Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of 1 nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.
Body Weight ; Breast Feeding ; Female ; Humans ; Infant ; Live Birth ; Male ; Postoperative Complications ; Pyloric Stenosis, Hypertrophic* ; Standard of Care ; Vomiting ; Wound Infection

Dislocation of the interphalangeal joint of the great toe is a condition which is reported rarely. Especially, it is extremely rarely reported as for the case of neglected dislocation. Here, we report one case of neglected dislocation for 6 weeks of the interphalangeal joint of the great toe. Reduction followed by a push of the incarcerated sesamoid bone based on dorsal approach, was done successfully, and we found satisfactory results after a 4 years of follow-up.
Dislocations ; Follow-Up Studies ; Joints ; Sesamoid Bones ; Toes

This is a report of 51 cases in renal allograft, which were treated at the Yeungnam University Hospital from February 1994 to July 1996 and compared the significance of changes of TNF-alpha in blood and urine as a diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF-alpha in patients with renal allografts. Renal allografts divided them into four groups (control, acute rejection, acute tubular necrosis and systemic infection) that obtained plasma and urinary TNF-alpha. The sampling day of blood and urine in each group were as follows: in control group at the day of transplantation and postoperative 1, 5, 7 days respectively, in acute rejection group at before the day of initiation of therapy and the 1, 3 days after therapy, in acute tubular necrosis group at the day of low urine output and the 4 subsequent days, and in systemic infection group at the day of diagnosis and the 3 subsequent days. The results were as follows: Plasma TNF-alpha levels were significantly elevated in 68.4% (p<0.01) of acute rejection group and 100.0% (p<0.05) of systemic infection group but did not increase in acute tubular necrosis group (20.0%, p>0.05). In contrast, urinary TNF-alpha were detected in acute rejection group (42.1%, p<0.01) and acute tubular necrosis group (20.0%, p<0.05). Control and systemic infection groups were not detectable in urinary TNF-alpha. The results suggested that plasma and urinary TNF-alpha may be used as the complementary diagnostic tool of acute rejection in renal allograft patients.
Allografts* ; Diagnosis ; Humans ; Necrosis ; Plasma ; Tumor Necrosis Factor-alpha*

STUDY DESIGN: Prospective study. OBJECTIVES: To define the prognostic factors by analyzing the survival rates of osteoporotic vertebral fracture treated by conservative management. SUMMARY OF THE LITERATURE REVIEW: Due to an increasing elder population, many recent studies of osteoporosis have been done; pointing out that osteoporotic vertebral fracture may produce serious complications. However, there is nothing obviously demonstrated in both the management and prognosis of the osteoporotic vertebral fracture. MATERIALS AND METHODS: Survival analysis was done for 130 patients who had undergone conservative management for a single level vertebral fracture. Univariant and multivariant survival analysis was done for age at trauma, sex, body mass index (BMI), bone mineral density (BMD), smoking, diabetic history, fracture level, fracture type, vertebral compression ratio and regional Cobb's angle. RESULTS: Survival rate for conservative management was 70.7%. Univariant analysis for survival rate revealed significantly inferior results for age over 78 (p=0.008), T score< -3.5 (p=0.047), and crush or biconcave type than wedge type (p=0.021). Only the age factor showed significance in multivariant analysis (p=0.025, Hazard ratio=2.08). CONCLUSION: Conservative management in a single level osteoporotic vertebral fracture, showed a survival rate of 70.7% and age was the most important factor in conservative management. We should notice that age of more than 78 years is at high risk for failure in conservative management of vertebral fracture.
Age Factors ; Body Mass Index ; Bone Density ; Humans ; Osteoporosis ; Prognosis ; Prospective Studies ; Smoke ; Smoking ; Survival Analysis ; Survival Rate