OBJECTIVES: The purpose of this study was to examine the electromyographic activities of the erector spinae muscle of the back and the rectus femoris muscle of the thigh, and to measure the angles of the spinal and knee flexions in order to determine the effect of wearing a back belt. METHODS: Fifteen healthy males participated in the study. Surface electromyography was used to measure the level of muscle activities at the two muscle groups. The Simi system, utilizing two-dimensional analysis of movement, was used to examine the range of motion of the back and low extremity. RESULTS: Firstly, the angle of the spinal flexion was significantly less in the back-belt-wearing group than in the control, and that of the knee flexion was significantly increased in the back-belt-wearing group. Secondly, there was no significant change in the electromyographic signals of the erector spinae muscle of the back and the rectus femoris muscle of the thigh. CONCLUSIONS: The use of back belts helps workers to correct their posture when lifting boxes. It can therefore protect workers from acute back injuries.
Back Injuries ; Electromyography ; Extremities* ; Humans ; Knee ; Lifting* ; Male ; Posture ; Quadriceps Muscle ; Range of Motion, Articular ; Thigh

Oral stereognosis is a function recognizing the characteristics, such as the size and shape, of objects in the mouth by integrating the senses with movement. As a child grows up, this function develops gradually but is reduced by aging and neurological damage, such as a stroke. In addition, it may affect the swallowing function in the oral phase of stroke patients with dysphagia. The shape and size of an intraoral bolus provide sensory information that is important for swallowing. Therefore, oral stereognosis is important for safety during eating and drinking. Oral stereognosis is designed for evaluation using two-dimensional or three-dimensional shapes of various sizes, and the accuracy or response rate is scored. On the other hand, there is no method of standardized examination. Accordingly, it is necessary to develop a new training method for promoting the recovery of the oral sensory function. The method should also aim to recover the oral stereognostic ability through a larger number of subjects and diseases in the future.

Pain relief becomes a major concern when treating patients with rib fractures so adequate ventilation must be maintained. Many techniques have been described for the management of frectured ribs, including systemic analgesics, intercostal nerve blockade, intrathecal morphine, epidural bupivacaine and epidural morphine. This case report illustrates the successful use of epidural narcotics in a patient with multiple fractured ribs.
Analgesics ; Bupivacaine ; Humans ; Intercostal Nerves ; Morphine ; Narcotics* ; Rib Fractures ; Ribs* ; Ventilation

The popular term malignant hyperthermia syndrome (MHS) refers to a clinical syndrome classically observed during general anesthesia. It is characterized by a rapidly increasing .temperature and a high mortality rate. A case of MHS was experienced which developed 60 minutes after induction of general anesthesia with thiopental sodium, succinylcholine, halothane, N2O and 02. High fever, muscle rigidity and cyanosis developed and were followed by arrythmia and unstable blood pressure. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient died about 6 hours after induction of anesthesia.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Blood Pressure ; Cyanosis ; Emergency Treatment ; Fever ; Halothane ; Humans ; Malignant Hyperthermia* ; Mortality ; Muscle Rigidity ; Succinylcholine ; Thiopental

The epidural abscess, while rare, should be taken seriously, as it can result in permanent neurological complications. Fever, back pain, leukocytosis and elevation of Erythrocyte Sedimentation Rate (ESR) are major signs and symptoms of epidural abscesses. But clinical recognition of such abscesses may be very difficult because of nonspecific symptoms or signs as well as previous or underlying painful disorders. Few cases has been reported of epidural abscess and epidural fibrosis associated with back surgery or temporary epidural blocks. In these cases, however, fever, low back pain, sciatica and elevation of ESR were the major findings. Magnetic Resonance Imaging findings after Gadolinium- diethylenetriaminopenta-acetic acid (Gd-DTPA) enhancement show central low signal intensity and surrounding high signal intensity at the anterior epidural space between the 5th lumbar and 1st sacral vertebrae. We suspected an epidural abscess caused by epidural block, and so operated. But our operative finding was epidural fibrosis without abscess. Our final pathological diagnosis was epidural fibrosis.
Abscess ; Back Pain ; Blood Sedimentation ; Diagnosis* ; Epidural Abscess* ; Epidural Space ; Fever ; Fibrosis* ; Leukocytosis ; Low Back Pain ; Magnetic Resonance Imaging ; Sciatica ; Spine

BACKGROUND: We studied the interaction between Succinylcholine (SCh) and mivacurium when mivacurium was administered during early and late recovery from SCh block was investigated. METHODS: Eighty patients undergoing elective surgery under general anesthesia were studied. General anesthesia was induced and maintained with propofol under TCI control. Neuromuscular function was measured in response to TOF stimulation of the ulnar nerve using an electromyographic method. The patients were allocated randomly to the following four groups; group 1 (n = 20): a bolus intravenous injection of 0.08 mg/kg mivacurium; group 2 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 2 minutes of 1 mg/kg SCh injection; group 3 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 25% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh; group 4 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 75% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh. The onset and duration of neuromuscular blockade, recovery rate and TOF ratio at T75% were measured. RESULTS: The onset of block in groups 3 and 4 were slower than in group 1 (5.2 +/- 0.7 and 2.3 +/- 0.6 vs 2.5 +/- 0.4 min P < 0.05). The clinical duration in groups 2 and 3 were longer than in groups 1 and 4 (12.5 +/- 2.1 min and 11.3 +/- 1.7 min vs 17.0 +/- 3.0 min and 18.5 +/- 2.6 min, p < 0.05). There was no difference in recovery index all groups. The TOF ratio of groups 2, 3 and 4 were smaller than for group 1 (38.2 +/- 5.3, 32.3 +/- 5.6 and 31.5 +/- 4.2 vs 56.0 +/- 7.3, P < 0.05). CONCLUSIONS: The Previous 1 mg/kg SCh injection was affected the time course of action of mivacurium 0.08 mg/kg-induced neuromuscular block.
Anesthesia, General ; Depression ; Humans ; Injections, Intravenous ; Neuromuscular Blockade* ; Propofol ; Succinylcholine* ; Ulnar Nerve

OBJECTIVES: This study was performed to measure the stress level of physically disabled workers, and to investigate the relationship between the stress dimensions and stress inducing factors of physically disabled workers in the Korean manufacturing industry. METHODS: The sample used in this study consisted of 341 physically disabled workers who had been working at companies in Seoul, Inchon, and Gyung-gi provinces. The Psycho-social Well-being Index (PWI), a modified version of Goldberg's 60-items of General Health Questionnaire (GHS), was used to measure the stress level. The following independent and moderate variables were designed for the same purpose. The independent variables were general and disability characteristics, workplace-related characteristics, and job stressor of the respondents. The other variables included organization-related stressors (social and family support) and person related stressors (needs and values, type A behavior pattern, locus of control and demographics), self-esteem and coping strategy. The collected data were analyzed using SAS version 6.12 program. RESULTS: Multiple logistic regression analysis showed that the significant variables on the stress level of physically disabled workers were poor self-perceived health status, low self-esteem, absence of regular exercise, physically disabled condition affecting work performance capability, dependent mobility at home, interpersonal conflict, role conflict and A type behavior pattern. CONCLUSIONS: The results of this study suggest that appropriate health promotion program should be established and provided for reducing the stress of physically disabled workers in the manufacturing industry. In addition, various vocational programs for decreasing interpersonal and role conflicts should be developed.
Data Collection ; Disabled Persons* ; Health Promotion ; Humans ; Incheon ; Internal-External Control ; Logistic Models ; Questionnaires ; Seoul

No abstract available.
Animals ; Hyaluronic Acid* ; Keratinocytes* ; Mice*

The CYP11A1 gene encodes for the cholesterol side-chain cleavage enzyme (P450scc), which initiates steroid hormone biosynthesis. Defective P450scc activity results in severe glucocorticoid and mineralocorticoid deficiencies. We describe a case of P450scc deficiency due to a novel homozygous CYP11A1 variant inherited from the mother with a possibility of uniparental disomy (UPD). The patient was a female, had no family history of endocrine disease, and showed adrenal insufficiency at 13 days of age. Hormonal analysis with an adrenocorticotropic hormone stimulation test showed both glucocorticoid and mineralocorticoid deficiencies, presumed to be a defect of the early stage of steroidogenesis. Exome sequencing reported a novel homozygous frameshift variant of CYP11A1 (c.284_285del, p.Asn95Serfs*10), which was inherited from the mother.Additionally, homozygosity in 15q22.31q26.2, which included CYP11A1, was identified using a chromosomal microarray. It was suggested that the possibility of maternal UPD was involved as the cause of a P450scc deficiency by unmasking the maternally derived affected allele. To our understanding, P450scc deficiency associated with UPD encompassing CYP11A1 had not been reported in Korea before. Genetic analysis can help diagnose rare causes of primary adrenal insufficiency, including P450scc deficiency.

In order to evaluate the radio-protective advantage of an enhanced dynamic wedge (EDW) over a physical wedge (PW), we measured peripheral doses scattered from both types of wedges using a 2D array of ion-chambers. A 2D array of ion-chambers was used for this purpose. In order to confirm the accuracy of the device, we first compared measured profiles of open fields with the profiles calculated by our commissioned treatment planning system. Then, we measured peripheral doses for the wedge angles of 15 degrees, 30 degrees, 45 degrees, and 60 degrees at source to surface distances (SSD) of 80 cm and 90 cm. The measured points were located at 0.5 cm depth from 1 cm to 5 cm outside of the field edge. In addition, the measurements were repeated by using thermoluminescence dosimeters (TLD). The peripheral doses of EDW were (1.4% to 11.9%) lower than those of PW (2.5% to 12.4%). At 15 MV energy, the average peripheral doses of both wedges were 2.9% higher than those at 6MV energy. At a small SSD (80 cm vs. 90 cm), peripheral dose differences were more recognizable. The average peripheral doses to the heel direction were 0.9% lower than those to the toe direction. The results from the TLD measurements confirmed these findings with similar tendency. Dynamic wedges can reduce unnecessary scattered doses to normal tissues outside of the field edge in many clinical situations. Such an advantage is more profound in the treatment of steeper wedge angles, and shorter SSD.
Heel ; Silver Sulfadiazine ; Toes