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*

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.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

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

BACKGROUND: To date, many methods have been proposed to resolve the sunken eyelid. We treated our clinical cases of sunken upper eyelid based on whether there is a concurrent presence of the dermatochalasis or blepharoptosis and then performed the autologous fat grafting using either closed or open technique. METHODS: According to the classification of the patients, we used the following injection techniques: First, we solely performed the autologous fat grafting using the closed technique in the sunken upper eyelid only group, for which we did the injection using a micro-injector cannula on the suborbicularis plane. Second, we performed such procedures as skin excision, orbicularis oculi muscle strip excision and levator aponeurosis advancement to manage each symptom in the sunken upper eyelid with dermatochalasis or blepharoptosis group. Simultaneously, we also made a small window in the lateral portion of the orbital septum using the open technique with metzenbaum scissors. Thus, we performed the intraseptal injection of the autologous fat. RESULTS: During a period ranging from January of 2012 to April of 2014, we treated a total of 53 patients. The patients were followed up during a mean period of four months. Thus, we obtained satisfactory treatment outcomes without notable complications. CONCLUSIONS: In conclusion, our results indicate not only that surgeons should consider the fat grafting as one of eyelid-surgery procedures but also that they should perform it concurrently with blepharoplasty or blepharoptosis correction for the purposes of obtaining good treatment outcomes.
Blepharoplasty ; Blepharoptosis* ; Catheters ; Classification ; Eyelids* ; Humans ; Orbit ; Skin ; Transplants*

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

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: The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS: The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with 10degrees of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (alpha = .05), and the statistical significance was set at P < .05. RESULTS: The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION: Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and 10degrees mesial angulated groups.
Light ; Polyvinyls ; Siloxanes

The presence of distant metastases from differentiated thyroid carcinoma decreases the 10-year survival rates of patients by 50%. This is a report of a 61-year-old female with follicular thyroid carcinoma who presented initially with low back pain. 2-deoxy-2-[18F] fluoro-D-glucose whole-body positron emission tomography/computed tomography (PET/CT) demonstrated a hypointensity lesion in the left thyroid gland with malignant uptake in L1 vertebra and magnetic resonance images revealed paravertebral and epidural extension of mass in L1 vertebra. After thyroidectomy, histopathological study showed a follicular carcinoma. We performed L1 total en bloc spondylectomy with expandable cage for long-term local control. The technical details of total en bloc spondylectomy in follicular carcinoma are described herein.
Adenocarcinoma, Follicular ; Electrons ; Female ; Humans ; Low Back Pain ; Magnetic Resonance Spectroscopy ; Middle Aged ; Neoplasm Metastasis ; Spine ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy