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.
Primary Myelofibrosis*

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*

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: We report the correlation between known risk factors for cerebrovascular disease and formation of multiple intracranial aneurysms. METHODS: We reviewed the medical records and outcomes of 524 patients who had undergone aneurysmal operation at our hospital between January 1996 and May 2001. Of 524 patients who had undergone operations with intracranial aneurysm, 130 patients had multiple intracranial aneurysms. The authors examined the correlations between the risk factors(patient age, sex, menopausal state of female patients, hypertension, cigarette smoking) and the presence of multiple intracranial aneurysms by using chi-square test retrospectively. RESULTS: The male to female ratio was about 1 : 2.05(male : female=129 : 265) for patients with single intracranial aneurysm, and male to female was about 1 : 3.06(male : female=32 : 98) for patients with multiple intracranial aneurysms. Among 256 female patients with single intracranial aneurysm, 182 patients(68.9%) were postmenopausal, and, among 98 female patients with multiple intracranial aneurysms, 81 patients(82.6%) were postmenopausal. The mean age of the patients with single intracranial aneurysm was 54 years, and, with multiple intracranial aneurysms, the mean age was 57.8 years. The presence of hypertension was found in 149 patients(37.8%) with single intracranial aneurysm, and, in 55 patinets (42.3%) with multiple intracranial aneurysms. Cigarette smoking was found in 116 patients(29.4%) with single intracranial aneurysm and 47 patients(36.1%) with multiple intracranial aneurysms. CONCLUSION: There is a significant correlation between menopausal state of female patients and presence of multiple intracranial aneurysms. However, gender, hypertension and smoking are not related to multiple intracranial aneurysms.
Aneurysm ; Female ; Humans ; Hypertension ; Intracranial Aneurysm* ; Male ; Medical Records ; Postmenopause ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Tobacco Products

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*

The nuclear receptor superfamily consists of the steroid and non-steroid hormone receptors and the orphan nuclear receptors. Small heterodimer partner (SHP) is an orphan family nuclear receptor that plays an essential role in the regulation of glucose and cholesterol metabolism. Recent studies reported a previously unidentified role for SHP in the regulation of innate immunity and inflammation. The innate immune system has a critical function in the initial response against a variety of microbial and danger signals. Activation of the innate immune response results in the induction of inflammatory cytokines and chemokines to promote anti-microbial effects. An excessive or uncontrolled inflammatory response is potentially harmful to the host, and can cause tissue damage or pathological threat. Therefore, the innate immune response should be tightly regulated to enhance host defense while preventing unwanted immune pathologic responses. In this review, we discuss recent studies showing that SHP is involved in the negative regulation of toll-like receptor-induced and NLRP3 (NACHT, LRR and PYD domains-containing protein 3)-mediated inflammatory responses in innate immune cells. Understanding the function of SHP in innate immune cells will allow us to prevent or modulate acute and chronic inflammation processes in cases where dysregulated innate immune activation results in damage to normal tissues.
Chemokines ; Child ; Child, Orphaned ; Cholesterol ; Cytokines ; Glucose ; Humans ; Immune System ; Immunity, Innate ; Inflammasomes ; Inflammation ; Metabolism ; Orphan Nuclear Receptors ; Social Control, Formal ; Toll-Like Receptors

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

Now, in the 1980s computer literacy is an integral part of education. This is a result of both normal cultural evolution and revolutionary technical advances which have greatly deereased the cost of computers and made them for far easier to use and understand. Accordingly, the possible application for the anesthetist are varied and range from educational game to sophiscated servo control of vital signs. The following is an experience of application program named AMS(Anesthetic Management System). The AMS is for scheduling and auditing of anesthetic record. The usage is simple and accurate but have some problems including lack of uniformity in data input especially type of anesthesia and anesthetic agent used. Authors expect the better programs which can be used in risk analysis in anesthsiology will be developed.
Anesthesia ; Computer Literacy ; Cultural Evolution ; Education ; Humans ; Microcomputers* ; Vital Signs