The objectives of this study were to investigate and compare the efficacy for glycopyrrolate and atropine in the suppression of the OCR. Preoperative medication of the glycopyrrolate and atropine were studied in 114 pediatric patients for adequate prevention of the OCR. The results obtained were summarized as follows. 1) OCR occurred in 31.8% in Group I(use of atropine) and in 31.3% in Group II(use of Glycopyrrolate). 2) Traction on the extraocular muscles, particularly the medial or lateral rectus muscles most likely elicit the OCR, but there was not a significant difference in occurance of the PCR during each muscle traction. 3) There is great individual variation in response to muscle traction with in each group, no group was fully protected from marked slowing in heart rate. 4) The use of intramuscular administration of atropine or glycopyrrolate prior to induction has not been found to decrease the incidence of the reflex. 5) The dysrhythmias of the OCR were bradycardia, bigeminy, nodal rhythms, and ectopic beats.
Atropine* ; Bradycardia ; Glycopyrrolate* ; Heart Rate ; Humans ; Incidence ; Muscles ; Polymerase Chain Reaction ; Reflex ; Traction

Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

From May, 1985 to July, 1986, 500 cases of intraocular lenses were implanted, and all 500 cases had been followed up for more than 2 months. The results were as follows: 1. In the 500 cases of intraocular lens implantation, the number of patients were 318 men and 115 women. Patient's age was largely distributed to fifth decade in men and fourth decade in women. 2. IOL power ranged from +13.5D to +23.0D in PCL and ranged from +12.5D to +20.0D in ACL. The most frequently used IOL poeer was +19.5D in PCL and +18.0D in ACL. 3. Postoperative corrective vision with IOL was improved up to 0.8 or better in 446 cases(89.2%). 4. During operation, some complications were developed and those were posterior capsular rupture in 19 cases(3.8%), hyphema in 15 cases(3.0%), Descemet's membrane stripping in 2 cases(0.4%), and corneal edema in 1 case(0.2%). More frequently developed postoperative complications were clinical cystoid macular edema in 26 cases(5.2%), secondary glaucoma in 18 cases(3.6%), and distorted pupil in 13 cases(2.6%). 5. Postoperative corrective vision lower than 0.4 was observed in 22 cases(4.4 %), and the causes were diabetic retinopathy, cystoid macular edema, vitreous opacity, congenital cataract, phacoanaphylactic uveitis, endophthalmitis, amblyopia, optic nerve atrophy, corneal opacity, glaucoma, hypertensive retinopathy, and others.
Amblyopia ; Atrophy ; Cataract ; Corneal Edema ; Corneal Opacity ; Descemet Membrane ; Diabetic Retinopathy ; Endophthalmitis ; Female ; Glaucoma ; Humans ; Hypertensive Retinopathy ; Hyphema ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Macular Edema ; Male ; Optic Nerve ; Postoperative Complications ; Pupil ; Rupture ; Uveitis

OBJECTIVES: MR fluid-attenuated inversion recovery(FLAIR) image uses paired long inversion time and relaxation time that nulls the signal from CSF. With nulling of the CSF long echo time readout could be used to increase T2-weighting, hence improving the conspicuousness of most tissue lesions without the deleterious effects of CSF artifact seen on T2 weighted sequence. We examed the usefulness of FALIR image in the diagnosis of mild head injury. METHODS: A total of 38 patients with mild head injury were examined by FLAIR image. We compared those images with CT scan and T1, T2-weighted images. Careful observation of MR images were done by two well-trained neuroradiologists. Each image was compared for conspicuousness and detectability of traumatic lesions might have shown abnormal signal intensities. The Wilcoxon signed ranks test was used for statistical evaluation. RESULTS: The FLAIR image was significantly more sensitive than those of other images(p<0.001). T2 FFE(Fast Field Echo) image was more useful for detection of small petechial hemorrhages. CONCLUSION: FLAIR image is considered to be more sensitive than those of conventional MR images in the evaluation of mild head injuries.
Artifacts ; Craniocerebral Trauma* ; Diagnosis ; Head* ; Hemorrhage ; Humans ; Relaxation ; Tomography, X-Ray Computed

No abstract available.
Embryonic Structures* ; Humans* ; Upper Extremity*

Mental deterioration and signs of cerebellar dysfunction developed 5 years after lateral ventricle shunting in 36-year-old hydrocephalic female patient. Fourth ventricle enlargement was seen on CT scan. Reevaluation of the cerebrospinal fluid pathways with metrizamide ventriculography showed isolated fourth ventricle with aqueductal stenosis. Shunting of the fourth ventricle with an Y-connector returned the patient to normal neurological status.
Adult ; Cerebellar Diseases ; Cerebrospinal Fluid ; Female ; Fourth Ventricle* ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Metrizamide ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

The case of a 44-year-old female with extraskeletal osteosarcoma is reported. She had been treated by low anterior resection and radiation therapy due to rectal cancer (Modified Duke's classification B2) about 35 months ago. Also, she had a history of hematoma formation in a previous incision scar of the low mid-abdomen due to a fall. The patient developed a hard, nontender, fixed mass in the low abdominal wall after the hematoma. Treatment consisted of a wide surgical excision and local advanced flap. To our knowledge, an osteosarcoma of the abdominal wall is very rare, but the outlook for recovery is grave.
Abdominal Wall* ; Adult ; Cicatrix ; Classification ; Female ; Hematoma ; Humans ; Osteosarcoma* ; Rectal Neoplasms*

The case of a 44-year-old female with extraskeletal osteosarcoma is reported. She had been treated by low anterior resection and radiation therapy due to rectal cancer (Modified Duke's classification B2) about 35 months ago. Also, she had a history of hematoma formation in a previous incision scar of the low mid-abdomen due to a fall. The patient developed a hard, nontender, fixed mass in the low abdominal wall after the hematoma. Treatment consisted of a wide surgical excision and local advanced flap. To our knowledge, an osteosarcoma of the abdominal wall is very rare, but the outlook for recovery is grave.
Abdominal Wall* ; Adult ; Cicatrix ; Classification ; Female ; Hematoma ; Humans ; Osteosarcoma* ; Rectal Neoplasms*

OBJECTIVE: This research aimed to define the usefulness of the computerized neuropsychological test (CNT) for evaluation of cognitive deficit in the patients with brain injury. METHOD: Twenty five subjects with brain injury (16 males, 9 females) were enrolled. Their mean age was 39.2 years. All patient were assessed their cognitive function using CNT. The CNT consisted of digit span, verbal learning test, visual span test, visual learning test, auditory continuous performance test, auditory controlled continuous performance test, visual continuous performance test, visual controlled continuous performance test, word-color test, hypothesis formation test and trail making test. Scores of each subtest on CNT analysed according to the brain lesion and involved hemisphere of the patients. RESULTS: In patients with left hemisphere lesion, scores in digit span and verbal-learning test were lower than that of right side lesion (p<0.05). In contrast, patients with right hemisphere lesion showed significantly lower scores in visual span and visual-learning test (p<0.05). The patients with frontal lobe lesion marked lower scores in verbal-learning and word-color test than the patients without frontal lesion (p<0.01). Whereas the patients with parietal lobe lesion showed significantly lower scores in visual learning test (p<0.05) than the patients without parietal lesion. CONCLUSION: The cognitive deficit following the brain lesion could be characterized using CNT. CNT is considered to be used as a useful tool in the patients with brain injury for the assessment of their cognitive function.
Brain Injuries* ; Brain* ; Frontal Lobe ; Humans ; Learning ; Male ; Neuropsychological Tests* ; Parietal Lobe ; Rabeprazole ; Trail Making Test ; Verbal Learning

A 64-year-old male patient presented with hand numbness and gait disturbance. He had undergone cervical artificial disc replacement (C-ADR) at another hospital nine years earlier. Magnetic resonance imaging (MRI) revealed a protruded disc at the surgical level compressing the spinal cord. The implant and protruded disc were removed. Fusion was then performed. This case report highlights the importance of long-term follow-up of patients who have undergone C-ADR, and the need to be aware of the potential for late complications.In addition, it is important to ensure as complete a disk removal as possible during C-ADR.