No abstract available.
Asthma* ; Immunotherapy*

PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma ; Adrenalectomy* ; Angiomyolipoma ; Hemorrhage ; Humans ; Hyperplasia ; Kidney ; Length of Stay ; Mortality ; Nephrectomy ; Prone Position ; Subcutaneous Emphysema

A case of Maffucci's syndrome is reported in a 6-year-old girl. She had multiple enchondromas of the long bones and the phalangeal bones with hemangiomatous skin lesions. The hemangiomas were the capillary type and were not anatomically related to the bone lesions.
Capillaries ; Child ; Chondroma ; Enchondromatosis ; Female ; Hemangioma ; Hemangioma, Capillary ; Humans ; Skin

No abstract available.
Humans ; Osteosarcoma*

Chronic cough is a symptom frequently encountered by the pediatrician. Although most coughs are self-limited, chronic cough often proves to be a frustrating problem. This study was performed at Kangnam St. Mary's Hospital from January 1, 1992 to December 31, 1992, and 83 children with chronic cough persisting for longer than 3 weeks was evaluated. We categorized these patients into 5 age groups (1. Infant: uner 12 months of age, 2. Toddler: above age 1~below age 3, 3. Preschool: above age 3~below age 6,4. School: above age 6~below age 6~below age 12, 5. Adolecent: above age 12). The most common cause of chronic cough was the reactive airway disease (71.1%) such as asthma with or without sinusitis (56.6%) and bronchiolitis-reactive (14.5%). In infant age group, the most frequent causes of chronic cough were reactive airway disease(52.4%)such as bronchiolitis-reactive (28.6%) and infantile asthma (23.8%). The second and third common causes were congenital anomalies(23.8%) and bronchiolitis-nonreactive (23.8%). In toddler age, the most common cause was the reactive airway disease such as infantile asthma (10 cases: 50%) and bronchiolitis reactive (6cases; 30%) and congenital anomalies were the second common causes of chronic cough. In preschool, school and adolescent age group, asthma and sinusitis were the main causes of chronic cough. In the groups above age 3,73.2% of chronic cough were associated with sinusitis. Therefore, in the diagnostic and therapeutic approach of chronic cough, it should be considered that the cause of cough is either reactive airway disease with or without sinusitis or not. In infant and toddler age, congenital anomaly should be considered.
Adolescent ; Asthma ; Bronchiolitis ; Child* ; Cough* ; Humans ; Infant ; Sinusitis

Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.
Age Distribution ; Asthma ; Breast ; Child, Preschool ; Classification ; Cough* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Dyspnea ; Egg White ; Eosinophilia ; Fees and Charges ; Female ; Fever ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk ; Pediatrics ; Pulmonary Atelectasis ; Respiratory Sounds ; Sinusitis ; Thorax

The diagnosis of painful hips of the children are very difficult in their early stage of diseases. Transient synovitis, Legg-Calve-Perthes' diseas juvenile rheumatoid arthritis and pyogenic hip are very similar in clinical manifestation and plane radiology. But the treatment methods and prognoses are very different, so it is very important to make an accurate diagnosis and differential diagnosis as early as possible. In the above mentioned diseases hip joint effusion is one of common manifestations, so we studied the hip joint effusion by ultrasonography in 49 children with painful hips and also we studied both hips of healthy children to determine the criteria of the normal hip joint. And the results are summerized as follows: l. Ultrasonography was very good method for detection of hip joint effusion. 2. In healthy children, the average bone-to-capsule distance was 2.95mm. 3. In children patients with unilateral painful hip, the average bone-to-capsule distance was 2.96mm, so it was very similar to that of healthy children. 4. The difference more than 2mm between both hips was abnormal. 5. In 49 children with painful hips, over all positive rate was 63.3%.
Arthritis, Juvenile ; Child ; Diagnosis ; Diagnosis, Differential ; Hip Joint ; Hip ; Humans ; Methods ; Prognosis ; Synovitis ; Ultrasonography

In pediatric ages, the supracondylar fractures of the humerus are common and often associated with complications. In these days, the serious complications were reduced with a lot of apprehension for the treatment. While the fracture itself was healed properly, the remained deformity was frequent and it was known that this deformity was derived not from growth disturbance after fracture but from inaccurate reduction at the time of initial reduction. We have performed an anatomical study. Identical skeletal models were osteotomized at the supracondyle of the humerus and every combination of 0°,10°, 20°, 30° of each of varus, valgus tilt, internal rotation and flexion were tried at osteotomized site and were taken radiography and photographed. We measured T-C angle, carrying angle and displacement of distal radial styloid process on X-ray. We got the results as follow. 1. Simple rotational deformity of 50° have resulted in only 20% decrease of width of distal osteotomized surface in AP films in pure rotational deformity. 2. Flexion at the osteotomized site have no specific effect on the change of varus and valgus deformity. There were remarkable increase from 0° to 20° after then the changes were decreased in varus tendency according to internal rotation. 3. Among the changes of varus and valgus angle, the varus deformity was largest at the change of angle from 0° to 10° and other change of angle of varus and valgus deformity were incrersed at similar degree. 4. At the osteotomy site, without changes of varus and valgus angle, it showed that internal rotation resulted in varus defromity.
Congenital Abnormalities ; Humerus ; Osteotomy ; Radiography

PURPOSE: Evaluating the clinicopathologic characteristics of recurred gastric cancer is essential for early detection of the recurrence and for better clinical outcome. The aim of this study was to establish the patterns of the recurrence, the timing of the recurrence, and the clinical result after recurrence according to the clinicopathologic characteristics of gastric cancer. MATERIALS AND METHODS: From June 1992 to December 2005, of the 1338 gastric cancer patients who underwent a curative gastric resection, 241 patients who recurred during the follow-up period were selected and their cases were analyzed. The clinicopathologic characteristics of the patients, the time to recurrence after operation and survival were determined retrospectively according to the type of recurrence. RESULTS: For the recurrent group, the numbers of total gastrectomies, advanced stages, lymphatic and/or venous infiltrations, whole stomach cancer cases, large tumors, undifferentiated tumors, and Borrmann type 4 tumors were higher than they were for the non-recurrent group, and the differences were statistically significant. When the recurrence types were classified as peritoneal seeding, hematogenous recurrence, and locoregional recurrence, independent risk factors were female gender, stage III, upper third, and whlole stomach cancer, and undifferentiated-type, diffuse-type, and Borrmann type 4 tumors for peritoneal seeding; early gastric cancer, stage I for hematogenous recurrence; and Borrmann type 1, 2, and 3 tumors for locoregional recurrence. Survival duration after detection of the recurrence was shorter for peritoneal seeding than for hematogenous or locoregional recurrence (7.0 months vs. 9.5 months and 12.5 months). CONCLUSION: For early detection of the recurrence after curative surgery for gastric cancer, it is important to recognize that the high risk factors for recurrence vary with the clinicopathologic data for the patients.
Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

Patients with inflammatory bowel disease are known to have hypercoagulability and an increased risk for venous thromboembolism. The deep veins of the lower extremities and the pulmonary veins are the most common sites of thrombosis in ulcerative colitis. However, hepatic vein thrombosis (Budd-Chiari syndrome) is a very rare extra-intestinal complication of ulcerative colitis in children. We describe a case of hepatic vein thrombosis in a 15-year-old girl with ulcerative colitis who presented with abdominal pain and hematochezia. Doppler ultrasonography and an abdominal CT scan revealed the characteristic filling defects caused by large thrombi in both hepatic veins. These lesions were successfully treated with conventional management for ulcerative colitis and anticoagulation therapy.
Abdominal Pain ; Adolescent ; Budd-Chiari Syndrome ; Child ; Colitis, Ulcerative ; Gastrointestinal Hemorrhage ; Hepatic Veins ; Humans ; Inflammatory Bowel Diseases ; Lower Extremity ; Pulmonary Veins ; Thrombophilia ; Thrombosis ; Ulcer ; Ultrasonography, Doppler ; Veins ; Venous Thromboembolism