Lidocaine is considered a safe and effective local anesthetic in anesthesiology and is the standard to which new amide anesthetics are compared. As it an amide derivative, and the frequency with which lidocaine elicits an allergic response is much less than that of anesthetics derived from paraaminobenroic acid esters. Case reports od sensitivity to lidoeaine have been reported, but they are rare. This 29 year old male patient had on episode of asthmatic breathing after supraclavicular brachial plexus block using 30 ml of 1% lidocaine with epinephrine(1:200,000). We report a case of asthmatic breathing due to lidocaine and a review of the literature for allergy local anesthetics.
Adult ; Anesthesiology ; Anesthetics ; Anesthetics, Local ; Brachial Plexus ; Esters ; Humans ; Hypersensitivity ; Lidocaine* ; Male ; Respiration*

No abstract available.
Meconium* ; Peritonitis* ; Ultrasonography*

We must be assured that sympathetic ganglion block interrupts a vicious cycle of nerve impulses. Therefore, it prevents vasospasm and improves local circulation. The sympathetic ganglion block is effective in acute stage of herpes zoster and reduces the incidence of post-herpetic neuralgia. Herpes zoster is more often involved in an immunosuppressive imbalance. Three cases of herpes zoster were treated by repeated sympathetic ganglion block with 1% proved. Duration from onset of pain was 1 week, 1 month and 2 months, respectively. The block decreased the degree of pain markedly and dried up the vesicle in the early stage. Two of these three cases had suffering from diabetes melitus.
Action Potentials ; Ganglia, Sympathetic ; Herpes Zoster* ; Incidence ; Neuralgia

PURPOSE: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning- related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. METHODS: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. RESULTS: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. CONCLUSION: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning.
Adult ; Aged ; Automobiles ; Child ; Death Certificates ; Drowning ; Humans ; Incidence ; Insurance ; Korea ; Male ; National Health Programs ; Prognosis ; Seasons

No abstract available.
Cerebral Hemorrhage ; Parkinson Disease

We investigated a topographical distribution of managanese, and immunohistochemical density of tyrosine hydroxylase (TH), and histopathologic findings in globus pallidus and substantia nigra according to manganese dose and time course in the brain of rats which received MnCl2 intravenously. Topographical distribution of manganese was also investigated after injection of FeCl2. The manganese concentrations of brain in control and experimental group were highest in pituitary gland and thalamus, and lowest in the cerebral cortex. The manganese concentration of blood was increased proportionally to the dose administered, and the biological half-life of blood manganese was between 21 and 42 days. The manganese concentrations of brain were increased proportionally to the dose, and increase rate was highest in olfactory bulb, and the biological half-lives of brain manganese ranged from 42 days to 90 or more days; the longest were observed in pituitary gland, medulla oblongata and cerebral cortex. In case of administration of FeCl2, the manganese concentrations of brain were higher than that of control group in dose of 2.5 mg/kg, and decreased proportionally to the administered dose, resulting in lower level compared with control group in high dose of FeCl2 administered. Significantly decreased number of nerve cell and increased gliosis in globus pallidus were observed in experimental group, which were closely correlated with the duration after manganese injection, but no significant change of number of nerve cell expressing TH and gliosis were observed in substantia nigra. Density of immunohistochemical reaction for TH in globus pallidus made little difference between control and experimental group. These results suggest that pathology of manganese intoxication is caused by the loss of nerve cells in globus pallidus, and closely correlated with the duration after manganese exposure.
Animals ; Brain* ; Cerebral Cortex ; Gliosis ; Globus Pallidus ; Half-Life ; Manganese* ; Medulla Oblongata ; Neurons ; Olfactory Bulb ; Pathology ; Pituitary Gland ; Rats* ; Substantia Nigra ; Thalamus ; Tyrosine 3-Monooxygenase

OBJECTIVE: Sonography is a noninvasive and safe bedside imaging modality that provides rapid and repeatable real-time radiological evaluations without a radiation hazard. However, sonography has not gained widespread acceptance as a diagnostic tool in adult brain disease because of limited imaging resolution through the bony window. We investigated the diagnostic potential and clinical usefulness of bedside brain sonography through surgical bone defects in neurosurgical patients. METHODS: We evaluated twelve patients, each of whom had undergone a decompressive craniectomy, via bedside sonography, and performed comparison CT or MRI for all patients. RESULTS: We obtained reliable information regarding anatomical structure displacement, ventricle systems, intracranial fluid collection, presence and distribution of cerebral infarctions, and hemorrhages. We performed several interventional trials under sonography guidance, including aspiration of entrapped fluid collection and insertion of an external ventricular drainage catheter into a collapsed and displaced ventricle cavity. CONCLUSION: Bedside sonography through surgically created bone defects is a non-invasive method that physicians can repeat as required with no radiation hazard, and it is of particular value in emergent and critical situations when conventional neuroimages are unobtainable. Bedside sonography can be a first-line monitoring tool, in lieu of CT, for critically ill patients with surgical cranial defects.
Adult ; Brain ; Brain Diseases ; Catheters ; Cerebral Infarction ; Critical Illness ; Decompressive Craniectomy ; Displacement (Psychology) ; Drainage ; Hemorrhage ; Humans ; Neurosurgery ; Ultrasonography, Doppler

PURPOSE: To compare corneal sensitivity and recovery of corneal innervations after a temporal clear corneal incision in cataract surgery. METHODS: We measured changes to corneal sensitivity using Cochet-Bonnet esthesiometer in 25 eyes of 20 patients and analyzed corneal nerve density with confocal microscopy in 20 eyes of 20 patients who had undergone cataract surgery. The parameters were measured before, and at 1 week, 1 month, and 3 months after cataract surgery. RESULTS: The mean preoperative corneal sensitivity was 56.40+/-3.39 mm at the temporal corneal incision site, and there was a significantly decreased sensitivity of 29.80+/-2.69 mm and 42.40+/-4.36 mm postoperatively at 1 week and 1 month, respectively. Nonetheless, by three months, corneal sensitivity had returned to 56.00+/-2.89 mm and was not significantly different from measurements prior to the cataract surgery. The mean preoperative subbasal nerve density was 5296+/-1642 micrometer/mm2. After cataract surgery, the subbasal nerve density was significantly reduced to 4113+/-1421, 3555+/-1448, 4198+/-1239 micrometer/mm2 at 1 week, 1 month, and 3 months, respectively. CONCLUSIONS: Corneal sensitivity after cataract surgery returned to near preoperative levels within 3 months before complete restoration of normal corneal innervations. Therefore, regeneration of subbasal nerve fibers (, as determined by confocal microscopy,) requires more time than the return of corneal sensation after cataract surgery.
Cataract* ; Humans ; Microscopy, Confocal ; Nerve Fibers ; Regeneration ; Sensation

PURPOSE: To compare corneal sensitivity and recovery of corneal innervations after a temporal clear corneal incision in cataract surgery. METHODS: We measured changes to corneal sensitivity using Cochet-Bonnet esthesiometer in 25 eyes of 20 patients and analyzed corneal nerve density with confocal microscopy in 20 eyes of 20 patients who had undergone cataract surgery. The parameters were measured before, and at 1 week, 1 month, and 3 months after cataract surgery. RESULTS: The mean preoperative corneal sensitivity was 56.40+/-3.39 mm at the temporal corneal incision site, and there was a significantly decreased sensitivity of 29.80+/-2.69 mm and 42.40+/-4.36 mm postoperatively at 1 week and 1 month, respectively. Nonetheless, by three months, corneal sensitivity had returned to 56.00+/-2.89 mm and was not significantly different from measurements prior to the cataract surgery. The mean preoperative subbasal nerve density was 5296+/-1642 micrometer/mm2. After cataract surgery, the subbasal nerve density was significantly reduced to 4113+/-1421, 3555+/-1448, 4198+/-1239 micrometer/mm2 at 1 week, 1 month, and 3 months, respectively. CONCLUSIONS: Corneal sensitivity after cataract surgery returned to near preoperative levels within 3 months before complete restoration of normal corneal innervations. Therefore, regeneration of subbasal nerve fibers (, as determined by confocal microscopy,) requires more time than the return of corneal sensation after cataract surgery.
Cataract* ; Humans ; Microscopy, Confocal ; Nerve Fibers ; Regeneration ; Sensation

OBJECTIVE: Cancer pain has been treated by gamma knife radiosurgery(GKS), targeted to the pituitary gland-stalk, as an alternative new pain control method. The purpose of this study is to prove the efficacy and the safety of this treatment. METHODS: Seven patients with intractable cancer pain underwent pituitary gland-stalk irradiation by gamma knife. Selections for patient inclusion in this treatment protocol were no other effective pain treatment options, general condition rated as greater than 40 on Karnofsky Performance Scale, and pain relief by morphine though not satisfactory. The target was the junction between the pituitary stalk and the neurohypophysis. The maximum dose was 150~160Gy with one isocenter in 8mm collimator or two isocenters in 4mm collimator keeping the radiation dose to the optic nerve less than 8Gy. RESULTS: In all seven cases, the significant pain reduction was obtained during immediate post-GKS period without serious complications except one patient who developed transient hypopituitarism and diabetes insipidus. Pain relief was observed within several days, and this effect was prolonged for a quite long time. At a follow up of 1.5 to 13 months, pain recurred in two patients and no hormonal and visual dysfunctions were observed. CONCLUSION: Despite insufficient experience, the efficacy and the safety of GKS for intractable cancer pain were demonstrated in seven patients. This treatment has the potential to ameliorate cancer pain, and GKS will play a more important role in the treatment of intractable pain.
Clinical Protocols ; Diabetes Insipidus ; Follow-Up Studies ; Humans ; Hypopituitarism ; Morphine ; Optic Nerve ; Pain, Intractable ; Pituitary Gland ; Pituitary Gland, Posterior ; Pituitary Irradiation* ; Radiosurgery