Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

OBJECTIVE: Elucidation of questionable dementia of the Alzheimer type(QDAT) is important far accurate estimation of prevalence and incidence of dementia of the Alzheimer type, understanding of its natural history and evaluation of treatment strategies for dementia of the Alzheimer type. Subject and METHODS: Performances neuropsychological tests were compared between non-demented controls and 14 elderly people in a community diagnosed as having questionable senile dementia of the Alzheimer type. They lived in a rural community and their sex, age and education were controlled. RESULTS: The two groups were not significantly different comprehension and digit span of the Wechsler Memory Scale. Performances on arithmetic, similarity and block design were significantly lower in QDAT subjects. Scores on associate learning of the Wechsler Memory Stale and immediate and delayed recalls of logical memory were lower in QDAT subjects with statistical significance. performance on the semantic verbal fluency tended to the lower for the QDAT subjects. CONCLUSION: These findings suggest that QDAT may be early dementia of the Alzheimer type.
Aged* ; Aging ; Alzheimer Disease ; Cognition ; Comprehension ; Dementia* ; Education ; Humans ; Incidence ; Learning ; Logic ; Memory ; Natural History ; Neuropsychological Tests ; Prevalence ; Rural Population ; Semantics

The effect of prior administration of d-tubocurarine on the increased intraocular pressure associated with the use of succinylcholine was studied in 30 randomely selected human subjects, who did not have cardiopulmonary or ocular disease preoperatively. Intraocular pressures were measured with Schiotz tonometer. The major findings of this study were as follows: 1) When succinylcholine was given alone, a rise from 15.5mmHg to 18.OmmHg (16.1%) was seen(p<0.05). 2) When d-tubocurarine, 3mg, was given three minutes prior to the administration of succylchin oline, 15 healthy human subjects had no significant increase in intraocular pressure(p>0.05). 3) Intrsocular pressure were significantly increased in both groups after endotracheal intubation, but the d-tubocurarine precurarization group had minimal pressure compured to the succinylcholine alonegroup(p<0.05). An intraocular pressure increase was inhibited in the d-tubocurarine precurarization group. This simple, convenient method prevents the increased intraocular pressure associated with the use of succinylcholine.
Humans ; Intraocular Pressure* ; Intubation, Intratracheal ; Succinylcholine ; Tubocurarine*

PURPOSE: To evaluate the effects of threshold values, reconstruction interval, slice thickness and table speed on the spiral CT volumetry. MATERIALS AND METHODS: Two phantoms made of a balloon and diluted contrast media underwent spiral CT scanning with section thicknesses of 5, 7 and 10 mm and table speeds of 5, 8 and 10 mm with scans of 5 mm section thickness, 7, 10, and 14 mm with scans of 7 mm section thickness, and 10, 15, and 20 mm with scans of 10 mm section thickness. The volumetric values of phantom A and B were obtained at varying threshold values and a reconstruction interval of 5 and 10 mm for all scans. Volumes were also determined with the threshold value fixed and a reconstruction interval of 1, 5, 7 and 10 mm, respectively. Three-dimensional display and volumetric measurements were obtained using reconstructed images. The effects of threshold value, reconstruction interval, slice thickness and table speed on volumetry were analyzed. RESULTS: Volumetric values varied according to threshold values. Where a threshold value was low, value increased as pitch increased, but where a the threshold value was high, value decreased as pitch increased. With varying threshold values, measurement errors in hydrostatic volumetry were between 0.19 and 27.98%; at a fixed threshold value, measurement errors in CT volumetry were 1.6 to 9.0%. Volume decreased as reconstruc-tion interval increased. Where the table speed/ slice thickness ratio was constant, volume was constant though slice thickness differed. At fixed threshold values, variation in the reconstruction interval was statistically more significant than variation in slice thickness or table speed ( p<0.05, Kruskal-Wallis one-way ANOVA). CONCLUSION: Among serveral spiral scanning and image reconstruction parameters including threshold value, reconstruction interval, slice thickness, and table speed, threshold value most affected the result obtained. At fixed threshold values, the reconstruction interval usded had more effect on CT volumetry than other parameters.
Contrast Media ; Image Processing, Computer-Assisted ; Tomography, Spiral Computed*

No abstract available.
Humans

No abstract available.
Brain Abscess* ; Brain* ; Salmonella*

BACKGROUND: Endoscopic urologic surgery including transurethral resection of prostate (TURP) requires adequate sacral analgesia for insertion of resectoscope. But epidurally administered local anesthetic does not produce anesthetic effects uniformly. Failure to completely block S1 during epidural anesthesia because of the large size of nerve root has been noted. The purpose of this study to compare the relation between catheter direction and sensory anesthesia. METHODS: Thirty patients scheduled for endoscopic urologic surgery were enrolled. The epidural catheter was inserted at L3-4 using a standard 18 gauge Tuohy needle. In group A (n=15), the Tuohy needle with bevel pointed in a cephalad direction during catheter insertion. In group B (n=15), it pointed caudally. And the catheter was introduced 3 cm into the epidural space. After test dose, 2% lidocaine 5 cc, 0.5% bupivacaine 5 cc and 2% lidocaine 3 cc were administered with fractionate dose through it. The extent of the sensory anesthesia to loss of cold sensation and pin prick test was measured every 5minute for 30 minutes. RESULTS: Analgesia spread to loss of cold sensation and pin prick test was no significant statistical difference between the two groups. In 15 minutes after injection of surgical dose, complete blockade in L5, S1 dermatome was present in both groups. CONCLUSION: Our results conclude that epidural catheter direction is not significantly influence the epidural anesthetic spread including sacral area in continuous lumbar epidural anesthesia in elderly patients.
Aged ; Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthetics ; Bupivacaine ; Catheters* ; Epidural Space ; Humans ; Lidocaine ; Needles ; Sensation ; Transurethral Resection of Prostate

No abstract available.
Fructosamine* ; Hyperthyroidism*

A 19-year-old boy was admitted with complaints of headache and generalized seizure for 5 months. On physical examination, he had a moon-face, a farty breast, no sexual hair, and childish voice. Neurological examination showed no abnormality except slightly decreased visual acuity in the left eye. Lumbar CSF had total 194 leucocytes in a high power field, and among these 95% was lymphocyte. Marked sellar ballooning was seen in simple X-rays. Both carotid angiogram revealed bilateral A1 elevation as tent-like fashion, and subfrontal mass was suspected in lateral view. Transfrontal Conray ventriculography was done, and accidentally tumor cyst was punctured and dark pinkish blood was evacuated. Transcoronal ventriculography was again performed and we knew the cystic subfrontal midline mass. Tumor mass was nearly removed, and pathological report was germinoma. He was discharged and radiation theraphy was given. He is well for 7 months post-operatively.
Breast ; Frontal Lobe* ; Germinoma* ; Hair ; Headache ; Humans ; Lymphocytes ; Male ; Neurologic Examination ; Physical Examination ; Seizures ; Visual Acuity ; Voice ; Young Adult

A 19-year-old boy was admitted with complaints of headache and generalized seizure for 5 months. On physical examination, he had a moon-face, a farty breast, no sexual hair, and childish voice. Neurological examination showed no abnormality except slightly decreased visual acuity in the left eye. Lumbar CSF had total 194 leucocytes in a high power field, and among these 95% was lymphocyte. Marked sellar ballooning was seen in simple X-rays. Both carotid angiogram revealed bilateral A1 elevation as tent-like fashion, and subfrontal mass was suspected in lateral view. Transfrontal Conray ventriculography was done, and accidentally tumor cyst was punctured and dark pinkish blood was evacuated. Transcoronal ventriculography was again performed and we knew the cystic subfrontal midline mass. Tumor mass was nearly removed, and pathological report was germinoma. He was discharged and radiation theraphy was given. He is well for 7 months post-operatively.
Breast ; Frontal Lobe* ; Germinoma* ; Hair ; Headache ; Humans ; Lymphocytes ; Male ; Neurologic Examination ; Physical Examination ; Seizures ; Visual Acuity ; Voice ; Young Adult