No abstract available.
Catheters* ; Ventriculoperitoneal Shunt*

OBJECTIVES: The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. MATERIALS AND METHODS: Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. RESULTS: Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was 49.0+/-8.1 years, mean duration of admission was 17.27+/-10.51 days, mean costs for treatment was 1,970,000+/-475,000 won. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was 28.7+/-10.4 days, mean costs for treatment was 2,194,473+/-561,639 won. The periods of stabilization was 6.6+/-3.36 weeks on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14-patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was 11.24+/-3.29 days, mean costs for treatment was 1,850,823+/-389,372 won. The periods of stabilization was 5.88+/-7.07 weeks on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. CONCLUSIONS: The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.
Cost-Benefit Analysis ; Diskectomy ; Follow-Up Studies ; Humans ; Outpatients ; Transplants*

OBJECTIVE: The purpose of this study was to evaluate the effects of malocclusion on the self-esteem of female university students. METHODS: The subjects were composed of 67 female university students who showed Class I molar relation, no missing or supernumerary teeth and has had no orthodontic treatment experience. Each subject was evaluated with Rosenberg's Self-esteem Scale to measure the level of self-esteem and also evaluated the degree of anterior crowding and lip protrusion through model analysis and cephalometric soft tissue profile analysis. RESULTS: The results showed that a protrusive profile and crowding of upper anterior teeth had significant reducing effects on the level of self-esteem. The protrusion and crowding groups showed no significant differences in self-esteem between groups. CONCLUSIONS: Malocclusion had significant negative effects on the self-esteem of female university students. Further research to investigate the negative psychological influence of malocclusion and the education of lay people about this influence is necessary.
Crowding ; Female ; Humans ; Lip ; Malocclusion ; Molar ; Tooth ; Tooth, Supernumerary

PURPOSE: Thallium (TI+) autometallography is often used for the imaging of neuronal metabolic activity in the rodent brain under various pathophysiologic conditions. The purpose of this study was to apply a thallium autometallographic technique to observe changes in neuronal activity in the forebrain of rats following acute carbon monoxide (CO) intoxication. METHODS: In order to induce acute CO intoxication, adult Sprague-Dawley rats were exposed to 1100 ppm of CO for 40 minutes, followed by 3000 ppm of CO for 20 minutes. Animals were sacrificed at 30 minutes and 5 days after induction of acute CO intoxication for thallium autometallography. Immunohistochemical staining and toluidine blue staining were performed to observe cellular damage in the forebrain following intoxication. RESULTS: Acute CO intoxication resulted in significant reduction of TI+ uptake in major forebrain structures, including the cortex, hippocampus, thalamus, and striatum. In the cortex and hippocampal CA1 area, marked reduction of TI+ uptake was observed in the cell bodies and dendrites of pyramidal neurons at 30 minutes following acute CO intoxication. There was also strong uptake of TI+ in astrocytes in the hippocampal CA3 area following acute CO intoxication. However, there were no significant histological findings of cell death and no reduction of NeuN (+) neuronal populations in the cortex and hippocampus at 5 days after acute CO intoxication. CONCLUSION The results of this study suggest that thallium autometallography can be a new and useful technique for imaging functional changes in neural activity of the forebrain structure following mild to moderate CO intoxication.

A 69-year-old woman presented with right abducent nerve paresis caused by an ectopic pituitary adenoma invading the posterior wall of the sphenoid sinus. The tumor was removed via transsphenoidal approach. The histological diagnosis was invasive pituitary adenoma with bony destruction. The symptom was improved without complication. The authors present a rare case of ectopic pituitary adenoma with a literature review.
Abducens Nerve ; Aged ; Diagnosis ; Female ; Humans ; Paresis ; Pituitary Neoplasms* ; Sphenoid Sinus*

BACKGROUND AND OBJECTIVES: Supraglottic laryngectomy is a well established technique for the treatment of appropriate carcinoma of supraglottic larynx. The purpose of this study was to determine factors that may contribute to postoperative aspiration related to deglutition problem following supraglottic laryngectomy. MATERIALS AND METHOD: A retrospective analysis of medical records of 19 patients who consecutively underwent supraglottic laryngectomy was undertaken. Contribution of the following factors was investigated: age, T stage, pack-years of smoking, and parameters of pulmonary function test. The authors used a computerized acoustic analysis program (CSL-MDVP) to measure fundamental frequency, jitter, shimmer, and noise to harmonics ratio. RESULTS: Eleven patients had no problem, 5 patients had clinically insignificant problem, and 3 patients had moderate problem in postoperative 6 months. A greater number of pack-years of smoking and decreasing FEV1/FVC were significantly correlated with poor outcome with regards to postoperative aspiration and deglutition problem. No statistically significant difference was seen between patients with supraglottic laryngectomy and the control group. CONCLUSION: This study showed that less than 60% FEV1/FVC signifies a greater risk for postoperative aspiration.
Acoustics ; Deglutition ; Forced Expiratory Volume ; Humans ; Laryngectomy* ; Larynx ; Medical Records ; Noise ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Vital Capacity ; Voice

Cardiac manifestations of hypereosinophilic syndrome rarely include left ventricular thrombosis leading to peripheral emboli. And the cases of thrombectomy in patients with left ventricular thrombus and hypereosinophilic syndrome are extremely rare. Recently we experienced a 58-years-old woman with hypereosinophilic syndrome, the history of thalamic infarction and a huge thrombi in left ventricle. We report this case with literatures.
Female ; Heart Ventricles ; Humans ; Hypereosinophilic Syndrome* ; Infarction ; Thrombectomy ; Thrombosis*

BACKGROUND: Anesthetic requirements are affected by the preoperative levels of some hormones. This study investigated to identify the hormonal status such as plasma level and maximal secretary capacity correlating with propofol and remifentanil requirements in pituitary adenoma patients who show various hormonal secretory states perioperatively. METHODS: From 51 adult female pituitary adenoma patients, preoperative basal values and maximal stimulated levels of various hormones related to the axis of hypothalamus-pituitary-target organs on combined pituitary function test were recorded. Total intravenous anesthesia using target controlled infusion with propofol and remifentanil was administered. The effect-site concentration (Ce) of propofol reaching anesthetic induction and the consumed dosages of propofol and remifentanil during operation were measured. Anesthetic maintenance was controlled within 30% of preanesthetic hemodynamic variables by remifentanil and within ranges of BIS 45 +/- 10 by propofol. Spearman correlations between hormonal status and anesthetic requirements such as propofol Ce for induction, total consumed doses of propofol and remifentanil were performed with a statistical significance at P of 0.05. RESULTS: The preoperative basal level of ACTH was correlated positively with propofol induction Ce and maintenance dose, and the maximal secretory capacity of prolactin also correlated positively with propofol induction Ce. Remifentanil consumption dose was not related with any hormones measured regardless of either preoperative basal levels or maximal secretory levels. CONCLUSIONS: Propofol requirements may be related with preoperative plasma level of ACTH or maximal secretory capacity of prolactin.
Adrenocorticotropic Hormone ; Adult ; Anesthesia, Intravenous ; Axis, Cervical Vertebra ; Female ; Hemodynamics ; Humans ; Piperidines ; Pituitary Function Tests ; Pituitary Neoplasms ; Plasma ; Prolactin ; Propofol

PURPOSE: Pneumonia is a common complication of organophosphate poisoning and increases the incidence of respiratory failure and the duration of mechanical ventilator support. Therefore, we investigated the clinical characteristics of pneumonia as a complication of organophosphate insecticide poisoning and then determined the factors related to the development of pneumonia. METHODS: A retrospective study was performed on patients with organophosphate insecticide poisoning, who were treated at our hospital with medical records and chest radiograph of patients. From January 1, 2001, to July 31, 2004, eighty five patients were included in this study. RESULTS: 1) Thirty-two (71% of the patients developing pneumonia) patients developed pneumonia later than 48 hours from admission and twenty-five (55.6% of the patients developing pneumonia) patients developed pneumonia later than 48 hours after mechanical ventilatory support. 2) The mean onset of pneumonia resistant to initial empirical antibiotics was 4.8 days from admission, and that of susceptible pneumonia was 3.7 days from admission. 3) Patients with pneumonia as a complication needed larger doses of atropine and more 2-pralidoxime injections, as well as longer mechanical ventilatory support, ICU admission, and total hospital admission. CONCLUSION: Most Pneumonia in organophosphate poisoning patients were nosocomial pneumonia & ventilator-associated pneumonia. Thus, to reduce the incidence of pneumonia complication in organophosphate poisoning patients, Physicians must take measures, such as hand-washing and careful periodic drainage of tubing condensate, etc., to reduce the incidence of nosocomial pneumonia. In selecting empirical antibiotics for pneumonia complicating organophosphate poisoning patients, physicians should take regional prevalence of nosocomial pathogens into consideration. In late-onset ventilator-associated pneumonia, physicians must consider pneumonia caused by organisms resistant to commonly used empirical antibiotics.
Anti-Bacterial Agents ; Atropine ; Drainage ; Humans ; Incidence ; Medical Records ; Organophosphate Poisoning ; Pneumonia* ; Pneumonia, Aspiration* ; Pneumonia, Ventilator-Associated ; Poisoning* ; Prevalence ; Radiography, Thoracic ; Respiratory Insufficiency ; Retrospective Studies ; Ventilators, Mechanical

OBJECTIVE: Authors conducted the pilot trial to evaluate whether the virtual reality using mirror therapy induces analgesia and functional improvement to the patients of rheumatoid wrist arthritis. METHOD: Three patients with no symptom or sign of active phase at both wrists were recruited. Voluntary range of motion (ROM) of each wrist over as far as possible was recorded and then the same movement was recorded only over 60% of the previous one after break of 5 minutes. For the virtual reality treatment, the second recorded motion was reconstructed into the another one of as same ROM and spent time as the first one, providing confusing visual information to the patients while patients were instructed to reach only the red flags (60% ROM of 1st one). This exercise was repeated for 5 days. Numerous scales such as VAS, ROM, Michigan Hand Outcomes Questionaire (MHQ), Performance and Satisfaction in Activities of Daily Living (PS-ADL), patient-rated wrist evaluation (PRWE) were evaluated before and after repetition. RESULTS: The increased satisfaction with their hands (satisfaction score of MHQ; 5.8 ± 2.3, [6-30]), improved ADL performances (PS-ADL score: 5.0 ± 3.5, [0-117]), and no side effect were noticed. CONCLUSION: The virtual reality using mirror therapy may be safe and has some analgesic effect, which warrants a clinical trial in the future for the patients of rheumatoid wrist arthritis.
Activities of Daily Living ; Analgesia ; Arthritis ; Arthritis, Rheumatoid* ; Hand ; Humans ; Michigan ; Range of Motion, Articular ; Virtual Reality Exposure Therapy ; Weights and Measures ; Wrist