Journal of Yeungnam Medical Science

Case Report

A Case of Scopolamine-Induced Central Anticholinergic Syndrome.: Dong Sung Shin, Ho Sun Lee, Se Jin Lee; Yeungnam Univ J Med. 2012;29(1):58-60. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.58

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Abstract PDF: Central anticholinergic syndrome occurs when an anticholinergic substance works in vivo or as a result of the insufficient release of acetylcholine. Its symptoms include confusion, agitation, behavioral change, hallucination, blurred vision, and dysarthria. Occasionally, these symptoms occur with the use of a scopolamine patch. A 54-year-old female complained of behavioral change and confused mentality. She attached a scopolamine patch at the postauricular area in the morning of the day before her hospital visit. Neurological examination revealed bilateral symmetric mydriasis without light reflex. The brain MRI was normal, and electroencephalography showed nonspecific abnormalities. The patient recovered completely after the removal of the scopolamine patch.

Original Articles

The Effect of Anticholinergic Agents on Postoperative Sore Throat in Patients Undergoing Endoscopic Sinus Surgery.: Joo Young Lee, Deok Hee Lee; Yeungnam Univ J Med. 2007;24(2):305-310. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.305

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Abstract PDF: BACKGROUND
After sinus surgery, airway dryness is made worse because patients breathe by mouth. Anticholinergic agents have antisialogogue effects. The airway dryness that occurs after surgery is severe and can increase the incidence of postoperative sore throat. MATERIALS AND METHODS: One-hundered patients who were scheduled for endoscopic sinus surgery(ESS) were divided into four groups. Each group was premedicated with glycopyrrolate or had no premedication and reversed with glycopyrrolate or atropine. After the surgery the patients were asked about a sore throat and hoarseness postoperatively after 1h, 6h, 12h, 24h, and 48hours, respectively. RESULTS: The incidence of postoperative sore throat and hoarseness was not significantly different among the four groups at any time. CONCLUSION: The severity of complications after ESS was low and subsided within 24 hours. Therefore, the use of anticholinergic agents does not need to be limited.

Existance of cholinergic and purinergic receptor on the detrusor muscle of rat urinary bladder.: Tae Su Choi, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1991;8(2):138-149. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.138

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Abstract PDF: This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.

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