Rieger's syndrome is a rare autosomal dominant developmental anomaly characterized by ocular and systemic abnomalities. These disorders are typically bilateral and usually diagnosed at birth or in the childhood. The most common ocular defects are hypoplasia of the iris, a prominent Schwalbe's line with iris strands and corectopia. A large number of patients have glaucoma due to devel-opmental defects of the anterior chamber angle structure. The authors experienced a case of Rieger's syndrome which was found in 31-year-old female, who had characteristic ocular and other systemic abnormalities. Associated glaucoma was well controlled by filtering surgery.
Adult ; Anterior Chamber ; Atrophy ; Edema ; Female ; Filtering Surgery ; Frontal Lobe ; Glaucoma* ; Glioblastoma ; Humans ; Intracranial Pressure ; Iris ; Neurofibromatoses ; Optic Atrophy ; Optic Nerve ; Optic Nerve Diseases* ; Parturition ; Skin

Acute airway obstruction during endotracheal anesthesia is embarrassing and critical situation which requires early diagnosis and immediate management. The authors experienced extremely high inspiratory resistance and declared expiration time during endotracheal anesthesia for right pneumonectemy of lung cancer in the left decubitus position. A foreign material was suspected to be dislodged in the trachea distal to the endotrac-heal tube. But the surgical procedure did not allow to change the tube for examination. Ventilation was managed by rotating and moving the endotracheal tube frequently. After extubation, the patient expectorated a polypoid mass and the cause of the obstru-ction was proved to be a result of the detached and dislodged tumor mass of the lung, in diameter 3X1.5 cm.
Airway Obstruction ; Anesthesia ; Early Diagnosis ; Humans ; Lung ; Lung Neoplasms ; Trachea ; Ventilation

High-voltage electrical burns are associated with deep muscle injuries. A hidden, deep muscle injury has no specific clinical manifestations, and undetected muscle injury sometimes leads to septisemia or major amputations. From January to December 1996, 52 burned patients were admitted to the burn center. We evaluated their laboratory findings and the results of diagnostic tools. The items of study were urine, EKG, CK-MB, CPK, LDH, SGOT, SGPT, PYP scanning, Plethysmography, and arteriography. The presence of myoglobinuria and the increase in SGOT and SGPT two weeks after the injury were related to the extent of the burns. The PYP scanning was a very sensitive and useful tool for detecting hidden muscle injuries. The arteriographic findings were unsatisfactory for deciding the amputation level. The PCR findings converting to obstructive type were helpful in predicting possibile amputations.
Alanine Transaminase ; Amputation ; Angiography ; Aspartate Aminotransferases ; Burn Units ; Burns* ; Electrocardiography ; Humans ; Myoglobinuria ; Plethysmography* ; Polymerase Chain Reaction ; Radionuclide Imaging*

BACKGROUND/AIMS: The caudal anesthsia is most commonly used for benign anorectal surgery, The combination of long-acting anesthetics and opiates has been used for longer duration and successful control of postoperative pain. But the side effects of peridural anesthesics and morphine have commonly occured in caudal anesthesia. This study was performed to assess the difference in clinical effects between peridural mepivacaine and bupivacaine with morphine. METHODS: We evaluated the clinical effects in 60 patients who had anal operation with Jack-Knife position under caudal anesthesia. We divided randomly these 60 patients into two groups, M and B groups (in each group, 30 patients included). Group M (n=30) was given 2% mepivacaine 20 ml with morphine 2 mg caudally, and Group B (n=30) was given 0.5% bupivacaine 20 ml with morphine 2 mg in the same manner. We measured the onset time, duration, postoperative analgesia, and side effects including urinary retention. RESULTS: The onset time for analgesia was significantly shorter in group M than in group B. The duration of postoperative pain complaints was significantly longer in group M than in group B. The postoperative analgesic effects and side effects were not significantly different between two groups. CONCLUSIONS: Caudal mepivacaine and morphine mixture is effective for control of postoperative pain without significant side effects.
Analgesia ; Anesthesia, Caudal* ; Anesthetics ; Bupivacaine* ; Humans ; Mepivacaine* ; Morphine* ; Pain, Postoperative ; Urinary Retention

Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their numerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fracture and the remaining 11 were open. The comminuted and segmental fractures were 18 (57.7%) in number and the most common fracture site was the middle one third (53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
Accidents, Traffic ; Ankle ; Congenital Abnormalities ; Female ; Fractures, Bone ; Fractures, Closed ; Humans ; Male ; Orthopedics ; Soft Tissue Infections ; Tibia*

No abstract available.
Hand*

A 30-year-old primipara at 41 weeks gestation was admitted with regular labor pain and delivered a healthy male infant without complications except for a 4th degree tear of perineum. Two hours after delivery, she complained of sore throat and developed mild swelling of left side face, neck and upper chest. A chest radiography showed mild subcutaneous emphysema of neck. There was no pneumomediastinum and pneumothorax. She was managed conservatively and discharged without any complication at the 6th postpartum day. We report a rare case of subcutaneous emphysema with a brief review of literatures that presented shortly after vaginal delivery without complications except for a 4th degree perineal tear and resolved without special treatment.
Adult ; Female ; Humans ; Infant ; Labor Pain ; Male ; Mediastinal Emphysema ; Neck ; Obstetric Labor Complications ; Perineum ; Pharyngitis ; Pneumothorax ; Postpartum Period ; Pregnancy ; Radiography ; Subcutaneous Emphysema* ; Thorax ; Vacuum*

Tinea capitis in adults, especially healthy, is known to be rare but a significant increase in case has recently been observed. Trichophyton rubrum is an anthropophilic, the commonest dermatophyte affecting man but rarely involves the scalp and hair. We describe a 63-year-old healthy woman with tinea capitis due to T. rubrum who has clinical improvement after oral terbinafine therapy.
Adult* ; Arthrodermataceae ; Female ; Hair ; Humans ; Middle Aged ; Scalp ; Tinea Capitis* ; Tinea* ; Trichophyton*

BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons