BACKGROUND: Despite good surgical results from right transverse hypochondrial incisions for Ramstedt's pyloromyotomies, children remain concerned by the presence of an obvious and permanent scar. The aim of this study is to compare the results of two approaches. METHODS: Forty-eight infants underwent a Ramstedt pyloromyotomy for infantile hypertrophic pyloric stenosis. To facilitate the delivery of the pyloric mass, 22 patients were operated on via a standard right transverse hypochondrial incision and 26 patients via a circumumbilical incision with or without lateral wound extension. These two group were compared retrospectively. RESULTS: The groups did not differ significantly with respect to the length of the hospital stay or the perioperative complications. The circumumbilical incision with lateral wound extension allowed easy access to the pyloric mass without conversion of incisions due to inadequate exposure. All circumumbilical incisions healed well, resulting in an apparently unscarred abdomen. The final good cosmetic result of the circumumbilical incision satisfied all parents. CONCLUSIONS: We propose the circumumbilical incision as an alternative to be used in the operative approach to the pylorus in the treatment of infantile hypertrophic pyloric stenosis.
Abdomen ; Child ; Cicatrix ; Humans ; Infant ; Length of Stay ; Parents ; Pyloric Stenosis, Hypertrophic ; Pylorus ; Retrospective Studies ; Wounds and Injuries

Epstein-Barr virus (EBV)-encoded small non-coding RNAs (EBERs) are abundantly expressed in various EBV-associated malignancies, and play critical roles in cell proliferation, tumorigenesis, and apoptosis resistance. However, the mechanism how EBERs regulate cell function awaits further clarification. In this study, we investigated the effect of EBERs on the expression of cellular microRNA (miRNA) and mRNA expression. To test the effect of EBERs while unaffected by other EBV genes, we used EBERs-deleted recombinant EBV infected Burkitt's lymphoma cell line (Akata(+)EBERs(-)) as well as EBV-infected (Akata(+)) and EBV uninfected (Akata(-)) cell lines. They all have the same genetic backgrounds. First, 15 different cellular miRNAs which have reverse complementary sequences to EBERs and have reported targets were selected by bioinformatics analysis. When RT-PCR was carried out for the 16 miRNAs using RNAs from Akata(+), Akata(-), and Akata(+)EBERs(-) cells, hsa-miR-7-5p was the only one showing down-regulated expression in Akata(+) than in Akata(-) and Akata(+)EBERs(-) cells. Bioinformatics and mRNA microarray analyses for Akata(+), Akata(-), and Akata(+)EBERs(-) cell lines were then carried out to predict putative targets of hsa-miR-7-5p. Among the 6 predicted targets of hsa-miR-7-5p, only low density lipoprotein receptor-related protein 6 (LRP6) was up-regulated in EBERs-expressing cells when tested by RT-PCR and Western blot. However, luciferase reporter assay showed that the 3'-UTR of LRP6 was not directly targeted by hsa-miR-7-5p. Our data suggest that both hsa-miR-7-5p and LRP6 are regulated by EBERs in Akata cells, and these genes may partly mediate the tumorigenic function of EBERs in Burkitt's lymphoma.
Apoptosis ; Blotting, Western ; Burkitt Lymphoma* ; Carcinogenesis ; Cell Line* ; Cell Proliferation ; Computational Biology ; Herpesvirus 4, Human ; Low Density Lipoprotein Receptor-Related Protein-6 ; Luciferases ; MicroRNAs ; RNA* ; RNA, Messenger ; RNA, Small Untranslated

P-glycoprotein (P-gp) is encoded by the ABCB1 gene and acts as an efflux pump for xenobiotics. In the Border Collie, a nonsense mutation caused by a 4-base pair deletion in the ABCB1 gene is associated with a premature stop to P-gp synthesis. In this study, we examined the full-length coding sequence of the ABCB1 gene in an ivermectin-sensitive Border Collie that lacked the aforementioned deletion mutation. The sequence was compared to the corresponding sequences of a wild-type Beagle and seven ivermectin-tolerant family members of the Border Collie. When compared to the wild-type Beagle sequence, that of the ivermectin-sensitive Border Collie was found to have one insertion mutation and eight single nucleotide polymorphisms (SNPs) in the coding sequence of the ABCB1 gene. While the eight SNPs were also found in the family members' sequences, the insertion mutation was found only in the ivermectin-sensitive dog. These results suggest the possibility that the SNPs are species-specific features of the ABCB1 gene in Border Collies, and that the insertion mutation may be related to ivermectin intolerance.
ATP-Binding Cassette Transporters/*genetics ; Animals ; Depression/chemically induced ; Dogs/*genetics ; Female ; Ivermectin/*adverse effects ; Male ; Mutagenesis, Insertional/*genetics ; Polymorphism, Single Nucleotide/genetics ; Sialorrhea/chemically induced

Nasoalveolar molding (NAM) device is an effective treatment for protruding maxilla in infants with cleft palate. However, only a few studies have investigated the effect of NAM devices on the treatment of protruding maxilla in infants with cleft lip only. We have designed a combination treatment using NAM devices prior to cheiloplasy for cleft lip-only patients with severe anterior protrusion of the premaxilla. Three cleft lip-only infants with 1-cm or more of premaxilla protrusion were included. Definitive cheiloplasty was performed at 6 months of age without any preoperative correction in infant 1. Cheiloplasty was performed in conjunction with the use of NAM device and lip adhesion in infants 2 and 3. Postoperative columella length and anterior-posterior dimension of the protruding premaxilla were compared amongst the infants. We were able to obtain satisfactory postoperative columella length and general nasal appearance.
Cleft Lip* ; Cleft Palate ; Fungi* ; Humans ; Infant ; Lip* ; Maxilla ; Orthodontic Appliances

PURPOSE: Dexamethasone is a well-known treatment for preterm infants with bronchopulmonary dysplasia. However, serious side effects have been identified, including hypertension, and cardiac hypertrophy. This study was undertaken to examine whether dexamethasone induced cardiac hypertrophy in preterm infants with bronchopulmonary dysplasia. METHODS: We retrospectively reviewed 12 infants with bronchopulmonary dysplasia treated with dexamethasone at Korea University Hospital from August 1995 to February 1999. Serial two-dimensional and M-mode echocardiographic measurements were taken before treatment and at 1,2,3,4,5 weeks after the start of dexamethasone therapy. RESULTS: Patients receiving dexamethasone had a significantly increase in interventricular septal thickness and left ventricular posterior wall thickness. These effects were transient, reached their maximal degree by the third week of treatment, and approached pretreatment conditions by the fifth week of treatment. Heart rate was increased but statistically not significant. The fractional shortening, systolic and diastolic arterial pressure were transiently increased during dexamethasone therapy. CONCLUSION: We conclude that a transient myocardial hypertrophy is associated with dexamethasone therapy in infants with bronchopulmonary dysplasia. Follow up of careful echocardiac monitoring should be considered in infants with dexamethasone therapy.
Arterial Pressure ; Bronchopulmonary Dysplasia ; Cardiomegaly* ; Cardiomyopathy, Hypertrophic* ; Dexamethasone* ; Echocardiography ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension ; Hypertrophy* ; Infant ; Infant, Newborn ; Infant, Premature* ; Korea ; Retrospective Studies

Objective: Most affective neuroscience studies use pictures from the International Affective Picture System or standard facial expressions to elicit emotional experiences. The attention system, including the prefrontal cortex, can mediate emotional regulation in response to stimulation with emotional faces. We hypothesized that emotional experience is associated with brain activity within the neocortex. In addition, modification within the neocortex may be associated with brain activity within the attention system. Methods: Thirty-one healthy adult participants were recruited to be assessed for emotional expression using clinical scales of happiness, sadness, anxiety, and anger as and for emotional experience using brain activity in response to pictures of facial emotional expressions. The attention system was assessed using brain activity in response to the go-no-go task. Results: We found that emotional experience was associated with brain activity within the frontotemporal cortices, while emotional expression was associated with brain activity within the temporal and insular cortices. In addition, the association of brain activity between emotional experiences and expressions of sadness and anxiety was affected by brain activity within the anterior cingulate gyrus in response to the go-no-go task. Conclusion Emotional expression may be associated with brain activity within the temporal cortex, whereas emotional experience may be associated with brain activity within the frontotemporal cortices. In addition, the attention system may interfere with the connection between emotional expression and experience.

INTRODUCTION: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. MATERIALS AND METHODS: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. RESULTS: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) CONCLUSION: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.
Humans ; Internal Fixators ; Mandible ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Recurrence ; Sitosterols

A melanotic neuroectodermal tumor of infancy (MNTI) is a uncommon osteolytic pigmented neoplasm that primarily affects the jaws of newborn infants. Most patients (> 90%) present with the tumor in the first year of life. Approximately 65% form in the maxilla, 11% in the mandible, 5% in the brain and elsewhere. MNTI is normally benign, but up to 15% may recur and a few have metastasized. Approximately 200 cases of MNTI have been reported but only 2 of them presented as multifocal. A case of MNTI in a 7 month old boy was encountered. The chief complaint was maxillary anterior ridge swelling. The incisional biopsy findings were MNTI. Two months after the first operation, mild swelling of another site was observed. The infant was examined periodically since undergoing two procedures with no recurrence. This case demonstrates the possibility of a multicentric MNTI. We report a multicentric MNTI with a review of the relevant literature.
Biopsy ; Brain ; Humans ; Infant ; Infant, Newborn ; Jaw ; Mandible ; Maxilla ; Neuroectodermal Tumor, Melanotic ; Polyenes ; Recurrence

PURPOSE: Chlamydia pneumoniae is a common intracellular bacterial pathogen and plays an important role in acute respiratory infections. The purpose of this study was to investigate clinical presentations of C. pneumoniae in children with acute respiratory infections. METHODS: We examined the medical records of pediatric patients (age<18 years) admitted with acute respiratory infections of C. pneumoniae to Gachon University Gil Medical Center between March 1, 2011 and August 31, 2014. We compared the clinical features of C. pneumoniae infection with that of Mycoplasma pneumoniae infection. RESULTS: We confirmed acute respiratory infections of C. pneumoniae in 110 patients out of 2,156 patients (5.1%) admitted with acute respiratory infections. The mean age was 37.2+/-30.1 months. More than half of them (54.5%) had coinfection. C. pneumoniae infection had mild and subacute courses. The mean duration of symptoms prior to admission was 8.5+/-13.8 days. There were remarkable seasonal variations and prevalence was higher in December and April (P=0.03 and P=0.02, respectively). Although rhinorrhea and pharyngeal injection were more common in C. pneumoniae infection (P<0.05), clinical signs and symptoms were similar between C. pneumoniae and M. pneumoniae. Extrapulmonary manifestations such as skin lesion, Gastrointestinal symptoms, hepatitis, and neurologic symptoms were common (41.0%) in C. pneumoniae infection and, had similar incidence in M. pneumoniae infection. CONCLUSION: C. pneumoniae is an important infectious agent of acute respiratory infections in children. Clinical pictures of C. pneumoniae are similar to M. pneumoniae, even in extrapulmonary manifestations. C. pneumoniae should be taken into consideration in differential diagnosis of acute respiratory infection in children.
Child* ; Chlamydia* ; Chlamydophila pneumoniae* ; Coinfection ; Diagnosis, Differential ; Hepatitis ; Humans ; Incidence ; Medical Records ; Mycoplasma pneumoniae ; Mycoplasma* ; Neurologic Manifestations ; Pneumonia ; Pneumonia, Mycoplasma* ; Prevalence ; Respiratory Tract Infections* ; Seasons ; Skin

PURPOSE: Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI). METHODS: Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated. RESULTS: Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11+/-5.18 vs. 3.27+/-3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR. CONCLUSION: We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.
Bacteremia ; Humans ; Incidence ; Infant ; Male ; Odds Ratio ; Prednisolone ; Retrospective Studies ; Sensitivity and Specificity ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux