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.

Respiratory syncytial virus (RSV) is a main cause of hospitalization for bronchiolitis and pneumonia in infants worldwide. Children with hemodynamically significant congenital heart disease (HS-CHD), as well as premature infants are at high risk for severe RSV diseases. Mortality rates for CHD patients hospitalized with RSV have been reported as about 24 times higher compared with those without RSV infection. Recently with advances in intensive care, mortality rates in CHD patients combined with RSV have decreased below 2%. The requirements of intensive care and mechanical ventilation for CHD patients with RSV infection were still higher than those without RSV infection or with non-CHD children. RSV infection has frequently threatened CHD infants with congestive heart failure, cyanosis, or with pulmonary hypertension. As a progressive RSV pneumonitis in those infants develops, the impairment of oxygen uptake, the breathing workload gradually increases and eventually causes to significant pulmonary hypertension, even after the operation. Preventing RSV infection as much as possible is very important, especially in infants with HS-CHD. A humanized monoclonal antibody, palivizumab, has effective in preventing severe RSV disease in high-risk infants, and progressive advances in supportive care including pulmonary vasodilator have dramatically decreased the mortality (<1%). Depending on the global trend, Korean Health Insurance guidelines have approved the use of palivizumab in children <1 year of age with HS-CHD since 2009. Korean data are collected for RSV prophylaxis in infants with CHD.
Antibodies, Monoclonal, Humanized ; Bronchiolitis ; Child ; Cyanosis ; Heart ; Heart Diseases ; Heart Failure ; Hospitalization ; Humans ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Insurance, Health ; Critical Care ; Oxygen ; Pneumonia ; Respiration ; Respiration, Artificial ; Respiratory Syncytial Viruses ; Palivizumab

Hypertension is a major risk factor for myocardial infarction, stroke, and cardiovascular mortality in adults; its treatment reduces the risk of cardiovascular events. In recent times, attention is being paid to monitoring of blood pressure from childhood to adulthood. Childhood hypertension is associated with hypertension in later life, and early intervention is important. In the Korean socioeconomic background, a rapid increase is observed in the number of obesity cases and the rate of increase in the incidence of obesity is more in childhood. The strong association of high blood pressure with obesity and the marked increase in the incidence of childhood obesity indicate that both hypertension and prehypertension are becoming significant health issues. In this comprehensive review, we acquaint the clinician with the available literature on childhood hypertension to provide recommendations for the diagnosis, evaluation, and treatment of hypertension based on the available evidence and consensus in Korean clinical conditions.
Adolescent ; Blood Pressure ; Child ; Consensus ; Early Intervention (Education) ; Humans ; Hypertension ; Incidence ; Myocardial Infarction ; Obesity ; Prehypertension ; Risk Factors ; Stroke

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

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*

No Abstract available.
Diagnosis* ; Ebstein Anomaly*

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