No abstract available.
Pierre Robin Syndrome*

No abstract available.
Pyloric Stenosis*

Ketotifen, a benzocycloheptathiophene, has an orally effective antiallergic as well as antihistaminic properties. In pervious studies, Ketotifen has shown encouraging results on patient with allergic rhinitis, either perennial or seasonal. 39 patients with allergic rhinitis had been treated with Ketotifen 1 mg twice daily for 8 weeks. And we obtained following results. 1) The efficacy rate in sneezing attack was 73.5%, in nasal discharge 71%, in nasal obstruction 58%. 2) Some improvements in at least one of three-major symptoms were noted within 1 week in 30.7%, within 2 weeks in 55.8%, within 3 weeks in 66.7%, within 8 weeks in 87.2%. 3) Physical findings such as colour, swelling of turbinate, character of rhinorrhea were not improved significantly. 4) Side effect was observed only in one patient with abdominal pain and diarrhea, which was subsided after interruption of administration. These results suggested that Ketotifen was effective in treatment of allergic rhinitis.
Abdominal Pain ; Diarrhea ; Humans ; Ketotifen* ; Nasal Obstruction ; Rhinitis, Allergic* ; Seasons ; Sneezing ; Turbinates

A prominent crista terminalis is a normal anatomic variant which consist of thick muscular bridge within the right atrium. However, it could be often misdiagnosed with an abnormal mass on the transthoracic echocardiography. The case report presented here, describe the findings of transthoracic echocardiography that suggested a right atrial mass in patients with pulmonary embolism. However, subsequent transesophageal echocardiography and cardiac computed tomography/magnetic resonance imaging differentiated a true right atrial mass from a prominent crista terminalis.
Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Pulmonary Embolism

PURPOSE: To compare the efficacy of an intralesional steroid injection in the treatment of chalazion according to triamcinolone acetonide (TA) concentrations. METHODS: A total of 108 patients with 120 chalazia received an intralesional injection of TA. Patients were divided into 3 groups according to the concentrations of TA: 5 mg/ml, 10 mg/ml, and 40 mg/ml. A regular follow-up was performed and the size of lesion and recurrence were evaluated. RESULTS: Success was defined as a minimum of 80% decrease in size with no recurrence. The success rate was 78.1% in the 5 mg/ml group, 76.2% in the 10 mg/ml group, and 78.4% in the 40 mg/ml group. These results were not statistically significant (p = 0.999, Fisher's exact test). Yellow deposits developed in 4 out of 37 lesions in the 40mg/ml group, and in 1 out of 42 lesions in the 10 mg/ml group. Skin depigmentation was observed in 1 case in the 5 mg/ml group. CONCLUSIONS: Intralesional TA injection is an effective treatment for chalazion. There is no significant difference in success rates according to the concentrations of TA. However, caution is advised in cases of high injection concentrations of TA to prevent yellow deposits.
Chalazion ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Recurrence ; Skin ; Triamcinolone ; Triamcinolone Acetonide

Hajdu-Cheney syndrome (HCS) is a rare skeletal dysplasia that is characterized by acroosteolysis of the distal phalanges, distinctive craniofacial and skull changes, dental abnormalities and generalized osteoporosis. The clinical and radiologic characteristics are variable and these characteristics progress with age. This syndrome shows autosomal dominant inheritance with sporadic cases. The genetic defects or molecular pathogenesis of HCS are still unknown. We experienced a case of Hajdu-Cheney syndrome in a 20-year-old man who had generalized osteoporosis with multiple non-traumatic spine compression fractures. He had acroosteolysis of the hands and feet, wormian bones in the skull, facial dysmorphism (mid-facial flattening, micrognathia and bushy eyebrows), a high arched palate, malocclusion and short dental alveolar processes. HCS was diagnosed based on the clinical and radiologic evidence. For the differential diagnosis, we excluded the other possible causes of the acroosteolysis and wormian bones, including hyperparathyroidism, osteogenesis imperfecta, hypophosphatemia and mandibuloacral dysplasia. The specific treatment of HCS is unknown, but case reports with bisphosphonate treatment have been reported.
Acro-Osteolysis ; Alveolar Process ; Diagnosis, Differential ; Foot ; Fractures, Compression ; Hajdu-Cheney Syndrome ; Hand ; Humans ; Hyperparathyroidism ; Hypophosphatemia ; Malocclusion ; Osteogenesis Imperfecta ; Osteoporosis ; Palate ; Skull ; Spine ; Wills ; Young Adult

BACKGROUND: Recovery from anesthesia, postoperative pain, nausea and vomiting are very important after pediatric tonsillectomy surgery. We compared the effects of supplemented opioids (remifentanil, meperidine) combined with sevoflurane on the recovery and side effects. METHODS: Patients were randomized to receive meperidine (group M, n = 41) or remifentanil (group R, n = 43). Group R received a bolus dose of normal saline, and group M 1 mg/kg of meperidine. A continuous infusion of normal saline was followed in the group M, and remifentanil 0.25micro/kg/min in the group R. In all patients, signs of inadequate anesthesia were treated with an increase of sevoflurane concentration. Intraoperative hemodynamics, recovery profiles, and side effects were assessed. RESULTS: Supplemented remifentanil resulted in significantly lower systolic blood pressure and heart rate during operation (P < 0.05). The emergence from anesthesia was not different between groups. Although the patients in the group R had early recovery characteristics at recovery room, time to discharge at recovery room was longer in the group R than in the group M (P < 0.05). The incidence of retching and vomiting was not different between groups. Supplemented meperidine resulted in less analgesic requirements than the other group (P < 0.05). CONCLUSIONS: Supplemented remifentanil was associated with hemodynamic stability, however it provided later discharge time at recovery room. Postoperative analgesic requirements were reduced by the supplemented meperidine without increasing postoperative nausea, vomiting.
Analgesics, Opioid ; Anesthesia* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Meperidine ; Nausea ; Pain, Postoperative ; Pediatrics* ; Postoperative Nausea and Vomiting ; Recovery Room ; Tonsillectomy* ; Vomiting

PURPOSE: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. METHODS: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. RESULTS: Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1–17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p<0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. CONCLUSION: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.
Abdominal Pain ; Bacteria ; C-Reactive Protein ; Campylobacter ; Campylobacter Infections ; Child* ; Clostridium difficile ; Colon ; Diagnosis ; Enterocolitis* ; Humans ; Ileum ; Male ; Medical Records ; Multiplex Polymerase Chain Reaction ; Retrospective Studies ; Salmonella ; Shiga-Toxigenic Escherichia coli ; Shigella ; Staphylococcus aureus ; Ultrasonography

PURPOSE: To confirm the effect of water exercise program for treating the gestational edema. METHODS: Both low leg volume, body weight and urine specific gravity were measured in thirty women with gestational edema before and after water exercise program. Fetal heart rate, maternal heart rate and maternal blood pressure were measured before and after water exercise program. RESULTS: Right leg volume was decreased by 286 ml from 1714 to 1428 mL (P<.0001), left leg volume was decreased by 267 mL from 1,644 to 1,377 mL (P<0.0001), and total leg volume was decreased by 553 mL from 3,359 to 2,805 mL (P<0.0001). Urine specific gravity was decreased by 0.0047 from 1.0197 to 1.0150 (P=0.004). Maternal body weight, heart rate, blood pressure, and fetal heart rate were showed no significant change. CONCLUSION: Water exercise program is effective and safe method for treating the gestational edema.
Blood Pressure ; Body Weight ; Edema ; Female ; Heart Rate ; Heart Rate, Fetal ; Humans ; Leg ; Pregnancy ; Specific Gravity

PURPOSE: To evaluate the efficacy of anterior-side rectangular 4-snip punctoplasty, a modification of posterior ampullectomy that is currently used in patients with punctal stenosis. METHODS: We performed a retrospective chart review of patients with punctal stenosis who underwent anterior-side rectangular 4-snip punctoplasty at our hospital. Fluorescein dye disappearance test (FDT) and questionnaire on tearing symptoms and tear meniscus height (TMH) based on spectral-domain optical coherence tomography (SD-OCT) were evaluated in preoperative and postoperative follow-up examinations of the patients. Anatomical success was defined as punctum without re-stenosis at last visit; functional success was defined as FDT grade of 0 or 1, or tearing symptom score of 2 or less. RESULTS: A total of 44 anterior-side 4-snip punctoplasty procedures were performed in 27 patients. The average age of all subjects was 56.0 +/- 11.0 years (range, 39 to 82 years). The mean follow-up period was 9.4 months (range, 6 to 20 months). FDT, tearing symptom score (p < 0.01, Wilcoxon signed-rank test), and TMH (p < 0.01, paired t-test) were significantly decreased after surgery. Anatomical success was 40/44 cases (90.9%) and functional success was 38/44 cases (86.4%). There were no complications such as skin defect or cosmetic problems. CONCLUSIONS: Anterior-side rectangular 4-snip punctoplasty is an effective surgical procedure for patients with punctal stenosis, maintaining functions of the lacrimal drainage system without re-stenosis of punctum.
Constriction, Pathologic* ; Drainage ; Fluorescein ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Skin ; Tomography, Optical Coherence