Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

Deposition of monosodium urate crystal in joints and periarticular soft tissue is regarded as one of the characteristics of chronic gouty arthritis. In spine, however, only nineteen cases of tophaceous deposits have been reported to date suggesting the rarity of clinical symptoms secondary to involvement of spine. Authors report a case of spinal stenosis due to hypertrophy of ligament flavum with monosodium urate deposits. The patient was 65 years of age with chronic gouty arthritis who underwent a decompressive laminectomy at L4-5. At surgery, hypertrophied ligament flavum that was covered with chalky amorphous materials was noted without any evidence of radiologic features. Microscopically, a portion of ligament flavum had been focally destoryed by amorphous material deposits that were surrounded by a thin layer of mononuclear and giant cells along with occasional sprinkling of chronic inflammatory cells and negative birefringence on polarizing microscopy.
Arthritis, Gouty ; Birefringence ; Giant Cells ; Humans ; Hypertrophy* ; Joints ; Laminectomy ; Ligaments* ; Microscopy ; Spinal Stenosis* ; Spine ; Uric Acid*

A retrospective study was designed to determine the diagnostic contribution of oblique view in 740 consecutive lumbar spine examinations done in adults. In 12 cases (1.62%) there was a change in the radiographic interpretation when the oblique views were used for diagnosis. Considering the significant gonadal radiation, additional cost, and limited diagnostic value, the authors feel that the oblique view should not be a routine part of the initial lumbar spine examination in adults.
Adult ; Diagnosis ; Gonads ; Humans ; Retrospective Studies ; Spine

STUDY DESIGN: A retrospective follow-up study comparing soft disc cervical myelopathy (Group A) and spondylotic bar cervical myelopathy (Group B). OBJECTIVES: To analyze different factors by comparing preoperative radiological and clinical data of Group A with that of Group B. SUMMARY AND LITERATURE REVIEW: The different causes of cervcal myelopathy resulted in different symptoms and prognoses. MATERIALS AND METHOD: A clinical and radiological analysis of the data in 31 patients who underwent an anterior cervical decompression and fusion was performed to assess the different factors between two groups. The patients were classified into two groups; 20 in Group A and 11 in Group B. Comparisons between the two groups were made in regard to the physical findings, radiological and clinical evaluation. RESULTS: The duration of myelopathy was 3 months in Group A and 8.7months in Group B. Of all cases, 5 cases (25.0%) in group A and 4 cases (36.4%) in group B had myelopathy associated with radiculopathy. Of the 20 cases in group A with myelopathy, 7 cases had a median compression and 13 cases had a paramedian compression on MRI. Of the 11 cases in group B with meylopathy, 9 cases had a median compression and 2 cases had a paramedian compression on MRI. The follow-up MRI of the 14 cases (73.7%) in group A and 2 cases (20.0%) in group B showed spontaneous regression of the T2 WI high signal intensity. CONCLUSION: In degenerative disc disease, the different causes of cervcal myelopathy result in different symptoms and prognoses. However, the treatment of choice in both groups is a one level anterior decompression and fusion.
Decompression ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiculopathy ; Retrospective Studies ; Spinal Cord Diseases*

Patients with ankylosing spondylitis are susceptible to fractures, which usually occur in the cervical spine. However, upper spinal fractures, particularly dens fracture-nonunion complicating ankylosing spondylitis, are quite rare. We encountered one such case. The patient was treated with posterior fusion followed by a halovest, which resulted in good conditions.
Humans ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*

PURPOSE: Pain is the most distressing feature of cancer patients. Thoracoscopic splanchnicectomy, first performed in 1993, has caused a resurgence of interest in surgical treatment of such excruciating pain. We wish to introduce a method of splanchnicectomy. METHODS: Five patients underwent a splanchnicectomy for intractable cancer pain, over a period of 11 months. We evaluated the type of splanchnicectomy performed and the results. The procedure was done using a double lumen catheter to deflate the lung at the operation side under general anesthesia with the patient in the lateral decubitus position. A small opening was made with scissors in the pleura of the 5th intercostal space to expose the terminal branch of the greater splanchnic nerve. Six-Seven branches of splanchnic nerve were cut downward until the splanchnic nerve trunk and then cut. A left thoracoscopic splanchnicectomy was done in one case, and a bilateral thoracoscopic splanchnicectomy in four cases. RESULTS: The splanchicectomy appears to result in significant reduction of abdominal pain in all cases. There were no postoperative complications. CONCLUSION: As a conclusion, thoracoscopic splanchnicectomy is the treatment of choice for intractable intraabdominal cancer pain, affording drug cessation and recovery of daily activity in most patients.
Abdominal Pain ; Anesthesia, General ; Catheters ; Humans ; Lung ; Pleura ; Postoperative Complications ; Splanchnic Nerves ; Thoracoscopy

No abstract available.
Hyperprolactinemia*

The survey of occupational injury has not been performed in Korean Air Force. The aim of this survey is to identify the feature of the occupational injury at the Korean Air force base. The occupational injury were monitored at the medical group in a Korean air base, from Aug 1998 to Jul 1999. Because the medical group has supported 2 different groups, we analysed and described some results seperately; group 1 consisted of workers in line maintenance operation, group 2 included workers in base maintenance operation. There were 59 injuries(injured persons) in group 1, and 9 injuries in group 2, so the incidence(per 1000) were 21.5, 4.46 respectively. 11 persons transferred to well-equiped hospital. Most of injured persons were air men, and then sergeant, civilian employee in order. The median age of injured persons was 22 years old in group 1 and 21 years old in group 2. The median work experience was 0.8 and 8 years respectively. The median delay time to arrive at the hospital from the time of injury were 30 min in group 1, 20 min in group 2, but maximum delay in group 1 was about 9 days. The occupational injuries were most common in October in the year, Tuesday in a week. Also the injury occurred common from 13 to 13:59, and from 11 to 11:59 in a day. The injury occurred most commonly by the collision with something, when working with more than 4 coworkers, and repairing the machinery. The most common injured part of the body were hands and feet, the patterns of injury were laceration and fracture.
Foot ; Hand ; Humans ; Incidence ; Lacerations ; Male ; Occupational Injuries* ; Young Adult

The Di(a+b-) phenotype is extremely rare among Caucaclans and mostly confined to mongoloids. The incidences of Di antigen among Koreans were reported to be 6.1 to 14.5%, with an average of 9.6%; it can be calculated that the frequency of Di(a+b-) is 0.25% on the average. Authors report the first case of hemolytic disease of the newborn due to anti-Dib in Korea. The Diego phenotypes of the mother, baby and father were Di(a+b-), Di(a+b+) and Di (a-b+), respectively. The mother's serum and eluate from infant's erythrocytes contained anti-DP antibody active in the antiglobulin phase. After transfusions of Di-negative red cells from the mother and mother's relative, the patient was recovered from anemia and jaundice.
Anemia ; Erythrocytes ; Fathers ; Humans ; Incidence ; Infant, Newborn* ; Jaundice ; Korea ; Mothers ; Phenotype

The analysis of heart rate variability is a useful tool to investigate the physiologic phenomena related with autonomic functions. At first, it was developed to evaluate the relation between cardiovascular disease and autonomic balance. Nowadays, the application of it's use has been considered in psychiatric practice. And its convenient usage and non-invasiveness gathered more interest of clinicians and investigators. However, no systematic review of the studies on the heart rate variability in psychiatric field is tound. Thus we reviewed the literatures on the usage and it's limitations of the heart rate variability in terms of the spplication in psychiaric practice and research. Interviews with experts on autonomic functions were also included to supplement the review. Studies found that patients with schizophrenia showed reduced heart rate variability while taking clozapine, and severely depressed patients showed more reduced heart rate variability than normal control. Patients with various anxiety disorders including panic disorder and posttraumatic stress disorder showed eleated sympathetic autonomic tone compared with normal control subjects. However these findings remained controversial because of many confounding factors including drug effects and individual and situational factors affecting heart rate variability. With further studies after successful control of confounding variables, the analysis of heart rate variability would be a useful physiologic parameter of asessing psychiatric patients in clinical practice and research.
Anxiety Disorders ; Cardiovascular Diseases ; Clozapine ; Confounding Factors (Epidemiology) ; Heart Rate* ; Heart* ; Humans ; Panic Disorder ; Research Personnel ; Schizophrenia ; Stress Disorders, Post-Traumatic