The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.
Analgesia ; Analgesics ; Anesthetics, Local* ; Body Weight ; Bupivacaine ; Child* ; Femoral Nerve ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Nerve Block* ; Pain, Postoperative* ; Paralysis ; Postoperative Period ; Wounds and Injuries

A 12-year-old boy developed cholestatic hepatitis with Steven-Johnson syndrome following the use of amoxicillin. The skin lesion and general condition were improved over 2 weeks, but jaundice was gradually aggrevated. We performed liver biopsy, on 30th hospital day, which showed cholestatic hepatitis. The patient improved gradually and liver function was normalized 5 months later.
Amoxicillin ; Biopsy ; Child ; Hepatitis* ; Humans ; Jaundice ; Liver ; Male ; Skin

Purpose: This study was performed to evaluate changes in Achilles tendon (AT) characteristics of asymptomatic tendons in patients with acute AT ruptures on the contralateral side by using ultrasonography. Methods: From January 2016 to December 2018, 31 patients were enrolled. The contralateral asymptomatic ATs were assessed: (1) fluid collection of paratenon, (2) echogenicity, and (3) thickness. The ATs were divided into the distal, middle, and proximal thirds for evaluation and were assessed before the surgery, as well as at 6 weeks, 3 months, 6 months, and 12 months after the surgery. At each time, pain in the tendons was recorded. Results: In all cases, it was observed that there was a hypoechoic lesion or fluid collection of the paratenon, which did not show a significant change over time. There was no significant difference in tendon thickness according to the period in the distal and proximal areas, and significant differences were observed only in the middle area (p＜ 0.05). A new pain around the tendon occurred most often at 6 weeks after surgery (eight cases of 31 cases, 25.8%). Eight cases of pain (47.1%) remained at 12 months after surgery. Conclusion In patients with acute AT rupture, ultrasonographic hypoechoic lesions or fluid collections of the paratenon were initially observed on the contralateral tendon, but this did not show significant changes over time. A significant change in tendon thickness was observed in the middle area, but this did not show a close association with pain.

Owing to rapid development of laparoscopic thechnique and equipment, even to laparoscopic radical hysteretomy was possible. The objectives of this study were to evaluate the feasibilltiy, and operative and postoperative outcomes fo our intial experience of total laparoscopic hysteretomy(TLH) at the Department of Obstetrics nad gynecology, Kyong Pook National Unviersity Hospital from April 1995 to July 1995.20 cases were completely performed by laparoscopy(80%). 5case were conveted to vaginal procedure (20%) due to bleeidng and difficulty in dissection of parametrial tissue.None of these patient had laparotomy. The mean age of the patients was 46.6 +/- 6.2 years old. The most common indication was myoma (50%). Other indications were adenomyosis (25%), myoma with adenomyosis(15%), adenomysis with endometriosis(5%) and endometrial carcinoma(5%). The mean operative time was 148.0 +/- 51.0(100~245)minutes, the mean estimated blood loss was 99.9 +/- 84.9(20~350)ml, the mean uterine weight was 312.1 +/- 110.2(105~570)gm, and the mean hospital stay was 5.1 +/- 1.7(3~11) DAY. The complications of TLH were 2cases of vaginal cuff infection, and 4 transfusions due to anemia and blood loss during operation. The most common combined operation was bilateral salpingoophorectomy. Out sutdy suggested that even large sized myoma up to 570mg can be removed by laparoscopy without delayed bleeding. Even the technique of TLH was difficult and only performed by an experienced laparoscopic pelvic surgeon in the selected cases, but we had experience of many advatages by use of vaginal tube, such as avoiding ureter injury, reducing volume of parametrium and reducing gas loss during laparoscopic suturing. It is clear that not all patients requiring hysterectomuy will benefit from total laparoscopeic hysterectomy but some patients who were dificult for vaginal hysterectomy beacse of narrow and atrophic vagina and poor uterine mobility may have some benefits from TLH.
Adenomyosis ; Anemia ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Length of Stay ; Myoma ; NAD ; Obstetrics ; Operative Time ; Ureter ; Vagina

Owing to rapid development of laparoscopic thechnique and equipment, even to laparoscopic radical hysteretomy was possible. The objectives of this study were to evaluate the feasibilltiy, and operative and postoperative outcomes fo our intial experience of total laparoscopic hysteretomy(TLH) at the Department of Obstetrics nad gynecology, Kyong Pook National Unviersity Hospital from April 1995 to July 1995.20 cases were completely performed by laparoscopy(80%). 5case were conveted to vaginal procedure (20%) due to bleeidng and difficulty in dissection of parametrial tissue.None of these patient had laparotomy. The mean age of the patients was 46.6 +/- 6.2 years old. The most common indication was myoma (50%). Other indications were adenomyosis (25%), myoma with adenomyosis(15%), adenomysis with endometriosis(5%) and endometrial carcinoma(5%). The mean operative time was 148.0 +/- 51.0(100~245)minutes, the mean estimated blood loss was 99.9 +/- 84.9(20~350)ml, the mean uterine weight was 312.1 +/- 110.2(105~570)gm, and the mean hospital stay was 5.1 +/- 1.7(3~11) DAY. The complications of TLH were 2cases of vaginal cuff infection, and 4 transfusions due to anemia and blood loss during operation. The most common combined operation was bilateral salpingoophorectomy. Out sutdy suggested that even large sized myoma up to 570mg can be removed by laparoscopy without delayed bleeding. Even the technique of TLH was difficult and only performed by an experienced laparoscopic pelvic surgeon in the selected cases, but we had experience of many advatages by use of vaginal tube, such as avoiding ureter injury, reducing volume of parametrium and reducing gas loss during laparoscopic suturing. It is clear that not all patients requiring hysterectomuy will benefit from total laparoscopeic hysterectomy but some patients who were dificult for vaginal hysterectomy beacse of narrow and atrophic vagina and poor uterine mobility may have some benefits from TLH.
Adenomyosis ; Anemia ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Laparoscopy ; Laparotomy ; Length of Stay ; Myoma ; NAD ; Obstetrics ; Operative Time ; Ureter ; Vagina

PURPOSE: To evaluate the efficacy of wide excision of subconjucntival fibrovascular tissue after conjunctivo-limbal autograft of primary and recurrent pterygium. METHODS: Sixty-five eyes of 59 patients underwent pterygium excision with conjunctivo-limbal autograft. Thirty-six eyes of 33 patients had wide excision of pterygium, 29 eyes of 26 patients did not have wide excision of pterygium. All patients underwent follow-up for more than one year. Complications, recurrence rate, and operation time were evaluated. RESULTS: With a minimum of one year of follow-up, there was no recurrence in either group. Six cases (17%) of subconjunctival fibrosis at the donor site, one case (3%) of subconjunctival neovascularization at the donor site, and one case (3%) of wound gapping at the recipient site were noted in the wide excision group. In the non-wide excision group, there were two cases (7%) of subconjunctival fibrosis at the donor site, one case (3%) of granuloma at the donor site, and one case (3%) of retention cyst at the recipient site. Mean operating time in the non-wide excision group (45.2 +/- 6.9 minutes) was significantly shorter than that in the wide excision group (62.4 +/- 6.2 minutes). CONCLUSIONS: Non-wide excision with conjunctivo-limbal autograft in pterygium surgery can be considered an effective treatment with shorter operating time than the wide excision method. Both of these methods show low recurrence rates and few complications for both primary and recurrent pterygia.
Eye ; Fibrosis ; Follow-Up Studies ; Granuloma ; Humans ; Pterygium ; Recurrence ; Retention (Psychology) ; Tissue Donors

PURPOSE: The purpose of this study is to compare clinical outcomes with blood lipids level and lipid solubility of organophosphate-poisoned patients. METHODS: Data from 88 patients who visited the emergency room from January 2008 to July 2014 were analyzed. This study was conducted retrospectively using blood test results and progress notes. The contents of data included the type of organophosphate herbicide, ingesting dose, vital signs on emergency room, blood lipids level, electrocardiographic finding, and hospital course. For lipid solubility, octanol/water coefficient was used. RESULTS: Among a total of 88 patients with organophosphate herbicide intoxication, 48 patients ingested high lipophilic organophosphate. There were statistically significant between cholesterol and duration of ventilator care. And there was a trend toward significance between cholesterol and intensive care unit, total admission stay, between triglyceride and total admission stay. As cholesterol and triglyceride level of patient was higher, the prognosis was worse. CONCLUSION: In this study, blood cholesterol and triglyceride levels in high lipophilic organophosphate herbicide intoxicated patients are useful predictable factors for prognosis.
Cholesterol ; Electrocardiography ; Emergency Service, Hospital ; Hematologic Tests ; Humans ; Intensive Care Units ; Organophosphate Poisoning* ; Prognosis ; Retrospective Studies ; Solubility ; Triglycerides ; Ventilators, Mechanical ; Vital Signs

Osteochondroma, the most frequent benign bone tumor, is composed of trabecular bone covered with a hyaline cartilage cap. It is well known that multiple osteochondromatosis may undergo malignant change. Such sarcomatous change usually present with the form of chondrosarcoma, and transformation to other malignancy is extremely rare. This report describes one case of osteosarcoma arising in patients who had multiple osteochondromatosis, and includes brief review of the literatures.
Chondrosarcoma ; Exostoses, Multiple Hereditary* ; Humans ; Hyaline Cartilage ; Osteochondroma ; Osteosarcoma*

Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early 2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverse event and occurs in approximately 1%–6% of patients. Choosing the optimal treatment modality is a complex process. Clinicians must understand that nutritional support and drainage of fluid collection are essential for initial management. Conservative endoscopic management and sufficient drainage can resolve approximately 70% of SLLs. Endoscopic management of bariatric complications has been rapidly evolving in recent years and can be considered in all patients who are hemodynamically stable. We will review the available endoscopic management techniques, including stent placement (self-expanding stents and bariatric-specific stents), clipping, tissue sealant application, and internal drainage (double-pigtail stents [DPS] placement, endoscopic vacuum therapy, and septotomy). Stent placement remains the mainstream treatment for SLLs. However, healing with stents requires multiple sessions/stents and a long course of recovery. Endoscopic internal drainage is gaining popularity and has the potential to be a superior method. The importance of early intervention and combined endoscopic methods should be recognized.

Although the reconstruction with tumor prosthesis is a routine procedure for extremity sarcomas, this option has some technical limitation in children under 10 years old. Customized expandable tumor prosthesis is too expensive in most cases and arthrodesis of any kind is not functional. This report presents one case of osteosarcoma of distal femur in eight years old child which was reconstructed with adult type total elbow endoprosthesis as a reconstructive option, and includes brief review of the literature.
Adult ; Arthrodesis ; Child ; Elbow* ; Extremities ; Femur* ; Humans ; Knee Joint* ; Knee* ; Osteosarcoma* ; Prostheses and Implants ; Sarcoma