OBJECTIVES: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. METHODS: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. RESULTS: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). CONCLUSIONS: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggested that some education and support is needed at the early stage of the CPAP treatment.
Apnea ; Body Mass Index ; Compliance* ; Continuous Positive Airway Pressure ; Depression ; Education ; Humans ; Sleep Apnea, Obstructive*

The authors have reviewed 71 cases (70 patients) of the ankle fractures that were treated through the admission in Orthopedic Department, Paik Foundation Hospital, from June 1972 to April 1978. The average duration of the follow-up waa 15 months. The summary of the results were as follows; 1. Of the 71 cases, male was 54 cases and female 17 cases. The average age of the patients was 32. 2. The main cause of the injuries was traffic accident, and the other causes were sliding down and falling from a height, industrial accident, and sports injury in order. 3. By the classification of Lauge-Hansen, the pronation-external rotation and,supination-adduction types were commoner than the other types. 4. Open reduction was performed in 48 cases, and closed reduction in 23 cases. 5. The average duration of the cast immobilization after the closed reduction was 8 weeks, and that of the open reduction was 6 weeks. 6. The result of the treatment was better in those cases of the open reduction than that of, the closed reduction. 7. The good clinical results could be achieved by obtaining the anatomical position of the talus in the mortise and the reduction was achieved more satisfactorily when the key role of the lateral malleolus in complete reduction was well understood.
Accidental Falls ; Accidents, Occupational ; Accidents, Traffic ; Ankle Fractures ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Orthopedics ; Talus

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

A highly specific antigenic protein of 31 kDa from plerocercoid of Spirometra mansoni (sparganum) was obtained by gelatin affinity and Mono Q anion-exchange column chromatography. The purified 31 kDa protein was subjected to N-glycan enzymatic digestion for structural analysis. The relative electrophoretic mobility was analyzed by SDS-PAGE, before and after digestion. On SDS-PAGE after enzymatic digestion, the 31 kDa protein showed a molecular shift of approximately 2 kDa, which indicated the possession of complex N-linked oligosaccharides (N-glycosidase F sensitive) but not of high-mannose oligosaccharides (endo-beta-N-acetylglucosaminidase H, non-sensitive). Chemically periodated 31 kDa protein showed statistically non-significant changes with human sparganosis sera by enzyme linked immunosorbent assay (ELISA). Therefore, the dominant epitopes of the 31 kDa molecule in human sparganosis were found to be mainly polypeptide, while N-glycans of the antigenic molecule in sparganum was minimal in anti-carbohydrate antibody production.
Animals ; Antigens, Helminth/*analysis/chemistry/immunology/metabolism ; Carbohydrates/analysis/immunology ; Chromatography, Affinity ; Chromatography, Ion Exchange ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Epitopes/analysis/immunology ; Glucosaminidase/metabolism ; Human ; Peptide-N4- (N-acetyl-beta-glucosaminyl) Asparagine Amidase/metabolism ; Periodic Acid/chemistry ; Sparganosis/*parasitology ; Sparganum/immunology/metabolism ; Spirometra/immunology/*metabolism ; Support, Non-U.S. Gov't

The authors report the experience of twenty patients of transpedicular Zielke instrumentation after anatomical reduction of the spondylolisthesis. Anstomical reduction was done with the aid of temporary application of Harrington distraction rod, and the reduced segment was fixed with transpedicular Zielke instrumentation. And, anterior interbody fusion was supplemented in a single stage operation. Follow up period was between 13 to 25 months after operation with the average of 19 months. 1. The age of the patients was 38 years in average ranging from 11 to 61 years. 2. Types of the spondylolisthesis were spondylolytic type in 11 cases, degenerative type in 6 cases, dysplastic type in 1 case and pathologic type in 2 cases. 3. The level of the lesion were L5-Sl in 12 cases, L4-5 in 7 cases and L3-4 in 1 case. 4. Pre-operative clinical feature included low back pain in 95%, radiating pain in 65%, and neurological claudication in 45%. 5. The average percentage of slippage was changed from 24% preoperatively to 6% postoperatively and to 8% at the final follow up. The initial correction rate was 75% and the amount of correction loss during the follow up period was 11% in average. 6. Slip angle was changed from 3°preoperatively to −3°poetoperatively and to 0°at the end of follow up. In the 12 cases with local kyphosis, average slip angle of 14°preoperatively was improved to 2°postoperatively, and to 7°at the end of follow up. 7. Bony fusion was obtained in 19 cases within 4 to 6 months. 8. There were 2 cases of metal failure with considerable loss of reduction ; one patient with pathologic spondylolisthesie due to active tuberculous spondylitis required re-operation and another patient showed fusion eventually in the redisplaced position. Other complication included 1 transient dysuria, 1 ileus and 2 meralgia paresthetics. 9. Clinical symptoms were improved in 95%. Follow up result of the operation according to Gill's criteria were excellent 65%, good 25%, fair 5%, and poor 5%.
Dysuria ; Follow-Up Studies ; Humans ; Ileus ; Kyphosis ; Low Back Pain ; Spondylitis ; Spondylolisthesis

Traumatic spondylolisthesis of the axis is the fracture of both pedicles and is called commonly as hangman' s fracture. The fractures with the anterior displacement more than 3mm and the angulation, more than 11 degrees were classified as unstable and the surgical methods were recommended for the treatment of the fractures. As for the surgical methods, anterior C2-3 fusion with plate fixation or transpedicular screw fixation were used. However, the differences between the clinical results of both methods were not reported in the literatures. In order to clarisy the clinical results of both methods, the authors evaluated the clinical results of 11 patients treated by anterior plate fixation and 7 patients treated by transpedicular fixation who were operated on between Mar. 1987 and,Jan: 1992. Minimum follow-up period was 12 months. 1. As the surgical complications, two cases of transient dysphagia in anterior fixation group and three cases of malinserted screw in transpedicular fixation group were observed. 2. Limitation of rotatory neck motion, less than 20 degrees in one direction was observed in four cases of transpedicular fixation group. 3. Anterior angulation, more than 10 degrees was noted in three cases of transpedicular group. 4. Mild intermittent neck pain was observed in two cases of anterior fixation group and two cases of transpedicular fixation group. Constant neck pain was present in three cases of transpedicular fixation group. 5. Over-all clinical results were excellent or good in all of anterior fixation group, and in four of seven transpedicular group. Although the clinical materials were limited in number, method of anterior plate fixation was recommended by the authors in the management of traumatic spondylolisthesis of axis, because of the easier technique and the better clinical results than the transpedicular screw fixation.
Deglutition Disorders ; Follow-Up Studies ; Humans ; Methods ; Neck ; Neck Pain ; Spine ; Spondylolisthesis

A clinical and radiological observation was mde on 167 cases of urolithiasis among the number of 150 patientsduring 1 year and 6 months from June, 1981 to Nov. 1982. The results were summerized as follows. 1. There were 101man and 49 women, a ratio of 2:1. The ages of the patients ranged from 2 to 74 years, showing the highestincidence in 31 to 60 years(68.1%). 2. Locational distributions of urolithiasis were 80 cases (47.9%) in theureter, 66 cases(39.5%) in the kidney, 11 cases (6.5%) in the urethra and 10 cases (5.9%) in the bladder. 3. Amongthe 66 cases of renal stone, pelvis stone was 55 cases (83.3%) with staghorn types in 23 cases(34.8%), andcalyceal stone was 11 cases(16.6%). 4. The location of ureteral stone was 47.5% in lower, 40% in upper ureter and12.5% in mid-ureter. 5. The location of urethra stone was 82% in the anterior urethra and 18% in the posteriorurethra. 6. The chief complain of urolithiasis was flank pain in 59.2%, gross hematuria in 20.3%, renal colic in13.1% ,dysuria in 8.3%, nausea and vomiting in 4.7%, and sudden stoppage of urine stream in 3.5%. 7. Onurinalysis, gross hematuria was found in 54.4%, pyuria in 28.7%, bacteriuria in 23.3%, microscopic hematuria in18.5% and normal in 7.1%. 8. The size of urinary stone was 0.6-2.0cm in length in 105 cases(62.8%). 9. On I.V.P.study of renal stones(66 cases), mild and moderate hydronephrotic changes were detected in38 kidneys(57.5%), andthe relationsip between the urinary stasis and renal stone size was relatively good. 10. On I.V.P. study ofureteral stones(80cases), mild to severe hydronephrotic changes were detected in 64 kidneys(80%). 11. On K.U.B.film, paralytic ileus was found in 25 cases (14.9%). 12. Among the urinary stones, the radiolucent stones weredetected in 8 cases (4.7%). 13. Urinary stones diappeared in 11 cases (6.5%) spontaneously or medical treatment.
Bacteriuria ; Dysuria ; Female ; Flank Pain ; Hematuria ; Humans ; Intestinal Pseudo-Obstruction ; Kidney ; Nausea ; Pelvis ; Pyuria ; Renal Colic ; Rivers ; Ureter ; Urethra ; Urinary Bladder ; Urinary Calculi ; Urolithiasis ; Vomiting

Ten cases of unstable spine were treated with various surgical procedures under control of Halo apparatus and following results wen obtained. 1. Six cases of unstable cervical spine were treated with Halo apparatus and were able to obtain solid fusion for permanent stability. 2. Three cases of tuberculous kyphosis were corrected with halo-pelvic hoop on, and were able to obtain mean correction angle of 42 (65%) with little danger. 3. With halo on, staged operations such as anterior and posterior osteotomy, gradual distraction, anterior and posterior fusion of the spine for correcting deformity were carried out securely. 4. Average duration of halo application was eight weeks, no more twelve weeks, and there was no irreversible complication with halo apparatus per se.
Congenital Abnormalities ; Kyphosis ; Osteotomy ; Spine

No abstract available.
Anemia, Aplastic* ; Leukemia, Myeloid, Acute*

No abstract available.
Gerbillinae