No abstract available.
Ankle Fractures* ; Ankle*

A 25 year old patient who had low back pain and sciatica was diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the third and fourth lumbar vertebrae. The extradural defects defined with positive contrast myelography and postmyelographic computed tomographic scanning were posterolateral to the dural sac. Biopsy revealed the findings compatible with synovial cyst. Treatment consisted of laminectomy and surgical excision of the cyst.
Biopsy ; Humans ; Laminectomy ; Low Back Pain ; Lumbar Vertebrae ; Myelography ; Sciatica ; Synovial Cyst ; Zygapophyseal Joint

No abstract available.
Animals ; Locomotion* ; Rats* ; Spinal Cord Injuries* ; Spinal Cord*

The technetium (Tc)-99m pyrophosphate scans have been used to diagnose acute myocardial infarctions and to confirm the equivocal cases. Many articles have been reported about its diagnostic performance and pitfalls. But there has been no evaluation of its predictability according to the grades of the radioactivity land statistical evaluation of the trade-off point, i.e., grade 2 and the area under the receiver operating characteristic curve. To achieve the goals, we reviewed 252 cases of Tc-99m pyrophosphate scans (acute transmural infarction [n=99], acute subendocardial infarction [n=7], unstable angina[n=16], old myocardial infarction [n=19] others [n=111]). The predictabilities of the scan are 98% in grade 4, 84% in grade 3, 83% in grade 2, 53% in grade 1 and 18% in non-uptake. The usual trade-off point, grade 2 is not statistically significant(Z=1.945, P=0.0259>0.01). The area under the receiver operating characteristic curve(Az) is 0.885. Our study shows that the probable main cause of the false negative cases is the time interval between the onset of symptoms and the test.
Infarction ; Myocardial Infarction ; Radioactivity ; ROC Curve ; Technetium

Myotonic dystrophy is a muscle disorder characterized by progressive muscle wasting and weakness associated with myotonia. It is a systemic disease transmitted in an autosomal dominant pattern. Myotonia may be precipitated by hypothermia, shivering, and mechanical or electrical stimulation. Furthermore, sensitivity to sedative, anesthetic and neuromusclular blocking agents may result in intraoperative and early postoperative cardiovascular and respiratory complications, as well as prolonged recovery from anesthesia. Therefore, a patient with myotonic dystrophy is at high risk for complications from anesthetic management. We report the successful anesthetic management of such a patient undergoing a total abdominal hysterectomy, in which we used an epidural technique for intraoperative anesthesia and postoperative analgesia.
Analgesia ; Anesthesia ; Electric Stimulation ; Humans ; Hypothermia ; Hysterectomy ; Muscular Diseases ; Myotonia ; Myotonic Dystrophy* ; Shivering

OBJECTIVES: Because shipyard workers are involved with various manufacturing process, they are exposed to many kinds of hazardous materials. Welders especially, are exposed to bisphenol-A (BPA) during the welding and flame cutting of coated steel. This study was conducted to assess the exposure status of the endocrine disruptor based on the job-exposure matrix. The effects of the genetic polymorphism of xenobiotic enzyme metabolisms involved in the metabolism of BPA on the levels of urinary metabolite were investigated. METHODS: The study population was recruited from a shipyard company in the K province. A total of 84 shipbuilding workers 47 and 37 in the exposed and control groups, respectively, were recruited for this study. The questionnaire variables included, age, sex, use of personal protective equipment, smoking, drinking and work duration. The urinary metabolite was collected in the afternoon and correction made for the urinary creatinine concentration. The of the CYP1A1, CYP2E1 and UGT1A6 genotypes were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with the DNA extracted from venous blood. RESULTS: The urinary BPA level in the welders group was significantly higher than in the control group (p< 0.05). The urinary BPA concentration with the wild type UGT1A6 was higher than the other UGT1A6 genotypes, but with no statistical significant. From themultiple regression analysis of the urinary BPA, the regression coefficient for job grade was statistically significant (p< 0.05). CONCLUSIONS: The grade of exposure to BPA affected the urinary BPA concentration was statistically significant. However, the genetic polymorphisms of xenobiotics enzyme metabolism were not statistically significant. Further investigation of the genetic polymorphisms with a larger sample size is needed.
Biomarkers* ; Creatinine ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2E1 ; DNA ; Drinking ; Genotype ; Hazardous Substances ; Metabolism ; Personal Protective Equipment ; Polymorphism, Genetic ; Sample Size ; Smoke ; Smoking ; Steel ; Welding ; Xenobiotics

Propofol is widely used for supportive sedation in local and regional anaesthesia in plastic surgical procedure. We studied comparative effect of propofol comparing fontanel and midazolam that was previously used. From April 2003 to July 2005, 118 patients were reviewed whom propofol was used intravenous sedation in various plastic surgical procedures. In some cases, midazolam were used initially then converted to propofol. Patients were questioned for their satisfaction in group of propofol alone and midazoline and propofol combination. Vital sign(Blood pressure, Respiration rate) and O2 saturaion, sedation time, side effect and subjective satisfaction were evaluated. The result reveals that propofol is effective medicine for supplement intravenous sedative medicine for plastic surgeries especially when it was used with combination of midazolam.
Humans ; Midazolam ; Propofol* ; Respiration ; Surgery, Plastic*

Pleomorphic adenoma is a tumor rarely seen in the breast. To date, only about 70 cases have been reported in the literature. Many reports have used fine-needle aspiration biopsy in the preoperative diagnosis of these lesions. However, pleomorphic adenoma is sometimes mistaken for a malignant tumor because of its cytologic features. In this study, we present a 56-year-old woman with a palpable breast mass. Ultrasound indicated a 15 mm oval-shaped hypoechoic mass with complex echogenicity in the palpable region. Ultrasound-guided core needle biopsy (US-CNB) revealed a pleomorphic adenoma of the breast, which was confirmed through surgical excision. Although pleomorphic adenoma is rarely seen in the breast, results demonstrate the usefulness and accuracy of US-CNB in diagnosing pleomorphic adenoma of the breast.
Adenoma, Pleomorphic ; Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Breast ; Female ; Humans

OBJECTIVES: This study was conducted to identify the effect of a stretching exercise on myofascial pain syndrome patients that work in small and medium-sized industry. METHODS: Questionnaires surveys including general characteristics, work-related characteristics, and musculoskeletal symptoms on neck and shoulder area was administered to 393 subjects who worked in small and medium sized industries. Symptomatic workers were examined to identify whether they had myofascial pain syndrome (MPS). Of the 393 subjects, 108 MPS patients performed 6 weeks stretching exercise program. Intensity of pain was estimated with visual analogue scales (VAS). All patients were interviewed to estimate their compliance to stretching exercise program. RESULTS: Of the 393 workers, 119 workers were diagnosed with MPS of the neck and shoulder. Post-exercise VAS was significantly reduced compared to pre-exercise VAS (p<0.05). High compliance patients to stretching exercise were more effective to exercise therapy (OR 2.89, 95% CI 1.19~7.04), and overtime workers were less effective to exercise therapy (OR 0.41, 95% CI 0.17~0.95). CONCLUSION: The Stretching exercise program was identified to be effective in MPS patients in small and medium-sized industries. It is recommended that workers with MPS in small and medium-sized industries practice a well-designed stretching exercise program, and avoid overtime work.
Compliance ; Exercise Therapy ; Humans ; Myofascial Pain Syndromes ; Neck ; Questionnaires ; Shoulder ; Trigger Points ; Weights and Measures

A Bezold-Jarisch reflex (BJR) mediated vasovagal syncope is the most common neurally mediated reflex characterized by the sudden failure of the autonomic nervous system and have been reported in patients undergoing a peripheral nerve block. The concomitant administration of a beta-adrenoreceptor antagonist and calcium channel blocker have a synergistic suppressant effect on the autonomic nervous system and interact with the anesthetics significantly. We report a case of a 57-year-old female patient with essential hypertension controlled with lercanidipine and carvedilol. Cardiac arrest developed with spontaneous respiration 50 min after the brachial plexus block to remove a plate in the humerus. Epinephrine was administered and the pulse immediately returned to a normal sinus rhythm. This event might be vasovagal syncope mediated by BJR, and realted to the antihypertensive medication used.
Anesthetics ; Autonomic Nervous System ; Brachial Plexus* ; Calcium Channels* ; Calcium* ; Epinephrine ; Female ; Heart Arrest* ; Humans ; Humerus ; Hypertension ; Middle Aged ; Peripheral Nerves ; Reflex ; Respiration ; Syncope, Vasovagal