The recovery process of brain damage caused by an acute severe cerebral hypoxia has been reported in various literatures. And the possibility of complete recovery of such case was said to be good in younger age group than in adult's group. We experienced a case of cardiac arrest of a 12 year old girl during halothane anesthesia induction and the cardiac and pulmonary resuscitation was succeeded promptly. But the hypotensive period persted for few minutes before the diagnosis was made. The condition of the patient after the resuscitation was good except that her unconsciousness state persisted unusually. The proposed appendectomy performed uneventfully and the anesthesia recovery of the patient was carefully observed in our I.C.U. The uncoscious state lasted for 2 days with agitated movements of legs, EEG showed abnormal, irregular patterns but showed no signs of damage of gobus pallidum and putamen. During the first month, the order of recovery of cerebral function was comatous state, swallowing, eating, and urination. The cerebellar dysunction was prominent. Then recovery of amnesia and defection followed. Speech and gate started to regain in the 26 and 36 post-operative day respectively. Writing function started recover quickly with the recovery of speech function, which occurred in 4 to 6 post-operative months. Recovery of intelligence was slowest and gradually reached to the intelligent level of 11 year old child in one year. It was found the primitive function recovered first and the highly cultivated function recovered last.
Amnesia ; Anesthesia* ; Appendectomy ; Brain* ; Child ; Deglutition ; Diagnosis ; Dihydroergotamine ; Eating ; Electroencephalography ; Female ; Halothane ; Heart Arrest* ; Humans ; Hypoxia, Brain ; Intelligence ; Leg ; Putamen ; Resuscitation ; Unconsciousness ; Urination ; Writing

This is a case report of pulmonary embolism which occurred as a complication of mesenteric venous stasis with sepais. This 49 year old nun was operated upon for an obstructed intestine under general anesthesia with halothane and d-tubocurarine. She had a hystrectomy for myoma 2 years ago and has ailed for 6 days from this condition. The patient became dyspneic and cyanotic suddenly three hours after the surgery. The chest X-ray revealed three or four bilateral, rounded and moderately increased densities, and her ECG showed a large S wave in limb leads, P-pulmonare, and right ventricular strain pattern with right axis deviation. CPPV with 100% oxygen by the manual method improved the condition of the patient for about three hours, but tachycardia and a failing heart could not be corrected in site of digitalis, steroid, diuretics and heparinization. The patient died 11 hours after the operation.
Anesthesia, General ; Digitalis ; Diuretics ; Electrocardiography ; Extremities ; Halothane ; Heart ; Heparin ; Humans ; Intestinal Obstruction* ; Intestines ; Methods ; Myoma ; Nuns ; Oxygen ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tubocurarine

We retrospectively investigated long-term visual prognosis following successful retinal reattachment in eyes with rhegmatogenous retinal detach-ment involving the macula. We operated 852 eyes using scleral buckling technique between May 1983 and May 1995. Among them 20 patients with macular detachment had been followed for more than three years postoperatively. The age range of patients was between 13 and 37 years[mean 23.6 +/-8.0]. Among 10 eyes, the best-corrected visual acuity at 3 years after surgery improved by one line than best-corrected visual acuity at 3 months postoperatively[improved group]. Among the other 10 eyes, no interval change was found during the period[unimproved group]. Improvement of long-term postoperative visual acuity was found to be statistically correlated with shorter duration of macular detachment[< or =30 days]and the location of detachment[inferior][p<0.05]. According to this study, surgeon should be aware that the visual function of reattached retina may improve during the long postoperative peroid, especially in eyes with above features.
Humans ; Prognosis ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Visual Acuity*

Meniscal tears are a common source of knee pain in military personnel. We aimed to investigate the arthroscopic findings of isolated meniscal tears in soldiers younger than 30 years of age. Between May 2011 and April 2014, a total of 36 soldiers with 37 knees who underwent arthroscopic surgeries for isolated meniscal tears were included in this study. All patients were male soldiers and average age was 22 years (range, 19 to 30 years). Thirty patients (83%) were identified as having trauma in sports activity or military training, but no definite trauma was documented in six patients. We analyzed whether medial or lateral meniscus, the location and type of tear according to the arthroscopic findings. The incidence of meniscal tears was nearly same for both knees (right 18 and left 19). Twenty-six of 37 tears (70%) were found in the lateral meniscus and 11 (30%) in the medial meniscus. Twenty-five tears (68%) were located in mid body and traumatic vertical type tears (65%) were more common than degenerative horizontal type tears (35%). Although our study based on relatively small cohort, isolated meniscal tears in young soldiers were usually resulted from trauma such as sports or ranger training and commonly located in lateral meniscus. Regarding the type of tear, traumatic vertical type was more common than degenerative horizontal type.
Arthroscopy ; Cohort Studies ; Humans ; Incidence ; Knee ; Male ; Menisci, Tibial ; Military Personnel* ; Sports ; Tears*

PURPOSE: To analyze the incidence, clinical characteristics and postoperative prognosis of simultaneous bilateral rhegmatogenous retinal detachment (SRD). METHODS: We retrospectively analyzed the medical records of 22 patients who visited the Department of Ophthalmology, Yeungnam University College of Medicine, for treatment of SRD and who had been in regular surveillance for at least 6 months. RESULTS: The incidence of SRD was 22 patients among 792 (2.8%). Eleven were male and 11 were female, and the average age was 27.6 years. Eighteen patients (81.8%) complained of visual disturbance and visual field defect of one eye, and myopia of more than -4.00D was noted in 30 eyes (68.2%). The size of the detached area was 2 quadrants in 19 eyes (43.2%). The most common type of retinal break was atrophic hole with lattice degeneration. The most common location of the break was the inferotemporal quadrant. The anatomical success rate of primary operation was 91.9% (34 of 37 eyes). CONCLUSIONS: Simultaneous bilateral rhegmatogenous retinal detachment was associated with young age, and myopia. As for the retinal break, the most common type was atrophic hole with lattice degeneration, and the most common location was the inferotemporal quadrant.
Female ; Male ; Humans ; Incidence

BACKGROUND: Exposure to Rhus (Japanese lacquer) can cause many adverse effects such as contact dermatitis, pruritus, rash and even hepatitis in human, and these effects can be caused by contact or ingestion of Japanese lacquer. Many Koreans currently eat Japanese lacquer boiled with chicken although it has many side effects. Koreans believe that Rhus will improve their health. However, they don't known its adverse effects, and there is no experimental report on this topic. OBJECTIVE: The principle objective of this study was to gather evidence on the toxicity and negative effects of Japanese lacquer through an experimental study with rats. METHODS: A total of 60 Sprague-Dawley rats were included in the study; 30 rats (experimental group) were given 0.1 ml of Japanese lacquer sap extract, water and food, and 30 rats (control group) were given only food and water. The WBC, the Hgb, ALT, AST, BUN and creatinine levels, the presence of pruritis and skin eruption, the skin biopsy findings and the liver biopsy findings were all checked at 5, 10, and 15 days. RESULTS: The rats that were given Japanese lacquer sap showed a higher WBC and higher ALT and AST levels and only these rats demonstrated erythroderma (5th day: 30%, 10th day: 40%, 15th day: 70%). In addition, they exhibited frequently scratching behavior. On histological examination of the skin of the rats given Rhus, dermal edema and mild inflammatory cell infiltration were found. On histological examination of the liver of the rats given Rhus, there was no significant change as compared with the rats that weren't given lacquer. CONCLUSION: In this experimental study, it was proven that Rhus could induce pruritis, erythroderma, skin inflammation and hepatotoxicity.
Animals ; Asian Continental Ancestry Group ; Biopsy ; Chickens ; Creatinine ; Dermatitis, Contact ; Dermatitis, Exfoliative ; Eating ; Edema ; Exanthema ; Hepatitis ; Humans ; Inflammation ; Lacquer ; Liver ; Pruritus ; Rats ; Rats, Sprague-Dawley ; Rhus ; Skin ; Water

Parry-Romberg syndrome is an extremely rare connective tissue disorder. It might be a form of linear scleroderma, and it manifests as progressive hemifacial atrophy, epilepsy, exophthalmos or alopecia. Herein we report a case of Parry-Romberg syndrome. A 68-year-old woman had left hemifacial atrophy, shortening and deformity of the left leg, and deformities to her side fingers that occurred from her 1st decade to 2nd decade. Sclerotic change had stopped spontaneously when she was 20 years old. Histopathologically, there were a few signs of skin appendages, but no sclerotic change. On autoimmune antibody test, no positivity was shown. X-ray showed shrinkage of the lung field, elevation of the left diaphragm, shortening of length and reduction of bone mass in the left femur, tibia, and fibula. And there were multiple melorheostasis. Neck CT showed left facial sclerotic change, bone mass loss, and multiple melorheostasis. Because the progression of sclerosis had stopped the patient did not receive any treatment.
Aged ; Alopecia ; Congenital Abnormalities ; Connective Tissue ; Diaphragm ; Epilepsy ; Exophthalmos ; Facial Hemiatrophy ; Female ; Femur ; Fibula ; Fingers ; Humans ; Leg ; Lower Extremity ; Lung ; Neck ; Scleroderma, Localized ; Sclerosis ; Skin ; Tibia

PURPOSE: To report the clinical finding of 3 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). CASE SUMMARY: Five eyes of 3 patients with focal choroidal excavation detected by SD-OCT were enrolled in the present study. All patients had myopia (average refractive power -5.60 diopter). Two of the 3 patients had focal choroidal excavation in both eyes. All 5 eyes revealed foveal pigmentary changes on fundus examination. The excavation area in the autofluorescence image was hypofluorescent. Fluorescein angiographic finding was normal to various degrees of hyperfluoresence. Indocyanine green angiography revealed hypofluoresence at the excavation area. The excavation involoved from the retinal pigment epithelium layer to the external limiting membrane or outer nuclear layer and average choroidal thickness at excavation were statistically thinner than the uninvolved area based on SD-OCT (p = 0.002). Retinoschisis, serous pigment epithelial detachment and choroidal neovascularziation (CNV) were detected individually in 3 eyes. The other 2 eyes had no specific abnormalities. CONCLUSIONS: During the follow-up period, the choroidal excavation remained relatively stable in 4 of 5 eyes, but CNV developed in 1 eye. Therefore, intravitreal bevacizumab injection was performed. Longer follow-up periods are necessary to determine the etiology, clinical course and visual prognosis of eyes with focal choroidal excavation.
Angiography ; Choroid* ; Fluorescein ; Follow-Up Studies ; Humans ; Indocyanine Green ; Membranes ; Myopia ; Prognosis ; Retinal Pigment Epithelium ; Retinoschisis ; Tomography, Optical Coherence* ; Bevacizumab

PURPOSE: To compare the anatomical and functional results of vitrectomy for macular hole with and without prone posture. METHODS: We retrospectively reviewed the medical records of 71 eyes of 71 patients who received macular hole repair and were followed up for at least 6 months. The anatomical success, complications, and best corrected visual acuity at postoperative 6 months and last follow-up between patients who were advised to take a prone posture for 1 week (group 1) and patients who were advised to simply avoid the supine position right from the surgery (group 2) were analyzed. Subgroup division analysis according to macular hole size and concurrent phacoemulsification was performed. RESULTS: Macular hole closure rate was 91.7% (33 of 36 eyes) in group 1 and 88.6% (31 of 35 eyes) in group 2 (p=0.710). The mean visual acuity at final follow-up increased in both groups by 4.75 +/- 3.83 and 4.76 +/- 2.96 lines, respectively and revealed no statistically significant difference (p = 0.988). Twenty-seven of 36 eyes (75%) in group 1 and 30 of 35 eyes (85.7%) in group 2 underwent concurrent phacoemulsification, and no difference in macular hole closure rate and visual acuity improvement between the two postures was observed. CONCLUSIONS: Favorable anatomical and functional outcomes were achieved without postoperative face-down posturing in the case of phacovitrectomy with wide internal limiting membrane peeling and gas tamponade.
Follow-Up Studies ; General Surgery* ; Humans ; Medical Records ; Membranes ; Phacoemulsification ; Posture ; Retinal Perforations* ; Retrospective Studies ; Supine Position ; Visual Acuity ; Vitrectomy*

A 32-year-old woman had a brownish hard plaque with localized hypertrichosis. She had fallen down some stairs 1 year previously, and the injury had left a scar on her right shin. Even though pain and the scar had gone, the brown patch had remained. During that time hair had been grown on the site. Histologic examination showed lobular panniculitis, fat necrosis, fibrotic change and lipomembranous change. We diagnosed the patient as a traumatic panniculitis with localized hypertrichosis, based on the trauma history, skin lesion and histologic findings. We report a case of traumatic panniculitis with localized hypertrichosis.
Adult ; Cicatrix ; Fat Necrosis ; Female ; Hair ; Humans ; Hypertrichosis ; Panniculitis ; Skin