No abstract available.
Action Potentials* ; Adult* ; Humans ; Median Nerve* ; Ulnar Nerve*

The author had experienced 67 cases of blepharoptosis to be operated, such as anterior approach (Berke, 33 cases), posterior appoach (Iliff, 24 cases) and frontalis suspension with 2-0 supramid (10 cases) from March 1967 to Dec. 1978. To obtsurgical results in blepharoptosis, it is necessary to select the appropriate operation for each case according to levator function, degree of ptosis and its etiology and the others. In cases of 5 mm or more levator function, the author attempted to resect the levator muscle through Iliff's posterior approach; but in cases of beween 3 mm and 4 mm, levator resection through Berke's anterior approach for indication of ptosis repair was selected. On the other hand, in cases of 2 mm or less levator function, frontalis suspenion was done with 2-0 supramid. "With levator resection decided upon, how much in to be resected levator muscle considering levator function and condition of its aponeurosis in each case. The results were as follows: 1. The sex distribution was in ratio of 3:2 with 36 females and 24 males. 2. In cases of unilateral ptosis, left lid was higher incidence than right lid. 3. The majority of the patients (72% of all cases) was operated between the second and the third decade. 4. The highest incidence of degree of ptosis was 3-4 mm which comprised 61% of all cases. 5. The levator functions were as follows; below 3 mm ... 34.3% (23 cases), between 4 mm and 7 mm ... 44.8% (30 cases). above 8 mm ... 25% (14 cases). 6. The good and fair surgical results were as follows; Iliff's posterior approach ... 58.3% (14 case), Berke's anterior approach ... 75.5% (25 cases), Frontalis suspension ... 29.1% (7 cases). 7. Undercorrection (12 cases, 18%) was the most common type of postoperative complication. In 12 cases of this complication, the author noted 8 cases in Iliff's posterior approach. 8. It was concluded that good surgical indications for blepharoptosis were Iliff's posterior approach with above 8 mm levator function, Berke's anterior aproach with above 3 mm levator function and frontalis suspension with below 3 mm levator function.
Blepharoptosis* ; Female ; Hand ; Humans ; Incidence ; Male ; Nylons ; Postoperative Complications ; Sex Distribution

No abstract available.
Genetic Therapy*

PURPOSE: To determine the accuracy of MRI on postoperative pain syndrome (POPS), including early complications such as hematoma or infection. MATERIALS AND METHODS: Of the 54 patients with the POPS, we analyzed pre-operative MRI findings compared with operative findings on 39 patients, excluding nonunion, instability, metal failure and pseudarthrosis, who underwent an operation for POPS from December 1994 to June 1997. There were 25 men (64.1%) and 14 women (35.9%), aged from 16 to 68 years (average 44.5 years). They were divided into 5 subgroups and calculated for sensitivity, specificity and positive predictability. RESULTS: MRI accuracy in recurred disc was 84%, scar adhesion, recurred or developed stenosis, infection and hematoma was 100% for each overall accuracy of MRI was 93%. Average interval of reoperation in POPS was 3.2 years. In 21 cases (53.8%), symptoms persisted without pain-free interval after first operation. CONCLUSIONS: Early complications, including hematoma and infection, are easily detected with MRI. Especially if patient complains of severe leg pain or neurologic deficit, MRI is a good diagnostic tool. MRI is a useful method for evaluation of most cases of POPS, but it is limited in evaluating recurred disc or scar adhesion only in T1, T2 weighted image. Therefore, Gd-DTPA enhancement is necessary for an accurate diagnosis.
Cicatrix ; Constriction, Pathologic ; Diagnosis ; Female ; Gadolinium DTPA ; Hematoma ; Humans ; Leg ; Magnetic Resonance Imaging* ; Male ; Neurologic Manifestations ; Pain, Postoperative* ; Pseudarthrosis ; Reoperation ; Sensitivity and Specificity

PURPOSE: Medical treatment of Peyronie's disease with tamoxifen has been initially proposed as acting upon the early phase of the disease. As recent reports show no significant benefit of tamoxifen, we review the long term results of tamoxifen treatment of Peyronie's disease. MATERIALS AND METHODS: Time to progression during tamoxifen treatment of patients showing acute disease and chronic disease was compared. The acute phase was identified by pain during erection. Progression was defined as enlargement of plaque size or appearance of calcification. RESULTS: The average treatment duration was 15.9+/-13.8 months (range: 3 to 48 months). The median time to progression was 7 months for acute patients and 20 months for chronic patients. Eighty percent of patients in the acute phase showed relief of pain; however, overall progression was 72.1% (78.0% for acute, 66.7% for chronic). Patient history, comorbidities, serum testosterone or initial plaque characteristics, and severity of curvature were not predictive of disease progression. CONCLUSIONS: Tamoxifen showed no significant benefit in slowing the progression of Peyronie's disease in the acute phase over the chronic phase. Peyronie's disease continued to progress, though at a dampened rate for patient's in the chronic phase.
Acute Disease ; Chronic Disease ; Comorbidity ; Humans ; Male ; Penile Induration ; Tamoxifen ; Testosterone

No abstract available.
Female ; Female* ; Genitalia, Female* ; Humans ; Incidence*

Blind nasotrscheal intubation with preformed tube has been attempted in 20 conscious young male scheduled for surgical reduction of mandibular fracture. The patient was premedicated in the usual fashion with glycopyrrolate -midszolam- fentanyl. Airway anesthesia was performed with topical lidocaine ; Nasopharyngeal and translaryngeal. Of the 20 patients in whom intubation was performed, 12 (60%) required one to three attempts, 6 (30%) required four to six, and only two failures occurred. Contrary to our expectation, this procedure met with almost positive acceptance by the patients in the series, and the surgical staff had no adverse criticism. In addition to the effectiveness and ease of learning, this technique is simple and free from major morbidity.
Anesthesia ; Fentanyl ; Glycopyrrolate ; Humans ; Intubation* ; Learning ; Lidocaine ; Male ; Mandibular Fractures

The fiberscope is no longer an experimental instrument, and it is a state-of-the-art technique for airway management in the operating room, recovery room, and intensive care unit. Changing the oral tube to a nasal one is often necessary if the trachea is to be intubated for a long period. A nasal tube is better tolerated by the patient, is easier to secure when the patient is moved, and is easier to attach to the respiratory care equipment. We describe three cases report changing the oral tube to a nasal one in neurosurgical pa- tient post operatively under flexible fiberoptic laryngoscope, while the interruption of venti- lation is minimized.
Airway Management ; Humans ; Intensive Care Units ; Laryngoscopes* ; Operating Rooms ; Recovery Room ; Trachea

Hyperglycemic hyperosmolar state (HHS) is usually associated with type 2 diabetes mellitus (T2DM) with signigicant mortality and morbidity and is rare in pediatric population. The incidence of obesity and T2DM in children and adolescents is increasing at an alarming rate. With increasing rates of T2DM, the incidence of HHS may increase in pediatric population. HHS is characterized by severe hyperglycemia, a marked increase in serum osmolarity and clinical evidence of dehydration. The significance of HHS in children and adolescents remains largely unappreciated. We describe two obese adolescents with hyperglycemic hyperosmolar state at the onset of T2DM.
Adolescent ; Child ; Dehydration ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Hyperglycemic Hyperosmolar Nonketotic Coma ; Incidence ; Obesity ; Osmolar Concentration

OBJECTIVES: Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. METHODS: The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean +/- SD age of 58.1 +/- 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. RESULTS: The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). CONCLUSIONS: We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness.
Aging* ; Artifacts ; Delivery of Health Care* ; Discrimination (Psychology) ; Photoplethysmography* ; Pulse Wave Analysis* ; Vascular Stiffness