The anatomy of oral cavity in Down syndrome is characterized by hypotonic macroglossia, small oral cavity, and narrow palate with high-arch shape. Because of such characteristics, patients show difficulty in articulation, resonance and phonation. They also suffer from respiratory difficulty due to narrow upper respiratory tract which is exaggerated by hypertrophied tonsil and adenoid. So far we operated on 100 children with Down syndrome for partial glossectomy in average volume of 4.6 cc. We analyzed the results by means of questionnaires and speech test with multi-speech model 3700 program before and after the operation. After partial glossectomy, we observed that they could close their lips comfortably, and it can mitigate the stigma of Down syndrome. We could also observe the improvement in voice quality, pitch, resonance and articulation. Through paired t-test using SAS, we analyzed value of F1, F2-F1, and changes of fundamental frequency(Fo). After partial glossectomy, anteriorly positioned tongue of Down patients became significantly smaller in size and be located posteriorly.
Adenoids ; Child* ; Down Syndrome* ; Glossectomy* ; Humans ; Lip ; Macroglossia ; Mouth ; Palate ; Palatine Tonsil ; Phonation ; Surveys and Questionnaires ; Respiratory System ; Tongue ; Voice Quality

We examined uncorrected visual acuity, surgically induced astigmatism and complications of 122 eyes underwent cataract surgery with implantation of the AMO Phacoflex SI-30NB. More than 80% of all cases showed uncorrected visual acuity better than 20/40. Temporal incision revealed less surgically induced astigmatism and faster rehabilitation than superior incision. Posterior capsular opacity was found in 14.8%, however Nd-YAG laser capsulotomy was performed in 2.5%. The incidences of contraction of capsular opening and displacement of intraocular lens were 4.9% and 4.1%, respectively. The range of displacement was within 1mm. Conclusively, cataract surgery with implantation of the AMO Phacoflex SI-30NB through clear corneal incision of 3.2mm revealed a low incidence of complication and provided patients rapid visual rehabilitation.
Astigmatism ; Cataract ; Humans ; Incidence ; Lasers, Solid-State ; Lenses, Intraocular ; Rehabilitation ; Silicones* ; Visual Acuity

Percutaneous balloon angioplasty has been reported to be useful in the treatment of intracranial atherosclerotic arterial stenosis. However, arterial dissection with increased risk of acute closure and stroke has limited its widespread implementation. Stenting of the intracranial vasculature recently has been shown to be feasible in a variety of circumstance. However, stenting of middle cerebral artery has been limited because of difficulty with tracking stents across the carotid siphon. We report a case of successful percutaneous stenting of a symptomatic middle cerebral artery stenosis using a balloon-expandible flexible coronary stent.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic* ; Middle Cerebral Artery* ; Stents* ; Stroke

A weight-holding tremor is a rare type of hand tremor that occurs only when someone holds some weight. Here we report three cases of isolated weight-holding tremors, of which one patient was diagnosed with Parkinson’s disease (PD) and the others as a variant of essential tremor (ET). A 68-year-old woman presented with a left-hand tremor that appeared only when she held objects with some weight. Her tremor was reminiscent of the re-emergent tremor of PD, and dopamine transporter imaging revealed reduced uptake at the right posterior putamen. A 21-year-old man and a 71-year-old woman also presented with similar weightholding tremors. However, these tremors were not re-emergent, and no signs of parkinsonism were observed during follow-up. Although the underlying etiologies of these tremors differed, all three tremors worsened as the held weight increased. These tremors could be isolated isometric tremors, but further research is needed to clarify the nature of this rare tremor.

No abstract available.
Infection Control* ; Jeollanam-do*

No abstract available.

Methemoglobinemia is an uncommon but potentially fatal disorder. Most cases have no adverse clinical consequence and require no treatment, but methemoglobinemia is often overlooked as a cause of low oxygen saturation, and often mistaken for the more common causes of hypoxia by anesthesiologists despite simple bedside tests that indicate the presence of this treatable abnormality. We present a 68-year-old female patient who underwent gastrectomy for advanced gastric cancer with bleeding. In the preoperative period, the patient showed cyanosis and oxygen saturation was 85% by pulse oximeter, but oxygen saturation by arterial blood gas analysis was 100%. After tracheal intubation, the methemoglobin level was 18.3%. Ascorbic acid and methylene blue were administered. During preanesthetic evaluation, the patient had not informed the anesthesiologist that she had been taking dapsone.
Aged ; Anesthesia, General ; Anoxia ; Ascorbic Acid ; Blood Gas Analysis ; Cyanosis ; Dapsone ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Intubation ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Oximetry ; Oxygen ; Preoperative Period ; Stomach Neoplasms

Two cases of familial asymmetric septal hypertrophy diagnosed by myocardial biopsy and clinical studies are reported with literature reviewed. Myocardial biopsy was done at right ventricular septal wall, and pedigree of family members was observed clinically and examined by noninvasive methods including chest X-ray and echocardiography.
Biopsy ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Humans ; Pedigree ; Thorax

Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.
Aged ; Aneurysm ; Cardiopulmonary Bypass ; Endocardium ; Follow-Up Studies ; Heart Aneurysm ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Neck ; Rare Diseases ; Recurrence ; Tachycardia, Ventricular

OBJECTIVE: Although middle cerebral artery (MCA) aneurysms are less amenable to coil embolization, an increasing number of studies support favorable endovascular treatment for them. The purpose of this study is to compare the outcomes of two different treatments (surgery versus coiling) and evaluate the benefits of surgical clipping for MCA aneurysms. METHODS: Here we retrospectively analyzed the outcomes of 178 ruptured and unruptured MCA aneurysms treated in patients between September 2008 and April 2012. Parameters assessing treatment outcomes include degree of aneurysm occlusion, presence of regrowth, clinical status, and complications. RESULTS: Among 178 MCA aneurysms, 153 were treated surgically. After a mean follow-up of 12 months, the surgery group showed a clinically significant complete occlusion rate (98%) compared with the coiling group (56%) (p<0.001). Follow-up radiologic evaluation showed a higher regrowth rate (four of 16 cases) in the coiling group than in the surgery group (one of 49 cases) (p=0.003). There was no statistically significant difference in favorable clinical outcome rate between the two groups. The procedure-related permanent morbidity and mortality rates were 2% (three of 153 cases) in the surgery group and 0% (0 of 25 cases) in the coiling group. CONCLUSION: Compared to endovascular treatment, surgical neck clipping for both ruptured and unruptured MCA aneurysms results in a significantly higher complete obliteration rate and less regrowth. Therefore, even in this endovascular era, we still recommend surgical clipping as the primary treatment option for MCA aneurysms rather than coil embolization.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Mortality ; Neck* ; Retrospective Studies ; Surgical Instruments