No abstract available.
Tachycardia, Supraventricular* ; Tachycardia, Ventricular*

PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

No abstract available.
Child* ; Humans ; Pneumonia*

Thirty consecutive anesthesia records of transurethral resection (TUR) have been reviewed. Patient's physical status, anesthetic management and complications were also discussed. Operations in this series were classified as follows: 25 cases of TUR for carcinoma of the prostate, 3 cases of bladder tumor. In all the thirty cases of TUR, circulatory diseases, such as hypertension were encountered most frequently. (10 cases) The patients had the highest mean age(66.5 years old) and their physical status was almost all ASA class II or III. Hypotension occurred in 1 patient during TURP. There was no death associated with anesthesia and operation in this study. Pain control after operation with epidural block was satisfactory in nearly all cases. Continuous epidural anesthesia for TUR and pain control after operation was desirable.
Anesthesia ; Anesthesia, Epidural* ; Humans ; Hypertension ; Hypotension ; Pain, Postoperative* ; Prostate ; Transurethral Resection of Prostate ; Urinary Bladder Neoplasms

Postoperative pain control is very important not only for the relief of pain. but in the prevention of respiratory acidosis, pulmonary complications, emotional disturbances and sleeping disturbances etc. Jn spite of its significance there are a few studies on postoperative pain control in medical literature. Techniques have been developed for postoperative pain control since the 19 century, for example analgesics, inhalational agents, regional block, hypnosis and accupuncture. However none of these techniques was satisfactory because of various complications. The intermittent intramuscular injection of narcotics (e.g. meperidine) has been used most widely pto the present. There have been many complications, induding addiction, from this method. Our study was done in the recovery room with intramuscular injections of Thalamonal to fully awake patients, with 20 cases each having operation done in the upper abdomen, lower abdomen, and in other sites. We evaluated the results for the requirement of meperidine after the adminstration of Thalamonal. This was compared with the control group. There were 85% of cases that did not require the injection of meperidine. One case was complicated by hypotension, but this patient was improved with routine management for , hypotension. Other complications were not found.
Abdomen ; Acidosis, Respiratory ; Affective Symptoms ; Analgesics ; Humans ; Hypnosis ; Hypotension ; Injections, Intramuscular* ; Meperidine ; Narcotics ; Pain, Postoperative* ; Recovery Room

Cerebral cysticercosis, is unfortunately, a frequent disease in Korea. Cysticercosis in man is exclusively due to the development of Taenia solium larvae, called Cysticercus cellulosae, which is a frequent parasite in the pig. The clinical symptoms which are varied and similar to those of any other tumor of the brain, are depent on the location, number of parasite, intensity of infestation and susceptibility of the host. The headache, vertigo, nausea and vomiting, appearing periodically, and chiefly after a rapid change in the position of the head, were indicative of a cysticercus lying free in the fourth ventricle. We have recently experienced a case of cerebral cysticercosis which involved the 4th ventricle. A forty-year-old man was aditted to the Department of Neurosurgery, College of Medicine, Korea University in June, 1978 because of severe headache, repeated vomiting and diplopia which progressed gradually for two months previous to admission. On admission, there were no specific localizing and lateralizing neurological abnormalities except for signs of mild cerebellar dysfunction and signs of increased intracranial pressure accompanying with bilateral optic papilledema. Conray ventriculogram disclosed the dilation of proximal portion of the 4 th ventricle and smoothly rounded central filling defect of the 4 th ventricle. Brain C-T Scan demonstrated the marked dilation of 4 th ventricle in found shape without evidence of midline shift or compression. This enlarged 4 th ventricle with water density was shown no evidence of the contrast enhancement. Suboccipital craniectomy was performed and a cystic mass was removed from the fourth ventricle. Pathological diagnosis of the specimen was cysticercosis. Following surgery, the patient's symptoms cleared up and neurological deficits and papilledema improved gradually.
Brain ; Cerebellar Diseases ; Cysticercosis* ; Cysticercus ; Deception ; Diagnosis ; Diplopia ; Fourth Ventricle ; Head ; Headache ; Intracranial Pressure ; Korea ; Larva ; Nausea ; Neurosurgery ; Papilledema ; Parasites ; Taenia solium ; Vertigo ; Vomiting ; Water

Clinical experience using different anesthetic methods for intravenous regional anesthesia in extremities was compared, To group 1 (22 cases, 20 for upper extremity and 2 for lower extremity surgery, with 5 min. limb elevation) 1.5mg/kg Lidocaine hydrochloride was administered and a single pneumatic tourniquet applied. For both group 2 (15 patients, 10 for upper limb and 5 for lower limb operations with limb elevation) and group 3 (11 cases, all for upper extremity operations, but Esmarch bandages instead of pre tourniquet elevation) 3. 0 mg/kg Lidocaine hydroehloride was used and a second tourniquet placed distal to the first. In all groups the anesthetic concentration was 0. 5 and 0. 25 per cent for the upper and lower extremities respectfully. Pneumatic tourniquet pressure applied was 250 mmHg for the upper limb and 500mmHg for the lower. Excellent anesthesia resulted in 68. 2 per cent in group 1, 73.3 per cent in group 2, and 100 per cent in group 3. No serious complications were encountered. Incidence of incomplete anesthesia and/or tourniquet pain could be decreased by increasing the anesthetic concentration, using a secondary tourniquet, and by selecting the region to be anesthetized (upper extremities in favor of the lower). It is concluded that intravenous regional anesthesia is simple, effective and safe and is recommended for ambulatory patients, emergency operations and for patients for whom general anesthesia is deferred.
Anesthesia ; Anesthesia, Conduction* ; Anesthesia, General ; Bandages ; Emergencies ; Extremities ; Humans ; Incidence ; Lidocaine ; Lower Extremity ; Tourniquets ; Upper Extremity

The effects of sodium hypochlorite for the destruction of P. aeruginosa, E. coli, K. pneumonias and S. anreas and for the prevention of contamination of irrigation fluid, which is either exposed to ICU environment or used for cleansing oral or trachea catheter tips, were tested and the following results were obtained. 1) The sodium hypochlorite solution 1: 800 destroyed P. aeraginosa, E. coli, K. pneomoniue and S. aweas in 5 minutes. This bactericidal effect was observed to be retained after the solution had stood 24 hours. 2) Viable P. aeraginosa was not detected immediately, 5 minutes and 10 minutes after exposure to 1: 500, 1: 800 and 1: 1000 sodium hypochloride solutions respectively. 3) The sodium hypochlorite solution 1: 800 prevented contamination of the irrigation fluids during a 24 hour exposure to the ICU environment. 4) P. aeraginosa and other gram-negative bacilli were frequently isolated from the plain fluid used for irrigating and holding the suction tips which had been used for patients. However, no organisms were isolated from fluid containing sodium hypochlorite 1: 800 even after 24 hour usage. It is concluded that the use of fluid containing sodium hypochlorite for the irrigation of catheter tips can reduce development of infections in the ICU patients.
Catheters ; Humans ; Infection Control* ; Pneumonia ; Sodium Hypochlorite* ; Sodium* ; Suction ; Trachea

A 79-year-old male patient presented with a continuous transsacral epidural block for the treatment of herpes zoster pain on the right Tll-12 and Ll dermatome levels. However, it was impossible to introduce the Tuohy needle below the subcutaneous tissue. By the C-arm image intensifier, flowing calcifications of the lumbar paravertebral ligaments, except L5-Sl interspace, were observed. Thus, an epidural approach was tried at the L5-Sl interspace, but the Tuohy needle was introduced in the subarachnoid space instead of the epidural space. After an X-ray of the whole spine, diffuse idiopathetic skeletal hyperostosis was diagnosed. The Tuohy needle was introduced into the sacral canal through the second posterior sacral foramen and the epidural catheter was inserted about 15cm in length cephalad through the needle. The pain was controlled by the injection of 1% lidocaine and 0.5% bupivacaine every 3-4 hours continuously After 3 weeks this patient was discharged from hospital without any postherpetic sequelae.
Aged ; Bupivacaine ; Catheters ; Epidural Space ; Herpes Zoster ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Lidocaine ; Ligaments ; Male ; Needles ; Spine ; Subarachnoid Space ; Subcutaneous Tissue