The authors carriod out lumbodorsal fasciotomy on six cases of paralytic scoliosis with pelvic obliquity. In our experience, in those older children and adolescents with paralysis in whom scoliotic curve is not severe and is more or less static, correction and maintenance of the correction can be achieved by lumbodorsal fasciotomy without resorting to spine fusion. While it is a common practice to leave a mild and static curve uncorrected, even a mild degree of scoliosis, when associated with pelvic obliquity, abduction contracture of the hip, instability of the other hip and leg length discrepancy, is a major problem in paralytic patients. Initial results indicate that lumbodorsal fasciotomy, combined with contralateral Soutters or Campbells fasciotomy if necessary, is a simple and effective method in correcting these deformities and restoring balance and function.
Adolescent ; Child ; Congenital Abnormalities ; Contracture ; Health Resorts ; Hip ; Humans ; Leg ; Methods ; Paralysis ; Scoliosis ; Spine

BACKGROUND: This study was designed to evaluate the antihypertensive efficacy and safety of nifedipine gastrointestinal system push-pull osmotic pump formulation in patients with mild to moderate essential hypertension. METHODS: After 2 weeks placebo run-in period, nifedipine 60 mg was administered once daily for 8 weeks in thirty-two patients with mild to moderate essential hypertension. RESULTS: At the end point of treatment, sitting blood pressure decreased as much as 33/16mmHg in average and rewarded 88% of efficacy and 69% of normalization. The ambulatoy blood pressure monitoring in 10 patients also revealed 11% decrease in 24 hr mean diastolic blood pressure and 32% decrease in % elevated blood pressure. The most frequent side reactions were constipation in 7 patients and polyuria in 6 patients which were tolerated during entire trial period. There were no significant changes in biochemical parameters and hematologic data, thus making the rate of safety 91% and overall rating of usefulness was 84%. CONCLUSION: Nifedipine GITS 60 mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Blood Pressure Monitors ; Constipation ; Humans ; Hypertension* ; Nifedipine* ; Polyuria ; Reward

No abstract available.
Femur* ; Tibia*

OBJECTIVES: Careful evaluation about mediastinal involvement is important in the management of patients with non-small cell lung cancer. Invasive staging procedure such as mediastinoscopy is advocated because of the unreliability of noninvasive staging methods such as CT, MRI. We compared differences between pre- and postoperative staging in non-small cell lung cancer without lymphadenopathy on CT scan and investigated the methods for more accurate preoperative staging. METHODS & RESULTS: 1) Records of a total of 41 patients with preoperative T1-3N0M0 non-small cell lung cancer were reviewed and the histologic types of tumors were squamous cell carcinoma in 32 cases, adenocarcinoma in 6 cases and large cell carcinoma in 3 cases. Twenty-four cases were central lesions and seventeen cases were peripheral lesions. 2) Among the 32 cases with preoperative T2, 2 cases were identified postoperatively as T3 with invasion of chest wall and among 6 cases with preoperative T1-3, 1 case was identified postoperatively as T4 with invasion of aorta and pulmonary arteries. 3) After the operation of 35 cases with T1-2, 5 cases wore N1 and 3 cases were N2 postoperatively. After the operation of 6 cases with T3, 2 cases were N1 and 3 cases were N2 postoperatively Preoperative T3 showed more intrathoracic lymph node metastases and higher N2/N1 involvement ratio than preoperative T1-2. 4) Complete surgical resections were done in 34 out of 41 cases. Incomplete resection were done in all postoperative N2 tumors. CONCLUSION: Invasive staging procedures such as mediastinoscopy should be considered in the case of preoperative T3 non-small cell lung cancer even though mediastinal lymphadenopathy is not recognized on the CT scan of the chest.
Adenocarcinoma ; Aorta ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Magnetic Resonance Imaging ; Mediastinoscopy ; Neoplasm Metastasis ; Pulmonary Artery ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

Background & Objective: EGB 761 is a standardized natural extract used to treat impaired cerebral perfusion and nutrition (cerebrovascular insufficiency) in Korea. Although several animal studies have been conducted, few studies have investigated the clinical effects of EGB 761 in acute stroke. This study assessed the clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. Methods: This retrospective study examined a prospectively collected stroke database. We evaluated 232 patients with acute ischemic stroke within 48 hours of symptom onset. All patients were treated with antiplatelet or anticoagulation agents. We compared baseline characteristics between the EGB 761-treated and non-treated groups. The functional outcome measure was the modified Rankin Scale (mRS) score 90 days after stroke onset. Results: Of the 232 patients, 170 received EGB 761 during the first 3 days after arrival in the emergency department. We found no significant differences in baseline characteristics between the groups, with the exception of atrial fibrillation (p=0.032). After adjusting for baseline factors, intravenous administration of EGB 761 was associated with an improved 90-day functional outcome (mRS ≤2) compared with the control group (odds ratio, 2.56; p<0.05). Conclusions: Our results showed a clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke
Stroke

Acute motor and sensory axonal neuropathy (AMSAN) are recently described subtypes of Guillain-Barre syndrome characterized by acute onset of distal weakness, loss of deep tendon reflexes, and sensory symptoms. A 21-yr-old male was transferred to our hospital due to respiration difficulties and progressive weakness. In laboratory findings, immunoglobulin M antibodies against hepatitis A were detected in blood and cerebrospinal fluid. The findings of motor nerve conduction studies showed markedly reduced amplitudes of compound muscle action potentials in bilateral peroneal, and posterior tibial nerves, without evidence of demyelination. Based on clinical features, laboratory findings, and electrophysiologic investigation, the patient was diagnosed the AMSAN following acute hepatitis A viral infection. The patient was treated with intravenous immunoglobulin and recovered slowly. Clinicians should consider this rare but a serious case of AMSAN following acute hepatitis A infection.
Acute Disease ; Electromyography ; Guillain-Barre Syndrome/*diagnosis/drug therapy/etiology ; Hepatitis A/complications/*diagnosis ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Young Adult

No abstract available.
Acute Lung Injury* ; Inhalation* ; Nitrogen Dioxide* ; Nitrogen*

No abstract available.
Oxygen*

BACKGROUND: Paradoxical puborectalis syndrome (PPS) is a complex and poorly understood entity characterized by contraction rather than relaxation of the pelvic floor muscles during attempted evacuation. Anal electromyography (EMG) and cinedefecography (CD) are the most commonly used tests for the diagnosis of PPS. Therefore, the aim of this study was to prospectively assess the correlation of EMG and CD in the diagnosis of PPS. METHODS: All patients with symptoms of obstructed evacuation who underwent EMG and CD between September 1998 and February 1999, were evaluated. The clinical criteria for PPS included incomplete or difficult evacuation, straining, tenesmus, and the need for an enema or digitation. The EMG criteria included failure to achieve a significant decrease in the electrical activity of the puborectalis during attempted evacuation. The CD criteria included either paradoxical contraction or failure of the puborectalis to relax along with incomplete evacuation. RESULTS: Twenty-nine (29) patients had clinical evidence of PPS, 8 males and 21 females with a mean age of 42.6 years (range, 19-75 years), and underwent CD and EMG. The mean duration of symptoms was 7.2 years (range, 3 months-30 years). Nineteen patients (65.5%) had evidence as having PPS on CD and/or EMG. Of these patients, six patients (20.7%) were diagnosed as having PPS on both tests, five patients (17.2%) were only diagnosed on CD, and eight patients (27.6%) were only diagnosed on EMG. The remaining ten patients had normal puborectalis muscle relaxation on CD and EMG. Therefore, the correlation rate between the two tests was 55.2%. If EMG was considered as the ideal test for the diagnosis of PPS, CD had a sensitivity of 42.9% and a specificity of 66.7%. Conversely, if CD was considered as the ideal test, EMG had a sensitivity of 54.5% and a specificity of 55.6%. CONCLUSIONS: The sensitivity and the specificity values of EMG and CD for the diagnosis of PPS are suboptimal, and a low correlation existed between the two tests. This result suggests that the diagnosis of PPS should not be based upon only one test.
Constipation ; Diagnosis* ; Electromyography* ; Enema ; Female ; Humans ; Male ; Muscle Relaxation ; Muscles ; Pelvic Floor ; Prospective Studies ; Relaxation ; Sensitivity and Specificity

No abstract available.
Pulmonary Alveolar Proteinosis*