No abstract available.
Bone Marrow* ; Radionuclide Imaging*

The authors performed a retrospective review to find out optimal treatment plan in infantile fistula-in-ano. There were seventy-one patients in a 2-year period. All were male and other clinical characteristics were similar to previous reports. The onset in 60 patients(97%) of the cases was in the first 1 year of alee, especially in the first 3 months(52%). We investigated patterns of disease progression in multiple-lesion cases(19cases 29%). In 5 out of 9 cases of which we could identify the patterns, new lesion developed from 1 month to 4 months after index lesion. Fifty Patients underwent fistulotomy under principle of early surgical intervention, No recurrence was found except 2cases who needed second operation during 30 months of median follow-up(23~48 months). In 21 patients whose parents did not want operation, we performed simple drainage and followed-up. Six out of 12 patients who could be communicable had no fistula-related symptoms from 20 months to 31 months. This suggests that simple drainage has therapeutic effect in some portion of infantile abscess. We conclude that simple drainage should be initial treatment of choice in infantile perianal abscess. We suggest that definite operation for recurrent abscess and fistula with relatively mild symptoms should be delayed until 1-year of age because of interval ccurrence of multiple lesions and therapeutic effect of simple drainage.
Abscess ; Child ; Disease Progression ; Drainage ; Fistula ; Humans ; Infant* ; Male ; Parents ; Rectal Fistula ; Recurrence ; Retrospective Studies

BACKGROUND: The purpose of this study is to assess the ability of dipyridamole99mTc-MIBI SPECT to identify and localize coronary artery disease(CAD). METHODS: The study population consists of 60 patients(37 males, 23 females : mean age 57+/-10 years) including 30 with prior myocardial infarction who underwent both dipyridamole99mTc-MIBI SPECT and coronary angiography for the evaluation of chest pain. RESULTS: The sensitivities for detection of CAD(> or =50% and > or =70% coronary stenosis by angiography) by dipyridamole99mTc-MIBI SPECT are 96% and 98% respectively, and specifities are 71% and 73% respectively. The sensitivities for detection of individual diseased vessels(> or =50% and > or =70%) are 79% and 90% for left anterior descending artery(LAD), 53% and 59% for left circumflex artery(LCX), 45% and 53% for right coronary artery(RCA), 64% and 77% for LCX/RCA, 63% and 72% for total. The specificities for detection of individual diseased vessels(> or =50% and > or =70%) are 62% for LAD, 98% and 98% for LCX, 92% and 89% for RCA, 91% and 89% for LCX/RCA, 87% and 86% for total. The concordances for ditection of individual didseased vessels beteen coronary angiography and dipyridamole99mTc-MIBI SPECT are all fair for SAD(Kappa=0.4 in > or =50% stenosis, 0.54 in > or =70% stenosis)LCX(Kappa=0.56,0.63),RCA(Kappa=0.4,0.44) and LCX/RCA(Kappa=0.56,0.67). CONCLUSION: Dipyriddamole99mTc-MIBI SPECT appers to be an useful noninvasive test for both identification and localization of coronary artery disease.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Female ; Humans ; Male ; Myocardial Infarction ; Tomography, Emission-Computed, Single-Photon*

Video-assisted thoracic surgery (VATS) is a minimally invasive technique that has many advantages in postoperative pain and recovery time. Because of its advantages, VATS is one of the surgical techniques widely used in patients with lung cancer. Most surgeons perform VATS for lung cancer with three or more incisions. As the technique of VATS has evolved, single-port VATS for lung cancer has been attempted and its advantages have been reported. We describe our experiences of VATS for lung cancer with a single incision in this report.
Humans ; Lung ; Lung Neoplasms ; Pain, Postoperative ; Thoracic Surgery, Video-Assisted

BACKGROUND: Recently, single-port video-assisted thoracic surgery (VATS) has been proposed as an alternative to the conventional three-port VATS for primary spontaneous pneumothorax (PSP). The aim of this study is to evaluate the early outcomes of the single-port VATS for PSP. METHODS: VATS was performed for PSP in 52 patients from March 2012 to March 2013. We reviewed the medical records of these 52 patients, retrospectively. Nineteen patients underwent the conventional three-port VATS (three-port group) and 33 patients underwent the single-port VATS (single-port group). Both groups were compared according to the operation time, number of wedge resections, amount of chest tube drainage during the first 24 hours after surgery, length of chest tube drainage, length of hospital stay, postoperative pain score, and postoperative paresthesia. RESULTS: There was no difference in patient characteristics between the two groups. There was no difference in the number of wedge resections, operation time, or amount of drainage between the two groups. The mean lengths of chest tube drainage and hospital stay were shorter in the single-port group than in the three-port group. Further, there was less postoperative pain and paresthesia in the single-port group than in the three-port group. These differences were statistically significant. The mean size of the surgical wound was 2.10 cm (range, 1.6 to 3.0 cm) in the single-port group. CONCLUSION: Single-port VATS for PSP had many advantages in terms of the lengths of chest tube drainage and hospital stay, postoperative pain, and paresthesia. Single-port VATS is a feasible technique for PSP as an alternative to the conventional three-port VATS in well-selected patients.
Chest Tubes ; Drainage ; Humans ; Length of Stay ; Medical Records ; Pain, Postoperative ; Paresthesia ; Pneumothorax* ; Retrospective Studies ; Thoracic Surgery, Video-Assisted* ; Wounds and Injuries

PURPOSE: The identification of risk factors for bronchial hyperresponsiveness (BHR) is important in furthering the understanding of the cause of asthma. BHR is known to be related to atopy. We investigated the relations of BHR to sensitization to the five allergen groups in children aged 6-8 years. METHODS: Four hundred and seven 6-8 year old children with acute or chronic respiratory symptoms were enrolled. Each subject underwent methacholine bronchial challenge and skin-prick tests with airbone allergens. BHR was defined as PC20< or =8 mg/mL methacholine. Multiple logistic regression analysis was performed to study the independent relationship between BHR and sensitization to individual allergen group. RESULTS: The significant associations between BHR and skin-test response were against house dust mites (odds ratio=1.64, 95% confidence interval=1.02-2.65) and pollen (3.47, 1.18- 10.17) in total subjects, all after adjustment by sex, age, FEV1/FVC, total IgE, and a positive response to any of the other four allergen groups measured. In subjects with asthma, the significant association between BHR and positive skin-test response was observed only for house dust mites (2.53, 1.11-5.77). CONCLUSION: BHR was found to be related to atopy against house dust mite and pollen in subjects with respiratory symptoms, and against only house dust mites in subjects with asthma. These findings suggest atopy, especially against house dust mites, is an important risk factor for bronchial hyperresponsiveness in this age group.
Allergens ; Asthma ; Child* ; Humans ; Immunoglobulin E ; Logistic Models ; Methacholine Chloride ; Pollen ; Pyroglyphidae ; Risk Factors

PURPOSE: This study aimed to evaluate the validity of chest auscultation and oxygen saturation measurement in the assessment of bronchial hyperreactivity to inhaled methacholine in preschool children who were thought to be asthmatic clinically. METHODS: Seventy-two children with a history of more than three wheezing episodes in the previous year were considered the asthma group and underwent methacholine bronchial challenges. Provocation concentration at wheezing (PCw), at 5% fall of oxygen saturation (PCSat), and at 50% increase in respiratory rate (PCRR) were determined in each subject. One hundred and eighteen children who have had less than two wheezing episodes in their life served as control group. RESULTS: The geometric means of PCw, PCSat, and PCRR of asthma group were significantly lower than those of the control group. The optimal cut-off level for PCw was 8 mg/mL, giving a sensitivity of 63% and a specificity of 78%. Corresponding values for PCSat and PCRR were 8 mg/mL (72%, 67%) and 16 mg/mL (49%, 86%), respectively. The area under the receiver operating characteristic (ROC) curve for PCw, PCSat, and PCRR were 0.80, 0.88, and 0.70 respectively. The discriminative capacity of PCSat as judged by ROC curve analysis exceed those of PCw and PCRR. CONCLUSION: These findings provide support for the use of chest auscultation and oxygen saturation measurement as a tool in the assessment of bronchial hyperreactivity. The cut-off level of 8 mg/mL for PCSat, owing to its highest discriminative capacity, may be useful for the diagnosis of asthma in preschool children.
Asthma ; Auscultation* ; Bronchial Hyperreactivity* ; Bronchial Provocation Tests ; Child ; Child, Preschool* ; Diagnosis ; Humans ; Methacholine Chloride ; Oxygen* ; Respiratory Rate ; Respiratory Sounds* ; ROC Curve ; Sensitivity and Specificity ; Thorax*

The aim of study was to describe Mycoplasma pneumoniae epidemics in a hospital-based population. Special attention was paid to the relationship between antibody titer to M. pneumoniae and sex, age, and atopy. During the eight 6-month periods between January 2000 and December 2003, serum samples were obtained from 1,319 Korean children who presented with respiratory symptoms, and were examined for antibodies to M. pneumoniae using the indirect particle agglutination test. Geometric mean antibody titers peaked in the second half of 2000 and then decreased gradually, a second peak occurred in the second half of 2003. Likewise, the frequency of high antibody titers (>or=1:640) also peaked during these two periods. Antibody titers in children aged 0-3 yr were lower than in older children during both peak periods and for 2 yr after the first peak. Sex and atopy had no effect on antibody titers. During the years 2000-2003, geometric mean antibody titers and the frequencies of high antibody titers varied with time. These changes suggest a cyclic pattern of M. pneumoniae infection, with two epidemic peaks separated by 3 yr.
Adolescent ; Age Distribution ; Antibodies, Bacterial/*blood ; Child ; Child, Preschool ; Disease Outbreaks/statistics & numerical data ; Female ; Humans ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Mycoplasma pneumoniae/*immunology ; Pneumonia, Mycoplasma/*blood/epidemiology/immunology ; Research Support, Non-U.S. Gov't ; Sex Distribution ; Time Factors

PURPOSE: To determine whether Tc-99mMIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively Tc-99mMIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular Tc-99m-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. MATERIALS AND METHODS: We measured percentage uptake of Tc-99m-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of Tc-99m-MIBI were also evaluated with or without overexpression of mdr1 gene in cultured murine leukemia L1210 cells. RESULTS: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of Tc-99m-MIBI was higher in mdr1 negative L1210 cells than those of mdr1 positive cells, and higher when incubated in 37 degree C than 4 degree C. In the presence of verapamil, cyclosporin or dipyridamole, Tc-99m-MIBI uptake was increased upto 604% in mdr1 positive cells. CONCLUSION: Cellular uptake of Tc-99m-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MDR-reversing agents increase cellular uptake. These results suggest that Tc-99m-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents In vitro.
Animals ; Cell Line ; Cyclosporine ; Dipyridamole ; Doxorubicin ; Drug Resistance, Multiple* ; Leukemia L1210 ; Leukemia* ; P-Glycoprotein ; Technetium Tc 99m Sestamibi* ; Verapamil ; Vincristine

Duplications of the alimentary tract are rare congenital malformations and accurate diagnosis is difficult. Duplications can occur at any level in the gastrointestinal tract. Ileal duplications are the most common while colonic duplications are rare. Duplications are usually single, vary widely in size, are more often spherical than tubular and are lined by alimentary tract mucosa. They usually share a common smooth muscle wall and blood supply with the adjacent bowel, with which they may be communicated. Some duplications are asymptomatic but more than 80% of cases present before age of 2 years. Recently, we have experienced a case of duplication of the transverse colon in 9-year old female patient without any other combined anomaly. The chief complaint were palpable abdominal mass, defecational difficulty and intermittent cramping pain of abdomen. The duplication of the transverse colon was diagnosed at operation. A left hemicolectomy was performed with complete resection of duplicated bowel. We report a case of colonic duplication and review the literature.
Abdomen ; Child ; Colon ; Colon, Transverse* ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Mucous Membrane ; Muscle Cramp ; Muscle, Smooth