Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

The muscle glycogen is an important energy source for muscle contraction especially in prolonged exercise. One of the important factors for improvement of physical performance in athletes is the storage of extra-amount of glycogen (supercompensation) in liver and muscles. During 120 minutes treadmill exercise (intensity of exercise was approximatly 80% VO2max), the glycogen concentration was significantly decreased to 36% in liver and 46% in muscles after 60 minutes exercise. At 90 and 120 minutes of exercise, the level of glycogen concentration of liver and muscles statistically were not different from the levels of the 60 minutes exercise. The repletions of glycogen in the liver and muscles in overnight fasted control(C) and 120 minutes treadmill exercise(E) groups during l80minutes after glucose ingestion were investigatect. ln the liver, the concentration of glycogen in C and E groups were markdly increased till 120 minutes after zlucose ingestion, hut the levels of concentration at 180 minutes were decreased comparing to the levels of 120 minutes in both groups. In the muscles, the repletion of glycogen at 60, 120 and 180 minutes of C and E groups were significantly increased comparing to 0 minute of respective groups in the soleus and plantaris muscles. In soleus(SOL), the repletion of glycogen in all of the E groups was significantly higher than that of the respective C groups. However, the repletion of glycogen in all of the E groups of plantaris was revealed higher tendency comparing to respective C groups. Mean repletion rates of glycogen in liver and muscles after glucose ingestion were highest during the first 60 minutes in all groups and the rates of E groups were 2-3 times than those of respective C groups. These results suggest that the glycogen supercompensation in the muscle be provided with decrement of glycogen concentration by exercise, increment of glucose uptake by muscuiar contraction itself and increased insuJin level, and the activation of glycogen synthetase by insulin.
Animals ; Athletes ; Eating* ; Glucose* ; Glycogen Synthase ; Glycogen* ; Humans ; Insulin ; Liver* ; Muscle Contraction ; Muscles ; Rats*

The authors present a case of interstitial keratitis due to congenital syphilis in a 25-years old Korean army soldier, who had admitted to our Eye clinic at 2nd Feb. 68'. The patient may be present, such as interstitial keratitis, deafness and Hutchinson's teeth. Syphilitic interstitial keratitis is known as a rare case in recent time. A brief review of the related literatures is present.
Adult ; Deafness ; Humans ; Keratitis* ; Military Personnel ; Syphilis, Congenital*

The effects of intravenous Verapamil administration on ventricular function were evaluated using grated radionuclide ventriculography in 15 patients with essential hypertension. Verapamil(0.1mg/kg) was injected as a bolus for 2 minutes followed by an infusion of 0.007mg/kg/min. Heart rate, blood pressure, ejection fraction, peak ejection rate, total filling time, and prak filling rate were assessed before and after Verapamil administration. The results were was as follows ; 1) Verapamil administration increased heart rate from 63+/-5 to 75+/-9 beats/min(p<0.01) and reduced systolic and diastolic blood pressure from 156+/-17/99+/-6mmHg to 139+/-16/88+/-6mmHg(p<0.01). 2) Ejection fraction, peak ejection rate, and total filling time were not changed significantly after Verapamil injection. 3) Right and left ventricular peak filling rate increased significantly only in patients in whom it was subnormal in the basal study) from 1.6+/-0.4 to 2.3+/-1.1 end-diastolic volumes/s, p<0.05 and from 2.5+/-0.6 to 3.1+/-0.8 end-diastolic volumes/s, p<0.05, respectively). In conclusion, it was found that intravenous Verapamil administration enhances ventricular diatolic function in patients with essential hypertension.
Blood Pressure ; Heart Rate ; Humans ; Hypertension* ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Right* ; Verapamil*

Aneurysms of the great vein of Galen are rare and the authors report a case of primary type aneurysm of the great vein of Galen. Clinicaly aneurysm of great vein of Galen give rise to different symptoms and signs at different age. New born infants have intractable heart failure, infancy have hydrocephalus, and adolescents have headache and syncope. The diagnosis rests upon angiography, especially four-vessel angiography is mandatary to delineate all of the feeding arteries. The posterior cerebral arteries supply most of the blood to the aneurysm. The only effective treatment is ligation of the feeding vessels at the point of entry into the vein of Galen.
Adolescent ; Aneurysm* ; Angiography ; Arteries ; Cerebral Veins* ; Diagnosis ; Headache ; Heart Failure ; Humans ; Hydrocephalus ; Infant ; Ligation ; Posterior Cerebral Artery ; Syncope ; Veins*

Authors analysed 25 cases of the narrow spinal canal in cervical and lumbar region, who admitted to the Catholic Medical Center, Seoul from Jan. 1970 to August 1976. Correlation between neurologic feature and radiologic finding was attempted and compared the measurements of narrow cervical and lumbar spinal canal with that of the healthy Korean. The mean anterioposterior diameter of the cervical canal in healthy Korean was 16.2mm at C4, 16.4mm. at C5, 16.6mm. at C6, and 16.4mm. at C7. The ratio of canal to vertebral body in the plain lumbar spine was 1 : 3.9 at L3, 1 : 3.8 at L4 and 1 : 3.8 at L5. The measurements of 25 cases of narrow spinal canal were significantly reduced comparing with the healthy one. The clinical symptoms were closely related to the severity of the narrow spinal canal while there was intermittent or insidious course of symptom in the group of mild narrow spinal canal. Symptom of root compression or neurogenic claudication is frequent manifestation in the severe narrow spinal canal. and the symptom is correlated to the severity of the narrowing. Urinary disturbance and pyramidal tract sign were evident in the cervical narrow canal. The characteristic myelographic feature was multiple constrictive defect at the level of the narrow canal. Common findings in laminectomy were the thickened laminae and hypertrophied ligamentum flavum in the narrow canal. Herniated disc was not found but in one case in the cervical narrow canal at surgery. The recovery of the symptom was better in the group of the narrow canal who had mild degree of narrowing or who had the symptom in short duration rather than prolonged course.
Intervertebral Disc Displacement ; Laminectomy ; Ligamentum Flavum ; Lumbosacral Region ; Pyramidal Tracts ; Seoul ; Spinal Canal* ; Spine

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection

PURPOSE: To assess the usefulness of diffusion-weighted imaging(DWI) in evaluating serial parenchymal changesin renal infarction induced by renal artery ligation, by comparing this with the conventional spin echo techniqueand correlating the results with the histopathological findings. MATERIALS AND METHODS: In 22 rabbits, renalinfarction was induced by ligation of the renal artery. Spin-echo T1-weighted imaging(T1WI), turbo spin-echo(TSE)T2-weighted imaging(T2WI), and DWI were performed, using a 1.5-T superconductive unit, at 30 minutes, 1 hour, 2,3, 6, 12 and 24 hours, and 2, 3, 7 and 20 days after left renal artery ligation. Changes in signal intensity onT1WI, T2WI, and DWI were correlated with histopathologic findings. RESULTS: On MR images obtained 30 minutesafter ligation, the signal intensity of affected kidney was not significantly different from that of contralateralkidney, as seen on T1WI and T2WI, but was noticeably higher on DWI. On T2WI, the signal intensity ratio(SIR) wasslightly higher over time from 30 minutes to 2 days after ligation, and then decreased slightly. The SIR on DWIincreased abruptly at 30 minutes, remained high until 12 hours, and then fell, returning to close to the normalrange at between 2 and 3 days. It fell further, below the normal range, until 20 days after ligation. The mainhistopathologic findings after ligation were congestion and swelling of renal tubules (1-6 hours after ligation),degeneration and necrosis of renal tubules (12 hours - 2 days), coagulation necrosis of renal tubules(3 days),collection of cellular debris between renal tubules (7 days), and proliferation of fibroblast between renaltubules (20 days). CONCLUSION: Diffusion-weighted imaging is useful for the detection of hyperacute renalinfarction, and the apparent diffusion coefficient may provide additional information concerning its evolution.
Animals ; Diffusion ; Estrogens, Conjugated (USP) ; Fibroblasts ; Infarction* ; Kidney ; Ligation* ; Magnetic Resonance Imaging* ; Necrosis ; Rabbits* ; Reference Values ; Renal Artery*

A case changing blood pressure severely by manipulation of the huge tumor mass during the brain tumor surgery was observed. Decreased blood pressure (55/35 mmHg) might be caused by the stimulation of the brain increased to 150/75 mmHg after a neurosurgeon undermined and elevated the tomor mass, and blood pressure decreased again to 55/35 mmHg when he put it on the same position. Removing the mass completely, blood pressure was stabilized (about 130/70 mmHg). There are central vasomotor centers of autonomic nervous organization in the hypothalamus, midbrain, pons or medulla oblongata of the brain. By the stimulation of specific region in the above area, various features of responses were anatomically defined. The supratentorial contents may herniate through the tentorial incisura into the infratentorial spaces and posterior fossa, when intracranial pressure gradients become large enough to overcome the resistance of the brain tissue, and they can affect vital changes.
Blood Pressure* ; Brain Neoplasms* ; Brain* ; Hypothalamus ; Intracranial Pressure ; Medulla Oblongata ; Mesencephalon ; Pons

Intramedullary neurilemmoma of the spinal cord is extremely rare. This is not surprising, since schwann cells, considered the histogenetic source of such a tumor, normally are not present within the spinal cord. A case of intramedullary neurilemmoma in 47-year-old man is reported and the hypotheses as to it's origin are discussed. In a discussion on the origin of the condition, its is concluded that this case might have an origin from the dorsal root entry zone.
Humans ; Middle Aged ; Neurilemmoma* ; Schwann Cells ; Spinal Cord ; Spinal Nerve Roots