No abstract available.
Pancreaticoduodenectomy*

A study was carried out to figure the cases and to observe the endemic status of clonorchiasis and metagonimiasis in endemic areas in Korea. Total 13,373 inhabitants living in 40 villages along 7 main rivers and 9 small streams were subjected to stool examination. They were selected randomly among the riverside population. Their specimens were examined both by cellphane thick smear method and Stoll's egg countung technique. This study was performed during the period from May 1979 to April 1980. The results obtained are as follows: The egg positive rate of any kind of helminths was 58.7% out of 13,373 examned cases, and the egg positive rates by each helminth were; Clonorchis sinensis 21.5%, Metagonimus yokogaqai 4.8%, large type Metagonimus eggs 0.4%, Ascaris lumbricoides 22.9%, Trichuris trichiura 35.2%, hookworm 0.2%, Taenia sp. 0.5%, Hymenolepis nana 0.07%, Paragonimus westermani 2 cases, Fasciola sp. 4 cases, Echinostoma sp. 1 case and Hymenolepis diminuta 1 case respectively. Many endemic foci of clonorchiasis were revealed along the 7 major rivers. The egg positive rates of each river basin differed from each other significantly; Nagdonggang 40.2%, Yeongsangang 30.8%, Seomjingang 17.3%, Hangang 15.7%, Tamjingang 15.9%, Geumgang 12.0% and Mangyeonggang 8.0%. The cases of clonorchiasis were estimated in range 830,000 to 890,000 in riverside areas of the 7 rivers. By grading the infection intensity, 64.7% was in Grade I(EPG 0-900), 28.6% in Grade II (EPG 1000-9,900), 5.5% in Grade III (EPG 10,000-29,900) and 1.3% in Grade IV (EPG over 30,000). The proportion of the cases in Grade III and IV was 6.8% among positive cases. Therefore 60,000 cases at least were regarded to suffer from it clinically. Males of 30-60 years of age showed higher positive rate and heavier burden of infection. This makes clonorchiasis more important socially because the patients lose their social productivity. A few endemic foci of metagonimiasis were detected newly by egg detection; Samcheong 28.5% egg positive rate, Uljin 21.3%, Yeuongdeog 46.3%, Milyang 6.7%, Yeongil 9.2% and Geoje 18.2%. The mean EPG values were in range of 320-7, 120 by the focus. The egg positive rate and proportion of EPG Grade varied greatly by the area, and mean proportion of the positive cases were 69.7% in Grade I, 24.1% in Grade II, 5.0% in Grade III and 1.2% in Grade IV. Males of 30-60 years were infected in higher rate also. The large sized eggs of Metagonimus were found also in upper basin of Hangang and Geumgang mainly. They were regarded as eggs of M. takahashii which is mediated by the cyprinid fishes. Its significance should be studied further. Clonorchiasis and metagonimiasis should be realized as important public health problems in Korea by their wide distribution, high prevalence rate and heavy infection intensity. Comprehensive measures against them are needed urgently.
parasitology-helminth-trematoda ; clonorchiasis ; metagonimiasis ; Clonorchisis sinensis ; Metagonimus yokogawai ; epidemiology

BACKGROUND: Controlled hypotension is used to reduce bleeding and improve surgical conditions during surgery. Remifentanil is an ultrashort-acting opioid with potent analgesic effect and is useful for rapid emergence. This study was performed to investigate the clinical usefulness of remifentanil for induced hypotension during orthognathic surgery. METHODS: Fifty adult patients scheduled for orthognathic two jaw surgery were randomly allocated to nitroglycerin (group N) and remifentanil group (group R). After induction of anesthesia, group N (n = 25) was infused with nitroglycerin to induce hypotension, and group R (n = 25) was infused with remifentanil. Mean arterial pressure (MAP) and heart rate (HR) were measured before, 5, 10, 20, and 30 min after drug administration. Surgical field rating and blood loss were measured after surgery. RESULTS: Heart rates at 10, 20, 30 minutes after continuous infusion of drug were lower in group R than in group N (P < 0.05). The time for the MAP to return to the baseline after discontinuation of drug infusion was shorter in group R than in group N (P < 0.05). There were no significant differences in the surgical field rating and blood loss between the groups. CONCLUSIONS: Remifentanil enabled controlled hypotension and provided good surgical conditions for orthognathic surgery with no need for additional use of a hypotensive agent.
Adult ; Anesthesia ; Arterial Pressure ; Heart Rate ; Hemorrhage ; Humans ; Hypotension ; Hypotension, Controlled* ; Jaw* ; Nitroglycerin ; Orthognathic Surgery*

Twenty four subjects at weaning period were selected for experimental feeding of 10% fish flour supplements with wheat flour noodles. Experimental regimen was 2 months. Total serum protein, hemoglobin, hematocrit, and red blood cell counts were increased significantly in both sexes. However, a reduction of albumin concentration in serum was found ; also significant increases in globulin fractions occured. Although results suggest an advantage of fish flour supplements, further investigation is required to conclude the definite benefit of fish Hour supplements to Korean children, who need taste acceptability tests of fish flour under strictly controlled conditions.

PURPOSE: This study was aimed to evaluate the clinical features of seizures in breastfed children with vitamin D deficient rickets. METHODS: Seventeen children, breastfed and diagnosed as vitamin D deficient rickets at Inha University Hospital from January 2000 to July 2010, were retrospectively investigated. Subjects were divided into two groups according to the presence/absence of seizures. Demographic and biochemical results were compared and statistically analyzed between the two groups, and the relative risk for seizure occurrence was estimated. Clinical features of seizures were also analyzed. RESULTS: Out of the 17 subjects, nine patients (53.0%) had seizures, while eight patients (47.0%) did not. The mean age for the two groups were 4.1+/-2.0 months and 9.3+/-2.7 months, respectively, which was statistically different between the two groups (P<0.0001). Serum calcium (Ca) and 25-hydroxyvitamin D3 (25-OHD3) levels were significantly lower in the 'seizure' group (5.7+/-1.0 vs. 9.5+/-0.9 mg/dL, P<0.0001; 5.7+/-0.8 vs. 15.3+/-4.2 IU/L, P<0.0001). The relative risk for seizure occurrence was 8 times higher in hypocalcemia and 17 times higher in 25-OHD3<8 ng/mL. Seizures occurred several times as generalized or focal types, but none of them developed epilepsy nor showed developmental abnormalities later on. CONCLUSION: Seizures in breastfed children with vitamin D deficiency rickets are mainly due to hypocalcemia, which is affected by 25-OHD3 levels. Seizures may also occur more frequently in children in the stages of rapid growth. Although seizures occurred multiple times, future outcomes were favorable. Further large-scaled prospective studies are required in the future.
Breast Feeding ; Calcifediol ; Calcium ; Child ; Epilepsy ; Humans ; Hypocalcemia ; Retrospective Studies ; Rickets ; Seizures ; Vitamin D ; Vitamin D Deficiency

Burkitt's lymphoma is a distinct pathologic entity characterized as a diffuse undifferentiated malignant lymphoma of B-lymphocyte origin. We experienced a case of Burkitt's lymphoma with bilateral renal enlargement in which a 3year-old male patient was admitted with complaints of abdominal distention and facial edema. Laboratory examination revealed positivity for CD 19, CD 10, CD 20 and c-myc on flow cytometry, bilateral renal enlargement(10x12cm in longitudinal length) on abdominal ultrasonogram and CT, malignant lymphoma of Buritt's type with prominent nucleoli and cytospin of cerebrospinal fluid. Initially he showed tumor lysis syndrome and clinical stage D by Zigler(stage IV by Murphy) with CNS involvement. After initial management with hydration, urine alkalinization and allopurinol, combination chemotherapy had been applied with the craniospinal radiotherapy according to the CCG 503 II regimane, with achievement of complete remission. Thus we report a case of Burkitt's lymphoma with bilateral renal enlargement with a biref review of literatures.
Allopurinol ; B-Lymphocytes ; Burkitt Lymphoma* ; Cerebrospinal Fluid ; Drug Therapy, Combination ; Edema ; Flow Cytometry ; Humans ; Lymphoma ; Male ; Radiotherapy ; Tumor Lysis Syndrome ; Ultrasonography

PURPOSE: With a remarkable increase in the prevalence of childhood obesity, the prevalence of nonalcoholic fatty liver disease is assumed to be increasing. The aim of this study is to evaluate the prevalence of nonalcoholic fatty liver disease, hyperlipidemia, and glucose intolerance in normal and obese children. METHODS: A total of 2,206 elementary students (boys: 1340, girls: 866) were grouped according to obesity index; normal group and obesity group (mild, moderate, severe). Aspartate aminotransferase (AST, SGOT) and alanine aminotransferase (ALT, SGPT) were measured with total cholesterol, triglyceride, and fasting blood glucose. RESULTS: Compared with the 4.6% of elevated aminotransferases in normal group, obese groups showed significantly higher prevalence; 12.1% in mild obesity group, 19.4% in moderate group, and 21.6% in severe group (p<0.0001). The prevalence of hypertriglyceremia was 16.9% in normal weight group, which was significantly lower than obesity group (mild obesity group 30.3%, moderate and severe 37.6%, 38.2% each). In boys, the prevalences of elevated aminotransferases in normal weight and obese groups (mild, moderate, severe) were 6.8%, 18.0%, 23.0%, and 26.0%, respectively (p<0.0001). In girls, those were 2.1%, 5.1%, 12.0%, and 12.6%, respectively (p<0.0001). The prevalence of hypertriglyceremia was relative to severity of obesity in boys and girls (p<0.0001). CONCLUSION: The prevalence of elevated serum liver enzymes increased with severity of obesity. For the prevention and treatment of fatty liver and hypertriglycemia, it is important to lower the obesity degree and enforce the education for a weight loss in the student and the parents.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Child* ; Cholesterol ; Education ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Humans ; Hyperlipidemias ; Liver* ; Obesity ; Parents ; Pediatric Obesity ; Prevalence* ; Transaminases ; Triglycerides ; Weight Loss

Patients with giant congenital melanocytic nevi may grow up to have melanotic tumors characterized by central nervous system involvement, termed neucutaneous melanosis. Neurocutaneous melanosis is a rare but a significant congenital syndrome characterized by large or multiple congenital melanocytic nevi and benign or malignant pigment cell tumors of the leptomeninges. The prognosis is extremely poor for symptomatic patients, even in the absence of malignant melanoma. We experienced a case of a neurocutaneous melanosis with congenital giant hairy nevi, who grew up to have progressive leptomeningeal melanomatosis and whose neurologic conditions were rapidly deteriorated to death. So we report the case with a brief review of related literature.
Central Nervous System ; Child* ; Humans ; Melanoma ; Melanosis* ; Nevus* ; Nevus, Pigmented ; Prognosis

Norwegian or crusted scabies is a rare, highly contagious atypical form of scabies caused by the mite Sarcoptes scabiei var. homonis. It is usually associated with advanced age, immunosuppression, physical debility, and developmental disabilities. We report here a case of Norwegian scabies in an institutionalized patient with chronic kidney disease (CKD) and Down syndrome. A 56-year-old male presented at our department with pruritic rash and general weakness of 2 months' duration. Examination showed hyperkeratotic, scaly, crusted erythematous plaques on the hands, trunk, and back of the patient. The microscopic examination of the skin scales with potassium hydroxide demonstrated numerous scabies mites. The patient was treated with hemodialysis and repeated applications of 1% lindane lotion for 2 weeks. He reported significant relief of pruritus and resolution of the skin lesions after the treatment. In addition to uremic pruritus, infectious skin diseases such as Norwegian scabies should be considered in the institutionalized patients with advanced CKD and resistant pruritus.
Developmental Disabilities ; Down Syndrome ; Exanthema ; Hand ; Humans ; Hydroxides ; Immunosuppression ; Kidney Failure, Chronic ; Lindane ; Male ; Middle Aged ; Mites ; Potassium ; Potassium Compounds ; Pruritus ; Renal Dialysis ; Renal Insufficiency, Chronic ; Sarcoptes scabiei ; Scabies ; Skin ; Skin Diseases, Infectious ; Weights and Measures

Cyclosporin A-induced central neurotoxicity has been rarely reported in patients with nephrotic syndrome. We report a pediatric patient who developed acute leukoencephalopathy diagnosed by MRI during CsA therapy for nephrotic syndrome.
Cyclosporine* ; Humans ; Leukoencephalopathies* ; Magnetic Resonance Imaging ; Nephrotic Syndrome*