No abstract available.
Family Practice* ; Humans ; Internship and Residency*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.

PURPOSE: To present the results of patients undergoing surgical treatment and determine clinical guidelines for the face turn, and up and down shoot in Duane retraction syndrome (DRS). METHODS: Thirty-four patients with DRS were treated with single horizontal rectus muscle recession, lateral rectus (LR) recession with Y-splitting, or LR recession with Y-splitting combined with medial rectus (MR) recession. The different treatment approaches were based on the angle of deviation in the primary position, versions, and ductions. In all patients, ocular alignment, face turn and up and down shoot were assessed preoperatively and postoperatively. RESULTS: The average standard deviation reduced from 18.5 +/- 6.5 prism diopters (PD) to 4.6 +/- 5.8 PD in horizontal rectus muscle recession and 14.4 +/- 5.5 PD to 1.6 +/- 2.8 PD in LR recession with Y-splitting. LR recession with Y-splitting combined with MR recession was effective in reducing globe retraction. Postoperative 4-mm LR recession with Y-splitting did not change ocular alignment; 7-mm LR recession with Y-splitting showed an average correction of 12.8 PD. Postoperatively, all patients presented a reduction in face turn; however, there was no statistically significant difference between the 2 procedures (Mann-Whitney U test, p = 0.620). CONCLUSIONS: Decisions regarding surgical approaches in DRS should be based on the amount of deviation in primary eye position, the expression of up and down shoot, and the degree of face turn. Surgeons planning Y-splitting of LR with MR recession must consider modifying the MR recession amount due to the smaller LR recession effect of Y-splitting compared with conventional LR recession.
Duane Retraction Syndrome ; Eye ; Humans ; Muscles

No abstract available.
Liver Cirrhosis* ; Liver* ; Pregnancy*

Sixty diabetic cystopathy patients (symptomatic DCP, 4.9%) among 1236 patients of diabetes mellitus (DM) from May, 1995 to June, 1996 were analyzed to ascertain the usefulness of urodynamic study in the diagnosis of DCP. The mean age was 58 (24--80) years and mean duration of DM was 9 (1~30) years. 36 (60%) patients had diabetic neuropathy, 31 (52%) had diabetic retinopathy and 4 (7%) had diabetic nephropathy. DM was managed by insulin pump (DIABECARETM, 52%) and subcutaneous insulin injection (42%). In residual urine and voiding diaries, residual urine volume more than 40ml was 83%, voiding interval less than 2 or more than 5 hours was 67% and voiding amount less than 200ml or more than 400ml was 48%. According to urodynamic findings, patients were classified as detrusor areflexia (63%), impaired detrusor contractility (18%), detrusor instability (15%) and normal detrusor contraction (3%). There were no significant differences of age, semm-HbA1C, treatment method and duration of diabetes mellitus among above groups. Mean duration of DM in irritative symptom group (32%), combined symptom group (23%) and obstructive symptom group (45%) were 2 years, 8 years and 15 years respectively (p<0.001). The shape of the cystometrographic curve was not influenced by the rate of bladder filling (40ml/min versus 100ml/min). In conclusion, because DCP is marked by insidious onset and progression with minimal symptoms, DCP can be early diagnosed using urodynamic study especially in patients with voiding symptoms and 1ong.DM duration.
Diabetes Mellitus ; Diabetic Nephropathies ; Diabetic Neuropathies ; Diabetic Retinopathy ; Diagnosis ; Humans ; Insulin ; Urinary Bladder ; Urodynamics*

No abstract available.
Buprenorphine* ; Meperidine*

Pain is a sensory experience that is subjective and individual. It frequently exceeds its protective function and becomes destructive. We have met one case of causalgia, three cases of Buergers disease, and one case of arteriosclerosis obliterance. They sufferred from persistent pain and exkausted with the marked distrophy of affected limbs. Management of these patient involving lower limbs is a continuing challenge. Many other therapheutic procedures could be tried for these patients, but we tried chemical lumbar sympathectomy for these cases. With respect to the lower extremity, four patients had neurolysis of the 1st, 2nd and 3rd ipsilateral or 2nd and 3rd bilateral lumbar ganglia using 3 to 5 ml pure alcohol for each space under the image intensifier. Immediately after these procedure, rest pain has relieved dramatically in most cases and marked skin temperature rising. This implied increased peripheral blood flow of sympathectomised portion and the relief of rest pain is probably explained by destrcution of the afferent pain fibres running with the sympathetic trunk.
Arteriosclerosis ; Causalgia ; Extremities ; Ganglia ; Humans ; Lower Extremity ; Running ; Skin Temperature ; Sympathectomy* ; Thromboangiitis Obliterans

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: The purpose of this study was to investigate psychological capital, sense of community and stress in relation to school adjustment and to identify factors influencing school adjustment in middle school students. METHODS: This study population consisted of 150 middle school students. Data were analyzed using t-test, analysis of variance, Pearson correlation coefficient, and multiple regression analysis. RESULTS: The mean score for school adjustment in middle school students was 3.68 out of 5 points. School adjustment explained 34% of the variance in sense of community (β=.39, p < .001), positive psychological capital (β=.35, p < .001), academic performance (β=.26, p < .001), and stress (β=−.21, p < .001). CONCLUSION: The results of our research suggest that sense of community is an important variable influencing school adjustment in middle school students. Therefore, to promote school adjustment in middle school students, it is necessary to develop and implement active educational strategies promoting sense of community, positive psychological capital, academic perfomance, and controlling stress.
Adolescent ; Humans