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.

BACKGROUND: Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. However, nearly 50% of patients suffering inferior infarction will have complications such as heart block, concomitant precordial ST-segment depression and right ventricular infarction or distinguishing features associated with an increased mortality that will substantially alter an otherwise favorable prognosis. METHODS: Clinical characteristics, electrocardiograms, and angiographic findings of coronary artery were viewed in 47 patients with inferior myocardial infarction. Significant ST-segment change was defined as > or =0.1mV horizontal or down sloping depression in acute inferior myocardial infarction patients with ST-segment elevation on leads II, III, aVF measured with reference to the TP segment, 80ms after J point. A group=no precordial ST-segment depression. B group=sum of ST-segment depression in leads V1 to V3 equal to or more than the sum of ST-segment depression in leads V4 to V6. C group=maximal precordial ST-segment depression in leads V4 to V6. RESULTS: 1) Incidence of multi-vessel disease in group A and in group B were 23% and 22%, respectively, compared with 60% for those of group C(p<0.05). 2) Incidence of Killip class III and IV rates in patients with group A and B were 8% and 12%, respectivly, compared with 47% for those patients with group C(p<0.05). 3) No significant difference of sex, age, peak CK level were found among three groups(p>0.05). CONCLUSION: The patients with acute inferior myocardial infarction with the maximal ST-segment depression in leads V4 to V6 would be at high risk for congestive heart failure and multi-vessel disease.
Coronary Vessels ; Depression* ; Electrocardiography ; Heart Block ; Heart Failure ; Humans ; Incidence ; Infarction ; Inferior Wall Myocardial Infarction* ; Mortality ; Myocardial Infarction ; Prognosis

BACKGROUND: Surgical trauma is a potent stimulus for the neurohormonal axis. The catecholamine response to surgical stress may be modulated by the anesthetic regimen utilized. We compared the hemodynamic response and catecholamine concentration to lower abdominal surgery during anesthesia with propofol or enflurane. METHODS: Forty six patients undergoing lower abdominal surgery were assigned randomly to two groups. In group I, anesthesia was induced with thiopental sodium 5.0mg/kg and maintained with enflurane-N2O. In group II, anesthesia was induced with propofol 2.0mg/kg and maintained with propofol 12 mg/kg/min by infusion pump. Hemodynamic responeses were recorded at tracheal intubation. Blood samples for later determination of plasma catecholamine were drawn and hemodynamic responses were recorded at preinduction, 1 minute after skin incision, 30minutes after skin incision. RESULTS: There was no statistical significance in systolic and diastolic pressure between two groups. There was statistical significance in heart rate 30minutes after skin incision between two groups. There was no statistical significance in epineprine concentration between two groups. There was statistical significance in norepineprine 30 minutes after skin incision between two groups. CONCLUSIONS: Propofol may be useful alternative at lower abdominal surgery and it may be convenient and safe intravenous anesthetics.
Anesthesia* ; Anesthetics ; Anesthetics, Intravenous ; Axis, Cervical Vertebra ; Blood Pressure ; Enflurane* ; Epinephrine ; Heart Rate ; Hemodynamics ; Humans ; Infusion Pumps ; Intubation ; Plasma ; Propofol* ; Skin ; Thiopental

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

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