No abstract available.
Pregnancy*

No abstract available.
Dupuytren Contracture*

Inappropriate administration of thrombolytic agents to acute type A aortic dissection patients with acute myocardial infarction could result in catastrophic outcomes. A 38-year-old female patient without any previous cardiac history visited the emergency room due to a severe acute onset of retrosternal chest pain. The ECG showed a complete heart block with a junctional escape rhythm at 33 beats/min and more than 2 mm of ST elevation in the inferior and anterior precordial leads. Because of an acute myocardial infarction, prompt thrombolytic agent (tPA) was administered. The patient had cardiogenic shock and persistent chest pain after the thrombolytic therapy. We performed the transthoracic echocardiography (TTE). The TTE showed a dissection flap just above the aortic valve and akinesia of the inferior wall of the left ventricle. She underwent an emergency surgical correction. However, the patient died due to the failure of weaning from the cardiopulmonary bypass machine.
Adult ; Aortic Valve ; Cardiopulmonary Bypass ; Chest Pain ; Echocardiography ; Electrocardiography* ; Emergencies ; Emergency Service, Hospital ; Female ; Fibrinolytic Agents ; Heart Block ; Heart Ventricles ; Humans ; Myocardial Infarction ; Shock, Cardiogenic ; Thrombolytic Therapy ; United Nations ; Weaning

The pattern reversal visual evoked potential(PRVEP) and flash electroretinogram(flash ERG) were performed in 22 patients with optic atrophy. Patients with ophthalmologic problems other than optic atrophy or with systemic disorders were excluded from the analysis The results are as follows: 1. In the 41 eyes of patients with optic atrophy, 39 of them showed abnormal PRVEP, in which all the eyes had no consistent waveform except in one patient 2 eyes with delayed P1 latency. 2. 13 eyes were abnormal in both PRVEP and flash ERG but no eye was abnomnal in flash ERG only 3, Regarding the flash ERG examination, 13 eyes were abnomlal. Of these, there was a period of 1 to 2 years for 1 eye's disease, a period of 2 to 5 years for another eye' disease and after 5 years 11 eyes were diseased. Therefore, it showed that the longer the duration of disease lasted, the more flash ERG abnormalities developed. 4. The abnormalities of PRVEP haxe no significant relationship with the duration of the disease.
Evoked Potentials, Visual* ; Humans ; Optic Atrophy*

OBJECTIVE: This study was conducted to evaluate the impairment of cognitive functions, which include verbal and visual memory, visuospatial function, and executive function, and also to investigate if there is improvement of cognitive impairment after antidepressant treatment in patients with major depressive disorder (MDD). METHODS: Fifteen female patients with non-psychotic MDD in mild to moderate severity and 25 age-matched female normal control subjects participated in this study. Clinical severity of depression was measured by Beck Depression Inventory (BDI), Zung's Self-Rating Depression Scale (Zung), and Hamilton Rating Scale for Depression (HAMD). Cognitive functions were tested using Ray Complex Figure Test (RCFT) to evaluate visuospatial function and visual memory, Stroop test to evaluate conflict monitoring, Wisconsin Card Sorting Test (WCST) to evaluate executive function, and Seoul Verbal Learning Test (SVLT) to evaluate verbal memory. Both clinical depression scales and cognitive function tests were conducted at baseline and after 12 months of antidepressant treatment. RESULTS: At baseline, there were deficits in immediate and delayed recall of SVLT in patients with MDD compared to normal control subjects, while the impairment in visuospatial function, visual memory, and executive function was not clear. After antidepressant treatment, improvement of executive function, i.e. percent of error response and perseverative response of WCST in MDD patients was greater than that in normal control subjects. Improvement of executive function, however, did not show a significant correlation with the change of clinical severity of depression. CONCLUSION: The verbal memory was the most prominent domain of cognitive dysfunction in non-psychotic depression with mild to moderate severity. Of further note, differential improvement in executive function was observed in MDD patients after antidepressant treatment, although the improvement in executive function was not directly associated with the improvement of clinical depression.
Depression ; Depressive Disorder, Major ; Executive Function ; Female ; Humans ; Memory ; Prospective Studies ; Stroop Test ; Verbal Learning ; Weights and Measures ; Wisconsin

The purpose of this study was to evaluate the morphology of mandibular symphysis and location of lower incisor under the influence of the craniofacial skeleton in skeletal Class III malocclusion. The sample consisted of 132 adults who, have severe Class III malocclusion(prognathism group, 33 males and 33 females), and who have normal occlusion(normal group, 33 males and 33 females). They had not received any orthodontic treatment or orthognathic surgery. The, lateral cephalograms were evaluated. The results were as follows: 1. Prognathism group were larger than normal group in comparison of facial skeleton (p<0.05) with the exception of angle FH-Pal, angle SIN. 2. In the morphology of symphysis, measurements of anteroposterior width(LaABBW, LiABBW, SW) of prognathism group were significantly less than that of normal group(p<0.001). 3. In the correlative analysis between the craniofacial skeleton and symphysis measurements of prognathism group, vertical measurements in relation with cranial base and mandibular plane showed reverse correlationship with anteroposterior width of symphysis(LiACBW, LaACBW, LiABBW, SW)(p<0.05). But, there was not distinct difference between horizontal skeletal measurements and symphysis measurements (p>0.05). 4. The probability by regression test between vertical measurements(angle SN-Mn, angle FMA, angle Pal-Mn, angle LFH) and symphysis measurements(LiACBW, LiABBW, SW, angle LISA) were very high (p<0.001).
Adult ; Humans ; Incisor* ; Male ; Malocclusion* ; Orthognathic Surgery ; Prognathism ; Skeleton* ; Skull Base

In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. It's often insufficient for the house staff to make a decision through the information which is delivered in the form of only voice through the telephone line. To overcome the limitation of voice communication, we have designed an emergency teleradiology system which can be used for emergency surgical and medical decision making. The system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. Progressive transmission adopted in the system enables us to efficiently utilize the band-width of telephone line which is typically very low. The iterative residual coding/decoding algorithm compresses various medical images effectively, and thus fast-transmission of images date helps the house staff to perceive the status of emergent patient and make a fast and correct decision about the patient. The system also satisfies design requirements such as low-cost, ease of operation and interactive image communication including voice. 'Teleradiology system' proposed in this paper has been installed and operated in the emergency care unit of Severance Hospital, and as a result, it is effective in the emergency situations.
Decision Making ; Emergencies ; Emergency Medical Services ; Humans ; Internship and Residency ; Magnetic Resonance Imaging ; Modems ; Telephone ; Teleradiology* ; Voice

OBJECTIVE: To describe the findings of videofluoroscopic study (VFSS) and investigate the usefulness of VFSS as a predictor of aspiration pneumonia in infants with aspiration symptoms. METHOD: Thirty-eight infants with aspiration symptoms were divided into two groups: those who showed aspiration symptom but had no pneumonia (Aspiration group); those with episode of aspiration pneumonia (Pneumonia group). The subjects' medical records and the results of VFSS were reviewed. RESULTS: In aspiration group, oral phase was normal and the abnormalities were found only in pharygeal phase in a small number of subjects. On the other hand, pneumonia groups showed poor lip closure and bolus formation in oral phase. Abnormalities of pharyngeal phase were reduced laryngeal elevation, coating of pharyngeal wall, increased residue of valleculae, and delay of pharyngeal transit time. Penetration and aspiration were more frequently observed (p <0.05). Aspiration pneumonia occurred more frequently among infants who had supraglottic penetration (p <0.05). CONCLUSION: Mild abnormalities were found only in pharyngeal phase in aspiration group, whereas VFSS abnormalities were observed in both oral and pharyngeal phase in infants with pneumonia. Our results suggest that VFSS would be useful in predicting the development of pneumonia in infants with aspiration symptoms.
Deglutition Disorders ; Fluoroscopy ; Hand ; Humans ; Infant ; Lip ; Medical Records ; Pneumonia ; Pneumonia, Aspiration

The purpose of this study was to investigate the prevalence of cerebral palsy among neonates with risk factors and the relationship between cerebral palsy and risk factors. Among 6,220 neonates who were born in Yonsei University Hospital between January 1, 1990 and December 31, 1992; 699 neonates had more than one risk factors which were prematurity, low birth weight, perinatal asphyxia, and hyperbilirubinemia. This study comprised 361 neonates with risk factors who could be followed up to 1 year of age. The prevalence of cerebral palsy was 4.7% and the prevalence of delayed development was 2.5%. Among 264 cases with a prematurity, 15(5.7%) cases were diagnosed as cerebral palsy. Among 239 cases with a low birth weight, 12(5.0%) cases were diagnosed as cerebral palsy. Among 228 neonates with an APGAR score below 7 point in 1 minute, 16(7.0%) cases were diagnosed as cerebral palsy and among 79 neonates with an APGAR score below 7 point in 5 minute, 9(11.4%) cases were diagnosed as cerebral palsy.
Apgar Score ; Asphyxia ; Cerebral Palsy* ; Humans ; Hyperbilirubinemia ; Infant, Low Birth Weight ; Infant, Newborn* ; Prevalence* ; Risk Factors*

OBJECTIVE: To evaluate the efficacy of growth hormone in reversing glucocorticoid-induced musculoskeletal changes including osteoporosis and myopathy in rats. METHOD: Experimental rats were divided into five groups and each group was composed of 10 rats. The group 1 was administered with saline, group 2 with growth hormone, group 3 with glucocorticoid, group 4 with combined dosages of growth hormone and glucocorticoid, and group 5 with glucocorticoid for 4 weeks and then growth hormone for another 4 weeks. All injections were carried out every other day for 8 weeks. The half of animals were sacrificed after 4 weeks and another half after 8 weeks in each group. The triceps surae muscle was biopsied and examined histologically for the evaluation of mean area of muscle fiber. The femur was removed and dissected for the measurement of its weight, length, and diameter. The bone mineral density of the femur was measured by a dual energy X-ray absorptiometer. RESULTS: Administration of growth hormone partially reversed the complications of steroid such as decrease in body weight, decrease in weight, length, diameter, and bone mineral density of femur, and decrease in mean area of muscle fiber. CONCLUSION: This study indicated that growth hormone could be applied for the management of steroid-induced osteoporosis and myopathy.
Animals ; Body Weight ; Bone Density ; Femur ; Growth Hormone* ; Muscular Diseases ; Osteoporosis ; Rats*