Incomplete fixation of pancreas, which may be associated with a wide mobility of root of SMA, result in chronic midgut volvulus. Movable pancreas is an uncommon form of incomplete intestnal fixation and rotation. Herein, we present a caae of movable pancreas. A patient was a 32-year-old male with the complaint of colicky intermittent abdomnal pain. The abdominal ultrasonography and CT showed a movable pancreas. The head of pancreas was located in the left of the abdominal aorta during the inspiratory time and left decubitus position. At surgery, pancreas was mobile and the root of mesentery was very weak and fibrotic. Duodenum and mesentery were fixed by 0.7 mm Dacron patch along the right peritoneal gutter and the retroperitoneum from ligament of Treitz to the ileocecal attachment. Duodenojejunostomy was performed for the prevention of SMA syndrome. The symptoms disappeared and recovery was prompt. Following the procedure, the patient remains asymptomatic until 10 months after operation
Adult ; Aorta, Abdominal ; Duodenum ; Head ; Humans ; Intestinal Volvulus* ; Ligaments ; Male ; Mesentery ; Pancreas* ; Polyethylene Terephthalates ; Ultrasonography

Fractures significantly involving the weight-bearing articular surface and the overlying metaphysis of the distal tibia have deserved notoriety as a severe and challenging subject of ankle injuries. It was not until 1963 that the AO group developed principles for open reduction and internal fixation of pilon fracture. But recently, limited internal fixation of the joint surface combined with external fixation may avoid the soft tissue complications associated with formal open reduction and internal fixation. We have treated 22 cases of tibial pilon fracture with biologic principle. The mean follow-up period was two years ranging from one to three years. According to the Riiedi and Allgower classification, three cases were type I, five cases were type II, and fourteen cases were type III Biologic treatment includes combination of internal and external fixation, external fixation alone, or plating was done with careful soft tissue dissection, limited stripping of fracture fragments, and indirect reduction technique. Radiographic results were assessed by Burwell and Charnley criteria. Three cases of type I, three cases of type II and seven cases of type III pilon fractures obtained good anatomic radiographic results. We also assessed the functional results by Mast and Teipner criteria. Three cases of type I, three cases of type II, six cases of type III pilon fractures obtained good functional outcome. We believed that combination of internal and external fixation provides the patient who has a markedly displaced pilon fracture and diaphyseal comminution with the best chance of good clinical result and minimal risks. As such, we believe biologic treatment is excellent for these injuries.
Ankle Injuries ; Classification ; Follow-Up Studies ; Humans ; Joints ; Tibia ; Weight-Bearing

Osteoid Osteoma occurs anywhere in skeleton. They are most common in lower extremity, particularly femur about 40%. Two-thirds of femoral lesions is in the intertrochanter or intracapsular regions of the hip. The lesion is usually cortical and may extend into the periosteal or endosteal surface of the bone. It is rare in the cancellous bone. We experienced a case of osteoid osteoma in intertrochanteric cancellous portion of the femur in 50 year old man. Many complained right hip pain worsend three weeks before his visit. Radiograph shows sclerosis around a lucent nidus in cancellous portion. The lesion did not extend to the endosteal surface. We have removed nidus and surrounding reactive portion completely with curettage. Follow up radiographic results after 20 weeks, showed no evidence of recurrence.
Adult* ; Curettage ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Lower Extremity ; Middle Aged ; Osteoma, Osteoid* ; Recurrence ; Sclerosis ; Skeleton

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal* ; Pregnancy, Twin* ; Salpingectomy* ; Twins*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal* ; Pregnancy, Twin* ; Salpingectomy* ; Twins*

Hepatitis B virus (HBV) currently infects more than 400 million people worldwide and they are at risk of developing chronic liver disease, cirrhosis and hepatocellular carcinoma. The immune response to HBV- encoded antigens is responsible both for viral clearance and for disease pathogenesis during HBV infection. While the humoral antibody response to viral envelope antigens contributes to the clearance of circulating virus particles, the cellular immune responses to the envelope, nucleocapsid, and polymerase antigens were known to eliminate virus in infected hepatocytes through cytolytic as well as noncytolytic mechanisms. Liver injury could be initiated by an immune response against HBV, but mainly resulted from HBV non-specific lymphocytes and macrophages. There are growing evidences that T helper 1 memory T cells play a predominant role in suppressing viral replication mainly by IFN-gamma through noncytolytic antiviral mechanism. Elucidation of the immunological and virological basis for HBV infection may yield effective immunotherapeutic and antiviral strategies to terminate chronic HBV infection.
Humans ; Hepatitis B virus/*immunology ; Hepatitis B Antigens/immunology ; Hepatitis B/*immunology

Randomly selected 193 patients who received elective operation under general anesthesia and were able to communicate with anesthesiologists and follow up for 5 days between May and September 1994 at Chonnam University Hospital, were interviewed and evaluated on the night before, 2 and 5 days after their operation. Distribution of physieal status by ASA was that more than half the total patients belongs to class I and 36.8% of patients were under class II. Sedation scores did not chang between on the night before and the day of operation. A significant correlation existed among the visibility of pharyngeal structures, the exposure of glottis by laryngoscopy, and the degree of difficulty with intubation. About 83% of patients was readily intubated, and none of patient was impossible to intubate. All of the patients lost consciousness during induction of anesthesia, and did not recall during operation. Postanesthetic complications were sore throat(30%), nausea and vomiting(28%), lumbago(15%), urticaria(3%), and dizziness(3%).
Anesthesia ; Anesthesia, General ; Consciousness ; Follow-Up Studies ; Glottis ; Humans ; Incidence* ; Intraoperative Awareness* ; Intubation* ; Jeollanam-do ; Laryngoscopy ; Nausea

BACKGROUND: Lidocaine or verapamil are used as an antiarrhythmic agent or agent blunting the cardiovascular changes induced by intubation or extubation during anesthesia. After recovery from general anesthesia with muscle relaxants, most patients remained in a residual paralytic state, hence it might develop easily recurarization by factors that affect neuromuscular transmission. Lidocaine and verapamil are well known as agents to potentiate the neuromuscular block. We investigated the effects of lidocaine or verapamil on neuromuscular transmission in vitro. METHODS: Square wave, 0.2 ms duration at a frequency of 0.1 Hz supramaximal or train of four stimuli was applied and the twitch height response was recorded mechanomyographically on rat phrenic nerve hemidiaphragm preparations. Dose responses of rocuronium, lidocaine, verapamil, rocuronium pretreated with lidocaine or verapamil, lidocaine pretreated with rocuronium, and verapamil pretreated with rocuronium were observed by cumulative method, and effective doses (Lag dose, ED50 and ED95) between a pretreated and nonpretreated agent were compared statistically. TOF ratios were observed at 80, 70, 40 and 30% of the control twitch height value during the observation of dose responses. RESULTS: Lag dose, ED50 and ED95 of rocuronium were reduced significantly after pretreatment of lidocaine, verapamil or their mixture, and the dose response of lidocaine, verapamil or their mixture were also reduced significantly by rocuronium pretreatment. TOF ratios at the point of each twitch height decreased significantly after pretreatment. CONCLUSIONS: Lidocaine or verapamil itself did not affect the neuromuscular transmission but might have potentiated the neuromuscular blocking effect induced by rocuronium. However, in excessive doses, these agents produced neuromuscular blockade. Consequently, in the residual neuromuscular block induced by rocuronium, lidocaine or verapamil may enhance recurarization.
Anesthesia ; Anesthesia, General ; Animals ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Phrenic Nerve ; Rats ; Verapamil*

OBJECTIVES: Postpartum blues is known to be a major risk factor for postpartum depression and can be associated with the problems of language skills, behaviors or learning skills of their children. Therefore, it is very important for clinicians to evaluate precisely and control postpartum blues. Recent studies have found that music has an effect on depressive mood and the frontal EEG asymmetry of the patients with depression. The purpose of this study was to find out the effects of music on the frontal EEG asymmetry of the mothers with postpartum blues. METHOD: Among one hundred and seventy mothers assessed with Korean version of the Edinburg Postnatal Depression Scale (EPDS), nine mothers with postpartum blues (EPDS > or = 10) as postpartum blues group and nine non-depressive mothers (EPDS < 10) as non-depressive mother group were included. Ten non-labored, non-depressive women were also included as a normal control group. The subjects were evaluated with the State Trait Anxiety Inventory (STAI)-X1, the Visual Analogue Scale (VAS) and the Depression Adjective Checklist-Korean version (K-DACL) and EEG twice before and after the music sesssion with the length of twenty minutes and thirty two seconds. The statistical analyses were done for A1 score (log R - log L) which were computed from the alpha powers at F3 and F4. RESULTS: No significant difference was noted in demographic data among all three groups. The postpartum blues group had higher scores in the STAI-X1, the VAS and the K-DACL compared to the other groups at baseline, and their A1 scores were lower than those of only normal controls. There was a statistically significant increase of A1 score only in the postpartum blues group after the music session. CONCLUSION: This study suggests that the mothers with postpartum blues may have a frontal EEG asymmetry which is possibly associated with their depressive mood, and the music session can affect the frontal asymmetry positively.
Anxiety ; Child ; Depression ; Depression, Postpartum ; Electroencephalography ; Female ; Humans ; Learning ; Mothers ; Music ; Music Therapy ; Postpartum Period ; Risk Factors

BACKGROUND: There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. METHODS: M.tuberculosis, differentiated MOTT (Tycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-1β, IL-12, *1 IFNγ and *2 TNFαblood levels were measured. All patients were regularly followed for 18 months after treatment. RESULTS: There was no correlation between the RFLP patterns of M.tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/ml. Most of the 53 cases on neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. CONCLUSION: A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.
Humans ; Interleukin-12 ; Korea ; Male ; Neck* ; Polymorphism, Restriction Fragment Length ; Treatment Failure* ; Tuberculosis* ; Tuberculosis, Pulmonary