Fourtyone patients fo gallbladder and bile duct diseases were studied clinically and sonographically.Tweentynine (Seventyone percent) patients were distributed between age fourty to fiftynine and male to femaleratio was 1:1.4. The order of frequency of biliary tract disease was cholelithiasis, acalculous cholecystitis, CBDstone and CBD cancer. Sonographic findings of cholelithiasis were strong echo with posterior shadowing, faintinternal echoes without shadowing, gallbladder wall thickneing and anechoicity of the gallbladder wall. Instead ofsmall proportion of gallbladder distension and wall anechoicity, faint internal echoes without shadowing were seenin ten of nineteen cases of cholelithiasis. On choledocholithiasis, meniscus sign at the junction of the stone andgallbladder wall was identified in most cases and was helpful to differentiation stone from malignancy. The degreeof CBD dilatation was more severe in malignancy than in CBD stones and ascaris in CBD. Sonographic examination wasuseful in detection of gallbladder and bilicary tree pathology and the cause of biliary tract obstruction could beidentified.
Acalculous Cholecystitis ; Ascaris ; Bile Duct Diseases ; Biliary Tract Diseases ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Gallbladder ; Humans ; Male ; Pathology ; Shadowing (Histology) ; Trees ; Ultrasonography

Background: It is well known that the addition of CO2 gas during cardiopulmonary bypass (CPB) can increase cerebral blood flow (CBF). In this study, we tried to find whether the increase of CBF by CO2 gas could be expressed on the measurement of body temperatures. Methods: This study included 22 adult patients who underwent CPB with moderate hypothermia and were assigned randomly to two groups by adding CO2 gas (CO2 group and Air group). We measured each tympanic (TM), nasopharyngeal (NP), oral, forehead, finger, rectal and CPB arterial line temperatures of CPB circuit for 20 times during cooling in every one minute for 20 minutes and during rewarming every two minutes for 40 minutes. Results: During cooling and rewarming, the TM, NP and oral temperatures changed more rapidly than the rectal and finger temperatures. In TM temperature, as time changed, the percent changes of temperature varied more prominently in the CO2 gas group than in the Air group. The statistical differences were significant especially during 13 minutes to 20 minutes in cooling and 8 minutes to 20 minutes during rewarming. Conclusion: From this data, we can postulate the effect of CO2 gas on CBF indirectly by measuring several sites of body temperatures.
Adult ; Body Temperature* ; Carbon Dioxide ; Cardiopulmonary Bypass* ; Fingers ; Forehead ; Humans ; Hypothermia ; Rewarming* ; Vascular Access Devices

OBJECTIVE: We conducted a retrospective data analysis to review the results of robot-assisted arm rehabilitation in post stroke patients during past 2 years and find out positive influences of the outcomes. METHOD: We measured improvements of arm function longitudinally in a group of sixty-four stroke patients, who participated in the robot-assisted arm therapy from January 2012 to December 2013. Treatment session lasted 30 to 40 minutes, 2 to 5 times a week. For at least more than one month, we used the InMotion2.0 (Interactive Motion Technologies, Watertown, MA, USA) and measured outcomes with the Fugl-Meyer assessment-upper extremity (FMA-UE), Korea-modified Barthel index (K-MBI) and InMotion robot arm evaluation index. Also, analysis on the subgroup was carried out. RESULTS: Following the robot-assisted arm rehabilitation, FMA-UE, K-MBI and InMotion robot arm evaluation index were significantly improved compared to baseline. Mean FMA-UE and K-MBI gain were 4.22 +/- 0.76, 7.63 +/- 1.18 in each. However, in the subgroup analysis, the group with less intensity treatment (640 repetition) did not show any significant improvement. CONCLUSION: This is an observational study showing improvements in arm function following robot-assisted arm rehabilitation compared to baseline, which was significant only in the subgroup who received the intervention longer and more intensity.
Arm* ; Extremities ; Humans ; Observational Study ; Rehabilitation* ; Retrospective Studies ; Statistics as Topic ; Stroke* ; Upper Extremity

OBJECTIVE: We used music as a rhythmic cue in gait training of patients with hemiplegia and analysed its effect on gait parameters. METHOD: Twenty hemiplegic patients were included in the study. Gait cycle, foot contact area, and center of pressure pathway were measured by F-scan with and without music. Four subjects were followed after 3 weeks of gait training using rhythmic cue with music. RESULTS: 1) In involved limb, stance phase was slightly increased from 65.8+/-9.9% to 67.8+/-7.9%, and single limb support was changed from 17.1+/-6.3% to 17.2+/-6.2%, without statistical significance. 2) Stance and swing symmetry was slightly increased from 0.77+/-0.13 and 0.52+/-0.21 to 0.83+/-0.09 and 0.54+/-0.16 respectively, without statistical significance. 3) Foot contact area and anteroposterior distance of center of pressure were not changed significantly. 4) All 4 subjects who were followed after 3 weeks showed increased single limb support of involved limb (from 14.5% to 18.8%) and swing symmetry (from 0.47 to 0.67). CONCLUSION: Though it was not proved to be effective for every hemiplegics, use of rhythmic cue with music in gait training may be helpful in some patients. Further study is needed to confirm these results.
Cues ; Extremities ; Foot ; Gait ; Gait Disorders, Neurologic* ; Hemiplegia ; Humans ; Music Therapy ; Music* ; Rehabilitation

No abstract available.
Trigger Points*

No abstract available.
Humans ; Stroke* ; Walking*

BACKGROUND: The goal of our study was to investigate the effects of propofol anesthesia on the pulmonary vascular response to prostacyclin during U46619 precontraction in dogs. METHODS: Eight mongrel dogs were anesthetized and instrumented to measure the left pulmonary vascular pressure-flow relation, by loosely positioning a hydraulic occluder around the right main pulmonary artery and placing an electromagnetic flow probe around the left main pulmonary artery. During slowly occlusion of the right main pulmonary artery, the pressure-flow plots were measured in the left main pulmonary artery in the control and propofol-anesthetized (5.0 mg/kg plus 0.5 mg/kg/min intravenously) states at baseline, after preconstriction with the U46619, and during the cumulative intravenous administration of prostacyclin. RESULTS: Propofol had no effect on the baseline pressure-flow relation versus the control state. A lower (P <0.05) dose of U46619 was necessary to achieve the same degree of preconstriction during propofol anesthesia. The pulmonary vasodilator response to prostacyclin was markedly attenuated (P <0.05) during propofol anesthesia compared to the control state. CONCLUSIONS: These results imply that propofol directly inhibits the pulmonary vasodilatory effects of prostacyclin. However the signal transduction pathway of cyclooxygenase-induced pulmonary vasodilation requires further investigation to determine mechanisms involved.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid* ; Administration, Intravenous ; Anesthesia ; Animals ; Dogs* ; Epoprostenol ; Magnets ; Propofol* ; Pulmonary Artery ; Pulmonary Circulation ; Signal Transduction ; Vasodilation*

BACKGROUND: Anesthesia induces the spectral changes in EEG. Attempts to relate these spectral changes to adequacy of anesthesia have been hindered due to the complex waveforms of EEG. The objective of this investigation is to monitor the awareness of patients during cesarean section by means of EEG spectral analysis. METHODS: 20 patients for cesarean section aged from 24 to 39 and ASA class I or II, were maintained with O2(50%)-N2O(50%)-enflurane(0.8%). And they were administered with midazolam(0.07 mg/kg) in group I(n=6), fentanyl(1 microgram/kg) in group II(n=7), and fentanyl(2 microgram/kg) in group III(n=7) after birth. The density of each spectral band in EEG (delta 1-3.25 Hz, theta 3.5-7.75 Hz, alpha 8-12.15 Hz and beta 13-31.75Hz) was analyzed to derive total density, delta ratio and median power frequency. RESULTS: The spectral data demonstrated that the alpha rhythm was dominant in pre-induction period and beta rhythm was abundant both in the immediate post-induction period and after birth for all three groups. Delta ratio and median power frequency decreased after injection of midazolam and fentanyl in all three groups. None of patients could recall the memory about experience during cesarean section. CONCLUSIONS: These findings indicate that EEG spectral analysis is potentially useful to determine the changes of cerebroelectrical activity but difficult to monitor the awareness of patients during cesarean section.
Alpha Rhythm ; Anesthesia ; Anesthetics ; Anesthetics, Intravenous* ; Beta Rhythm ; Cesarean Section* ; Electroencephalography* ; Enflurane ; Female ; Fentanyl ; Humans ; Isoflurane ; Memory ; Midazolam ; Parturition ; Pregnancy

Mazabraud syndrome (MS) is a rare and sporadic disorder. It is mainly characterized by fibrous dysplasia (FD) of single or multiple bones and intramuscular myxomas (IM). Data on the prevalence since it was first reported, clinical features, and prognosis are extremely scarce. We report a case of a 59-year-old woman with IM and polyostotic FD. She also had multiple cafe’-au-lait spots suggestive of McCune-Albright syndrome (MAS). On magnetic resonance imaging, there are masses with well-defined heterogeneous enhancement, accompanied by an inner cyst in the vastus lateralis muscle and femur. These radiological results are identical to those of FD. After surgical intervention with excision of intramuscular soft-tissue mass, a diagnosis of IM of MS was confirmed. Given that cafe’-au-lait spots also appeared, the patient was diagnosed with a variant of MS with some of the clinical characteristics of MAS.

BACKGROUND: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. METHODS: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. RESULTS: Total number of patients enrolled in this study was 38. 22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70+/-0.28 hours while that for the esophagoscope group was 5.96+/-2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 60 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). CONCLUSION: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.
Anesthesia ; Anoxia ; Catheters* ; Emergencies* ; Emergency Service, Hospital* ; Esophagoscopes ; Esophagus ; Foreign Bodies* ; Humans ; Operating Rooms ; Prospective Studies ; Specialization