A clinical review was made on 2,191 cases of general pediatric surgery under the age of 15 years which were operated upon at the Divisionof Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The number of operations in pediatric age were 13,144 (13.2%) out of total 99,555 operations at Chonnam University Hospital and the most prevalent age group was under 1 year of age (14.3%). The number of operations in Divisionof General Pediatric Surgery were 2,191 (16.7%) out of total 13,144 operations in pediatric age and the incidence of patients under 1 year of age in general pediatric surgery was 42.9% (941/2,191). The prevalent diseases under 1 month of age were anorectal malformations (20.6%) and hypertrophic pyloric stenosis (20.3%) and between 1 month to 1 year of age were inguinal hernia (32.4%) and intussusception (19.6%). The total motality rate in neonatal intensive care unit was 31.3%. Gastroschisis presented highest mortality.
Gastroschisis ; Hernia, Inguinal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intussusception ; Jeollanam-do ; Mortality ; Pyloric Stenosis, Hypertrophic

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Humans*

No abstract available.
Humans*

Conjoined twins are one of the rarest and most challenging congenital anomalies in pediatric surgery. Successful surgical separation is more unusual, since the majority of conjoined twins are incapable of separating successfully. The timing of separation is variable, but separation is usually delayed until such infants are relatively mature (i.e, 9-12 months of age). Operative survival was 50% in those operated on in the neonatal period, but 90% in those of over 4 months of age. Our case was early separated beacase of one of the twins having heart problems. These twins were omphalopagus and shared only simple liver bridge without vascular and biliary communications. Surgical separation was undertaken successfully on the 11th day of life, so we describe our experience with the review of the relevant literatures.
Heart ; Humans ; Infant ; Liver ; Twins, Conjoined*

PURPOSE: Mycophenolic acid (MPA), a selective inhibitor of inosine monophosphate dehydrogenase (IMPDH), is the active metabolite of the immunosuppressive drug, mycophenolate mofetil (MMF). MMF is used to prevent an immune- mediate rejection response following organ transplantation via the inhibition of the IMPDH and GTP biosynthesis pathway. This study was designed to elucidate the mechanism by which MPA exerts its cytotoxic effect on human T lymphocytic and monocytic cell lines. METHODS: MOLT-4 and U937 cell lines were treated with MPA. Cell viability, expression of Bcl2 family proteins and Fas/Fas-L, effects of antioxidants and intracellular Ca2+ regulating agents and apoptosis were measured using a variety of microscopic and biochemical techniques. RESULTS: MPA induced the death of U937 and MOLT-4 cells in dose and time dependent manners, which was revealed an apoptosis with a characteristic ladder pattern of DNA fragmentation. In addition, BAPTA/AM, an intracellular Ca2+ chelator protected MOLT-4 cells from MPA treated apoptosis, although it did not have an additive with thapsigargin, and increases cytosolic Ca2+ stores. However, antioxidants including reduced glutathione (GSH) and N-acetyl-L-cysteine (NAC) did not inhibit the apoptosis of cells by MPA. Furthermore, guanosine suppressed MPA induced apoptosis of MOLT-4 lymphocytes, although adenosine did not. MPA also increased the catalytic activity of caspase family cysteine proteases including caspase-8, 9 and 3 proteases in MOLT-4 cells. Sequential activation indicated that the cleavage of caspase-8 and 9 precedes those of caspase-3. CONCLUSION: The results suggest that MPA induces the apoptotic death of MOLT-4 lymphocytes via the activations of caspase family proteases and the depletion of GTP.
Acetylcysteine ; Adenosine ; Antioxidants ; Apoptosis ; Caspase 3 ; Caspase 8 ; Cell Line ; Cell Survival ; Cysteine Proteases ; Cytosol ; DNA Fragmentation ; Glutathione ; Guanosine ; Guanosine Triphosphate ; Humans ; Inosine Monophosphate ; Lymphocytes ; Mycophenolic Acid* ; Organ Transplantation ; Oxidoreductases ; Peptide Hydrolases ; Signal Transduction* ; T-Lymphocytes* ; Thapsigargin ; Transplants ; U937 Cells

Varicose vein is one of the most common vascular disorders of the lower extremities, and the two methods of treatment, ablative surgery and compression sclerotherapy are currently employed. Compression sclerotherapy has been controversial, but in recent, if it is performed in case of optimal indication, favorable effect can be expected. We reviewed 80 outpatients treated by compression sclerotherapy of varicose vein at Department of Surgery of Chonnam University Hospital from January, 1988 to December 1995 evaluate indication and usefulness of compression sclerotherapy. Indications for compression sclerotherapy included telangiectasia, reticular varicosities, reticular veins, isolated varicosities, below-the-knee varicosities, etc. Five percent ethanolamine oleate was utilized as a sclerosing agent in cases of absence of gross saphenous reflux, below knee varicosities, under 5.0mm in diameter, and elastic compression was continued for three months postsclerotherapy. The results were as follows ; 1) The distributions of age were 4th decade(38.7%), 5th decade(30.0%), 3rd decade(26.3%), in order. 2) The predisposing factors of varicose vein were profession requiring long periods of standing(51.2%), pregnancy(15%), in order. 3) Varicose veins were located in greater saphenous system(50%), lesser saphenous system (45%), and both (5.0%), in order. 4) The duration of clinical manifestation was 8-10 years(35.0%), 1-5 years(33.8%), in order. 5) The cardinal symptoms and signs were tortuosity of veins(100%), aching(80%), heaviness (50%), walking discomfort(30%), in order. 6) The outcome of treatment was that no further treatment was needed in 68 cases(85.0%), and re-treatment(sclerotherapy) was needed in 12 cases(15.0%). Among them, sclerotherapy was performed 2 times in 6 cases, 3 times in 4 cases, and 4 times in 2 cases. 7) The postsclerosing complications were hematoma(5 cases) and pigmentation(1 case). If compression sclerotherapy of lower extremities varicose vein is performed in selected patients, it may be the method of less expensive, safe and effective treatment.
Causality ; Ethanolamine ; Humans ; Jeollanam-do ; Knee ; Lower Extremity ; Oleic Acid ; Outpatients ; Sclerotherapy ; Telangiectasis ; Varicose Veins ; Veins ; Walking

Arterial pseudoaneurysm is an infrequent but potentially catatrophic complication of pancreatitis. A pseudoaneurysm is encountered in 6~9.5% of patient with chronic pancreatitis and as many as 17% of all patients operated on for chronic pancreatitis. A ruptured pseudoaneurysm is the most fatal complication with reported mortality rate as low as 12.5% in treated patients, greater than 90% in patients not receiving treatment. Therefore bleeding pseudoanurysms are required early diagnosis and radical treatment. We reviewed 8 patients who were admitted to Department of Surgery of Chonnam University Hospital for treatment of pseudoaneurysm complicating chronic pancreatits from January, 1993 to December, 1997. The results were as follows. 1) The patiens were all male, and the age range was 30 to 65 years(mean 47 years). 2) The most prevalent symtom and sign were anemia and abdominal pain(100%). 3) Angiography and abdiminal CT were performed in all patients. 4) Pseudoaneurysms were located in gastroduodenal artery(4 cases), branch of superior mesenteric artery(2 cases), superior mesenteric artery(1 case) and pancreaticoduodenal artery(1 case). 5) Transarterial embolization was performed in 6 cases and reembolization was done in 1 case and 1 rebleeding case was expired. 6) Operative management(aneurysmorrhaphy) was performed without complication in 2 cases. We consider that complete resection of pseudoaneurysm complicating chronic pancreatitis is the treatment of choice but transarterial embolization using coil may be considered as the first method of treatment.
Anemia ; Aneurysm, False ; Angiography ; Early Diagnosis ; Hemorrhage ; Humans ; Jeollanam-do ; Male ; Mortality ; Pancreatitis ; Pancreatitis, Chronic

PURPOSE: Mizoribine (MZR), an inhibitor of Inosine monophosphate (IMP) dehydrogenase which depletes cellular GTP, is clinically used as an immunosuppressive drug. This study was designed to evaluate the mechanism by which MZR exerts the cytotoxic effect on Jurkat T cells. METHODS: Jurkat T cell is a human T lymphocytic cell line. It was obtained from the Korean Type Culture Collection. Cell viability was measured by the MTT assay and flow cytometry. Caspase activity assay, Western blotting, 2-D PAGE, and mitochondrial membrane potential were detected using biochemical analysis. Morphologic finding was observed by Hoechst staining. RESULTS: The data demonstrated that the treatment of MZR decreased cell viability in a dose- and time-dependent manner. MZR-induced cell death was confirmed as apoptosis, which was characterized by chromatin condensation and H2AX phosphorylation. MZR increased the catalytic activity of caspase-3 protease, -8 protease and -9 proteases. The activation of caspase-3 protease was further confirmed by the degradation of polymerase (PARP), a substrate of caspase-3 protease by MZR in Jurkat T cells. Furthermore, MZR induced the changes of the mitochondrial transmembrane potential (MTP) and the cytosolic release of cytochrome c from the mitochondria. In addition, MZR induced the decrease of Bcl-X(L) expression whereas the increase of Bcl-X(S), Bak and Bim expression. Guanosine markedly inhibited cell viability and apoptosis through consistent suppression of the activity of caspase-8 protease, an upstream caspase among the caspase family, H2AX phosphorylation and PARP cleavage in MZR-treated cells. Also, I have screened the expression profile of proteins in the Jurkat T cells by using two-dimensional (2-D) gel electrophoresis. Among 300 spots resolved in the 2-D gels, the comparison of the control versus apoptotic cells revealed that the signal intensity of 10 spots was decreased and 5 spots was increased. CONCLUSION: The results suggest that MZR functions as an inhibitor of IMP dehydrogenase in apoptosis of Jurkat T cells via activation of intrinsic caspase cascades as well as mitochondrial dysfunction.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Cell Death ; Cell Line ; Cell Survival ; Chromatin ; Cytochromes c ; Cytosol ; Electrophoresis ; Flow Cytometry ; Gels ; Guanosine ; Guanosine Triphosphate ; Humans ; IMP Dehydrogenase ; Inosine Monophosphate ; Membrane Potential, Mitochondrial ; Membrane Potentials ; Mitochondria ; Oxidoreductases ; Peptide Hydrolases ; Phosphorylation ; T-Lymphocytes*