BACKGROUND: Infantile hypertrophic pyloric stenosis is the common disease of neonate and infant but its etiology and pathogenesis are still obscure. Frequent vomiting lead to electrolyte imbalance in infantile hypertrophic pyloric stenosis. METHODS: This study is a clinical analysis of the 30 cases of infantile hypertrophic pyloric stenosis (IHPS), that was surgically treated at the Department of Surgery, St. Columban Hospital during period of 8 years from January, 1990 to December, 1997. RESULTS: 1) The ratio of male to female was 3.3:1 and 50% of patients was first-born baby. 2) The most prevalent age group was between 3 to 4 weeks (20%). 3) The body weight percentile at admission was lower than 3 percentile in 14cases (46.7%). 4) Nonbilous projectile vomiting was noted in all cases. 5) In 15 cases (50%) of patients, the onset of symptoms was at 1 to 2 weeks of age. 6) The duration of symptoms was highest between a week to 3 weeks (50%). 7) The most frequent physical finding was palpable abdominal mass (60%). 8) At admission, clinical jaundice was noted in 3 cases (10%). 9) Hypochloremia was noted in 15 cases (50%) and hypokalemia in 6 cases (20%). 10) All cases were treated with Fredet-Ramstedt pyloromyotomy and duodenal perforation was complicated in 1 case. 11) Electrolyte abnormalities at admission did not significantly influence on the hospital stay. CONCLUSIONS: Through the surgical treatment so called Fredet-Ramstedt pyloromyotomy after accurate and rapid correction of dehydration and electrolyte imbalance, it can be cured.
Body Weight ; Dehydration ; Female ; Humans ; Hypokalemia ; Infant ; Infant, Newborn ; Jaundice ; Length of Stay ; Male ; Pyloric Stenosis, Hypertrophic* ; Vomiting

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.
Age Distribution ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Frozen Sections ; Goiter ; Humans ; Male ; Neck ; Needles ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Function Tests ; Thyroid Gland* ; Ultrasonography

No abstract available.
Renal Insufficiency*

No abstract available.
Glomerulonephritis, IGA* ; Hodgkin Disease* ; Immunoglobulin A*

PURPOSE: The purpose of this study was to analyze the patterns of intervertebral disc enhancement seen in tuberculous and pyogenic spondylitis, and to evaluate their utility in differentiating between the two groups. MATERIALS AND METHODS: Magnetic resonance images obtained in 31 consecutive infectious spondylitis patients (43 discs) in whom intervention occurred due to infected vertebral bodies, were retrospectively analysed. Nineteen of the patients had tuberculosis and 12 were infected by pyogenic organisms. After analysis, the patterns of disc enhancement revealed by contrast-enhanced T1-weighted axial and sagittal MR imaging were classified as of four types: Type I, non-enhancing; Type II, enhancement of the peripheral margin of the disc; Type III, enhancement of the peripheral margin and central area adjacent to the cortical vertebral endplate; Type IV, general enhancement and/or destruction of the disc. RESULTS: There were 19 cases of tuberculous spondylitis involving 28 intervertebral discs, and the enhancement patterns observed were as follows: Type I: n=4, 14%, Type II: n=17, 61%, Type III: n=1, 4%, Type IV: n=6, 21%. Twelve cases of pyogenic spondylitis involved 15 intervertebral discs; the enhancement patterns observed in these cases were as follows: Type I: n=1, 7%, Type II: n=2, 13%, Type III: n=10, 67%, Type IV: n=2, 13%. CONCLUSION: Careful analysis of the patterns of disc enhancement occurring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic varieties of this condition.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylitis* ; Tuberculosis

Congenital thoracic ectopic kidney is a very rare developmental disorder and the rarest type of ectopic kidney. This condition is usually asymptomatic and detected incidentally on routine chest radiography. Most cases of thoracic ectopic kidney develop in adulthood and during the neonatal period, and congenital thoracic ectopic kidney rarely develops in children. Most patients are asymptomatic, and the treatment depends on the diagnosis. Herein, we report a rare case of ectopic thoracic kidney associated with a diaphragmatic hernia in a 15-month-old male infant, who presented with periodic severe irritability. The thoracic ectopic kidney was detected as a mass in the right base of the chest on routine chest radiography.
Child ; Diagnosis ; Hernia, Diaphragmatic* ; Humans ; Infant* ; Kidney* ; Male ; Radiography ; Thorax

BACKGROUND: Functional dyspepsia (FD) is a commonly encountered disturbance of gut function and has been shown to be associated with psychological disturbance such as depression and anxiety. Of particular importance to clinicians are the relationship between anger, alexithymia, and depression. In this study, we investigated anger, alexithymia, and depression in patients with functional dyspepsia. METHODS: Thirty patients who visited Wonkwang University Hospital from January 2001 to June 2001, were diagnosed with functional dyspepsia by a gastroenterologist and compared with 37 healthy control group. Medical investigation of FD including gastrofiberscopy, esophageal manometry, and ambulatory 24-hours intraesophageal reflux test were negative. All subjects were evaluated for depression, anxiety, anger and anger expression, and alexithymia. The measures included Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Spielberger State-Trait Anger Expression Scale (STAXI), and Toronto Alexithymia Scale (TAS). RESULTS: The FD patients reported significantly more symptoms of depression, more difficulty describing feeling to others in TAS, less anger-in and anger-out expression in STAXI than the control subjects. Depressive symptoms in FD were positively correlated with state anxiety, trait anxiety, alexithymia, state anger, trait anger, and anger-in expression. In multiple regression model, state anger and trait anxiety together accounted for 69.1% of the depression in FD. CONCLUSION: The FD patients reported more depressive symptoms, and the depressive symptoms were related to anxiety, anger and anger-in, and alexithymia. These finding lend support that FD is a syndrome in which biopsychosocial process and affect dysregulation may play a role in features of FD.
Affective Symptoms* ; Anger* ; Anxiety ; Depression* ; Dyspepsia* ; Humans ; Manometry

Objective: Somatic symptoms in psychiatry include underlying depression, anxiety, or other psychiatric disorders. This study aimed to conduct a validation study of a Korean version of the Somatic Symptom Scale-8 (K-SSS-8), and to utilize the K-SSS-8 effectively in clinical settings. Methods: For reliabilty, test-retest reliability and internal consistency were analyzed. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Known-group validity was verified, Jonckheere-Terpstra test (J-T statistic) were used. Results: Maternal Cronbach’s alpha was 0.85 and r value of test-retest reliability was 0.777. In the EFA, 2-, 3- and 4-factor model showed cumulative percentile for variance of 60% or more. In the CFA, the 3-factor model was found to be the most appropriated and simplest (χ2=10.992, df=17, CFI=1.000, TLI=1.022, RMSEA=0.000). The verifying the difference in K-SSS-8 also showed significant difference. (J-T statistic=-2.510, p<0.05). Conclusion K-SSS-8 can be useful for exploring symptoms such as panic symptoms, physical pain, and physiological symptoms experienced by patients in a short time. In addition, the K-SSS-8 is expected to be very useful for determining the current severity by using the severity categories and for establish additionally required assessment plans for depression and anxiety symptoms.

PURPOSE: Acute fulminant hepatic failure (FHF) is associated with high mortality. Recent studies have shown that a liver support system based on viable hepatocytes can prolong life in animal models of FHF and also in some FHF patients who were successfully bridged to liver transplantation. To be applied in humans, the bioartificial liver (BAL) system should have sufficient liver cell mass to provide adequate bioactive support. The most widely investigated bioreactor at present is based on hollow fiber membrane. However, it is difficult to build a scaledup module of this model. We devised a fluidized-bed bioreactor that is packed with isolated porcine hepatocytes, and these hepatcytes are immobilized in Ca-alginate hydrogel. METHODS: We isolated fresh porcine hepatocytes using a 2-step collagenase perfusion method, and they were suspended in 1.5% alginate solution. Through a drop-generator, this mixture was gelled in 135mM Cacl2. The resulting spherical beads (mean size: 500 micrometer) were embedded in a module. An average of 2x10(10) hepatocytes were present in the module. The efficacy of our design was tested in pigs that had undergone total hepatic devascularization and portocaval shunt. RESULTS: The BAL-treated group showed a significantly lower ammonium build-up rate compared to the control group (598.6+/-344.2 microgram/dl vs 1937.6+/-744.1 microgram/dl, respectively, at 8 hours after connecting to BAL). In addition, the intracranial pressure was well controlled in the BAL-treated group, whereas the control group showed a progressive increase of the intracranial pressure (16.9+/-1mmH2O vs 21.9+/-2.6mmH2O, respectively, at 8 hours after connecting to BAL). CONCLUSION: Our bioartificial liver system is a fluidized-bed bioreactor packed with immobilized porcine hepatocytes, and it seems to be a more effective scaled-up module.
Alginates ; Bioreactors ; Collagenases ; Glucuronic Acid ; Hepatocytes ; Hexuronic Acids ; Humans ; Intracranial Pressure ; Liver ; Liver Failure, Acute ; Liver Transplantation ; Liver, Artificial ; Membranes ; Models, Animal ; Perfusion ; Quaternary Ammonium Compounds ; Swine

Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum ajdn subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With coservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.
Asthma* ; Chest Pain ; Cough ; Emphysema* ; Fascia ; Humans ; Lung ; Mediastinal Emphysema ; Neck ; Physical Examination ; Radiography, Thoracic ; Respiratory Sounds ; Subcutaneous Emphysema ; Thorax ; Tomography, X-Ray Computed