No abstract available.

OBJECTIVE: To determine the functional outcomes of the patients with total hip replacement and to evaluate the variables associated with the functional recovery. METHOD: Subjects were 188 patients, who had undertaken total hip replacement between March 1, 1997 and July 31, 1999 at Asan Medial Center. The four functional milestones including sitting, standing, 50 m walking, and climbing stairs were evaluated. RESULTS: The average duration of treatment was 8.3 +/- 7.0 days, and the days required for sitting were 1.9 +/- 1.0; standing 2.4 +/- 1.8; walking 50 m 6.4 +/- 4.3; climbing stairs 7.9 +/- 4.5 days. In results of analysis of each variable, male patients showed faster functional improvement than female patients in standing and climbing stairs. The patients of age 60 years and over had slower recovery in sitting and standing. The patients with sequelae of septic hip or Legg-Calve-Perthes disease had slower recovery than the others in standing. The patient with the use of cement showed rapid improvement in sitting and standing. Those who could bear full weight had rapid recovery than those with partial weight. CONCLUSION: We would like to suggest that careful consideration on characteristics of each patient should be given in determining the duration of rehabilitation management of the patients who had total hip replacement.
Arthroplasty, Replacement, Hip* ; Chungcheongnam-do ; Female ; Hip ; Humans ; Inpatients* ; Legg-Calve-Perthes Disease ; Male ; Rehabilitation* ; Walking

PURPOSE: To evaluate the usefulness of the helical CT in the differentiation of periampullary malignanttumors. MATERIALS AND METHODS: Fifty-five periampullary carcinoma patients (pancreatic head carcinoma (n=18);distal CBD carcinoma (n=17) ; carcinoma of the ampulla of Vater(n=16) ; periampullary duodenal cancers,(n=4), alldiagnosed by histopathologic study] underwent helical CT with 5mm scan thickness and 5mm/sec table speed. Afterscanning, retrospective reconstruction was performed at 2mm intervals, followed by multiplanar reformation. Inboth retrospective reconstructed axial and multiplanar reformation images, the authors analyzed the detection rateand size of the mass, and associated findings including invasion of peripancreatic fat, dilatation of CBD and itsnarrowing pattern, dilatation of the pancreatic duct and its degree of dilatation, wall thickening of CBD,extension of dilated bile duct into the ampulla, and of protruding mass into the duodenal lumen, and lymph nodemetastasis all according to the origin sites of tumors. Differential points were thus determined. RESULTS: Thedetection rate of the masses was 96% (53/55). Their size was 1-5cm, with a mean size of 2.4 +/-0.5cm in carcinomaof of ampulla of Vater and 3.5 +/-1.0cm in pancreatic head carcinoma. Invasion of peripancreatic fat was mostcommonly observed in pancreatic head carcinoma (100%, 18/18) (P >0 . 0 5 ), dilatation of CBD was observed in allcases except one of periampullary duodenal cancer (98%, 54/55), and abrupt termination of dilated bile duct wasnoted in all cases except one of the pancreatic head carcinoma (98%, 53/54). Dilatation of pancreatic duct wascommonly observed in pancreatic head carcinoma (94%, 17/18) and carcinoma of the ampulla of Vater (75%, 12/16).Its degree of dilatation was mostly moderate in pancreatic head carcinoma (56%, 10/18) and mostly mild incarcinoma of the ampulla of Vater (63%, 10/16) ( P >0.05). Wall thickening of the distal CBD was most commonlyobserved in distal CBD carcinoma (76%, 13/17). Extension of dilated bile duct into the ampulla was commonlyobserved in the carcinoma of the ampulla of Vater (81%, 13/16) and periampullary duodenal cancer (75%, 3/4) (P>0.05). A mass protruding into the duodenal lumen was commonly observed in periampullary duodenal cancer (100%,4/4) and carcinoma of the ampulla of Vater (94%, 15/16) (P >0.05). Lymph node meatastasis was observed inpancreatic head carcinoma (17%, 3/18) and distal CBD carcinoma (6%, 1/17). CONCLUSION: Because of improvement inthe rate at which the mass is detected, and a clear demonstration of associated findings, helical CT is useful inthe differentiation of periampullary carcinomas.
Ampulla of Vater ; Bile Ducts ; Diagnosis* ; Dilatation ; Duodenal Neoplasms ; Head ; Humans ; Lymph Nodes ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed*

Purpose: Regular aerobic exercise has been recommended as an effective lifestyle strategy for the prevention and treatment of cardiovascular disease. However, it is unclear whether short-term exercise (＜ 6 weeks) can also improve vascular function. Thus, we sought to evaluate the efficacy of short-term spinning exercise to improve vascular function and body composition in young women. Methods: Twelve young women (age, 22±2 years; body mass index, 22.2±3.3 kg/m 2 ) participated in 10 spinning exercise sessions (50 minutes per session including 5 minutes for warm up and cool down) at 60% to 85% age predicted maximal heart rate. Assessments were hemodynamics (heart rate [HR], rate-pressure product [RPP], brachial and central blood pressure) and vascular function (carotid to femoral pulse wave velocity [c-f PWV], augmentation index normalized to a HR of 75 beats [AIx@75], brachial artery flow-mediated dilation [FMD]), and body composition. All measurements were obtained at baseline before (test 1 [T1] and test 2 [T2]) and again after completion of the last spinning exercise session (test 3 [T3]). Results: Short-term spinning exercise reduced c-f PWV (T1 : 6.2±0.7 m/sec, T3 : 5.7±0.6 m/sec, p=0.012), AIx@75 (T1: 2.4%±8.8%, T3: −5.9%±9.3%, p＜ 0.001) and increased brachial artery FMD (T1: 8.0%±4.0%, T3: 11.8%±5.4%, p=0.002). Percent body fat also decreased after short-term spinning exercise (T1 : 29.3%±6.0%, T3 : 28.4%±6.1%, p=0.011). In addition, all participants achieved 100% adherence. Conclusion These findings provide preliminary evidence for the effects of short-term spinning exercise to improve vascular function and body composition in young women.

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

Simultaneous contraction of various muscles with levator palpebrae have been reported as a phenomenon of the paradoxic synkinesis. The authors observed an unilateral eyelid retraction induced by the postural change from supine to sitting position in a 33-month-old girl and a 4-year-old boy. In both cases, the levator function of both eyes was normal and ptosis was not observed. These cases were presumed to be related with postural righting reflex, but the exact neurological basis is not fully defined yet.
Child, Preschool ; Eyelids* ; Female ; Humans ; Male ; Muscles ; Reflex, Righting ; Synkinesis

Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used the CT scanner and the X-ray fluroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occurred in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily established according to the surrounding anatomical structures. 2) the operator can introduce the needle without anxiety. 3) the time required for block are saved.
Alcoholics ; Anxiety ; Celiac Plexus* ; Humans ; Needles

No abstract available.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans

OBJECTIVES: The purpose of this study was to correct the statistical errors in the previous article on "The Development of the 'Mental Fitness' Scale" (MFS) and to confirm the validity of factor structure via confirmatory factor analysis. METHODS: Based on re-analysis of the factor structure of 25 preliminary items using the original dataset, we identified 22 items of the MFS and assessed test-retest reliability. Concurrent validity was assessed by correlating the new set of MFS with total scores of the Beck Depression Inventory and Positive and Negative Affect Schedule. We also performed confirmatory factor analysis (CFA) in order to verify the factor structure resulting from the exploratory factor analysis. RESULTS: Re-analysis yielded five factors of 22 items, which is different from four factors of 20 items in the previous paper. 'Self-understanding' was added as one of the five factors. The test-retest reliability coefficients were significantly high, ranging between 0.57-0.73. Internal consistency was computed, and Cronbach's alpha for five factors ranged between 0.67-0.86, and was 0.91 for the total score. Concurrent validity and discriminant validity were both significant. The validity of five factor structure based on CFA was verified as root mean square error of approximation was significant. CONCLUSION: Based on results of confirmatory factor analysis, the validity and utility of the revised MFS was increased.
Appointments and Schedules ; Depression ; Factor Analysis, Statistical*

The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows : Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.
Follow-Up Studies ; Tomography, X-Ray Computed