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.
Cyclosporine* ; Dermatomyositis*

No abstract available.

A complete history and physical examination for heart diseases in children, especially neonates and infants, enables the pediatrician to compile an appropriate differential diagnosis, order tests such as chest radiography and electrocardiogram in a suitable manner, and efficiently care for the patients. The ability to obtain an accurate history and to perform an excellent physical examination is very important and provides the basis for best management of children with heart diseases. As such, we are reviewed the components of the history and the physical examination that are critical in assessing the cardiovascular system.
Cardiovascular System ; Child* ; Diagnosis, Differential ; Electrocardiography ; Heart Diseases* ; Heart* ; Humans ; Infant ; Infant, Newborn ; Physical Examination* ; Radiography ; Thorax

The congenital diverticulum of ventricle is a rare cardiac malformation arising from the left or right ventricle, the former being more common. Ventricular diverticulum is usually associated with other anomalies including intracardiac, midline thoracic, diaphragmatic and abdominal wall defect. The authors experienced a case of congenital diverticulum of left ventricle in nine month-old female infant. Left Blolock-Taussig shunt operation was done and total correction will be done later. Thereafter we presented a case with brief review of the related literatures.
Abdominal Wall ; Diverticulum* ; Female ; Heart Ventricles ; Humans ; Infant ; Pulmonary Atresia*

The pulmonary sarcomatoid carcinoma is a rare malignant tumor, which is composed of an admixture of carcinomatous and sarcomatous components, and accounts for 0.3% of all pulmonary neoplasms. Clinicopathological features are often related to anatomical location: central endobronchial type and peripheral parenchymal type. Noninvasive diagnostic test had a low yield in detection sarcomatoid carcinoma. Metastasis to the regional lymph nodes and to distant organ is common. The prognosis is poor and the median survival is about 15 months. We report two cases of pulmonary sarcomatoid carcinoma with review of literatures.
Diagnostic Tests, Routine ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sarcoma

Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.
Male ; Humans

This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's alpha was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's alpha coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Diet ; Health Behavior* ; Humans ; Pain Management ; Reproducibility of Results ; Self Care ; Specialization ; Thinking

The complete echocardiographic evaluation of the patient with transposition of the great arteries requires diagnosing not only the ventriculoarterial connections (transposition) but only the atrial situs and the atrioventricular connections. The echocardiographic features of the discordant ventriculoarterial connection with a subpulmonary conus and absent subaortic conus include a left-sided infundibulum connection the left ventricle to the pulmonary artery, a somewhat small subaortic ventricular septal defect through which the mitral valve is in fibrous continuity with the aortic valve, subvalvular and/ or valvular pulmonary stenosis, and a characteristic coronary artery pattern. The spatial relationship of the great arteries, the chamber sizes, and the associated defect including atrial septal defect/patent ductus arteriosus, ventricular septal defect, and left ventricular outflow tract obstruction provide supportive evidence of the diagnosis. Also the evaluation of coronary artery anatomy has become an major part of the preoperative echocardiographic examination.
Aortic Valve ; Arteries* ; Conus Snail ; Coronary Vessels ; Diagnosis ; Ductus Arteriosus ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Mitral Valve ; Pulmonary Artery ; Pulmonary Valve Stenosis

Adenosquamous cell carcinoma (Ad-SCC) of the colon is rare. The pathogenesis of Ad-SCC is unclear, however, several hypotheses have been suggested. The clinical presentation and gross findings of Ad-SCC of the colon are similar to those of adenocarcinoma of the colon, but Ad-SCC has a more aggressive clinical course and a poorer prognosis. We report on two cases of Ad-SCC of the colon with obstruction; a collision-type Ad-SCC that has not only obstruction but also numerous hepatic metastases, and a composite-type Ad-SCC treated with left hemicolectomy followed by an adjuvant chemotherapy.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Chemotherapy, Adjuvant ; Colon ; Colonic Neoplasms ; Neoplasm Metastasis ; Prognosis