A suspected case of air embolism in endonasal surgery using CO2 laser / 대한마취과학회지

No abstract available.

Prosody Processing of Korean Language in Stroke Patients: A Preliminary Study

OBJECTIVE: To investigate the hemispheric contributions to prosody recognitions and interference effects of semantic processing on prosody for stroke patients by using the Korean language. METHODS: Ten right hemisphere damaged patients (RHD), nine left hemisphere damaged patients (LHD), and eleven healthy controls (HC) participated. In pure prosody recognition task, four semantically neutral sentences were selected and presented in both sad and happy prosodies. In interference task, participants listened to emotionally intoned sentences in which the semantic contents were congruent or incongruent with prosody. Participants were asked to rate the valence of prosody while ignoring the semantic contents, and thus, reaction time and accuracy were estimated. RESULTS: In pure prosody recognition task, RHD showed low accuracy as compared to HC (p=0.013), and the tendency of group response showed that RHD performed worse than HC and LHD with regards to accuracy and reaction time. In interference task, analysis of accuracy revealed a significant main effect of groups (p=0.04), and the tendency implied that RHD is less accurate as compared to LHD and HC. The RHD took longer reaction times than HC in congruent and incongruent items (p<0.001). CONCLUSION: Right hemispheric laterality to prosody processing of Korean language in stroke patients was observed. Interference effects of semantic contents to prosody processing were not observed, which suggested unique characteristics of prosody for Korean language. These results could be referred as preliminary data for future researches on Korean languages.

Cerebral Infaction during Spinal Anesthesia : A case report / 대한마취과학회지

We experienced a case of acute cerebral infarction during spinal anesthesia. The patient was a seventy years old male with diagnosis of right femur periprosthetic fracture scheduled for a open reduction & internal fixation under spinal anesthesia. Intraoperatively, he developed a mental confusion and his blood pressure decreased from 115/70 mmHg to 80/45 mmHg. After operation, he appeared to have left hemiparesis and left facial palsy. Angiogram revealed thrombus in superior division of the right middle cerebral artery. He expired 3 months after the surgery despite supportive measures.

Transient Hypoglossal Nerve Palsy after Septorhinoplasty: A case report / 대한마취과학회지

Hypoglossal nerve palsy is a rare complication after general anesthesia with orotracheal intubation. It can present with symptoms of tongue deviation, dysarthria and swallowing difficulties. We report 33-year-old female who was scheduled to undergo surgery for a nasal bone fracture under general anesthesia, using orotracheal intubation. After surgery, she complained right side tongue deviation and, dysarthria, and was diagnosed with right hypoglossal nerve palsy. The cause of the hypoglossal nerve palsy was assumed to be a complication of the orotracheal intubation. Fortunately, the patient fully recovered 2 weeks after surgery.

Unexpected Difficult Intubation due to Lingual Thyroid: A case report / 대한마취과학회지

Lingual thyroid is a rare clinical entity that is due to the failure of the thyroid gland to descend early in the course of embryogenesis. It may be present with symptoms of dysphagia and upper airway obstruction. We report here on the case of a 63-year-old female who was scheduled for an operation for lumbar disc herniation and she could not be intubated. The cause of the airway obstruction was an ectopic thyroid at the base of the tongue, which made visualization of the glottis impossible. Several attempts at endotracheal intubation were unsuccessful. Fortunately, the patient was mask ventilated. We awakened the patient and consulted an otolaryngologist, and she was diagnosed with lingual thyroid. After a week, she was operated on using spinal anesthesia.

Pain Control by Permanant Spinal Cord Stimulation in the Post-herpetic Neuralgia / 대한마취과학회지

Post-herpetic neuralgia is the most frequent and feared complication of herpes zoster and is a common cause of chronic intractable pain in the elderly population. An 80 year old man who had suffered from intractable post-herpetic neuralgia received a percutaneous permanant spinal cord stimulator (ITREL3 Neurostimulator-Model 7425, Medtronic, USA) implantation. After implantation, he could sleep without interference of frequent acute sharp attacks of pain and showed improved daily life. We may suggest that this procedure could be applied for several kinds of intractable pain of neuropathic origin, including post-herpetic neuralgia, failed back surgery syndrome, complex regional pain syndrome, peripheral vascular disease and chronic intractable angina, after careful selection of the patient.

Severe Low Back Pain and Radiculopathy during Epiduroscopy / 대한마취과학회지

Epiduroscopy is a new method for managing chronic back pain. However there are potential complications such as hemorrhage, infection, neural damage, and increased pain due to increased epidural and intrathecal pressure. A 59-year-old male patient, suffering from lumbar radiculopathy after spine surgery was referred to the pain clinic. To ensure proper deposition of steroids and epidural lysis of adhesions, fibroptically directed epiduroscopy was planned. After positioning the epiduroscopy, 20 ml of normal saline was injected slowly. Immediately after injection, the patient complained of severe back pain and radiating pain to the lower extremities. When the pain was relieved, we restarted a saline injection. However, severe pain ocurred again and was sustained for more than an hour. There was no clinically significant findings on an emergency MRI. The symptoms improved slowly over a period of two hours.