No abstract available.
Fallopian Tubes* ; Female ; Pregnancy*

Canalith repositioning maneuver is effective to treat benign paroxysmal positional vertigo(BPPV). This case showed complicated form of the BPPV such as changes of canalolithiasis to cupulolithiasis, involvement of one canal to two canals and from unilateral to bilateral involvement during the reposition maneuver. This patient was diagnosed as left lateral canalolithiasis at first. After left barbecue maneuver, the type was changed to the right posterior cupulolithiasis. Semont maneuver was performed and then the type of BPPV was changed to combined type with right posterior canalolithiasis and left lateral canalolithiasis. We performed left barbecue maneuver and right Epley maneuver. Then the type of BPPV was changed to left lateral cupulolithiasis. After Brandt-Daroff maneuver and left barbecue maneuver, nystagmus and dizziness disappeared finally.
Dizziness ; Humans

PURPOSE: The purpose of this study was to examine and analyze the post operative fasting period of neonates in the intensive care unit (ICU) after receiving open heart surgery in order to provide optimal nutrition support for these neonates. The variables included biochemical nutrition indexes (albumin, total lymphocyte count, total cholesterol) and patient outcomes (duration of mechanical ventilation, ICU stay, hospital stay, infectious complication). METHODS: The participants were 124 neonates in ICU after receiving open heart surgery, and the design of this study was to investigate their post operative fasting period retrospectively to analyze the biochemical nutrition indexes and patient outcomes according to post operative fasting period. RESULTS: The results for 4 groups according to post operative fasting period showed that the group with less 48 hours of fasting had the best biochemical nutrition indexes and patient outcomes, followed by the 48-72 hour group, the 72-144 hour group, and the over 144 hour group. CONCLUSION: The results indicate that for new born babies receiving open heart surgery, the period of fasting after the operation should be minimized and tube feeding should be started as soon as possible.
Enteral Nutrition ; Fasting ; Heart ; Humans ; Infant, Newborn ; Intensive Care Units ; Length of Stay ; Lymphocyte Count ; Nutrition Assessment ; Respiration, Artificial ; Retrospective Studies ; Thoracic Surgery ; Child Health

Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using χ 2 -test, Fisher’s exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage.Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.

BACKGROUND: Epidural steroid injections benefit certain patients with radicular pain, and often have only a limited duration. We compared the efficacy of hyaluronidase and triamcinolone and triamcinolone alone in patients with lumbar herniated disc disease treated with transforaminal epidural block. METHODS: Forty patients who had undergone a transforaminal epidural injection were retrospectively reviewed. The T group received triamcinolone and local anesthetics; whereas, the HT group received hyaluronidase, triamcinolone and local anesthetics. We evaluated the improvement as being good, moderate, mild or no improvement, and in those where the improvement was good or moderate, also evaluated the duration of pain relief. Data were collected from the medical records of patients or via phone calls, which were analyzed using Student t- and chi-squared tests. A value of P < 0.05 was considered significant. RESULTS: There were no significant differences in the degree of pain improvement or duration of pain relief between the two groups. CONCLUSIONS: A hyaluronidase and triamcinolone injection during transforaminal epidural block has on benefit with respect to the degree of pain improvement or its duration compared to a triamcinolone only injection.
Anesthetics, Local ; Humans ; Hyaluronoglucosaminidase* ; Injections, Epidural ; Intervertebral Disc Displacement ; Medical Records ; Retrospective Studies ; Triamcinolone*

BACKGROUND: Recently, the number of patients visiting pain clinics has been increasing with the augmented concerns of those patients about the management of their pain. We conducted this study in order to elucidate the characteristics of patients visiting pain clinics and to determine a method to further raise their awareness about pain treatment. METHODS: We reviewed 1, 424 new patients who visited our pain clinic from March 2003 to December 2004. We analyzed these patients according to their age and sex, treatment method before visiting the pain clinic, coexisting disease, chief complaint and pain location, resident district, route of visiting pain clinic, and degree of impairment due to pain by use of questionnaire. RESULTS: In age distribution, the largest proportion (23.5%) was in their 50's. Most patients (64.0%) had received treatment in an oriental medicine clinic before visiting the pain clinic. The most common coexisting disease was hypertension (20.3%) and low back pain was the most common chief complaint (68.3%). Most of the patients lived in Gyeonggido (87%) and most visited our pain clinic on the recommendation of other patients who had visited our pain clinic before. CONCLUSIONS: We need to guide pain patients to undergo proper treatment much earlier using patient education or a referral system. Moreover, we should be more careful in patients with diabetes mellitus, and should have greater concern in the treatment of low back pain.
Age Distribution ; Diabetes Mellitus ; Gyeonggi-do ; Humans ; Hypertension ; Low Back Pain ; Medicine, East Asian Traditional ; Pain Clinics* ; Patient Education as Topic ; Surveys and Questionnaires ; Referral and Consultation

PURPOSE: The study examined the effects of early enteral nutrition on the patients' length of stay in an intensive care unit (ICU), length of stay and mortality rate. METHODS: A retrospective design was employed with a total of 461 patients (mean age=69.9±15.6 years; 253 males; 208 females). They were divided into two groups according to when they received enteral feeding: an "early enteral nutrition" (EEN) group of 148 patients (32.1%) who received enteral feeding within 48 hours of their arrival at the hospital and a "delayed enteral nutrition" (DEN) group of 313 patients (67.9%) who received enteral feeding at some point after 48 hours of their arrival at the hospital. The EEN group and control group were similar in terms of age, sex, body mass index, and underlying diseases. RESULTS: The EEN group's total length of stay in hospital was shorter (23.29±27.19 days) than that of the control group (36.74±32.24 days); the difference was significant (P<0.001). The EEN group also showed a shorter length of stay in the ICU (13.67±22.77 days) than the DEN group (17.46±21.02 days) and a lower mortality rate (17.6%) than the control group (18.8%), but these differences were not significant. CONCLUSION: The study found that early enteral nutrition treatment reduced total length of stay in hospital significantly. The findings suggest that early enteral nutrition treatment plays an important role in the patients' recovery and prognosis.
Body Mass Index ; Enteral Nutrition* ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Mortality ; Nutritional Support ; Prognosis ; Retrospective Studies

PURPOSE: There has been considerable controversy regarding the treatment of urinary incontinence(UI). The aim of our study was to investigate the efficacy and safety of the suprapubic arch(SPARC) procedure for the management of UI in elderly women. MATERIALS AND METHODS: A retrospective analysis was conducted on 301 women who underwent the SPARC procedure for SUI. The patients were divided into two groups: group A(<65 years) and group B(> or=65 years). Among these patients, women with mixed urinary incontinence(MUI) were assigned to either group C(<65 years) or group D(> or=65 years). The objective and subjective SPARC success rates were evaluated postoperatively. RESULTS: There were 258 patients in group A, 43 patients in group B, 44 patients in group C, and 11 patients in group D. The objective surgical success rates for groups A and B were 97.7% and 95.3%, respectively (p=0.304). The subjective success rates for groups A and B were 97.3% and 95.3%, respectively(p=0.311). Recommendation rates for the SPARC procedure were 93% in group A and 93% in group B(p=0.5). In patients with MUI(groups C and D), the objective success rates were 93.2%(group C) and 81.8%(group D)(p=0.286). The subjective success rates were 93.2% (group C) and 81.8%(group D)(p=0.286). The complication rates were similar between the two study groups: 5.4%(group A) vs 7.0%(group B) (p=0.359). CONCLUSIONS: The SPARC procedure is effective and safe, and it offers a satisfactory success rate in elderly women with UI.
Aged ; Female ; Humans ; Retrospective Studies ; Urinary Incontinence

BACKGROUND: Many Studies regarding hemodynamic changes by various vasodilators, such as nitroprusside, nifedipine, and hydralazine have been reported, however little data are available upon acute hemodynamic change due to captopril, an angiotensin converting enzyme inhibitor especially in chronic regurgitant valvular heart disease. Therefore the aim of this study is to evaluate the acute hemodynamic effects of sublingual captopril in patients with regurgitant valvular heart diseases. METHODS: Among the 9 patients enrolled in this study, 5 patients mitral regurgitation, 2 had aortic regurgitation, and 2 had both. Five had patients were male and 4 were female. Before, 15 minutes and 30 minutes after administration of 25mg of captopril via sublingual route, forward cardiac output was measured three times using Swan-Ganz catheter. Right and left cardiac catheterization were also done at each phase and measurement of pulmonary capillary wedge pressures, pulmonary artery pressures, right atrial pressures, aortic pressures, left ventricular pressures were done. RESULTS: 1) Heart rate, pulmonary capillary wedge pressures, cardiac output and cardiac indices left ventricular end-diastolic pressure, diastolic and mean aortic pressures, and diastolic pulmonary artery pressure showed no significant change after administration of sublingual captopril. 2) Systolic aortic pressure decreased significantly from basal value(130+/-35) to 15 minute value(126+/-39). 3) Systemic vascular resistance at 15 minute showed significant reduction as compared with basal value(from 1743+/-551 to 1642+/-491). Pulmonary vascular resistance at 30 minutes(254+/-193) was significantly lower than basal value(282+/-229). CONCLUSIONS: Reductions of systemic and pulmonary vascular resistance occurred relatively rapidly, however, acute effects on cardiac output and pulmonary capillary wedge pressures were not evident. Clinical implication of sublingual captopril in patients with regurgitant valvular heart diseases is worth evaluationg by more extensive hemodynamic studies.
Aortic Valve Insufficiency ; Arterial Pressure ; Arteries ; Atrial Pressure ; Blood Pressure ; Capillaries ; Captopril* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output ; Catheters ; Female ; Heart Rate ; Heart Valve Diseases* ; Hemodynamics* ; Humans ; Hydralazine ; Male ; Mitral Valve Insufficiency ; Nifedipine ; Nitroprusside ; Peptidyl-Dipeptidase A ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vascular Resistance ; Vasodilator Agents ; Ventricular Pressure

PURPOSE: To compare Icare rebound tonometer (IRT) and Goldmann applanation tonometer (GAT) and investigate the clinical usefulness of IRT. METHODS: In a retrospective study of 131 eyes with glaucoma and glaucoma suspect, intraocular pressure (IOP) was measured with IRT and GAT. The correlation between IRT and GAT and the influence of refractive error (spherical equivalent; SE) and central corneal thickness (CCT) were analyzed. RESULTS: A distinct correlation between IRT and GAT was found. IOP measured with GAT was 2.23 +/- 3.16 mm Hg higher than with IRT (p < 0.001). As CCT increased, IOP was measured higher with both GAT and IRT. IOP in myopic eyes (SE > or = -5 diopter) was measured relatively lower than in hyperopic eyes (SE < -5 diopter) with GAT (+1.50 +/- 0.68 mm Hg) and IRT (+1.88 +/- 0.75 mm Hg). CONCLUSIONS: IRT showed strong correlation with GAT, but IOP measured approximately 2 mm Hg lower. The IOP tends to measure lower at low CCT and in myopic eyes.
Eye ; Glaucoma ; Intraocular Pressure ; Iron-Dextran Complex ; Manometry ; Peptides ; Refractive Errors ; Retrospective Studies