Voice changes developing after endotracheal intubation during right hemicolectomy with endotracheal intubation have been found to be due to a right recurrent laryngeal nerve palsy in 43-years-old male patient. It was likely that the inflated cuffed tube rode up to the level of the cricoid cartilage during the course of surgery as traction was placed on the endotracheal tube because the condenser humidifier and breathing circuit weighed heavy. Cuff overexpansion, in addition to muscle relaxation and decreased tracheal elasticity were considered as contributing factors of vocal cord palsy. We believe that tube traction and cuff overexpansion were the mechanism of vocal cord palsy in our patient. So we recommend the routine use of tube stand so that weigh of the breathing circuit does not transmit traction to the endotracheal tube. Concurrently, filling the cuff with a sample of the inspired mixture of gases, saline and 4% lidocaine in special cases or regular deflation of the cuff must be considered.
Cricoid Cartilage ; Elasticity ; Gases ; Humans ; Intubation, Intratracheal* ; Lidocaine ; Male ; Muscle Relaxation ; Respiration ; Traction ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

In this study, in order to obtain physiologic synthesis of testosterone in primary or secondary gonadal insufficiency by Leydig cells transplantation, newborn rat testis tissues were transplantated in castrated male rat. The rats were castrated about 5-6 weeks after birth and were observed for 10 days. At this time, testes were removed from a one-day-old rat and these were transplanted onto the bilateral renal subcapsular lesions of the castrated rats under an operative microscope. Of the 27 rats that were castrated, testis transplantation was possible in 24 rats. The 24 transplanted rats which managed to survive were divided into three groups of 8 rats according to the different time in which blood samplings were to be done, at 2 weeks, 4 weeks, and 6 weeks. After the blood samplings, nephrectomy of the testis transplanted kidney was done. Among the 2 weeks group, one rat died during the experiment and one rat had the transplanted testis unilaterally. Among the 4 weeks and 6 weeks group, 2 rats died from each group, and in the rest 6 rats, the transplanted testes remained in both kidneys. The serum testosterone levels of transplanted group at 2, 4, 6 weeks, the control group of 2 weeks after the castration, and the normal mature rat(about 10 weeks old) showed significant difference(p= 0.001). However, the serum testosterone levels of the transplanted group for 2 weeks and the control group of 2 weeks showed no difference(p= 0.665). The serum testosterone levels of the transplanted group for 4 weeks and 6 weeks did not reach the level of the control group at 4 weeks and 6 weeks(p= 0.020 and 0.030), but their increase was definite. The differences in the Leydig cells of the control group and the transplanted group were observed, and in the control group, the development of the Leydig cells were nonspecific as compared to the somewhat hyperplastic findings in the transplanted group. The morphologic differences of the Leydig cells between these two groups were difficult to be found under an light microscope. In order to classify Leydig cells according to the developmental stage and to understand the functional aspects, the followings are needed to be studied further: the ultrastructural analysis of the Leydig cells; the interactions and changes between Leydig cells and other cells in the testis tissue; measurements of the receptors of the various sex hormones. These studies are thought to be contributory to the in vitro culture of Leydig cells as well as to the clinical applications of the testis transplantation.
Animals ; Castration ; Gonadal Steroid Hormones ; Gonads ; Humans ; Infant, Newborn* ; Kidney ; Leydig Cells* ; Male ; Male* ; Nephrectomy ; Parturition ; Rats* ; Testis* ; Testosterone* ; Transplantation

No abstract available.

Solid pseudopapillary tumor of the pancreas is a rare tumor that affects young females with low malignant potential and good prognosis with more than 90% survival at 5 years. Metastasis is very rare. We report the case of a 74-year-old female who had pancreatic solid-pseudopapillary tumor and synchronous hepatic metastasis.
Aged ; Female ; Humans ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis

PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

OBJECTIVES: The purpose of this study was to evaluated the difference of depressive symptoms and attention between estrogen user and non-user in postmenopausal women. METHODS: 30 Estrogen users and 30 non-users were participated in this study. They were all menopausal for at least 1 year and have 12 or more education years. We used BDI(Beck Depression Inventory), digit span and digit symbol to evaluate depressive symptoms and attention in both groups. We also measured the plasma estradiol level and identified the correlation between estradiol level and BDI, digit span and digit symbol. RESULTS: The demographic data was not different between both groups. Estrogen users scored higher than non-users in digit span(forward) and lower than non-users in BDI. The correlation between estradiol level BDI, digit span and digit symbol was not significant. CONCLUSION: Estrogen replacement therapy was effective in alleviation depressive symptoms but ineffective in improving attention in postmenopausal women.
Depression* ; Education ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Plasma

The methods of treatment of spondylolisthesis range from posterior fusion to instrumentation, and circumferential fusion. Combined anterior and posterior fusion with instrumentation had been carried out in one or two stages and satisfactory results were obtained in nighteen cases with follow-up period of one year to four years at department of orthopedic surgery of Ewha Womans University Hospital from 1987 to 1991. The results were as follows: 1. Of 19 patients, 7 patients were male and 12 patients were famale. 2. The isthmic type was 12 cases (63.1%) and the 5th lumbar vertebral involvement is common (12 cases, 63.1%). 3. The operative treatment was as follows: Posterior fusion with instrumentation was 8 cases, and anterior fusion with instrumentation was 11 cases. 4. The combined anterior and posterior fusion with instrumentation had been carried out in one stage operation at 8 cases, and two stage operation was done at 11 cases. 5. The average operation time was 3.0 hrs in one stage operation, 3.1 hrs in two stage operation, and the average amount of blood loss was 22cc/Kg in one stage, 17cc/Kg in two stage. 6. The satisfactory results were obtained in 19 cases, but there was no specific difference between one stage and two stage operation.
Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Spondylolisthesis

PURPOSE: We analysed perioperative and postoperative complications in a series of patients who had a pertrochanteric fracture which had been treated by using a Gamma Asia-Pacific Locking Nail. MATERIALS AND METHODS: A retrospective analysis was done on 44 patients who were available for follow-up over one year period. The Clinical analysis included their walking ability, buttock pain, thigh pain, and their leg length discrepancy. The correlation between radiological parameters and the incidence of complications was analysed. RESULTS: The average follow-up period was 26 months. The presence of buttock pain, thigh pain, a diminution of walking ability and a limb shortening were common findings. The amount of typical complications from a classic gamma nail in the pertrochanteric fractures of the femur were very low, but complications such as avascular necrosis of the femoral head or a refracture after removal of the nail occurred in patients who had been treated by a Gamma Asia-Pacific Locking Nail. The radiological parameters did not statistically correlate with the incidence of complications. CONCLUSION: There was mismatch of Gamma Asia-Pacific Locking Nail with Korean femorae. We recommend that a precise operative technique is essential and a modification of the nail must be made.
Buttocks ; Extremities ; Femur ; Follow-Up Studies ; Head ; Humans ; Incidence ; Leg ; Necrosis ; Postoperative Complications ; Retrospective Studies ; Thigh ; Walking

Background: Studies on prevalence and social variables affecting postpartum depression appear to be inconsistent. This study aimed to examine the prevalence of postpartum depression, as well as the correlation between education, offspring, age, and risk of the postpartum depression. Methods: This study included 144 mothers living in Chungju who appeared to experience postpartum depression based on a score of >10 marks on the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Correlation and logistic regression analyses were used to calculate correlation coefficients and odds ratios (OR) for postpartum depression based on the education level of mothers and number of offspring. Results: Prevalence of postpartum depression was found to be 29.17%. Age was not significantly correlated with EPDS score. EPDS scores tended to decrease with the increase in the number of education years (OR, 0.66); however, EPDS scores tended to increase with the increase in the number of offspring increased (OR, 1.65). Conclusion The result of this study demonstrates that education acts as a protective factor and number of offspring acts as a risk factor for postpartum depression. It also suggests that proper intervention in the mothers’ educational level and number of offspring is necessary.

Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual “niche construction” by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.