During ether anesthesia in man, succinylcholine(lmg/kg of body weight) was administered intravenously after pretreatment with 0.2% lidocaine 50-60mg or Inderal(1. 0mg). The effects were as follows: 1) Heart rates were increased during ether anestheaia. 2) Lidocaine produced no effects on heart rates rncreased by ether, but heart rates were decreased following administration of succinylcholine. 3) Inderal decreased heart rates, increased by ether anesthesia. Heart rates were increased following administration of succinylcholine.
Anesthesia ; Ether ; Heart Rate ; Lidocaine* ; Propranolol* ; Succinylcholine*

Early MRI and arthroscopic findings were compared to evaluate the efficacy of the former for patients, who upon physical examination, were diagnosed with possihle acute ACL tears. MRI, taken between 1-21 days after injury, had to reveal complete ACL tears and arthroscopic surgery should have taken place 3-12 weeks after the injury for patients of this prospective study. Fifty such cases were initially catagorized according to five MRI patterns. Types I to V were separated by the following ACL tear characteristics: Enlarged and diffusely increased in signal, horizontally oriented, non-visualized, discontinuous and vertically oriented. The cases were then divided into two groups of arthroscopic findings; Group A included cases of complete ACL tearing and group B included those with intact or minimally torn ACLs. Of MRI types I through V, there were 31, 9, 5, 4, and I cases of each respectively. 37 cases resulted in complete ACL tears (21 type I, 6 type II, 5 type III, 4 type IV and 1 type V) and 13 cases were catagorized into group B, 10 of which had pattern type I and 3 of which had pattern type II. As result, types III, IV and V had a 100% Positive Predictive Value (PPV) whereas types I and II together had a 67% PPV vaiue. Division of the cases into the five pattern types in early MRI proved valuble for possible cases of acute ACL tears. MRI pattern types III, IV and V were correlated with definite complete ACL tears. However, caution must be taken for types I and II, the majority of the cases, for which there exists a significant possibility for misdiagnosis and consequently unnecessary arthroscopic surgery.
Arthroscopy ; Diagnostic Errors ; Humans ; Knee ; Magnetic Resonance Imaging* ; Physical Examination ; Prospective Studies

We report a rare case of retinal detachment in colobomatous macrophthalmos with microcornea syndrome. A 25-year-old female who had suffered from poor vision in her left eye since early childhood and high myopia in her right eye (-11 D) visited our clinic because of a sudden deterioration of vision. Examination of the anterior segment showed microcornea with coloboma of the inferior pupil margin in the left iris. Fundus examination of the left eye revealed an inferior choroidal coloboma extending from the optic disc and macula. The patient also had total bullous retinal detachment. Pars plana vitrectomy with silicone oil tamponade was performed, and the retina was reattached. In the very rare condition of colobomatous macropthalmos with microcornea, retinal detachment may develop. Pars plana vitrectomy with additional silicone oil tamponade may be performed to treat this condition.
Adult ; Choroid/*abnormalities ; Coloboma/*complications/diagnosis ; Cornea/*abnormalities ; Female ; Follow-Up Studies ; Humans ; Retinal Detachment/diagnosis/*etiology/surgery ; Syndrome ; Vitrectomy/methods

It is well known that lidocaine and propranolol possess antiarrhythmic properties. In addition, the former has direct myocardial depressant effects with indirect stimulant effects mediated by the autonomic nervous system and the latter has negative chronotropic, inotropic and dromotropic effects through beta-adrenergic blockade. The heart rate is one of the principle determinants of myocardial oxygen demand, so prevention and treatment of tachycardia are very important during anesthesia. Therfore, the present study was undertaken to evaluate the effects of lidocaine(1mg/kg) and propranolol (0.02mg/kg) on the heart rates and blood pressures in patients with tachycardia(100~120 beats per minute) under halothane-nitrons oxide anesthesia. The results were as follows: 1) In the lidocaine receiving group, the heart rate and blood pressure decreased slightly, but these changes were not statistically significant. 2) in the propranolol receiving group, the heart rate decreased significantly and reached steady value(13bpm, p<0.01) at 7 min and blood pressure decreased slightly, but these changes were not statistically significant. 3) In propranolol-lidocaine mixture receiving group, heart rate decreased significantly and reached to steady value(13bpm, p<0.01) at 5 min and systolic blood pressure decreased about 5 torr(p<0.05), but the diastolic blood pressure remained unchanges. From the above results, it is suggested that the lidocaine and propranolol mixture rather than individual is more valuable in restoring the heart rate and blood pressure to normal value.
Anesthesia* ; Autonomic Nervous System ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Lidocaine* ; Oxygen ; Propranolol* ; Reference Values ; Tachycardia

PURPOSE: The purpose of this study was to identify awareness of hospital safety culture (AHSC) and safety activities (SA) of workers in a tertiary care hospital, and the factors influencing safety activities. METHODS: 303 Participants from the tertiary care hospital in Seoul were invited. Collected data were analyzed using SPSS 18.0. RESULTS: The level of AHSC and SA was 3.61 and 4.17, respectively. There were differences between AHSC and SA according to gender, religion, employment status, job class, working period, safety education, need for safety education, and number of safety accident reports. There was a positive relationship between AHSC and SA. The factors influencing SA were communication and process, employment status, and safety accident reports. CONCLUSION: AHSC and SA are important factors to improve hospital safety, as well as increasing chances to receive hospital accreditation.
Accreditation ; Education ; Employment ; Humans ; Safety Management* ; Seoul ; Tertiary Healthcare*

PURPOSE: To report the use of autologous Tenon's capsule graft for repair of scleral defects caused by traumatic scleral perforation. CASE SUMMARY: An 81-year-old man presented with loss of vision in his right eye after a perforating injury caused by a cow horn. Examination showed a laceration of the sclera at 12 o'clock approximately 5~6 mm in length, and a uveal tissue was prolapsed into the wound. The best corrected visual acuity was 0.1. Primary repair of the eye was insufficient because of tissue loss. The inferonasal Tenon's capsule graft was carefully dissected from the sclera and tailored to fit the defect. The graft was covered with a conjunctival flap. The scleral defect was successfully closed with the autologous Tenon's capsule graft. Three months after grafting, phacoemulsification with intraocular lens implantation was performed. CONCLUSIONS: Autologous Tenon's capsule graft is an effective measure to repair traumatic scleral defects and is useful when patch grafts are unexpectedly needed.
Aged, 80 and over ; Animals ; Eye ; Horns ; Humans ; Lacerations ; Lens Implantation, Intraocular ; Phacoemulsification ; Sclera ; Tenon Capsule ; Transplants ; Vision, Ocular ; Visual Acuity

Behcet's disease is a systemic vasculitis that is characterized mainly by recurrent oral and genital aphthous ulcers, uveitis, and skin findings. Its neurological manifestations are well recognized. Recurrent meningitis in Behcet's disease is exceptional. We describe herein the case of a 31-year-old man who presented with recurrent aseptic meningitis without any specific cause. A few years later he developed oral and genital ulcers, and uveitis. Behcet's disease should always be considered in a differential diagnosis of recurrent aseptic meningitis without viral infection, particularly in the context of multisystem manifestations.
Adult ; Diagnosis, Differential ; Humans ; Meningitis ; Meningitis, Aseptic ; Neurologic Manifestations ; Skin ; Stomatitis, Aphthous ; Systemic Vasculitis ; Ulcer ; Uveitis

Thirty-three trabeculectomies were performed in various types of glaucoma during the periolf of May 1976 to May 1977. Mishima's modified method was applied as a surgical technique following the possible medical treatment controlling the normal I.O.P. before operations: the operations were performed without surgical microscoping in the most cases. Success was achieved in 26 (78.8%) of the 33 cases. Trabeculectomy was very effective in all pur cases of 5 chronic simple glaucoma and 3 chronic narrow angle glaucoma. However, in acute narrow angle glaucoma, we gained the good results in normotensive cases following medical treatment before operation, the results were not good in the cases that I.O.P. was not controlled despite of the vigrous medical treatment. It seemed that trabeculectomy was more advisable operation than goniotomy in long standing congenital glaucoma and in previously failed case with goniotomy. Success was achieved in 5 of 6 congenital glaucoma(4 previously failed with goniotomy and 1 with very severe buphthalmos). It seemed that, in the previously operated eye(e.g. in failed case with other glaucoma surgery or in aphakic glaucoma) the sound lower half was rather preferable to the upper half for operating site.
Glaucoma* ; Glaucoma, Open-Angle ; Trabeculectomy*

A case of retinoblastoma and Coats' disease in the same eye is presented. Coexisitence of the retinoblastoma and Coats' disease is very rarely seen, though the retinoblastoma or the Coats' disease are not uncommon diseases. After the enucleatIon under the clinical diagnosis of retinoblastoma, the careful histopathological study disclosed the unusual findings of a typical Coats' disease containing predominent telangiectasis adjacent to the undifferentiated retinoblastoma cell mass. Differentiation of Coats' disease to the so-called Coats' reaction associated with a certain retinal disorders is emphasized on the histological view point.
Diagnosis ; Retinaldehyde ; Retinoblastoma* ; Telangiectasis

We did a follow-up study of 49 patients who had vitrectomy with removal of the macular epiretinal membrane. The patients were followed over 3 months (3-86 months). The patients had an average age of 39.3(13-72) years. Changes of postoperative visual acuity, complications, cause of poor visual outcome, and the prognostic factors were evaluated. 34 eyes(69.4%) showed improvement of visual acuity two lines or more compared to preoperative visual acuity and 25 eyes(51.0%) achieved a final visual acuity of 0.5 or better. Complications were noted in 13 eyes. They were consisted of cataract progression in 6 eyes, retinal break in 3 eyes, recurred membranes in 2 eyes, increased intraocular pressure and endophthalmitis in each eye. The causes of poor visual outcome related with the complications and the preoperative macular damages. Among the various prognostic factors, the preoperative visual acuity and the duration of disease show statistical significance in this study(p<0.001, p<0.002).
Cataract ; Endophthalmitis ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Membranes ; Retinal Perforations ; Visual Acuity ; Vitrectomy