BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa, resulting in postoperative sore throat and hoarseness. Numerous studies have investigated the factors as contributing causes, but the influence of method of anesthesia induction and time for extubation of the endotracheal tube has not been systematically examined. The aim of this study was to establish the effects of the methods of anesthesia induction and timing of extubation on postoperative sore throat and hoarseness. METHODS: Eighty patients with ASA physical status 1 or 2 were randomly divided into four groups. Group 1 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and early extubated ; group 2 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and lately extubated ; group 3 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and early extubated ; group 4 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and lately extubated. All patients were interviewed 6, 24, 48, and 72 hrs after operation by an anesthesiologist in a double-blind manner. RESULTS: The incidence of sore throat at postoperative 6 and 24 hrs were decreased in group 3 compaired with group 1, 2, and 4 (p<0.05), respectively. The severity of sore throat at postoperative 6 hrs were decreased in group 3 compared with group 1, 2 and 4 (p<0.05), and that of postoperative 24 hrs were decreased in group 3 compared with group 1 and 2 (p<0.05), respectively. The severity of hoarseness at postoperative 6 hrs were decreased in group 3 compared with group 2 (p<0.05). CONCLUSIONS: We suggest that postoperative sore throat and hoarseness may be developed more when extubation was perfomed lately than early. Therefore, early extubation provide advantage in terms of reducing sore throat and hoarseness in limited cases of anesthesia.
Anesthesia* ; Anesthesia, General ; Hoarseness* ; Humans ; Incidence ; Intubation ; Mucous Membrane ; Pancuronium ; Pharyngitis* ; Succinylcholine

No abstract available.
Heart Septal Defects, Ventricular* ; Oximetry*

The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.
Aged* ; Arthroscopy ; Decompression* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Shoulder Joint ; Shoulder Pain ; Shoulder*

Although many approaches have been attempted in the evaluation of liver size such as measurement of length,area and volume, the linear measurements have been used most frequently because of simplicity. We measured theliver size using 4 linear measurements for evaluation of hepatic pliability on plain abdominal film in the erectand the supine position. Our cases consisted of 125 persons who have no symptom or signs clinically and havenormal liver function test. The results were as follows: 1. The measurements of the liver size using diagonaldiameter(DD), oblique diameter of right lobe(OD), midline vertical diameter(MD) and height of right dome of theliver(HD) were ; 19.6+-1.8cm, 13.7+-1.6cm, 2.03+-0.4cm in the supine position; and 20.5+-2.1cm, 21.9+-2.1cm,15.4+-2.1cm, 1.87+-0.4cm in the erect position, respectively. 2. The differences of each diameter between erectand supine position were 0.9+-1.0cm in DD, 0.9+-1.0cm in OD and 1.7+-1.4cm in MD, and they were longer in thesupine position (p<0.001). 3. The HD was slinghtly longer in the supine position than in the erect position(p<0.001). 4. Among the 4 measurements, the largest difference of linear diameter between the erect and the supineposition was by MD. 5. We found the change or size and shape of the normal liver in the different position.
Humans ; Liver ; Liver Function Tests ; Pliability ; Supine Position

May–Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the commonvenous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problemis due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-oldfemale with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiographyand angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacementarthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then insertedafter angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case isreported along with review of the relevant literature.

OBJECTIVES: Many chronic schizophrenics are suffered from treatment-refractory hallucinations. As a countermeasure, the combined use of neuroleptics and benzodiazepines has been studied. In this context, the authors tried to evaluate the anti-hallucinatory effect of neuroleptics-clonazepam combination therapy. METHODS: At first, the authors described 3 cases of chronic schizophrenics who reported alleviation of hallucinations, which are resistant to neuroleptic treatment, after adding clonazepam. And then, prospective open study including 6 female chronic schizophrenic inpatients having neuroleptic-refractory hallucinations was done. In addition to existing psychiatric medication, these patients were treated with clonazepam 1.5 mg for 6weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 6 weeks of treatment. The psychopathology was assessed by the items of hallucinatory behavior and anxiety/tension of PANSS and BPRS. Clinical improvement was defined by fall-off of the hallucinatory behavior below the moderate level. The side effects were assessed by UKU Side Effect Rating Scale. RESULTS: All patients completed 6 weeks' trial. At the end of 6 weeks, 2 (33.3%) of 6 patients showed decrement of the hallucinatory behavior below the moderate level, when evaluated by PANSS and BPRS. However, the courses of anti-hallucinatory effect were different in these 2 patients. Another one patient showed that the hallucinatory behavior assessed by BPRS fell to the moderate level, but not when assessed by PANSS. The item of anxiety/tension was unchanged in all 6 patients. Except very mild sedation in one patient, there was no side effect. CONCLUSION: This study suggests that neuroleptics-clonazepam combination therapy is effective against treatment-refractory hallucinations in some schizophrenics and generally safe.
Antipsychotic Agents ; Benzodiazepines ; Clonazepam* ; Female ; Hallucinations* ; Humans ; Inpatients ; Prospective Studies ; Psychopathology ; Schizophrenia

No abstract available.
Diabetes Mellitus* ; Humans ; Neutrophils* ; Superoxides*

A 25-year-old 7 month pregnant woman with mitral stenosis was hospitalized because of life threatening hemoptysis dispite intensive medical treatment. Emergency mitral commissurotomy resulted in prompt cessation of hemorrhage and at nine months follows-up, the hemoptysis has not recurred. Mitral valve surgery appears to be consitently associated with rapid and sustained cessation of hemoptysis. Therefore, surgery should be considered in hemoptysis due to mitral stenosis, particulary when the danger of asphyxiation exists.
Adult ; Emergencies* ; Female ; Hemoptysis* ; Hemorrhage ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Pregnant Women

OBJECTIVES: Significant progress has been made in understanding psychosocial, psychological, and environmental factors associated with suicide. However it is only recently that attention has been paid to the understanding of the neurobiology of suicide. The aim of this study was to examine the relationship between platelet serotonin level and suicidal behavior and psychological features of the suicidal attempters. METHODS: After a suicidal attempt platelet serotonin level was measured from 21 patients and compared it with those from depression patients and normal controls. Also MMPI, HAM-D, Barratt impulsiveness scale(BIS) were done to evaluate their psychological features. RESULTS: 1) There was no significant difference in sex ratio of the suicidal attempters. 2) There was no significant difference in platelet serotonin levels among three groups. 3) The analysis of MMPI revealed that the scores of D, Hs, Pt in clinical scales were significantly higher in suicide patients and scores of D, Pa, Si were in depression patients. 4)The HAM-D score was significantly higher in depression and suicide patients, especially in depression patients. 5) The analysis of Barratt impulsiveness scale revealed that the scores of nonplanning, motor and cognitive impulsiveness scale were significantly higher in suicide patients. CONCLUSIONS: There was no significant difference in platelet serotonin levels among three groups. However the analysis of psychological features revealed significant differences. Therefore we concluded that psychological examinations are benefit to evaluate the suicidal tendency.
Blood Platelets* ; Depression ; Humans ; MMPI ; Neurobiology ; Serotonin* ; Sex Ratio ; Suicide ; Weights and Measures

PURPOSE: Details on the hemodynamic differences among Fontan operations remain unclear according to respiratory and cardiac cycles. This study was undertaken to investigate hemodynamic characteristics in different types of Fontan circulation by quantification of blood flow with the combined influence of cardiac and respiratory cycles. MATERIALS AND METHODS: Thirty-five patients [10 atriopulmonary connections (APC), 13 lateral tunnels (LT), and 12 extracardiac conduits (ECC)] were evaluated, and parameters were measured in the superior vena cava, inferior vena cava (IVC), hepatic vein (HV), baffles, conduits, and left and right pulmonary artery. Pulsatility index (PIx), respiratory variability index (RVI), net antegrade flow integral (NAFI), and inspiratory/expiratory blood flow (IQ/EQ) were measured by intravascular Doppler echocardiography. RESULTS: The PIx between APC and total cavopulmonary connection (TCPC; LT and ECC) showed significant differences at all interrogation points regardless of respiratory cycles. The PIxs of HVs and IVCs in APC significantly increased, compared with that in LT and ECC, and the RVI between APC and TCPC showed significant differences at all interrogation points (p < 0.05). The NAFI and IQ/EQ between APC and TCPC showed significant differences at some interrogation points (p < 0.05). CONCLUSION: Patients with different types of Fontan circulation show different hemodynamic characteristics in various areas of the Fontan tract, which may lead to different risks causing long-term complications. We believe the novel parameters developed in this study may be used to determine flow characteristics and may serve as a clinical basis of management in patients after Fontan operations.
Circulatory and Respiratory Physiological Phenomena ; Echocardiography, Doppler ; Fontan Procedure ; Hemodynamics ; Hepatic Veins ; Humans ; Pulmonary Artery ; Vena Cava, Inferior ; Vena Cava, Superior