BACKGROUND: Various kinds of methods had been tried to reduce pain on injection of propofol. In this study, the effect of lidocaine pretreatment and that of temperature controlled injections were compared and evaluated its clinical utility. METHODS: One hundred and twenty patients were randomly allocated into 4 groups after permission. Room temperature propofol was used as induction agent in group P,. In group C, cooling (4 degrees C) propofol was used and warming propofol (37 degrees C) in group H. And room temperature propofol following lidocaine (1 mg/kg) was used in group L. Injection dosage of propofol was 2 mg/kg and injection speed was 2 ml/sec in all groups. In each patients, pain score and visual analog scale were measured and tested by ANOVA or Kruskal-Wallis test. RESULTS: There were no statistical significant difference in pain score among the 4 groups. But in visual analog scale analysis, group L markedly reduced values than the other groups by statistically significant manner (in Duncan grouping). CONCLUSION: The alleviating effect of lidocaine pretreatment on painful injection was better than that of changing temperature of propofol itself. More over effectiveness, in view of simplicity, we recommend lidocaine pretreatment.
Humans ; Lidocaine ; Propofol* ; Visual Analog Scale

No abstract available.

No abstract available.
Child* ; Hair* ; Humans

BACKGROUND: Postintubational sore throat and hoarseness are usually mild symptoms but they are very common complaints among the patients after endotracheal general anesthesia. In addition, some might have severe discomfort and need invasive procedure to relieve these problems. We tried new method of endotracheal tube cuff filling with local anesthetics to reduce postoperative sore throat and hoarseness and evaluated the results. METHODS: Endotracheal cuff filling was done with air 5 ml in healthy 20 patients (ASA I-II, control group). And in another healthy (ASA I-II) 35 patients, the cuffs were filled with 4% lidocaine 3.5 ml and 8.4% sodium bicarbonate 1.5 ml mixture. After 24 hours following general anesthesia, patients were visited and asked whether there were sore throat or hoarseness, if any, how the degree was. RESULTS: In lidocaine-treated group, the incidence of postintubational sore throat was less compared to control group significantly. There was no difference in incidence of hoarseness between two groups. CONCLUSION: Endotracheal cuff filled with lidocaine and sodium bicarbonate mixture is suggested as an effective protective method that reduces the frequency of postintubational sore throat.
Anesthesia* ; Anesthesia, General ; Anesthetics, Local ; Hoarseness* ; Humans ; Incidence ; Lidocaine* ; Pharyngitis* ; Sodium Bicarbonate* ; Sodium*

Background: and Purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods: We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including ‘spinocerebellar ataxia’ and several synonyms of ‘preataxic manifestation’. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results: We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament lightchain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.

Background: and Purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods: We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including ‘spinocerebellar ataxia’ and several synonyms of ‘preataxic manifestation’. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results: We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament lightchain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.

We report a patient with reactive arthritis induced by recent streptococcal infection. A 27 year man had suffered from fever, sore throat and pain on left sternoclavicular joint. Arthritis occurred two days after tonsillitis and involved left sternoclavicular joint. Left sternoclavicular joint showed redness, swelling and tenderness. There were no growth of microorganism in blood cultures, no evidence of group Abeta-streptococcus in throat cultures, but antistreptolysin-O (ASO) and c-reactive protein (CRP) serum titers were elevated in sequential monitoring. Bone scan showed focal hot uptake at left sternoclavicular joint and Gallium scan showed diffuse inflammation at left sternoclavicular joint and soft tissue biopsy around sternoclavicular joint showed mild chronic inflammation. We suspected septic arthritis and prescribed empirical antibiotics but his symptoms were wax and wane. From the poor responsiveness to antibiotics, sustained high titers of ASO and recent history of tonsillitis, we confirmed poststreptococcal reactive arthritis, and attempted high-dose anti-inflammatory drug (aspirin 6 gram). Left sternoclavicular and shoulder pain improved.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Arthritis, Reactive* ; Biopsy ; C-Reactive Protein ; Fever ; Gallium ; Humans ; Inflammation ; Palatine Tonsil ; Pharyngitis ; Pharynx ; Shoulder Pain ; Sternoclavicular Joint* ; Streptococcal Infections ; Tonsillitis

OBJECTIVE: In adhesive capsulitis, assessment of the mobility of the shoulder are likely to have intrinsic error because of the altering scapulohumeral rhythm and extrinsic error. For more objective and the precise assessment of shoulder mobility in adhesive capsulitis, we observed proper glenohumeral movement, the change of scapulohumeral angle, the scapulohumeral rhythm were evaluated with radiography and compared with clinical measurement of shoulder range of motion (ROM). METHOD: The subjects were 19 patients (21 shoulder) with adhesive capsulitis of the shoulder and undertook combination treatment of distention arthrography, per os medication of non-steroid anti- inflammatory drug, stellate ganglion block, physical therapy including exercise. We assessed change in visual analogue scale (VAS), joint space capacity, shoulder mobility by measurement of ROM, and scapulohumeral angle in active shoulder abduction under the fluroscopy. RESULTS: All the subjects experienced pain relief, increased shoulder mobility and restoration of scapulohumeral rhythm. The improvement of the shoulder extension and scapulohumeral angle is well correlated with the change of VAS and joint capacity. However, the improvement of the shoulder flexion, abduction, external rotation and internal rotation were poor correlated with them. CONCLUSION: We propose the measurement of scapulohumeral angle with active shoulder abduction in shoulder AP view as an assessment method for shoulder mobility in adhesive capsulitis.
Adhesives* ; Arthrography ; Bursitis* ; Humans ; Joints ; Radiography* ; Range of Motion, Articular ; Shoulder* ; Stellate Ganglion ; Treatment Outcome*

OBJECTIVE: The purpose of this study was to evaluate the effects of the prolotherapy on the healing of the tendon tissue and the proliferation of fibroblasts in the injured Achilles tendons. METHOD: The tendons of twenty eight Sprague-Dawley rats were transected at 2 mm above the calcaneal insertion in the right Achilles tendon and sutured. Then they were allocated randomly into two groups: prolotherapy group and control group. We injected 20% dextrose 0.1 ml on injured tendon area of prolotherapy group immediately after transection. After 2 and 4 weeks, the diameters of tendons were measured on both the injured and uninjured tendon. The number of fibroblasts and the ratio of fibroblast to fibrocyte on the injured tendon tissues were measured by the image analyzer. RESULTS: The diameters of the injured tendons of the prolotherapy group were not significantly different with that of the control group. However, the number of fibroblasts and the ratio of fibroblast to fibrocyte in the prolotherapy group showed significantly larger and more increased than the control group (p<0.05). CONCLUSION: This result showed the additional regeneration effect of the prolotherapy on the healing of the injured tendon tissue. Therefore, the prolotherapy would be an effective treatment on the tendon injury.
Achilles Tendon* ; Animals ; Fibroblasts ; Glucose ; Models, Animal* ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Tendon Injuries ; Tendons

OBJECTIVE: The purpose of this study was to observe the characteristics of the clinical improvement and the electrodiagnostic study in non-traumatic facial nerve palsy. METHOD: The clinical observation and the electrodiagnostic study were done in 57 of 266 patients who were treated at the Kyunghee Medical Center from December 2000 to July 2001. The initial study was done at 2 weeks from the onset time, and the follow-up study was done at 3 months later. The blink reflex, nerve conduction study and needle EMG were done, and made a statistical comparison between the initial and follow-up study. RESULTS: The clinical improvement and the change of the electrodiagnostic study between the initial and follow-up study were remarkable in the patients with expected to be good and fair prognosis. In the electrodiagnosis study, there were no statistical correlations on the % degeneration of the CMAP amplitude in the patients with expected to be poor prognosis. CONCLUSION: Although the ideal electrodiagnostic study does not yet exist, the best method of evaluating the facial nerve is side-to-side evoked amplitude comparison, and not only the initial study but also the follow-up, this method would be very useful.
Blinking ; Electrodiagnosis ; Facial Nerve* ; Follow-Up Studies ; Humans ; Needles ; Neural Conduction ; Paralysis* ; Prognosis