Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult* ; Corpus Callosum* ; Female ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Male ; Volunteers

No abstract available.
Korea* ; Lung Neoplasms* ; Lung*

No abstract available.
Lower Gastrointestinal Tract* ; Muscle, Smooth* ; Smooth Muscle Tumor*

The frequency of sexual dysfunction from rectal cancer operation has been reported with wide range from 8 to 86%. We have performed prospective study to analyze the cause of sexual dysfunction after operation in rectum which is anatomically adjacent to cavernous nerve and artery The study was done from April 1991 to March 1992 with 26 patients who were neurologically normal before the radical rectal surgery. To study intraoperative vascular damage, we performed duplex doppler sonography of penile arteries preoperatively and on tenth postoperative day. To study neurologic insult urodynamic study was performed preoperatively, tenth postoperative day and postoperative sixth month, and subjective sexual history was obtained preoperatively and postoperative sixth month. There was no evidence of change in the diameter and peak velocity of cavernous artery on penile duplex sonography and penile rigidity, implying no vascular damage. Fourteen patients (53%) complained of sexual dysfunction in postoperative sixth month. Subjective sexual dysfunction showed no correlation with age, stage, mode of operation, tumor size, tumor location from anal verge and intraluminal position of the tumor. We couldn't find any association between postoperative decreased libido and decreased self-esteem from stoma, which confirms that psychologic cause does not seem to ascribe to erectile dysfunction. Patients with neurologic deficit were 21(81%) on tenth postoperative day, but only 4(17 %) out of 23 who were followed up to postoperative sixth month. This suggests that recovery of sexual dysfunction was delayed or impossible, compared with rapid recovery of bladder dysfunction. This also suggests additional intraoperative nerve damage along cavernous nerve pathway. In conclusion, sexual dysfunction after rectal cancer operation was not caused by vascular damage nor psychologic etiology. Nerve damage is rather highly suggested, but there was no correlation with stage and mode of operation.
Arteries ; Erectile Dysfunction ; Humans ; Libido ; Male ; Neurologic Manifestations ; Prospective Studies ; Rectal Neoplasms* ; Rectum ; Urinary Bladder ; Urodynamics

PURPOSE: To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. MATERIALS AND METHOD: A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. RESULTS: Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. CONCLUSION: MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.
Brain ; Cerebral Palsy* ; Gestational Age ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

Recently diabetic neuropathy has been postulated to occur from reduced availability of neurotrophic factor. This experiment was performed to identify the effect of nerve growth factor on dorsal root ganglia (DRG) in the strepto-zotocin-induced diabetic rat using morphometry and immunohistochemistry. The results obtained are as follows : 1. Unlike in the diabetic group where the type A and B cells were significantly decreased in their total numbers and sizes, these cells were normal in NGF-administered diabetic group. 2. Numbers of cells immunoreactive with SP and CGRP were also significantly decreased in the diabetic group. However, the NGF-administered diabetic group did not show any reduction in the number of these cells. 3. Mean sizes of cells immunoreactive with SP and CGRP cells were reduced in the diabetic group by 18.1% and 26.6% respectively (P<0.01). On the other hand, in NGF-administered diabetic group, mean sizes of SP-immunoreactive cells were increased (10.5%) which was not statiatically significant, and those of CGRP-immunoreactive cells were decreased (18%) compared to the control group (P<0.01). 4. In the diabetic group, many of nerve cell bodies showed some degenerative characteristics including neuron-satellite cell interface of irregular shape, the presence of a number of vacuoles and dense bodies, and nucleus of irregular contour. However, NGF-administered diabetic group exhibited neuron-satellite cell interface of regular form, many neurofilaments and neurotubules, and normal intracellular organelles. These results suggest that administration of NGF protects spinal ganglion cells from morphometric and morphological changes which are associated with a streptozotocin -induced diabetic neuropathy.
Animals ; B-Lymphocytes ; Diabetic Neuropathies ; Ganglia, Spinal* ; Hand ; Immunohistochemistry ; Nerve Growth Factor* ; Neurons ; Organelles ; Rats* ; Streptozocin ; Vacuoles

PURPOSE: This study aimed at evaluation of the learning curve for laparoscopic colorectal surgery with varied operative procedures. METHODS: From June 2004 to May 2010, 269 consecutive patients underwent laparoscopic colorectal surgery. Patients were divided into four groups according to operative methods: right-side colectomy, left-side colectomy, rectal resection, and total colectomy group. Each group was divided into three-early, middle, and late-groups according to operation numbers. Learning curves were generated for each group using moving average methods. Prospective collection and retrospective review of data on operative outcomes, including open conversion, operation time, intra-operative blood loss, postoperative hospital stay, and postoperative complication were performed. RESULTS: Operations included 75 right-side colectomies, 12 left-side colectomies, 178 rectal resections, four total colectomies, and seven open conversions (2.6%). The mean operative time for right-side colectomy and rectal resection showed a significant decline from the early group to the middle and late groups, while the left-side colectomy group showed no significant difference. Operation time was platitude after 50 cases of whole laparoscopic colorectal surgery, 11 cases in the right-side colectomy group, eight cases in the left-side colectomy group, and 34 cases in the recto-sigmoid resection group. CONCLUSION: For the surgeon, laparoscopic colorectal surgery can be performed more independently after 50 cases. The learning curve may be determined according to the general skill of laparoscopic colorectal surgery. The question of whether the learning curve is determined by varied operative procedures has not yet been resolved.
Colectomy ; Colorectal Surgery ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Operative Time ; Postoperative Complications ; Postoperative Hemorrhage ; Prospective Studies ; Retrospective Studies ; Surgical Procedures, Operative

Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient’s demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n= 107), followed by the anterolateral thigh flap (n= 18) and fibula flap (n= 10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.