BACKGROUND: As the clinical-end point is not clear-cut in conscious sedation, there are no objective and feedback-providing methods to assess the depth of sedation within the levels appropriate for conscious sedation. METHODS: The investigation was carried out on 19 ASA PS 1 patients. The authors developed a system to measure the reaction time to visual (red colored flash, 40 lux for 30 msec) and auditory (beep, 1,000 Hz, 67.5 dB for 30 msec) stimulations. The authors confirmed the beeps to be audible to all the patients before the test began. When they perceived a visual or auditory stimulation, the authors instructed the patients to signal by pushing a button as soon as possible. The reaction time was defined as the time from the beginning of stimulation to the push of a button. The patients were gradually sedated with propofol TCI. The authors measured the visual and auditory reaction time and BIS after every 0.1 microgram/ml increment of the effect site concentration of propofol. RESULTS: As the effect site concentration of propofol increased, the reaction time to visual and auditory stimulations tended to be prolonged (P < 0.0001, respectively). The estimate was 409 and 498, respectively, which means the slope a in y = ax; x means unit change of the effect site concentration of propofol; y means the estimated values of the reaction time. The BIS values at loss of response to visual and auditory stimulations were 86 +/- 7 and 78 +/- 7 (mean +/- SD). CONCLUSIONS: The responses to visual and auditory stimulations were prolonged and ultimately abolished as the effect site concentration of propofol increased. The loss of response to visual stimulations preceded the loss of response to auditory stimulations. The BIS values at loss of responses to visual and auditory stimulations suggested light and moderate sedation, respectively.
Acoustic Stimulation ; Conscious Sedation* ; Humans ; Photic Stimulation ; Propofol* ; Reaction Time*

PURPOSE: Pelvic floor muscle exercise, biofeedback and electrical stimulation have been known as initial treatment options for women with stress urinary incontinence. We evaluated the clinical outcome of pelvic floor muscle exercise in combination with biofeedback and electrical stimulation as a treatment for stress urinary incontinence. MATERIALS AND METHODS: Twenty three patients with stress urinary incontinence who had been treated with biofeedback and electrical stimulation from June 1999 to March 2000 were analyzed. Patients were evaluated with their medical history, physical examination, SEAPI score, and urodynamic study including Valsalva leak point pressure(VLPP). All patients were assessed for the outcome of the procedure with subjective satisfaction by scores of SEAPI classification and the relative strength of pelvic floor muscle by maximal vaginal pressure and contraction time. RESULTS: Among 23 women followed up for 6 month to 1 year, urinary incontinence completely disappeared in 6 patients(26.1%), significantly improved in 13(56.5%) and not improved in 4(17.4%). There was a significant increase in maximal vaginal pressure, contraction time and decrease in the scores of SEAPI classification. CONLUSIONS: Pelvic floor muscle exercise in combination with biofeedback and electrical stimulation is a simple, safe, and effective treatment of stress urinary incontinence. The patient compliance is closely related to the success rate.
Biofeedback, Psychology* ; Classification ; Electric Stimulation ; Female ; Humans ; Patient Compliance ; Pelvic Floor* ; Physical Examination ; Urinary Incontinence* ; Urodynamics

OBJECTIVES: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. METHODS: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. RESULTS: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm²; post-treatment=256.9±70.5 mm²; p<0.05). CONCLUSIONS: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.
Electric Stimulation ; Flatfoot ; Foot ; Humans ; Isometric Contraction ; Lower Extremity ; Muscles ; Patient Care Team ; Physical Therapists ; Thailand

Cystic entrapment of infraspinatus branch of suprascapular nerve is a rare cause of shoulder pain with infraspinatus atrophy. We discuss the ultrasonographic diagnosis and ultrasonography- guided aspiration of the cyst as a treatment. Case: A 37-year-old, ship-yard laborer had experienced left shoulder discomfort and pain without trauma history. Physical examination showed profound selective atrophy of left infraspinatus muscle. Simple X-ray of shoulder showed normal findings. Electrodiagnostic examination revealed delayed motor latency of infraspinatus branch of suprascapular nerve and denervation potentials of infraspinatus muscle exclusively. Ultrasonographic finding showed 13.5X21.5 mm sized cystic mass around left infraspinatus notch. Ultrasonography-guided aspiration was done, and then electrical stimulation therapy and strengthening exercise of left shoulder were performed. Symptoms were improved. We report a rare case of cystic entrapment of infraspinatus branch of suprascapular nerve in a patient without traumatic insult.
Adult ; Atrophy ; Denervation ; Diagnosis ; Electric Stimulation Therapy ; Humans ; Physical Examination ; Shoulder ; Shoulder Pain ; Ultrasonography*

BACKGROUND: Sympathetic skin response (SSR) is a transient change in the electrical potential of the skin that is evoked by internal or external stimuli. In the present study, our purpose was to compare electrical and visual stimulation methods of evoking a SSR. METHODS: SSRs evoked by both electrical and visual stimulation were recorded from the palm and sole from 48 healthy volunteers. RESULTS: SSRs were obtained in all normal control subjects following both electrical and visual stimulation. The latency of SSR following electrical stimulation was 1383.75+/-223.56 msec at the palm and 1790.54+/-318.70 msec at the sole, and that following visual stimulation was 1518.75+/-252.64 msec at the palm and 1930.10+/-226.19 msec at the sole. The latencies of SSRs following visual stimulation were prolonged significantly more than those following electrical stimulation. The amplitudes of SSRs following visual stimulation were significantly lower than those following electrical stimulation, and the amplitude of SSRs following both electrical and visual stimulation had marked intersubject and intrasubject variabilities in each of the stimulations. CONCLUSIONS: The SSR evoked by visual stimulation is as reliable as known electrical stimulation for determining sympathetic functions and is a less invasive method. Latencies by visual stimulation are longer than those by electrical stimulation in both the palm and sole. The visual stimulation method of evoking a SSR is not influenced by an ascending somatosensory pathway theoretically, so we can postulate that it reflects a purely autonomic function if there is no problem in the visual pathway.
Electric Stimulation ; Healthy Volunteers ; Photic Stimulation ; Skin* ; Visual Pathways

Based on the theoretical and experimental researches of neuromuscular electrical stimulation to simulate muscular force training, the results showed: The effect of neuromuscular electrical stimulation (NMES) is much better than that of muscular electrical stimulation (MES); The increase of muscle force is closely related to the mode and electro properties of electrical stimulation; NMES can fulfill the muscle force training with lower energy consuming, so it is practical helpful method before, during and post training muscle force training; The method of NMES simulating muscle force training can meet the synchronous and harmonious ability of muscle group.
Electric Stimulation ; methods ; Female ; Humans ; Male ; Muscle Contraction ; Muscle, Skeletal ; physiology ; Neuromuscular Junction ; physiology ; Physical Education and Training ; methods ; Physical Endurance ; Physical Exertion

OBJECTIVES: OThis study aimed to explore the difference in emotional recognition of musical auditory stimulation and art-related visual stimulation between subjects with and without schizophrenia. METHODS: Twenty songs and 20 paintings that evoke sad or cheerful emotions were presented to 123 patients with schizophrenia and 224 non-schizophrenic people (control group). All subjects were asked to describe the emotions they felt during each auditory stimulation and each visual stimulation. To measure the emotional responses, the Emotional Empathy Scale was used. For members of the patient group, the levels of psychopathology and thought-related disorder were evaluated by using the Positive and Negative Syndrome Scale and the Formal Thought Disorder Rating Scale, respectively. RESULTS: The rate of correct answers to musical auditory stimulation in the schizophrenia patient group was significantly lower than that in the control group. In addition, the rate of correct answers to the art visual stimulation in the patient group was significantly lower than that in the control group. Moreover, the patient group showed lower emotional empathic ability than that shown by the control group. In the patient group, the correct answer rates to the musical and art stimulations were negatively correlated with the Formal Thought Disorder Rating Scale. CONCLUSION: Patients with schizophrenia have difficulty in achieving accurate emotional recognition of auditory and visual stimulations. This difficulty is associated with the lowered empathic ability and altered thinking disorder of patients with schizophrenia.
Acoustic Stimulation ; Empathy ; Humans ; Music ; Paint ; Paintings ; Photic Stimulation ; Psychopathology ; Schizophrenia* ; Thinking

BACKGROUND: In order to compare the differences between various mental activities and to determine the significance of chaotic patterns, we performed a fractal dimension and Lyapunov exponent analysis of digital EEG data which are known to be non linear biological signals. METHODS: During the EEG recordings, different kinds of tasks were performed, including eye closing, eye opening, calculation, listening to music, and remembering a picture. Performance signals were recorded for each test as a digital EEG for more than one minute. We used our own software, CHASIM, to calculate the fractal dimension and Lyapunov exponent. The statistical analysis performed was an ANOVA using SAS 6.12 for Windows (9.0). RESULTS: The fractal dimensions during the "listening to music and noise", and "moving both toes" tasks were increased. During the "eye opening", "calculation", and "moving both fingers" tasks, the fractal dimensions were decreased. CONCLUSIONS: Auditory stimulation generated a higher correlation dimension than visual stimulation. The interpretation of these results is still not totally clear, but we hope to find future applications for non-linear chaotic analysis for the functional evaluation of the central nervous system.
Acoustic Stimulation ; Central Nervous System ; Electroencephalography* ; Fractals ; Hope ; Humans ; Music ; Photic Stimulation

Integrating multisensory inputs to generate accurate perception and guide behavior is among the most critical functions of the brain. Subcortical regions such as the amygdala are involved in sensory processing including vision and audition, yet their roles in multisensory integration remain unclear. In this study, we systematically investigated the function of neurons in the amygdala and adjacent regions in integrating audiovisual sensory inputs using a semi-chronic multi-electrode array and multiple combinations of audiovisual stimuli. From a sample of 332 neurons, we showed the diverse response patterns to audiovisual stimuli and the neural characteristics of bimodal over unimodal modulation, which could be classified into four types with differentiated regional origins. Using the hierarchical clustering method, neurons were further clustered into five groups and associated with different integrating functions and sub-regions. Finally, regions distinguishing congruent and incongruent bimodal sensory inputs were identified. Overall, visual processing dominates audiovisual integration in the amygdala and adjacent regions. Our findings shed new light on the neural mechanisms of multisensory integration in the primate brain.
Animals ; Macaca ; Acoustic Stimulation ; Auditory Perception/physiology* ; Visual Perception/physiology* ; Amygdala/physiology* ; Photic Stimulation

Ovarian tumors of an epithelial origin in pediatric age are uncommon and mucinous cystadenoma, borderline malignancy is extremely rare. We experienced a case of ovarian mucinous cystadenoma, borderline malignancy in a 14-year-old girl. She was admitted due to huge abdominal distension for 2 months. Her past history and family history were normal. The physical examination was normal except tense and distended abdomen. All laboratory findings were normal. On abdominal ultrasonography and CT scan, a huge cystic tumor filled with fluid and inner multiseptation was noted. Unilateral salphingo- oophorectomy was done and pathologic findings were compatible with ovarian borderline malignancy of mucionous cystadenoma. The postoperative course was uneventful.
Abdomen ; Adolescent ; Cystadenoma ; Cystadenoma, Mucinous* ; Female ; Humans ; Mucins* ; Ovariectomy ; Physical Examination ; Tomography, X-Ray Computed ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography