Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

OBJECTIVE: Angiogenesis is a critical factor in the progression of solid tumors. The mechanisms responsible for angiogenesis in cervical neoplasia, however, are not well defined. Our study was aimed to determine the expression of VEGF(Vascular Endothelial Growth Factor), its receptor(KDR), and TGF-beta1(Transforming Growth Factor-beta1) in cervical neoplasia, to determine the role of these angiogenic factors in preinvasive(dysplastic) process and the progression of cervical cancer and to investigate the progression of angiogenesis in the transition from normal cervix to invasive squamous cell carcinoma of the uterine cervix. METHODS: The cervical lesions of 76 patients were punch biopsied and paraffin embedded. Among these, 5 were normal cervix, 36 were cervical intraepithelial lesion I-III, and the other 35 were invasive squamous cell carcinomas. The tissues were immunostained with antiVEGF, antiKDR, and antiTGF-beta1 polyclonal antibody. RESULTS: The expression of VEGF, KDR, and TGF-beta1 in CIN III was stronger than those of CIN I(p<0.01). Their expression were not significantly different among the each staged cervical cancers(p>0.01). CONCLUSIONS: These observations suggest that VEGF, KDR, and TGF-beta1 are important angiogenic factors in cervical neoplasia, especially in an early event to neoplastic transformation of cervical tissues, but these angiogenic factors are not associated with the progression of cervical cancer.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Paraffin ; Phosphotransferases* ; Transforming Growth Factor beta1 ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

No abstract available.
Primary Myelofibrosis*

We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.
Adult ; Brachiocephalic Veins ; Drainage ; Fibrosis ; Humans ; Hypertension ; Neurologic Manifestations ; Pericardium ; Postoperative Complications ; Superior Vena Cava Syndrome ; Transplants ; Veins ; Vena Cava, Superior* ; Venous Pressure

OBJECTIVE: To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis in patients who had failed medical management. METHODS: A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. RESULTS: There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from 3.78+/-0.78 preoperatively to 4.78+/-0.35 at final follow up and mean VAS score was improved from 7.43+/-0.54 to 2.07+/-1.12. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. CONCLUSION: According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.
Anti-Bacterial Agents ; Bone Transplantation ; Coinfection ; Debridement ; Decompression ; Discitis ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; Male ; Military Personnel ; Mycobacterium tuberculosis ; Spine ; Staphylococcus ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary

Current dental restorations present a relatively weak resistance to fracture. Owing to their unique mechanical properties, fibre-reinforced polymers are now being considered. Unidirectional or woven continuous fibres, made of glass, polyethylene, carbon or Kevlar, have been evaluated. This study focused on the use of glass fibre knitted fabrics to reinforce acrylate resins, in order to investigate the possibility to construct single crowns as well as three unit bridges. Some points affecting the final composite system were tested: 1) static strength, with focus on the stress transfer under a occlusal contact point; 2) modelling of a three unit bridge; 3) fatigue strength as a posterior three unit bridge material. The study demonstrated that knitted fabric reinforcements are showing an interesting compromise between stiffness, static strength for single crown. For three unit bridge applications in the posterior arch, however, knitted glass fabric reinforcements were not strong enough in fatigue. An additional reinforcement in the posterior arch fixed partial denture design was recommended.
Carbon ; Crowns ; Dentistry* ; Denture, Partial, Fixed ; Fatigue ; Feasibility Studies* ; Glass* ; Polyethylene ; Polymers ; Prosthodontics*

BACKGROUND: It has been reported that early prescription of statin might enhance the vascular protection in acute atherothrombosis by its various mechanisms. However, until now, there has been little information about the serial changes of high sensitive C-reactive protein (hs-CRP), one of the notable inflammatory markers in atherothrombosis, by early prescription of statin in acute ischemic stroke. METHODS: We retrospectively collected one hundred eighteen (118) patients with acute ischemic stroke who had conformed to the Atherosclerotic Stroke Mechanism Algorithm (ASMA), one of the guidelines for statin, and evaluated the effects of Atorvastatin 20 mg on the changes of hs-CRP levels and clinical severity at 7 days and 30 days after ischemic events. RESULTS: Among the 118 patients who should have been prescribed statin on the ASMA guideline, sixty-three patients (53.4%) used the statin (Atorvastatin 20 mg) within 48 hrs after admission. Serum concentration of hs-CRP levels was decreased from admission to 30 days later in both statin and non-statin users. Particularly, its extent was significant (0.39+/-0.74 vs 0.75+/-0.98 mg%, p=0.042) after 30 days of ischemic events in statin users. Statin users had lower mortality and vascular recurrence (p=0.083) and fewer bad prognosis rates (27.7% vs. 34.5%) compared to non-statin users over 30 dyas after ischemic events, although there was no statistical significance. CONCLUSIONS: These results suggest that early prescription of statin (Atorvastatin 20 mg) might regulate the inflammatory activity over 30 days after acute ischemic stroke.
C-Reactive Protein* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Mortality ; Prescriptions ; Prognosis ; Recurrence ; Retrospective Studies ; Stroke* ; Atorvastatin Calcium

PURPOSE: This study was carried out to determine whether the use of multimedia message service (MMS) as discharge instructions about post-suture care improves patient's comprehension for those information. METHODS: One hundred nineteen (119) patients with lacerations and their caregivers who visited the Emergency Room at Soonchunhyang University Cheonan Hospital were included in this study. Participants were randomly assigned to receive MMS (n=66) or paper (n=53) discharge instructions after providing informed consent to engage in this study. Within 48 hours of discharge, an investigator called each participant by phone and asked a series of questions designed to test the participant's comprehension of their discharge instructions. In addition, participants were asked to complete questionnaires about confidence, accessibility, compliance, and the usefulness of discharge instructions. RESULTS: There were no differences in age, sex, educational background and subject (patient or caregiver) between the MMS and the paper group. In both groups, the mean and standard deviation in comprehension score was 8.1+/-1.3 and 6.6 +/-1.8, respectively. The difference was statistically significant (p<0.001). 'Yes' group of MMS and paper was 40(60.6%) and 16(30.2%) in accessibility, 39(59.1%) and 19(35.8%) in compliance, 26(39.3%) and 20(37.7%) in usefulness, respectively. CONCLUSION: The use of MMS as discharge instructions for patients with laceration improves patient comprehension.
Caregivers ; Cellular Phone ; Compliance ; Comprehension ; Emergencies ; Humans ; Informed Consent ; Lacerations ; Multimedia ; Patient Discharge ; Surveys and Questionnaires ; Research Personnel ; Telecommunications

Toll-like receptors (TLRs) are the best-characterized membrane-bound receptors in innate immune cells, including macrophages and dendritic cells. Upon recognition of specific ligands originating from pathogen- and modified self-derived molecules, TLRs trigger intracellular signaling cascades that involve various adaptor proteins and enzymes, resulting in the generation of proinflammatory and antimicrobial responses through the activation of transcription factors such as nuclear factor-kappaB. TLR-dependent signaling pathways are tightly regulated during innate immune responses by a variety of negative regulators. This review focuses on the newly described regulation of TLR-dependent signaling pathways, and emphasizes the roles of TLRs in innate immunity. Efforts to modulate these regulatory pathways and signaling molecules may result in the development of new therapeutic strategies through TLR-based therapy.
Dendritic Cells ; Immunity, Innate ; Ligands ; Macrophages ; Proteins ; Toll-Like Receptors ; Transcription Factors