Infantile hypertrophic pyloric stenosis (HPS) is a relatively common entity. A number of studies for the postoperative feeding schedule has been studied to allow for earlier hospital discharge and improve cost-effectiveness in the treatment of HPS. The purpose of this study was to compare 3 feeding-methods and to evaluate the usefulness of ad lib feeding for HPS. The authors retrospectively reviewed the records of 116 patients who underwent pyloromyotomy for HPS from 1995 to 2004. Three cases were excluded because of the duodenal perforation during pyloromyotomy. Three feeding-methods were defined as: Conventional feeding (>10 hours nothing by mouth and incremental feeding every 2 hours, C), Early feeding(for 4 to 8 hours nothing by mouth and incremental feeding every 2 hours, E), and Ad lib feeding (for 4 hours nothing by mouth and ad lib feeding, A). Time to normal feeing in C, E and A were 51+/-24, 34+/-12 and 24+/-6 hours, respectively. Hospital-stay in C, E and A were 72+/-17, 55+/-13 and 43+/-12 hours, respectively. There were statistically significant differences according to the method of feeding. Frequency of postoperative emesis in C, E and A were 38%, 47% and 53%, but was not significant statistically. Ad lib feeding decreased time to normal feeding and hospital stay, and did not increase postoperative emesis. We conclude that ad lib feeding is recommended for patient with pyloromyotomy in HPS.
Appointments and Schedules ; Fees and Charges ; Humans ; Length of Stay ; Mouth ; Postoperative Nausea and Vomiting ; Pyloric Stenosis, Hypertrophic* ; Retrospective Studies

Appendicitis is a common disease in children. But left lower abdominal pain in acute appendicitis is a rare clinical feature. A 6 year-old-girl complained of left sided abdominal pain for 2 days. Past medical history was not contributory. Abdominal tenderness and guarding in left lower quadrant were noticed. Abdominal sonography and abdominal computed tomography scan demonstrated reversed position between superior mesenteric artery and vein, and a mass in the left lower quadrant abdomen suggesting appendicitis. Acute appendicitis in left lower quadrant, associated with intestinal malrotation, was found at laparatomy.
Abdomen ; Abdominal Pain ; Appendicitis* ; Child* ; Humans ; Mesenteric Artery, Superior ; Veins

The branchio-oto-renal (BOR) syndrome is a clinically and genetically heterogeneous disease entity which is characterized by the association of preauricular pits, branchial cleft anomaly, hearing loss and various renal anomalies. The incidence of BOR syndrome is approximately 1 : 40,000 and its genetic pattern of transmission is autosomal dominant. Hearing loss is the most common feature of BOR syndrome and is reported in almost 90% of affected individuals. EYA1, the human homologue of the Drosophila eyes absent gene, has been shown to cause BOR syndrome. We report, with a review of literatures, a female patient with BOR syndrome.
Branchial Region ; Branchio-Oto-Renal Syndrome ; Drosophila ; Eye ; Female ; Hearing Loss ; Humans ; Incidence

Copper is an essential trace element for numerous vital enzymes. Recently, copper can be used clinically as assessing the disease activity, prognosis, therapeutic effect and early prediction of recurrence in patient with neoplasia. But overloading of copper can cause fatal outcome. Copper intoxication is usually encountered following accidental ingestion or suicidal intoxication. A 43-year old male was admitted because of epigastric pain and hematuria after ingestion of the copper hydroxide and organophosphate for suicidal purpose. The laboratory findings showed that the serum and urinary copper concentration are elevated, then the acute renal failure, hemolytic anemia and liver injury progressed. With conservative management, the hemolytic anemia was improved, but disseminated intravascular coagulation with sepsis and respiratory failure by pneumonia were developed, and then finally expired on the eighth hospital days. We experienced a case of a patient who presented with acute renal failure, hemolytic anemia and liver injury after ingestion of copper, and we reported with review of literature.
Acute Kidney Injury ; Adult ; Anemia, Hemolytic ; Copper* ; Disseminated Intravascular Coagulation ; Eating ; Fatal Outcome ; Hematuria ; Humans ; Liver ; Male ; Pneumonia ; Prognosis ; Recurrence ; Respiratory Insufficiency ; Sepsis

PURPOSE: Although congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are rare, distinguishing them from other cervical cystic lesions (e.g., thyroglossal duct and branchial cleft cysts) and metastatic cervical lymph nodes is difficult preoperatively. Additionally, cystic degeneration of metastatic lymph nodes is common in patients with thyroid cancer. We investigated the clinical characteristics and proper treatment for individuals with cervical bronchogenic cysts. METHODS: Of the 18,900 patients treated for thyroid cancer, 18 patients with pathologically confirmed bronchogenic cysts were retrospectively reviewed. Bilateral total thyroidectomy or less than total thyroidectomy with central compartment node dissection, including cystic mass excision was done and cystic mass was confirmed by postoperative pathologic examination. RESULTS: All cervical bronchogenic cysts were asymptomatic. Their mean size was 1.2 cm (range, 0.3 to 3 cm). Of these 18 patients, 15 did not have any abnormal radiological findings, except for lymphadenopathy during preoperative evaluations. Most bronchogenic cysts were detected around the thyroid and paratracheal areas. On preoperative imaging and intraoperatively, most were indistinguishable from metastatic cervical lymph nodes or other cystic lesions. CONCLUSION: Although cervical bronchogenic cysts are rare and benign, they should be distinguished from other cystic cervical masses, especially metastatic cervical lymph nodes associated with thyroid cancer. Possible cervical bronchogenic cysts found during thyroid cancer evaluation or surgery should be surgically excised.
Branchial Region ; Bronchogenic Cyst* ; Humans ; Lymph Nodes* ; Lymphatic Diseases ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms* ; Thyroidectomy

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.
Diagnosis ; Follow-Up Studies* ; Immobilization ; Natural History ; Osteochondrosis ; Shoes

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.
Diagnosis ; Follow-Up Studies* ; Immobilization ; Natural History ; Osteochondrosis ; Shoes

Acute Achilles tendon rupture is a frequent injury during sports and recreational activities. Treatments for Achilles tendon rupture have been controversial in recent decades. Traditionally the surgical treatment had benefit over nonsurgical treatment in terms of low rerupture rate and early functional restoration. Recently, nonsurgical treatment was found to show no statistically significant inferiority in re-rupture rate, functional outcome, and calf strength. Whereas, surgical treatment had some complications including adhesion, nerve injury, and infection. Nonsurgical treatment has been increasing due to functional rehabilitation with early weight bearing and restricted early motion. It focuses more attention on the course of caring for patients with deep discussion. There are open repair and minimally invasive repair in terms of surgical treatment. There are various techniques for minimally invasive repair of Achilles tendon, which has some advantages over the open repair. However, the optimal technique for minimally invasive repair has not been established. The number of suture strands is important regardless of suture technique.
Achilles Tendon* ; Humans ; Rehabilitation ; Rupture* ; Sports ; Suture Techniques ; Sutures ; Weight-Bearing

Since the pancreas and the spleen lie in close proximity, splenic complications during the course of pancreatitis are possible, but uncommon. No previously published report in Korean has described splenic subcapsular hematoma due to pancreatitis, and we now report one such case.
Hematoma* ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Spleen*

No abstract available.
Adrenal Glands* ; Ganglioneuroma* ; Hyperplasia*