The authors have studied on the effect of digital pressure on eyeball under the surface anesthesia instead of other reducing agents of intraocular pressure and retrobulbar anesthesia in order to lower the intraocular pressure as a preoperative procedure of cataract extraction in 26 eyeballs of 24 patients and following results were obtained: 1. The authors had intraocular pressure lowered till averaging 10.8 mmHg (average 13.5 ~ 8.0 mmHg) of original pressure by ocular massage. 2. Massage on eyeball was thought to be a satisfactory preoperative procedure to perform cataract extractIon. 3. In operative complications, loss of vitreous and rupture of capsule were noticed 11.5% and 60% respectively. and it was thought to be caused by technical failure in surgeons. In view of this fact we could not find that the loss of vitreous was caused by intraocular pressure below 13.5 mmHg.
Anesthesia ; Cataract Extraction* ; Cataract* ; Humans ; Intraocular Pressure ; Massage* ; Preoperative Care ; Reducing Agents ; Rupture

OBJECTIVE: To study the changes of magnetic evoked potentials by thinking of simple motion without actual muscle action of that motion. METHOD: We use H-reflex to test the excitability of relevant pools of spinal motor neurons and Magnetic Evoked Potentials (MEPs) to study the core of brain motor activity. The H-reflex and MEPs were obtained in three different conditions. 1) non-facilitation (NF), that is, resting state without actual motion and without thinking of that motion. 2) volitional-faciliation (VF), with actual motion which is usual manner of facilitation of MEPs. 3) thinking-facilitation (TF), without actual motion but with imaginary thinking of that motion. We evaluate the thresholds, amplitudes and latencies of H-reflex and MEPs in each three condition. RESULTS: Comparing with the parameters in NF condition as a baseline, there were no significant changes in any parameters of H-reflex in TF condition, but there were significant changes in threshold and amplitude of H-reflex in VF. On the while there were significant changes both in VF and TF of MEPs. The amount of facilitation of MEPs were greater in VF than in TF; the amount threshold decrement, amplitude increment and latency decrement of MEPs were greater in VF than in TF. CONCLUSION: Thinking of simple motion without actual muscle action of that motion could facilitate the MEPs, and this facilitation is induced by increasing activity of brain motor cortex not by that of spinal cord level.
Brain ; Evoked Potentials* ; H-Reflex ; Motor Activity ; Motor Cortex ; Motor Neurons ; Spinal Cord ; Thinking*

OBJECTIVE: This study was designed to evaluate the usefulness of stretch reflex threshold speed (SRTS) in biomechanical assesment of spasticity of hemiplegic patients. METHOD: Thirty-eight hemiplegic patients and twenty-seven control subjects were studied. The spasticity of ankle plantar flexor muscles were assessed both clinically and biomechanically. Modified Ashworth scale (MAS) and Brunnstrom stage were used in clinical assessment. For biomechanical assessment, ankle plantar flexor muscles were stretched isokinetically while EMG signals were recorded simultaneously. SRTS was defined as a minimum angular velocity in which EMG signals evoked by stretch reflex were recorded. RESULTS: SRTSs of ankle plantar flexors were 128.1 47.1o/sec in control group, 163.7 79.7o/sec in intact legs, and 83.4 69.1o/sec in involved legs of hemiplegic group. STRS was significantly lower in involved legs of hemiplegic group than in intact legs of hemiplegic group and control group. Significant reverse correlation was observed between SRTS and MAS. There was significant difference in SRTS between MAS 0 group and other groups. The patients with Brunnstrom stage 3 and 4 groups showed decreased SRTS compared to the patients with other groups. CONCLUSION: SRTS is thought to reflect increased excitability of stretch reflex and seems to be one of useful parameters in quantitative assessment of spasticity.
Ankle ; Equidae ; Hemiplegia ; Humans ; Leg ; Muscle Spasticity* ; Muscles ; Reflex, Stretch*

OBJECTIVE: To observe changes in reflex threshold and gain in spastic muscles and to find useful parameters in biomechanical assessment of spasticity. METHOD: Ankle plantar flexor muscles of twenty two hemiplegic patients were stretched by isokinetic dynamometer. Stretching was done at the velocities of 10degrees/sec, 300degrees/sec, and at the threshold velocity (e.g. lowest velocity at which electromyographic evidence of stretch reflex was recorded). Peak eccentric torque, torque at joint angle of 20degrees, torque threshold angle, and stiffness index were measured. RESULTS: Peak eccentric torque and stiffness index were increased and torque threshold angle was decreased in hemiplegic side. Peak eccentric torque and stiffness index were increased at 300degrees/sec compared to 10degrees/sec. Stiffness index showed significant correlation with modified Ashworth scale at 300degrees/sec and threshold velocity. CONCLUSION: Both reflex threshold and reflex gain were changed in spastic muscles. Stiffness index was thought to be one of useful parameters in biomechanical assessment of spasticity.
Ankle ; Hemiplegia ; Humans ; Joints ; Muscle Spasticity* ; Muscles ; Reflex ; Reflex, Stretch ; Torque*

OBJECTIVE: To find out the incidence of reduced median conduction velocity of forearm (MNCV-F) in carpal tunnel syndrome (CTS) and to compare clinical and electrophysiologic characteristics of CTS with reduced MNCV-F and to observe the changes of reduced MNCV-F after carpal tunnel release. METHOD: One hundred and fifty nine hands with CTS are divided into two groups; MNCV-F of 50 m/sec and above as group I and that of below 50 m/sec as group II. For the electrophysiologic comparison, median sensorimotor distal latency, peak-to-peak amplitudes and abnormal spontaneous activity of abductor pollicis brevis were observed and for clinical comparison, sensorimotor symptoms, Phalen and Tinel sign were observed. Twenty four hands which had successful carpal tunnel release were examined for the changes of MNCV-F. RESULTS: The hands with reduced MNCV-F were 29 among 159 hands. Sensorimotor distal latency were significantly prolonged and sensorimotor amplitudes also significantly reduced in group II. Sensory change and Phalen signs were more frequently observed in group II. MNCV-F in group I had not changed after carpal tunnel release, but MNCV-F in group II was improved significantly. The changes MNCV-F in group II were much delayed than the improvement of parameters of distal conduction studies. CONCLUSION: The incidence of reduced MNCV-F in CTS was 18.24%. Patients with reduced MNCV-F had more severe CTS both electrophysiologically and clinically. Reduced MNCV-F had improved significantly, but there was significant time gap between the electrophysiologic improvements of distal and proximal portions of nerve. This findings may suggest that retrograde degeneration may play a partial role in reduced forearm motor nerve conduction velocity of the median nerve in CTS.
Carpal Tunnel Syndrome* ; Forearm* ; Hand ; Humans ; Incidence ; Median Nerve* ; Neural Conduction ; Retrograde Degeneration

PURPOSE: To assess the efficacy and resulting complications of tetracycline sclerotherapy in renal, hepatic, ovarian, and perivesical cysts. MATERIALS AND METHODS: We retrospectively reviewed 23 cases of benign cysts (16 renal, 4 hepatic, 2 ovarian, and 1 perivesical) in 22 patients in whom the condition was diagnosed or confirmed by either ultrasound, CT, or cytology, and who underwent percutaneous tetracycline sclerotherapy. Using a 21-gauge Chiba needle, the target cyst was punctured under ultrasound guidance. Prior to the injection of 1500 mg of tetracycline diluted in 5 ml of normal saline, almost all the cystic content was aspirated, and at the end of the procedure the tetra-cycline was left in the cyst. During a period of between 3 and 22 months, 18 of the 23 cases were followed up. RESULT: In six of the 18 cases followed up, the cysts either decreased in size by 10%, or collapsed completely. In seven cases a collapse of over 50% was noted, and in the remaining five the cyst recurred. In one of these, complete collapse occurred after retreatment at ten months, and the patient with a perivesical cyst underwent surgery six months after recurrence. Thus, treatment was effective (a collapse of at least 50%) in 13 of 18 cases (72.2%). This total of 13 comprised ten of 12 renal cysts (83.3%), two of two ovarian (100%), and one of three hepatic (33.3%). Percutaneous therapy was unsuccessful in five cases (two hepatic cysts, one renal, one para-pelvic and one perivesical). Complications occurring during the procedure or follow-up period included discomfort or mild pain, vomiting, and transient fever, though these subsided within 24 hours. In one patient with severe pain, this subsided after four days. CONCLUSION: As single-shot injection of tetracycline provides safe and effective treatment for renal and ovarian cysts, but for hepatic cysts is unsuccessful.
Female ; Fever ; Follow-Up Studies ; Humans ; Needles ; Ovarian Cysts ; Recurrence ; Retreatment ; Retrospective Studies ; Sclerotherapy* ; Tetracycline* ; Ultrasonography ; Vomiting

Sciatic nerve palsy after total knee arthroplasty, accompanied by motor power weakness and electromyographic evidence, is a rare occurrence. In a 78-year-old female, pneumatic tourniquet was used for 72 minutes, with a pressure of 300 mmHg. The time and pressure are generally accepted values. We noticed sciatic nerve palsy showing motor power weakness and electromyographic evidence. One year after the operation, she recovered full motor power, but complained about a tingling sensation below the knee. Given that the nerve injury after using tourniquet was due to neural ischemia, and since our patient had vascular circulation problems such as atrial fibrillation and clip insertion due to internal carotid artery aneurysm, our patient can be considered as a high-risk patient with weakness to neural ischemic damage, even with the use of conventional tourniquet. Therefore, surgeons should be cautious when using tourniquet in patients with vascular circulation problems.
Aged ; Aneurysm ; Arthroplasty, Replacement, Knee* ; Atrial Fibrillation ; Carotid Artery, Internal ; Female ; Humans ; Ischemia ; Knee ; Sciatic Nerve* ; Sciatic Neuropathy ; Sensation ; Surgeons ; Tourniquets

PURPOSE : To determine the etiology of distant metastasis that was a major factor in the death of a patient with early stage non-small cell lung cancer (NSCLC). Recent studies have suggested that UFT may be effective adjuvant chemotherapy for completely resected early stage NSCLC. This study was designed to clarify the feasibility of UFT adjuvant chemotherapy in early stage NSCLC. MATERIALS AND METHODS : We administered UFT adjuvant chemotherapy for 24 months to patients with completely resected stage I NSCLC from January 2003 to January 2007 and compared the results in patients who did not receive UFT. The control group was recruited between March 1992 and December 2003. The UFT group was followed until death or the study cut-off date (20 October 2007). The control group was followed until September 2004. RESULTS : The UFT group was comprised of 28 patients. In the UFT group, 18 patients had adenocarcinomas and 10 patients had squamous cell carcinomas. The control group was comprised of 91 patients. In the control group, 34 patients had adenocarcinomas and 57 patients had squamous cell carcinomas. Thirty-five patients in the control group recurred (38.5%) and 9 patients in the UFT group (32%) recurred. CONCLUSION : The oral administration of UFT adjuvant chemotherapy was well-tolerated long-term without severe complications. Especially in stage I NSCLC, there was an improvement in the survival rate in patients treated with UFT, even though there was no statistical difference compared to the control group. Additional studies will be necessary to demonstrate the clinical significance of UFT treatment in early NSCLC
Adenocarcinoma ; Administration, Oral ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Survival Rate

OBJECTIVE: This study was designed to evaluate the correlation of periventricular leukomalacia (PVL) on brain MRI and Denver II and Capute developmental test. METHOD: Thirty children with PVL on brain MRI showing delayed development were included. The severity of PVL was graded as localized/generalized lesion in three fields; periventricular hyperintensity in T2 weighted image (PVHI in T2WI), reduced volume of cerebral white matter (RV of CWM), ventriculomegaly with periventricular wall irregula rity (VM with PVWI). Development quotients were obtained by Denver II and Capute test, and assessed according to the severity of PVL. RESULTS: Although language, fine motor-adaptive, personal- social scale of Denver II and cognitive-adaptive and clinical linguistic and auditory milestone of Capute test had little correlation with severity of PVL, gross motor developmental scale assessed by Denver II had a certain degree of correlation with severity of PVL which was not significant statistically. The gross motor developmental scale of the nineteen preterm births had a significant correlation with VM with PVWI, but the other developmental scales still had no significant correlation with PVL. CONCLUSION: As for the children with delayed development the degree of motor development was a significant predictor of the PVL on brain MRI, but those of language and cognitive development were not.
Brain* ; Child ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular* ; Linguistics ; Magnetic Resonance Imaging* ; Premature Birth ; Weights and Measures

OBJECTIVE: This study was designed to evaluate the effect of stretching on decreasing spasticity of ankle plantar flexor muscles by biomechanical assessments. METHOD: Twenty two ankle joints of nineteen patients with upper motor neuron lesion were included. The spasticity was assessed both clinically and biomechanically before and after stretching of ankle plantar flexor muscles by tilt table. For clinical assessment modified Ashworth scale (MAS) was used. For biomechanical assessment, ankle plantar flexor muscles were stretched isokinetically while EMG signals were recorded simultaneously and peak eccentric torque, stiffness index and stretch reflex threthold speed (SRTS) were measured. RESULTS: Two cases showed improvement in MAS after stretching but the others did not. SRTS of ankle plantar flexor was increased significantly while peak eccentric torque and stiffness index were unchanged. CONCLUSION: Passive stretching of ankle plantar flexor muscles decreased the stretch threshold, that is a neural component of spasticity but it did not decrease the mechanical component of spasticity.
Ankle Joint ; Ankle* ; Humans ; Motor Neurons ; Muscle Spasticity* ; Muscle Stretching Exercises* ; Muscles* ; Reflex, Stretch ; Torque