Congenital duodenal obstruction in the newborn infant may be due to a variety of causes. Duodenal obstruction often presents with bilious vomiting and upper abdominal distention. Diagnosis is usually established on plain x-ray of the abdomen by the classic finding of the double-bubble. In the period July 1986 to June 1990, 16 patients with congenital duodenal obstruction were operated and the following results were obtained. 1. Sixteen patients were comprised of 11 males and 5 females, the ratio of male and female was 2.2:1. 2. Thirteen patients (81%) had been admitted to our hospital during one month of life. 3. Congenital duodenal obstruction was in 16 cases; malrotation in eight (50%), annular pancreas in six (38%), type 1 atresia in one (6%), and wind-sock anomaly in one (6%). 4. There were two premature patients and six patients of small for gestational age. 5. Overall, bilious vomiting, occurring in three fourths, was the single most frequent presenting complaint. 6. Polyhydramnios occurred in two of the patients. 7. Diagnosis was possible with clinical symptom and simple abdomen. 8. The operative procedures performed were; duodenoduodenostomy in five, duodenojejunostomy in two, excision of wind-sock membrane in one, and Ladd's procedure in eight. 9. A total of ten associated congenital anomalies were found in six patients. 10. Postoperative complications occurred in five cases (31%).
Abdomen ; Clinical Study* ; Diagnosis ; Duodenal Obstruction* ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Membranes ; Pancreas ; Polyhydramnios ; Postoperative Complications ; Surgical Procedures, Operative ; Vomiting

Etiologic factors and prognosis of delayed postanoxic encephalopathy (DPE) was analyzed in 30 patients admitted in Yeungnam University Medical Center from March, 1984 to April, 1987. Twenty-three among the 30 cases was possible to be followed. The results are as follows. 1. The incidence in over 30 years of age was 77%, and sex ratio was 1:1.7 for male and female. 2. The lucid interval of DPE was from 5 to 191 days (mean=19 days) and interval between 3 to 4 weeks occupied 60%. 3. The longer the duration of exposure to CO and the more comatous of the mental state, the more increased was the incidence of DPE. 4. The hyperbaric O2 threapy had no influence on the incidence of DPE but absolute bed rest on acute CO poisoning ws important to prevent DPE. Therefore, absolute bed rest during lucid interval at least 2 weeks is more important factor to prevent DPE. 5. DPE victims are likely to retire from his social position.
Academic Medical Centers ; Bed Rest ; Female ; Humans ; Incidence ; Male ; Poisoning ; Prognosis* ; Sex Ratio

Portal vein anomalies include absence, duplication, and malposition (preduodenal portal vein). Duplication of the portal vein or a preduodenal portal vein are hazards at the time of biliary or duodenal surgery, or liver transplantation. Preduodenal portal vein, which was first reported by knight in 1921, is extremely rare congenital anomaly and may cause duodenal obstruction. Recently, we experienced a case of preduodenal portal vein associated with dextrocardia, situs inversus, and duodenal obstruction in a 3 days old male newborn and report with review of the references.
Dextrocardia ; Duodenal Obstruction* ; Humans ; Infant, Newborn ; Liver Transplantation ; Male ; Portal Vein* ; Situs Inversus

Primary peptic ulcer disease in not known to be the result of underlying illness or trauma. These are most frequently duodenal or prepyloric. Since clinical features of peptic ulcer in children can easily be confused with many other disorders, the diagnosis is usually made when one of the more dramatic presentations, such as perforation, bleeding and obstruction. Recently, we experienced 2 cases of duodenal obstruction due to peptic ulcer in children. So, we report it with review of references.
Child* ; Diagnosis ; Duodenal Obstruction* ; Hemorrhage ; Humans ; Peptic Ulcer*

No abstract available.
Varicose Veins

PURPOSE:Hypochondroplasia is a skeletal dysplasia characterized by poor childhood growth and an inadequate pubertal growth spurt. Final height attainment of hypochondroplasia has been reported to range between 120 and 152cm. Increased availability of growth hormone with the introduction of recombinant human growth hormone has allowed for clinical trials in a number of growth hormone sufficient children with growth problems. The purpose of this study was to assess the growth promoting effect of human growth hormone in children with hypochondroplasia. METHODS:Five patients with hypochondroplasia diagnosed by clinical and radiological findings between 1993 and 1997 at our hospital was aged 3 and 1/2 -11 and 1/2 years. Each patients continuously received human growth hormone 0.6-0.7U/Kg/week, intramuscularly or subcutaneously in 6-7 divided dose for 2 years. Standard auxologic assessment was carried out every 3 month interval in the first year after commencement of therapy and then same assessment was 6 monthly. Bone age was assessed 6 monthly using Gleurich-Pyle method. RESULTS:Mean height velocity of pretreatment and year 1 and 2 of GH treatment were 3.9+/-0.7, 6.5+/-1.8 and 5.7+/-1.5cm/year, respectively. Mean height standard deviation score for chronological age of pretreatment and year 1 and 2 of GH treatment were -2.7+/-0.3, -2.4+/-0.3 and -2.2+/-0.4, respectively. The increase in the height velocity diminishes over the subsequent year. The increment of bone age after GH treatment were same as the increments of chronological age. CONCLUSION: Short-term GH therapy increases the height velocity of children with hypochondroplasia, but the effect of GH therapy on final height remains unknown.
Child* ; Growth Hormone* ; Human Growth Hormone ; Humans

PURPOSE: To evaluate the utility of ultrasonograpy(US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. MATERIALS AND METHODS: In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, into three groups, as follows: anechoic (n=5), linear septa (n=15), and honeycombing septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. RESULTS: Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycombing septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. CONCLUSION: The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion.
Catheters ; Drainage* ; Fibrosis ; Follow-Up Studies ; Humans ; Pleural Effusion* ; Radiography, Thoracic ; Ultrasonography* ; Urokinase-Type Plasminogen Activator

PURPOSE: To evaluate the spatial distribution of various proton metabolites in the human brain with use of water-suppressed in vivo 1H MR spectroscopic imaging (MRSI) technique MATERIALS AND METHODS: All of water-suppressed in vivo 1H MRSI were performed on 1.5 T whole-body MRI/MRS system using Stimulated Echo Acquisition Method (STEAM) Chemical shift Imaging (CSI) pulse sequence. T1 -weighted MR images were used for CSl Field Of View (FOV; 24 cm). Voxel size of 1.S cm3 was designated from the periphery of the brain which was divided by 1024 x 16 x 16data points. RESULTS: Metabolite images of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) + choline/phosphocholine (Cho), and complex of gamma-aminobutyric acid (GABA) -I- glutamate (Glu) were obtained on the human brain. CONCLUSION: Our preliminary study suggests that in vivo 1H MRSl could provide the metabolite imaging to compensate for hypermetabolism on Positron Emission Tomography (PET) scans on the basis of the metabolic informations on brain tissues. The unique ability of in vivo 1H MRSI to offer noninvasive informations about tissue biochemistry in disease states will stimulate on clinical research and disease diagnosis.
Biochemistry ; Brain* ; Diagnosis ; gamma-Aminobutyric Acid ; Glutamic Acid ; Humans* ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Protons

Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditrary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patients associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.
Anemia ; Anemia, Hemolytic ; Child ; Cholecystectomy ; Choledocholithiasis ; Coombs Test ; Diagnosis ; Drainage ; Erythrocyte Membrane ; Erythrocytes ; Female ; Gallstones ; Humans ; Jaundice ; Male ; Osmotic Fragility ; Postoperative Complications ; Reticulocytosis ; Spectrin ; Spherocytes ; Splenectomy* ; Splenomegaly ; Wills

PURPOSE: To evaluate the various phosphorus metabolism' of breast tumors with use of in vivo phosphorus-31 (31P) M R spectroscopy (MRS) MATERIALS AND METHODS: Five patients with breast tumor (benign in two, malignant in three) and three normal healthy volunteers participated in this study. All in vivo31P MRS examinations were performed on 1.5 Twhole-body MRI/MRS system by using a Free Induction Decay (FID) pulse sequence. Tl-weighted MR images were used for localization of tumors. Peak areas for each phosphorus metabolite were measured using a Marquart algorithm. RESULTS: Breast carcinoma had a substantially larger phosphomonoester (PME) and a smaller phosphocreatine (PCr) peak intensity than normal breast tissue. This was reflected in the relatively higher PME/PCr ratio of breast carcinomas as well as phosphodiester (PDE)/PCr, inorganic phosphate (Pi)/PCr, and adenosine triphosphate (ATP)/PCr ratios, compared with normal controls. The mean pH value of breast tumor demonstrating the alkaline nature was higher than that of normal controls. Spectral patterns between benign breast disease and normal breast tissue were quite similar, and differentiation was not established. CONCLUSION: Our preliminary study suggests that in vivo 31P MRS is a noninvasive examination which may be useful in the early differentiation of malignant breast tumors from normal and benign conditions. However, normal control and benign conditions could not be characterized on the basis of the phosphorus metabolite ratios.
Adenosine Triphosphate ; Breast Diseases ; Breast Neoplasms* ; Breast* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy* ; Phosphocreatine ; Phosphorus ; Spectrum Analysis