BACKGROUND: During the past eight years, we have been performing partial autonomic nerve preservation surgery (PANP) for the treaolent of advanced rectal cancer in order to reduce the postoperative male sexual dysfunctions. METHODS: This is a prospective study of 25 rectal cancer patients who underwent PANP from 1990 to 1997. All patient were in Duke C stage and their ages were between 30 and 55. Patients were divided into four types: 1) Partial sacrifice of inferior mesenteric plexus (PSIP). 2) Partial sacrifice of preaortic nerve (PSPN). 3) Complete sacrifice of preaortic nerve with complete pelvic nerve preservation (CSPN). 4) Unilateral sacrifice of pelvic autonomic nerve (USPN). RESULTS: The percentage of ejaculation and erection difficulties at each surgery was as follows: PSIP 0/5 (0%) for ejaculation vs. 0/5 (0%) for erection, respectively, PSPN 5/7 (71.4%) vs. 2/7 (28.6%), CSPN 6/7 (85.7%) vs. 0/7 (0%) and USPN 6/6 (100%) vs. 5/6 (83.3%). Summary: PANP is possible for the treatment of advanced rectal cancer.
Autonomic Pathways* ; Ejaculation ; Humans ; Male* ; Prospective Studies ; Rectal Neoplasms*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Scleroderma, Localized*

Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson' disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.
Adult ; Antipsychotic Agents ; Hallucinations ; Humans ; Levodopa ; Male ; Ondansetron ; Parkinson Disease ; Psychotic Disorders* ; Receptors, Serotonin, 5-HT3

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

BACKGROUND: The effect of Video Display Terminals(VDT) Syndrome is well documented. The purpose of this study is to examine the difference in systemic subjective symptoms between long term users of computers with that of the general population and to help plan to avoid the risk of developing Video Display Terminal Syndrome. METHOD: Data was collected for this study between August 1996 and February 1997. Two groups consisting of seventy(70) long term computer users(Exposed Subjects) and fifty nine(59) non users (Non Exposed Subjects), were selected for the survey. Data was gathered from the exposed subjects through their response to the survey questionnaire posted on the internet requiring detailed responses concerning ten systemic subjective symptoms that were experienced as a result of the long term exposure to VDT. Data was gathered from the non exposed subjects through written responses to the questionnaire. RESULTS: Among the more significant difference was the experience of ocular symptoms among the exposed group. The exposed group experienced in descending order eleven items of ocular symptoms. Congestion, strain, decreased visual acuity, ocular pain, and dryness. Among seven items of lifestyle, the exposed group characteristically exercised less(P<0.05) and did more home activity (P<0.05), characteristically lead healthier life than the non exposed group. Participation in exercise differed most among the groups. The exposed group participating in moderate exercise scored 517+/-551.6 compared to the non exposed group which exercised very vigorously(p<0.05). In comparison of subjective symptom and life styles per daily exposure time(over 8,10,16 hours daily) there was significant difference between 8 and 10hour exposers only in the stress item(P<0.05). In the exposure group there were less cardiovascular symptoms(P<0.05) due to more art activity(P<0.05), more cardiovascular symptoms and less sleep activity(P<0.001) and more ocular symptoms(P<0.05) due to higher levels of stress. CONCLUSIONS: By exercising, exposers can decrease the respiratory symptoms, and by seeking methods that enable efficient management of work time, the subjects can benefit from the reduced work time, and by seeking methods so that one receive less stress and can resolve them they can reduce their ocular symptoms, sleep problems, cardiovascular symptoms. And in their spare time, the subjects can be recommended to involve in art activity for each person, through PC indirectly. Designing the development of cyber gallery, museum, literature room, concert can reduce the oecur-rence rate of cardiovascular symptoms.
Computer Terminals ; Estrogens, Conjugated (USP) ; Humans ; Internet ; Life Style* ; Museums ; Visual Acuity ; Surveys and Questionnaires

Carotid endarterectomy is superior to medical treatment in preventing secondary stroke in patients with symptomatic high grade carotid stenosis. Transluminal angioplasty is a promising procedure as an alternative treatment for these patients. We report two cases of carotid angioplasty with Palmaz-Schatz stent in patients with carotid artery occlusive disease. One patient presented with decreased right visual acuity because of retinal arterial embolism. The angiogram demonstrated a discrete tight stenosis of right internal carotid artery carotid stenting with Palmaz-Schatz coronary stent was performed without any significant complications. The other patient presented with recurrent episodes of cerebral infarction, for which he had undergone left carotid erdarterectomy 3-years ago. The carotid angiogram demonstrated tight stenoses of both internal carotid arteries. Carotid artery stenting was performed at left and right internal carotid arteries without any complications. We suggest that stenting may be an effective and safe therapeutic alternative to surgical treatment in some selected patients with carotid artery occlusive disease.
Angioplasty* ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Cerebral Infarction ; Constriction, Pathologic ; Embolism ; Endarterectomy, Carotid ; Humans ; Retinaldehyde ; Stents* ; Stroke ; Visual Acuity

BACKGROUND & OBJECTIVES: Depression is one of the most common neuropsychiatric sequelae of stroke, and depression is a serious disorder that can compromise the quality of life and overall rehabilitating process. The aim of this study was to investigate the frequency of depression in acute stroke patient and to compare with nondepressive patients in terms of demographic data, lesion site, pathology and the days of hospitalization. METHOD: Total 200 stroke patients admitted in Korea university hospital from Jan. 1993 to Dec. 1994 were included in this study. Data was collected from the medical records retrospectively and analyzed by means of statistics. RESULT: The frequency of depressive episode was 17% (34/200). The pathologic lesion was more frequently located in the right hemisphere (no statistical significance) and patients with depressive episode showed a higher frequency of lesions in anterior areas of the left hemisphere and posterior areas of the right hemisphere. The hospitalization days of depressive group was longer than that of non-depressive group (student t-test, p<.05). The age of depressive group was younger than that of non-depressive group (student t-test, p<.05). There was a positive correlation between the hospitalization days and the severity of depression(r=0.41). There also was a positive correlation between NIH stroke scale and the severity of depression (r=0.4988). CONCLUSION: In patients with depressive episode after acute stroke, it was more frequently developed in right posterior hemispheric lesion and their hospitalization days was longer in the depressive group than in nondepressive patients.
Depression* ; Hospitalization ; Humans ; Korea ; Medical Records ; Pathology ; Quality of Life ; Retrospective Studies ; Stroke

No abstract available.
Pregnancy*

BACKGROUND: The axonal stimulation single fiber electromyography (S-SFEMG) is a relatively new electrophysio-logical technique and has several advantages over conventional voluntarily activated single fiber electromyography (V-SFEMG). This study was performed in patients with myasthenia gravis (MG) in order to analyze their neuromuscular transmission defects and thus to verify the usefulness of the S-SFEMG technique. METHODS: In 44 patients with MG, S-SFEMG was performed on the extensor digitorum communis muscle. The repetitive nerve stimulation test (RNST) on orbicularis oculi, trapezius, flexor carpi ulnaris, and abductor digiti quinti muscles was also performed at the same time. The results of the RNS and S-SFEMG were then analysed in detail. RESULTS: The S-SFEMG was found abnormal in 84.1%, while RNST was found abnormal in 75.0% of the patients tested. The normal S-SFEMG result was observed exclusively among 7 ocular type MG patients. The mean of the mean consecutive difference (MCD) value, % of fibers with blocking and % of fibers with abnormal jitter, was more increased in patients with generalized type MG than those with ocular type MG. This difference was statistically significant (P<0.01) in all 3 variables. CONCLUSIONS The S-SFEMG is a highly sensitive and useful diagnostic tool in MG. Although it demands more strict technical consideration than V-SFEMG, it is less time-consuming and applicable to uncooperative patients including children. Our study shows S-SFEMG to be especially useful in patients with ocular type MG whose RNST results do not show definite decremen-tal responses.
Axons* ; Child ; Electromyography* ; Humans ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

No abstract available.
Histiocytosis*