No abstract available.

No abstract available.
Dental Implants* ; Tissue Engineering*

Twenty-five consecutive patients who had contracture of the elbow were treated by arthroscopy. The techniques were removal of loose bodies, removal of osteohyte, anterior capsular release, abrasional arthroplasty and excision of the radial head. The type of arthroscopic procedure was determined by the cause of limiting motion which was intra-articular(intrinsic). The mean preoperative arc of total motion was 92°(21°-113°). Re-examination of the elbows after anaverage follow-up of 19 months showed tbat the mean arc of total motion was 116°(14°-130°). Twenty-three out of twenty-five patients (92%) who were followed up were satisfied with the results of the procedure and exhibited improved ability in carrying out daily activities. In conclusion, arthroscopy of the elbow is an effective diagnostic procedure and is also effective in treating certain intra-articular problems with minimal morbidity and rapid recovery to function.
Arthroplasty ; Arthroscopy ; Contracture ; Elbow ; Follow-Up Studies ; Head ; Humans ; Joint Capsule Release

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

"Idiopathic long QT syndrome" is characterized by prolongation of the QT interval due to unusual electrocardiographic repolarization abnormality and associated with variable clinical manifestations from no specific symptoms in lifetime to syncope or even sudden death. The prognosis of this syndrome is very grave and motality is approximately 50% within 10 years among untreated symptomatic patients after the initial syncope. But this sudden onset syncope may be misdiagnosed as epilepsy, being treated with antiepileptic drug for many years. However, this high mortality has been significantly reduced to less than 5% by the effective therapy. Therefore, it is crucial to make an early and accurate dianosis. We exprienced a case of 34 months old male who presented with recurrent syncopal attacks. He had no specific neurological abnomal finding except congenital deafness. He had normal EEG and brain MRI findings but ECG showed prolonged QT interval (QTc= 0.5), findings of which were compatible with long QT syndrome. He is currently being followed at OPD, but the pateint is still experiencing syncopal attack despite of treatment with beta-blocker, atenolol. Therefore, we are considering an insertion of pacemaker or performing thoracic sympathectomy.
Atenolol ; Brain ; Child, Preschool ; Deafness ; Death, Sudden ; Electrocardiography ; Electroencephalography ; Epilepsy* ; Humans ; Long QT Syndrome* ; Magnetic Resonance Imaging ; Male ; Mortality ; Prognosis ; Sympathectomy ; Syncope

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death* ; Brain Injuries* ; Brain* ; Extracorporeal Membrane Oxygenation* ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors*

No abstract available.
Narcolepsy*

Pediatric intestinal failure occurs secondary to short bowel syndrome, motility disorders, or malabsorption. The establishment of an intestinal rehabilitation program and the introduction of innovative surgical and medical treatments, such as the serial transverse enteroplasty procedure and omega-3-containing lipid emulsions, have been major advances in the treatment of intestinal failure. Intestinal transplantation is now established as a therapeutic modality in selected children with irreversible intestinal failure. The improved short to intermediate term survival of intestinal transplant recipients in the last decade can be attributed to immunosuppression with a lymphocyte-depleting agent, control of acute cellular rejection, and comprehensive infection control with careful monitoring of viral pathogens including cytomegalovirus and Epstein-Barr virus.
Child ; Cytomegalovirus ; Emulsions ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; Infection Control ; Rejection (Psychology) ; Short Bowel Syndrome ; Transplants

There is scientific evidence that administration of probiotics is effective in the treatment of acute infectious diarrhea in children and the prevention of antibiotic associated diarrhea and nosocomial/ community acquired diarrhea. Probiotics prevent relapse of recurrent pouchitis and decrease the initial onset of pouchitis in ulcerative colitis. Probiotic organisms suppress growth of pathogens as well as their epithelial attachment and/or invasion either directly by secreting antimicrobial substances or by stimulating host expression of protective molecules. Additionally, probiotics enhance mucosal barrier function and can stimulate host production of immunosuppressive molecules that downregulate inflammatory responses or allergic immune response. Mechanisms of action explain therapeutic effects and randomized controlled trials are warranted before recommendations for therapeutic or preventive use can be given.
Child ; Colitis, Ulcerative ; Diarrhea ; Epithelial Attachment ; Humans ; Pouchitis ; Probiotics* ; Recurrence

No abstract available.
Child* ; Hepatitis* ; Humans