Sirenomelia is a severe form of caudal regression syndrome that results in a fusion of the lower extremities, which is not compatible with life. A various spectrum of anomalies affecting primarily the musculoskeletal, genitourinary and gastrointestinal systems also can occur. This rare malformation has a reported incidence rate of approximately 1 in 60,000 births, with a range of 1 to 1 percent of all malformed infants. We experienced a sirenomelic case with combined anomalies of genitourinary, cardiovascular and gastrointestinal systems. Maternal obstetric history revealed oligohydramnios and intrauterine fetal growth retardation, and the baby was spontaneously delivered at 37 weeks of gestational age, but died I hour after birth.
Infant ; Male ; Female ; Humans ; Incidence

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

Malformations of umbilicus are a feature of many dysmorphic syndromes and the measurement of periumbilical skin length should be considered as the basic step in the description of the umbilical malformations. So, we measured the periumbilical skin length in the 103 normal neonates and obtained the following results. 1) The means (+SD) of the periumbilical skin length were the 11.7mm (+3.0) in the cranial site and the 8.2mm (+2.5) in the caudal site, and the cranial length was 3.5mm longer than the caudal length. 2) No difference was observed between the male and female groups in the periumbilical skin length. 3) Age was the only statistically significant variable associated with the periumbilical skin length and it was observed that the periumbilical skin length decreased according to the advance of age (hour).
Female ; Humans ; Infant, Newborn ; Male ; Reference Values* ; Skin* ; Umbilicus

Ovarian leiomyoma is a very uncommon tumor that usually presents as an unilateral neoplasm typically associated with uterine leiomyoma in middle aged to postmenopuasal women. These probably originate from smooth muscle cells of the ovarian blood vessel or from the smooth muscle fibers near the attachment of the ovarian ligament. We report a case of ovarian leiomyoma, bilateral and massive in 17 year-old woman. We document the smooth muscle origin of the tumors with immunohistochemical studies that show appropriate staining with antibodies to actin, desmin, vimentin, S-100 protein.
Actins ; Adolescent* ; Antibodies ; Blood Vessels ; Desmin ; Female* ; Humans ; Leiomyoma* ; Ligaments ; Middle Aged ; Muscle, Smooth ; Myocytes, Smooth Muscle ; S100 Proteins ; Vimentin

The purpose of the study is to evaluate the differential effects caused by the interviewers and the days of the week using the 24-hour dietary recall method on the dietary evaluation of nutrient intakes. Thirteen subjects were interviewed by three trained interviewers on a Monday, Wednesday, and Friday. The consumption of nutrients by the subjects during each day was assessed. The average intake of nutrients was found to be sufficient except in calcium, iron, and vitamin A. there was a significant difference between the food intake on the weekdays and that o the weekend. However, the were no significant differences between the interviewers assessments on the intake of nutrients consumed by the subjects. The standardization of the portion size, interview skill and experience may be a few of the reasons explaining the elimination of the potential error created by variations among the interviewers. This study suggests that repeated 24-hour recalls during weekdays and weekends may be a better method for estimating the nutrients consumed by the subjects.
Calcium ; Eating ; Interviews as Topic ; Iron ; Portion Size ; Vitamin A

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. HCC develops in various causes – Viral hepatitis infection, toxins, or other liver conditions - by activation of oncogenes and/or inactivation of tumor suppressors. Understanding of signal pathways and protein-protein interactions critical in tumor development may lead to novel treatment strategy. To evaluate the progression of HCC and effects of potential therapies, various animal models have been established. Experimental models of HCC provide valuable tools to investigate the risk factors, new treatment modalities and biologic characteristics. Subcutaneous xenograft models have been widely used in the past. However, with the advancement of in vivo imaging technology, investigators are more concerned with the orthotopic models nowadays. Genetically engineered mouse models have greatly facilitated studies of gene function in HCC development. Lately, a novel approach for stable gene expression in mouse hepatocytes by hydrodynamic injection has been developed. Each model has its own advantages and disadvantages. Therefore, selecting the optimal models based on study objectives is necessary. In this review, we highlight both the frequently used mouse models and some emerging ones with emphasis on their merits or defects, and give advices for investigators to choose a “best-fit” animal model in HCC research.
Animals* ; Carcinoma, Hepatocellular ; Gene Expression ; Hepatitis ; Hepatocytes ; Heterografts ; Humans ; Hydrodynamics ; Liver Neoplasms* ; Liver* ; Mice ; Models, Animal* ; Models, Theoretical ; Oncogenes ; Population Characteristics ; Research Personnel ; Risk Factors ; Signal Transduction

Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children’s hospital.Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

BACKGROUND: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. METHODS: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient-controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. RESULTS: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. CONCLUSIONS: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study.
Amides ; Analgesia ; Catheters ; Dyspnea ; Humans ; Nausea ; Needles ; Neurologic Manifestations ; Prospective Studies ; Punctures ; Sample Size ; Shoulder ; Vomiting

Neurolytic or surgical lumbar sympathectomy are commonly used for the treatment of intractable pain, peripheral vascular insufficiency and hyperhydrosis. For the procedure, the patient sometimes has to suffer from complications such as major vascular perforation, subarachnoid injection, genitofemoral neuralgia, somatic neuralgia, disc perforation, ureteral stricture, inflammation, ejaculatory failure, chronic lumbago. The authors came across with a case of ejaculatory failure a week after both lumbar sympathetic block with 6 ml of 100% alcohol at L3 level under the control of fluoroscopy. Three months after the block the patient recovered without any treatment.
Constriction, Pathologic ; Fluoroscopy ; Humans ; Inflammation ; Low Back Pain ; Neuralgia ; Pain, Intractable ; Sympathectomy* ; Ureter