Objective: The purpose of this study was to determine the force of lower extremities, the change in walking ability on the ground by applying a walking training program based on perceptual learning to improve gait capacity of chronic stroke patients.Method: This study included Twenty-four patients with chronic stroke. Using a perceptual-based gait training, the experimental group trained twice a day for 30 minutes each time, 5 times a week, for a total of 8 weeks. The control group underwent ground gait training that excluded the element of a perceptual training for 30 minutes, 5 times a week for 8 weeks. Results: In the two groups, the maximum forefoot pressure after intervention was significantly different in both the LEPGT and GGT (p<0.05). The maximum midfoot pressure was significantly different in LEPGT (p<0.05). There was a significant difference in the maximum heel pressure after intervention between the two groups (p<0.05). As a result of comparing the change in step length and stride length after intervention in the two groups, there was a significant difference between the two groups (p<0.05). Conclusion Both gait training programs was found that gait training based on perceptual learning and ground gait training were the training for improving the functional gait of stroke patient. Perceptual learning gait training utilizing intensive perceptual awareness was the training for improving gait capacity within the period than ground gait training.

Objective: The purpose of this study was to determine the force of lower extremities, the change in walking ability on the ground by applying a walking training program based on perceptual learning to improve gait capacity of chronic stroke patients.Method: This study included Twenty-four patients with chronic stroke. Using a perceptual-based gait training, the experimental group trained twice a day for 30 minutes each time, 5 times a week, for a total of 8 weeks. The control group underwent ground gait training that excluded the element of a perceptual training for 30 minutes, 5 times a week for 8 weeks. Results: In the two groups, the maximum forefoot pressure after intervention was significantly different in both the LEPGT and GGT (p<0.05). The maximum midfoot pressure was significantly different in LEPGT (p<0.05). There was a significant difference in the maximum heel pressure after intervention between the two groups (p<0.05). As a result of comparing the change in step length and stride length after intervention in the two groups, there was a significant difference between the two groups (p<0.05). Conclusion Both gait training programs was found that gait training based on perceptual learning and ground gait training were the training for improving the functional gait of stroke patient. Perceptual learning gait training utilizing intensive perceptual awareness was the training for improving gait capacity within the period than ground gait training.

No abstract available.
Endometriosis* ; Female ; Humans ; Hydronephrosis* ; Ureter* ; Uterine Cervical Neoplasms*

No abstract available.
Heel* ; Melanoma, Amelanotic* ; Ulcer*

A 60-year-old male was referred to the ophthalmologic clinic with aggravated anterior uveitis and corneal edema despite the use of topical and systemic steroids. He had undergone cataract surgery in both eyes 15 years previous. Slit lamp examinations revealed a retained lens fragment in the inferior angle of the anterior chamber, with severe corneal edema and mild anterior uveitis. The corneal edema and uveitis subsided following surgical extraction of the lens fragment. That a retained lens fragment caused symptomatic anterior uveitis with corneal edema 15 years after an uneventful cataract surgery is unique. A retained lens fragment should be considered as one of the causes of anterior uveitis in a pseudophakic patient.
Cataract Extraction/*adverse effects ; Corneal Edema/*etiology/*pathology ; Humans ; Lens, Crystalline/*pathology/surgery ; Male ; Middle Aged ; Postoperative Complications/pathology/surgery ; Pseudophakia/pathology ; Reoperation ; Severity of Illness Index ; Uveitis, Anterior/*etiology/*pathology

The isolation of fetal cells from maternal circulation has the potential to allow relativelyself prenatal diagosis for all pregnant women. The present technology, however, has notreached the accuracy required for clinical diagnosis because of maternal cell contaminationSo we published a new method for enrichment of nRBC in a fetal cell isolation(1996).In this study, attempted to FISH analysis of nRBC which was isolated by our ownmethods. We evaluated the efficiency of FISH.As the results, we have successfully used FISH on enriched nRBC.We were able to identified 2 abnormal fetus which were confirmed by conventionalcytogenentic study as Down syndrome(Fig.1) and Klinefeltre syndrome(Fig.2). And thesensitivity and specificity for FISH was 86%(49/57) and 92.3%(36/39), respectively.According to our results, fetal cell analysis by FISH can be reliable used for prenatalaneuploidy diagnosis. However, the problems of enrichment of the fetal cell and FISH probeor condition should be over come before analyze.
Aneuploidy ; Diagnosis ; Erythroblasts* ; Female ; Fetus ; Fluorescence* ; Humans ; Pregnant Women ; Sensitivity and Specificity

The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.
Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Critical Illness ; Diabetes Mellitus/diagnosis/drug therapy ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Kidney Failure, Chronic/diagnosis/therapy ; Liver Cirrhosis/diagnosis/therapy ; Peptic Ulcer/*therapy ; Risk Factors

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.
Episiotomy ; Female ; Humans ; Parturition*

BACKGROUND: Women with epilepsy tend to have hormonal and metabolic disturbances. This study was performed to investigate whether epileptic women with specific epileptic syndromes or antiepileptic drugs (AEDs) are at risk for metabolic and/or menstrual abnormalities. METHODS: Women with epilepsy aged 15 to 50 years old, currently on AED medications for more than 6 months, were recruited for this study. Subjects checked their oral temperature each morning. Serum tests for lipid profiles, insulin, glucose, and leptin were performed on menstrual cycle days 2 to 3. HOMA-index, as a marker of insulin resistance, was calculated. RESULTS: In total 57 patients, 19 women were diagnosed as primary generalized epilepsy (PGE) and the other 38 as localization-related epilepsy (LRE). Among them, 42 patients were on monotherapy; 19 women on carbamazepine (CBZ), 12 on valproate (VPA), and 11 on lamotrigine (LTG). Body mass index increased in VPA group (24.43+/-3.61) compared to CBZ (22.03+/-2.45) or LTG (21.68+/-2.14) group (p=0.046), and metabolic syndrome was more commonly associated in VPA group (5/12, 41.7%) than in CBZ (1/19, 5.3%) or LTG (0%) group (p=0.005). Epileptic women on VPA experienced menstrual irregularity (7/12, 58.8%) more frequently, compared to CBZ (4/19, 21.1%) or LTG (3/11, 27.3%) group (p=0.089). No differences were observed between PGE and LRE groups. CONCLUSIONS: Women with epilepsy on VPA tend to be more obese, and more frequently have metabolic and/or menstrual abnormalities than epileptic women on CBZ or LTG..
Anticonvulsants ; Body Mass Index ; Carbamazepine ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Generalized ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Leptin ; Menstrual Cycle ; Middle Aged ; Prostaglandins E ; Valproic Acid

This is a report of anesthesia done for 24 cases of renal transplantation performed at St. Mary's Hospital, Catholic Medical college, Seoul, Korea, between 25 March 1969 and 19 August 1976. The recipient of renal transplantation show many critical conditions which require special considerations in performing anesthesia. The patients preoperative condition should be evaluated more carefully than most other kinds of surgical patients and anesthesia technic also must be selected specially. All kidney grafts were obtained from living donors. The family linkage of 24 donors was: 7 cases(29.1%) were from parents, 3 cases(12.5%) from children, 9 cases (37.5%) from siblings, 3 cases(12. 5%) from other relatives and 2 cases (8. 3%) were from nonrelated prsons. In the sex distribution of the donors, each sex was equally distributed.: All donors were anesthetized by means of endotracheal anesthesia using halothane, nitrous oxide and oxygen. As to complications during the nephrectomy of donors, a case of hiccup and two cases of pleural tear were encountered. The removed kidney was perfused with Hartmanns solution before transplantation and the choice of anesthetic agents caused no problems in the function of transplanted kidneys. The recipients had histories of chronic glomerulozephritis or pyelonephritis from 6 months to 32 years and showed uremic conditions. Their mean age was 38 years, ranging from 18 years to 59 years. The most frequent age group of the recipients was the 30 and 40 year group. Most recipients were males; among 24 cases, only 3 were females. Most of the recipients had decreased function of heart and lungs, severe anemia difficult to correct by blood transfusion(Hb, 7. 3 gm%, Hct. 24, 2%), increased BUN(70. 36+/-31. 34 mg/dl), hyperkalemia (4. 67+/-0. 63 mEq/L), poor and fragile veins, bleeding tendency and decreased kidney function(serum creatinine 10. 48 edmea, +/-2. 99 mg/dl). Prolonged medication to the recipient was another hazard to anesthesia. To lessen the risk during the anesthesia maintenance, preoperative preperation of the recipient The Journal of The Korean Society of Anesthesiologists Vol. 10, No. 1, 1977 Premedication of the recipients was perfor med by valium(515 mg) and atropine(0. 4 0. 5 mg) one hour before anestl esia. For tlie anesthetic technic, endotracheal anesthesia was applied to aI1 cases. Induction was done with intravenous pentothal soium, l00~ 200 mg or Epontol 250~500mg. As to the muscle relaxant to facilitate intubation, succinylchline for ll cases of the initial period of the transplantation, later gallamine for one case and pancuronium for the recent 12 cases. All anesthesia was maintained with halothane, nitrous oxide and oxygen. Muscle relaxants were used in al) cases during the surgery: succinylcholine drip for the initial 7 cases, d-Tubocurarine for 2 cases, gallamine for 2 cases and pancuronium for the recent 12 cases. Galllamine seems to be not contraindicated, as far as the active diuresis could be anticipated after the transplantation. Amount of blood transfused during operation was 2, 041 ml in average, ranging from 800 ml to 5000 ml and fluid infused was 1, 242 m] of Hartmann's sol. and/or other solutions. Respiration was controlled manually or mechanically. During the anesthesia, 16 cases of hypertension, 7 cases of arterial hypotension, 3 cases of arrhythmia, one cas of tight chest and one case of tachycardia, were encountered. Emergence of anesthesia was within 15 minutes. After the transplantation, diuresis started in 33 minutes on the average and most patients showed marked diuresis in which urine volume of 24 hours was 10, 164 ml on the average. The total surgical procedure lasted 4 hours and 50 minutes on the average, ranging from 3 hours 50 minutes to 7 hours. The ischemic tine of the removed kidney was 32 minutes in average. Followup of the patients showed that 10 cases died out of 24 cases between 4 months and 4 years after the surgery Patients surviving more than 1 year were 11 cases out of 15 cases(73. 3%), two cases out of 8 cases(25%) survived more than 2 years and two cases out of 8 cases(25%) more than 3 years. One case had the longest survival of 7 1/3 years.
Anemia ; Anesthesia* ; Anesthetics ; Arrhythmias, Cardiac ; Child ; Creatinine ; Diuresis ; Female ; Follow-Up Studies ; Gallamine Triethiodide ; Halothane ; Heart ; Hemorrhage ; Hiccup ; Humans ; Hyperkalemia ; Hypertension ; Hypotension ; Intubation ; Kidney ; Kidney Transplantation* ; Korea ; Living Donors ; Lung ; Male ; Nephrectomy ; Nitrous Oxide ; Oxygen ; Pancuronium ; Parents ; Premedication ; Propanidid ; Pyelonephritis ; Respiration ; Seoul ; Sex Distribution ; Siblings ; Succinylcholine ; Tachycardia ; Thiopental ; Thorax ; Tissue Donors ; Transplants ; Tubocurarine ; Veins