neck was bent by more than 20degrees for nearly the entire working day. Daily vibration exposure was expressed in terms of an 8-hour energy-equivalent frequency-weighted acceleration magnitude (A(8)) and vibration dose value (VDV). The daily A(8) was measured to be 0.23 m/s2 and the daily VDV was 7.4 m/s(1.75). Although these levels were below the action level recommended by the International Organization for Standardization (ISO) and European Commission (EC), it cannot be ignored that whole body vibration in addition to an awkward neck posture may be related to an increased risk for neck disease. A long-term awkward posture can adversely impact the prevalence of neck disease. In addition, occupational exposure to whole body vibration along with an awkward neck posture seems to exacerbate these effects. CONCLUSION: An overhead crane operator may have acquired cervical HIVD due to an occupational causation. Therefore, to elucidate the causal relationship of an improper neck posture and whole body vibration to neck diseases, further investigations need to be conducted for lager sample of overhead crane operators that were exposed to a long-term awkward neck posture and whole body vibration.
Acceleration ; Ambulatory Care Facilities ; Humans ; Intervertebral Disc ; Neck ; Neck Injuries ; Neck Pain ; Occupational Exposure ; Posture ; Prevalence ; Vibration

Purpose: Pelvic floor injury diagnosis using 3-dimensional (3D) pelvic floor ultrasound or magnetic resonance imaging is unfeasible in many clinics. We assessed the efficacy of a novel diagnostic parameter, the anal canal coronal-sagittal (CS) ratio, for pelvic floor injury on 2D transanal ultrasound. Methods: This retrospective study analyzed the data of 126 female patients who underwent 3D pelvic floor ultrasound (including 2D transanal ultrasound) at a pelvic floor center between August and December 2020. The anal canal CS ratio on 2D transanal ultrasound and pelvic floor avulsion injury measurements were recorded for all patients. Results: A cutoff anal canal CS ratio of 1.15 was obtained using receiver operating characteristic analysis (sensitivity, 0.820; specificity, 0.763; and area under the curve, 0.838). Patients were categorized into the anal canal CS ratio ≥1.15 and the anal canal CS ratio <1.15 groups. Bilateral pelvic floor avulsion was more common in the anal canal CS ratio ≥1.15 group (n=35, 56.5%), and the incidence of pelvic floor avulsion was significantly different between the 2 groups (P=0.001). Existing parameters of pelvic floor injury, including minimal levator hiatus (P=0.001), levator plate descent angle (P=0.001), and levator ani deficiency score (P=0.001), were statistically different between the 2 groups. Conclusion The anal canal CS ratio was an efficient novel parameter that indirectly detected pelvic floor injury in 2D transanal ultrasound. It is a potential alternative indicator for pelvic floor injury on the widely popular 2D transanal ultrasound.

OBJECTIVE: The effect of transdermal nicotine patch on sleep physiology is not well established. The current study aimed to examine the influence of nicotine patch on homeostatic sleep propensity and autonomic nervous system. METHODS: We studied 16 non-smoking young healthy volunteers with nocturnal polysomnography in a double blind crossover design between sleep with and without nicotine patch. We compared the sleep variables, sleep EEG power spectra, and heart rate variability. RESULTS: The night with nicotine patch showed significant increase in sleep latency, wake after sleep onset, and stage 1 sleep; and decrease in total sleep time, sleep efficiency, and percentage of REM sleep. Also, spectral analysis of the sleep EEG in the night with nicotine patch revealed decreased slow wave activity in stage 2 and REM sleep and increased alpha activity in the first NREM-REM sleep cycle. Heart rate variability showed no differences between the 2 nights, but the low to high ratio (a parameter indicative of sympathetic nervous system activity) positively correlated with wake after sleep onset in night with nicotine patch. CONCLUSION: Transdermal nicotine patch significantly disrupts sleep continuity, sleep architecture, and homeostatic sleep propensity. The overactivation of the sympathetic nervous system may be responsible for these changes.
Adult* ; Autonomic Nervous System ; Cross-Over Studies ; Electroencephalography* ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Male* ; Nicotine* ; Physiology ; Polysomnography ; Sleep, REM ; Spectrum Analysis ; Sympathetic Nervous System ; Tobacco Use Cessation Products*

PURPOSE: The present study proposes to examine the change of IOP in response to the rise of abdominal pressure and in response to position change during laparoscopic surgery. METHODS: The subjects of the present study included 28 patients who had laparoscopic appendectomy and 20 patients who had laparoscopic cholecystectomy. In both groups, the IOP was measured before surgery, after general anesthesia, after the occurrence of pneumoperitoneum, after position change according to operative method, after the removal of pneumoperitoneum and under general anesthesia. RESULTS: When comparing the IOP before and after the occurrence of pneumoperitoneum, the IOP after the occurrence increased by 3.70 +/- 0.96 mm Hg in the appendectomy group and by 3.15 +/- 0.5 mm Hg in the cholecystectomy group. After the occurrence of pneumoperitoneum, the IOP measured in the head-low position was 3.25 +/- 0.16 mm Hg higher than measured in the level position in the appendectomy group, and the IOP measured in the head-high position was 2 +/- 0.12 mm Hg lower than measured in the level position in the cholecystectomy group. Between the 2 groups, there was a significant difference of 6.5 mm Hg in IOP according to the change of head position. CONCLUSIONS: In the present study, the occurrence of pneumoperitoneum in laparoscopic surgery increased IOP, and position change according to operative method also changed IOP. In addition, IOP was significantly different between the 2 groups. In order to prevent the patient from being exposed to high IOP for a long period during laparoscopic surgery, keeping the duration of pneumoperitoneum and a head-low position to a minimum may be helpful.
Anesthesia, General ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Head ; Humans ; Intraocular Pressure ; Laparoscopy ; Pneumoperitoneum

Pilomatricoma is a benign tumor differentiating towards the hair matrix. Perforation may rarely take place with extrusion of part of the contents. A 3-year-old girl presented with a 5×6 mm sized, erythematous, elevated and indurated mass with a tiny horny projection on its surface, on her righ,t upper arm. It had been present for one year. Histopathologically, there were several islands of epithelial cells in the upper to mid-dermis composed of basophilic, shadow and transitional cells. A few tumor islands adjacent to the epidermis were in the course of a characteristic transepithelial elimination process.
Animals ; Arm ; Basophils ; Child, Preschool ; Epidermis ; Epithelial Cells ; Female ; Hair ; Horns* ; Humans ; Islands ; Pilomatrixoma*

PURPOSE: To evaluate the efficacy of short segment fixation in flexion-distraction injuries of thoracolumbar junction. MATERIALS AND METHODS: Twenty-five patients with a flexion-distraction injury in thoracolumbar junction confirmed by radiogram or MRI and stabilized with a short construct spanning short segment were included in this study. We investigated the location of fractures, type of fractures, anterior or posterior vertebral body height, and preoperative and postoperative kyphotic angle of injuried motion-segments on radiologic examinations and clinical outcome on the Oswestry score. RESULTS: A significant correction of deformity was achieved, from a mean preoperative kyphosis of 17.3 degrees to a mean postoperative kyphosis of 8.4 degrees. The loss of correction were minimal. The mean Oswestry score was 6.9, with 84% of patients having minimal disability (<20%) and no correlation with age, sex, the location of fractures, type of fractures, change of kyphotic angle. CONCLUSION: This study demonstrates the efficacy of posterior open reduction and short segment fixation of flexion-distraction injuries.
Body Height ; Congenital Abnormalities ; Humans ; Kyphosis ; Magnetic Resonance Imaging ; Spine*

No abstract available.
Animals ; Cattle* ; Lymphocytes*