Lumbar hernias are rare posterolateral abdominal wall defects that may be congenital or acquired. There are two types of lumbar hernia, the superior lumbar hernia through Grynfeltt triangle, and the inferior lumbar hernia through Petit triangle. Many techniques have been described for the surgical repair of lumbar hernias including primary repair, local tissue flaps, and conventional mesh repair. But these open techniques require a large skin incision. We report a case of superior lumbar hernia, which was successfully repaired using a laparoscopic approach.
Abdominal Wall ; Hernia ; Skin

Nowadays, to evaluate growth hormone(GH) deficiency-suspicious short stature, we usually use more than two kinds of provocative tests using various pharmacologic agents such as clonodine, L-dopa, insulin, etc. However, the importance of physiologic natural secretion of GH was recently approved. In the past, diagnosis of GH neurosecretory dysfunction was made by studying the 24-hour spantaneous GH secretion profile. But, because it is very clinically difficult, and so we measured and evaluated the mean GH concentrations of blood samples, obtained every 30 minutes during the first 3 hours' nocturnal sleep, instead of that. At the department of Pediatrics, Hanyang University Hospital from November, 1992 to February, 1994, we selected 34 GH deficiency-suspected children on the base of their growth data and bone age, etc. After GH stimulation with clonidine(100-150 ug/m2) and L-dopa(200-250 mg/m2), we measured their peak GH values by the immunoradiometric assay(IRMA) kit. And, we measured the mean GH concentrations of blood samples, obtained every 30 minutes during the first 3 hours noctumal sleep(22:OOPM-1:OOAM). RESULTS: 1. We analyzed the relationship between the mean of 3-hours' physiologic night-time surge of GH(X) and the phamacologically stimulated peak GH level(Y), except for the two neurosecretory dysfunction suspicious children. And so, for the 32 children, the relationship was Y=1.806X+ 3.177, r= 0.794, p<0.01. However, for all the tested children(34), the relationship is Y=1.709X+ 4.06, r=0.737, p<0.01. 2. We analyzed the relationship between the peak of 3-hours' physiologic night-time surge of GH(X) and the phamacologicaUy stimulated peak GH level(Y), except for the two neurosecretory dysfunction suspieious children. And so, for the 32 children, the relationship was Y=0.683X+ 3.686, r=737, p<0.01. CONCLUSION: For all the tested children(34), the relationship between the mean 3hr physiologic GH night time surge and stimulated peak GH value is Y=1.709X+4.06, r=0.737, p<0.01. The percentage of GH neurosecretory dysfunction is 5.8%(2/34). And, except for the two childrren, the relationship is more good, Y=1.806X+3.177, r=0,794, p<0.01. On the above relationship, the 3-hour GH night time-surge test might to give us some helpful information for the diagnosis of neurosecretory dysfunction.
Child* ; Diagnosis ; Growth Hormone* ; Humans ; Insulin ; Levodopa ; Pediatrics

The use of subcutaneously tunneled, cuffed central venous catheters like Broviac's or Hickman's has increased and complications related to catheter removal has also increased. However, there are only few reports of complications that occur at the time of removal. The authors report an unusual case of catheter fracture during removal of Broviac catheter.
Catheters* ; Central Venous Catheters

No abstract available.
Colon* ; Diverticulitis*

No abstract available.
Calcium* ; Child* ; Humans

Parricide, the crime of murdering a parent, accounts for about 5% of all homicides. Filicide is the crime of murdering one's own child. This study aimed to review demographic features and criminal characteristics of individuals who committed parricide and filicide in Republic of Korea (ROK). This study is based on data from the Korea Police Crime Analysis System, from 2006~2013. We assessed the diverse characteristics of both victims and perpetrators. Over the selected period, 381 parents were killed by their children and 230 children were killed by parents in the ROK. Parricides caused by schizophrenic murders accounted for 39.6% of all cases. Moreover, approximately 44.4% of the perpetrators attempted suicide following the maternal filicide. In our findings, psychiatric illness was a very important predictor in parricide, and these further suggest that young mothers with severe mental illness require careful monitoring by mental health support service.
Child ; Crime ; Criminals ; Homicide ; Humans ; Korea ; Mental Health ; Mothers ; Parents ; Police ; Republic of Korea ; Schizophrenia ; Suicide, Attempted

Dieulafoy's lesion is a rare distinetive arterial malformation that can cause massive gastrointestinal henorrhage. Although in most cases the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction, similar lesions have been described in the antrum, duodenum, jejunum, colon, and rectum. We report 3 unusually located Dieulafoy-like lesion, two gastric antrum and one jejunum in patient who had gastrojejunostomy for pancreatic caneer. After a year follow up there was no bleeding episode in patient after endoscopic treatment.
Colon ; Duodenum ; Esophagogastric Junction ; Follow-Up Studies ; Gastric Bypass ; Hemorrhage ; Humans ; Jejunum* ; Pyloric Antrum* ; Rectum ; Stomach

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

Cerebral gigantism(Sotos syndrome) is a growth disorder that consists of large size at birth, rapid early growth rate with accompanying advanced bone age, acromegalic features, and developmental delay. Clumsiness in the absence of other abnormal neurologic findings is common. The cause is unknown. We report here a case of 238/12-year-old Sotos syndrome with final adult height above 97 percentile, abnormal brain MRI findings(large ventricles, prominent trigone, prominent occipital horn & thining of corpus callosum), clumsiness, and some behavioral problems.
Adult ; Animals ; Brain ; Growth Disorders ; Horns ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Sotos Syndrome

We should better not confuse "short nose" with "the nose that the tip of it turned upward regardless of its length". If we simply diagnose "the nose that the tip of it turned upward" as "short nose", we might have the risk of focusing on lengthening the whole nose instead of correcting the angle of the tip of the nose. We, therefore, started to call "the nose that the tip of it turned upward" differently from "short nose" in the cases of Asian patients who have relatively short and small noses. We then decided to classify "the nose that the tip of it turned upward" as "upturned nose". And, in revision cases, we have to be careful about changes of anatomical structures, and the usage of the amount of shared cartilages, we have to be fully aware of various operation procedures to correct upturned nose. Furthermore, we have to consider many other different ways of corrections that possibly need various types of grafts and suture techniques combined or modified from the usual procedures. We achieved satisfactory results by using this new paradigm of "upturned nose" and concepts of procedures to have the better result of reforming the "short nose".
Asian Continental Ancestry Group ; Cartilage ; Humans ; Nose ; Rhinoplasty ; Suture Techniques ; Transplants