Glycopyrrolate, a synthetic quarternary ammonium compound, has a similar pharmacologic property to that of scopolamine, a belladonna alkaloid. Since glycopyrrolate, a quarternary ammonium compound, dose not readily cross the blood brain barrier, it has less central effect than that of scopoiamine a tertiary-amine compound. The authors administered a small dose of scopolamine and glycopyrrolate to human volunteers, and examined the effect on the heart rate ofr both drugs. The results were as follows: 1) A small dose of scopolamine(0.1mg) showed significnat decrease in the heart rate. 2) A small dose of gylcopyrrolate(0.1mg) indeced little change in the heart rate. 3) A small dose of gylcopyrrolate(0.1mg), 10minutes after glycopyrrolate(0.1mg), showed marked increase in the heart rate. 4) A small dose of scopolamine(0.1mg), given 10 minutes after glycopyrrolate (0.1mg), showed tendency for decrease in heart kate. 5) A small dose of gylcopyrrolate(0.1mg), 10 minutes afterscopolamine(0.1mg), showed significant increases in the heart rate. 6) Scopolamine induced bradycardia was suppressed by an additional dose of glycopyrrolate and a preceding dose of glycopyrrolate.
Humans

A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

One case of cerebral embolism developed during cessation of supraventricular tachycardia in Wolff-Parkinson-White syndrome is reported with brief review. Twenty five years old, male was admitted to Seoul National University hospital with palpitation. He had numerous episodes of paroxysmal tachycardia for 3 years. He was diagnosed as Wolff-Parkinson-White syndrome at this hospital, ca 6 months prior to admission. Wolff-Parkinson-White syndrome was improved with atropine test at that time. The electrocardiogram on admission revealed Wolff-Parkinson-White synd rome associated with supraventricular tachycardia. He developed cerebral embolism after paroxysmal tachycardia of 22 days.
Atropine ; Electrocardiography ; Humans ; Intracranial Embolism* ; Male ; Seoul ; Tachycardia, Paroxysmal* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome*

The morbidity of spondylolisthesis tends to increase in accordance with the popularization of sports and increase of mean life span by the development of medicine. We had applied surgical treatment for 39 cases of spondylolisthesis during the period of 8 yrs. from Jan. 1976 to Dec. 1983 at Department of Orthopaedic Surgery, National Police Hospital, among them 35 cases were followed up for mean 27 months. Twenty eight cases with posterolateral spinal fusion were isthmic spondylolisthesis and seven cases with posterior spinal fusion and facetectomy were degenerative type. We analysed them with clinical aspects and surgical treatment for 35 cases. The results were as follows: 1. The most common clinical symptoms were low back pain (96.7%) and tenderness (93.5%). 2. The degree of slipping was Grade I by Meyerding's classification in all cases and mean 12.5% by Taillard method. 3. In the 7 cases of isthmic spondylolisthesis, the degree of slipping increased on standing lateral view. And in these cases the clinical symptoms were aggrevated at welking. 4. In the degenerative spondylolisthesis with posterior spinal fusion and facetectomy, we found mean 70% spontaneous correction of slipping commpared with preoperative. 5. In postoperative evaluation we gained 94.3% above good according to Gill's criteria and no pseudarthrosis.
Classification ; Humans ; Low Back Pain ; Methods ; Police ; Pseudarthrosis ; Spinal Fusion ; Spondylolisthesis ; Sports

Myositis Ossificans Traumatica, ossifying hematoma and calcifying hematoma have been used interchangeably to dcscribe the process of calcification and ossification occuring within muscle tissue in response to trauma. Authors analysed 27 cases of traumatic myositis ossificans of the Quadriceps who were diagnosed and treated at the department of orthopaedic surgery, National Police Hospital from January 1978 to June 1984. The results are as follows: 1. In sex distribution, in all cases 27 were males, in age distribution they were between 19 and 25 years old. 2. The causes of trauma consisted of 11 in kicking and treading, 6 in falling and slipping, 6 in football, 4 in demonstration injury. 3. The duration from injury to initial visit was variable. The average duration was 2 weeks. 4. Quadriceps contusions in all cases were grouped according to severity of trauma as mild, moderate and severe. Among 27 cases, 4 cases were mild, 11 cases were moderate, 12 cases were grouped as severe. According to the severity of trauma, duration of treatment and restoration of affected knee joint motion were more prolonged. 5. Among 27 cases, 6 cases sustained reinjury. 6. Total 27 cases, average duration of treatment was 4.6 weeks. 7. In those patients presenting after 2 weeks from injury, the duration of treatment was 3.8 weeks, and in those patients presenting within 2 weeks it was 5.4 weeks. Thc moderate cases were required 3.8 weeks of the duration of treatment, severe cases were required 6.5 weeks. Reinjury cases, 6 cases required more prolonged treatment, 6.8 weeks. These results suggest that early treatment, low violence of trauma and prevention of reinjury were the factor of minimizing the impairment of knee joint motion and shortening the duration of treatment. 8. The earlist X-ray change was found of the 14th day from injury. (average the 27th day from injury). 9. Within 6 months, all cases regained full range of motion of knee joint. 10. With only conservative treatment applied on all cases, we get the satisfactory result.
Accidental Falls ; Age Distribution ; Clinical Study ; Contusions ; Dronabinol ; Football ; Hematoma ; Humans ; Knee Joint ; Male ; Myositis Ossificans ; Myositis ; Police ; Quadriceps Muscle ; Range of Motion, Articular ; Sex Distribution ; Violence

Fracture of the scaphoid constitute 60% to 70% of all diagnosed carpal injury. The acute fracture will heal approximately 90% of the time if recognized early and properly immobilized. But nonunion are common since the symtoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Authors have experienced 19 cases of scaphoid nonunion and accomplished good result in all case by Russe procedure. The results were summerized as follow: 1 The cause of fratures was mainly due to fall down dinjury (36.8%). 2. The most common mechanism of the fracture was fall on the outstretched hand (52.7%). 3. Fractures were shown on the anterior-posterior, lateral and billiards view in all cases. 4. In ten cases, the fractures were found on the waist of scaphoid. 5. The cases of nonunion were probably inadequate intial treatment and delayed diagnosis. 6. The good results were obtained by bone graft according to Russe procedure.
Delayed Diagnosis ; Diagnosis ; Hand ; Humans ; Transplants

The herniation of intervertebral disc is possibly diagnosed through the myelography, electromyography, discography or computerized tomography. Among them, the myelography is regarded as the popularized method that helps accurate analysis on the location and pattern of the lesion. The authors have studied 363 cases of herniated intervertebral disc with respect to the diagnostic accuracy of myelographic examination from January, 1982 to December, 1985 at the Department of Orthopedic Surgery and Radiology, National Police Hospital. The results were as follows; 1. The most common age group was 21 to 30 years old and ratio of male and female was 9.7: l. 2. The most common site of the lesion was between L4 and L5 vertebra in myelography. 3. Of the 363 cases which underwent the myelography, 305(84.0%) represented positive findings. 4. Myelographic accuracy was coincided with the clinical diagnosis regarding the location of herniation of intervertebebral disc in 262 cases(72.1%).
Diagnosis ; Electromyography ; Female ; Humans ; Intervertebral Disc ; Male ; Methods ; Myelography ; Orthopedics ; Police ; Spine

Through the review of 137 cases of ankle fracture treated and followed up in Department of Orthopedic Surgery, National Police Hospital, we got the following results. 1. Slipping was the most frequent cause of the fractures(45.3%). 2. Supination-external rotation type of Lauge-Hansen classification was more common than any other types(67.9%). 3. 94 cases out of 137 cases were treated by open reduction and internal fixation, and remaining 43 cases were treated conservatively. 4. The average duration of cast immobilization was 7.3 weeks for the operatively treated cases and 9.1 weeks for the conservatively treated cases. 5. The result of treatment was good or excellent in 87 cases(92.6%) of operatively treated 94 cases and in 36 cases(83.7%) of conservatively treated 43 cases. 6. We think that the anatomical reduction of the lateral malleolar or distal fibular fracture is necessary for better end results.
Ankle Fractures ; Ankle ; Classification ; Clinical Study ; Humans ; Immobilization ; Orthopedics ; Police

No abstract available.
Histiocytosis*

No abstract available.