No abstract available.
Reference Values*

The authors studied anxiety, using Zung's self-rating anxiety scale (SAS), in the subjects of 127 male and 38 female patients with anxiety disorder. The authors investigated 165 patients in Yeungnam university hospital from January, 1987 to June, 1991. In order to analyze the data on anxiety scores Pearson's product moment coefficient correlation method and factor analysis were carried out by SPSS/PC+ program. The results were as follows: There was significant difference in the mean averages of total anxiety scores among patients with anxiety disorder and male and female college freshmen: patients with anxiety disorder scored 42.40±7.74, male students scored 32.91±5.70, female students scored 34.48±6.00. The anxiety scores relating to the items of body aches & pains, fatigue, anxiousness, panic and urinary frequency were relatively high in patients with anxiety disorder. The anxiety scores on the items of restlessness, apprehension, dyspnea, sweating, and insomnia were relatively low in patients with anxiety disorder. Twenty-nine anxiety disorder group (17.5%) showed significantly high anxiety scores of 50 or over. The inter-rater reliability of Zung's self-rating anxiety scale was 0.71.
Anxiety Disorders* ; Anxiety* ; Dyspnea ; Fatigue ; Female ; Humans ; Male ; Methods ; Panic ; Psychomotor Agitation ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating

No abstract available.
Evidence-Based Practice* ; Humans

BACKGROUND: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic steno, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. METHOD: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due. to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-YAG) laser through a flexible bronchoscopy. RESULTS: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. CONCLUSION: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.
Aluminum ; Bronchoscopy ; Cartilage ; Cicatrix ; Diaphragm ; Dilatation ; Dyspnea ; Follow-Up Studies ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Respiratory Insufficiency ; Tuberculosis

BACKGROUNDS: Percutaneous radiofrequency neurotomy of posterior primary ramus has been in use as a treatment for persistent, mechanical low back pain for two decades. However, there has been limited studies regarding to prognostic factors related to outcome. We report our experience with at least 2-year follow up with special aftention on prognostic factors. METHODS: Of total 228 patients who underwent percutaneous radiofrequency neurotomy (PRN) of posterior primary ramus for refractory low back pain during last 3 years, 128 patients whose pain was considered to be originated from facets joints or their surrounding soft tissue and responded to temporary blocks were assigned to a group II. All patients had more than 6 months of pain. These patients were compared with 100 patients to whom PRN were provided for chronic nonspecific low back pain without all inclusion criteria (Group I). RF procedures were done under local anesthesia with C-arm intensifier guidance. Pain reliefs were estimated at 1week, 1month, 6months and 2 years using visual analog scale(VAS). For patients with more that 50% reduction of previous pain was regarded as positive responder. Various clinical variables such as age, sex, symptom duration, types of pain, bilaterality, and previous surgery were studied for prognostic factors. RESULTS: Positive responders were 56% at 1week, 46% at lmonth, 18% at 6months, and 13% at 2years after PRN in group I, and 78.9% at lweek, 75.4% at lmonth, 62.5% at 6months, and 54.7% at 2years in group II. Some variables were found to be significantly related to outcome including prominent local tenderness, percussion tenderness, combination of symptoms with pain on gefting up, extension, transitional movement, pain radiating to buttock and/or posterior thigh, and good immediate response. Age, sex, symptom duration, bilaterality, imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not related to outcome. CONCLUSIONS: These results indicate that PRN of posterior primary ramus has a moderate overall long-term beneficial effect, with no morbidity in our series. But, the long-term good results will be anticipated only in properly selected patients with low back pain originating from facet joints and surrounding structures.
Anesthesia, Local ; Buttocks ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain* ; Percussion ; Thigh ; Zygapophyseal Joint

Recently the internal rigid fixation with plates and screws became popular procedure. In the cases of the zygomatic fracture, it is sufficient to fix more than 2 point in many studies. Therefore, the internal rigid fixation requires the aggressive incision to expose the zygoma, such as coronal incision. Since many patients are afraid of this aggressive operation, we have provided a simple and effective method which is a 3-dimensional one point fixation on the zygomaticofrontal suture with X-shaped(6-hole) miniplate for the treatment of zygomatic fractures. From March 1995 to september 1995, we treated 13 cases of zygomatic fractures by open reduction and X-shaped miniplate fixation on the zygomaticofrontal suture. The results were as follows: 1) plane to plane contact on each side of the fracture with one point X-shaped miniplate. 2) 91.8% correction on Water's views, and 93.3% correction on zygomatic arch view with one point fixation. 3) patients were satisfied with these procedures because of minimal incision, mild edema and low operation price (short operation & anesthetic time, one plate & 6 screws cost).
Edema ; Humans ; Sutures ; Zygoma ; Zygomatic Fractures*

No abstract available.

No abstract available.

BACKGROUND: Blood pressures rneasured by a nurse at reception room as a part of routine physical examination are oft,en used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors. METHODS: Two hundred ninety one patients who visited to one university hospital farnily practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting t,ime, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer. RESULTS: Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6+/-11.9mmHg (P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(SBP) in more than 5mmHg is more likely to be hypertensive than the group with SBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5rnmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa, 0.747, P<0.01). CONCLUSIONS: Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patients factors which may influence blood pressure level.
Blood Pressure* ; Coffee ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Mass Screening ; Outpatients* ; Physical Examination ; Smoke ; Smoking ; Sphygmomanometers

BACKGROUND: Doppler echocardiography is a non-invasive technique that has been used to evaluate LV diastolic dysfunction. Impaired left ventricular diastolic filling is known to occur in patients with coronary artery disease. Compared with those in normal subjects, Doppler-derived transmitral blood flow velocities have been reported to be reduced during early diastolic filling and to be compensatory elevated subsequent to atrial systole in patinets with coronary artery disease. But stiffness of myocardium normalize the E/A ratio, and normal E/A ratio may reveal increased ventricular filling pressure. We tried to investigate left ventricular filling parameters by Doppler echocardiography in patients with early myocardial infarction, and to compare left ventricular diastolic function regarding infarct location on EKG, one or multivessel disease on coronary angiography, and treatment modality. METHODS: From September 1993 to August 1995, Pulsed wave Doppler echocardiography was performed in patients with early acute myocardial infarction(N=95) and control group(N=20) within 5 days after admission, and parameters of diastolic function was evaluated. RESULTS: Echocardiographic data showed significant differences in mean ejection fraction, mean left ventricular mass, and mean left ventricular mass index between two groups. There was no significant difference in E/A ratio, deceleration time, and isovolumetric relaxation time between two groups. Neither, there was significant difference in each diastolic parameter for infarct related wall on EKG. And there was no significant difference in deceleration time for one or multi vessel disease on coronary angiography, treatment modality(conservative treatment, thrombolytic therapy, or primary PTCA). CONCLUSION: In patients with early acute myocardial infarction, left ventricular diastolic dysfunction was absent. And there was no significant correlation between the presence of diastolic dysfunction and the location of infarct related wall on EKG, or one or multi vessel disease, or treatment modality.
Blood Flow Velocity ; Coronary Angiography ; Coronary Artery Disease ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Myocardial Infarction* ; Myocardium ; Relaxation ; Systole ; Thrombolytic Therapy