PURPOSE: Tension-free hernioplasty has become the most popular procedure for the repair of groin hernias in the United States and United Kingdom. The purpose of this study is to describe a 7-year personal experience with Lichtenstein's tension-free groin hernia repair under local anesthesia. METHODS: We retrospectively studied the clinical outcome of 321 cases of Lichtenstein repairs, performed consecutively by an experienced surgeon between Jan. 1994 and Dec. 2000. RESULTS: Of the 321 cases, 242 (75.4%) were indirect, 34 (10.6%) were direct, 8 (2.5%) were femoral, 7 (2.2%) were pantaloon, and 30 (9.3%) were recurred hernias. The mean age was 55 years; 91% were male. The mean number of injections of analgesics required in the postoperative period was 3.2. The mean hospital stay following repair was 2.7 days. Complications occurred in 23 cases (7.1%). Most of these were minor, consisting of five cases of bruising or hematomas (1.6%), four superficial infections (1.3%), three seromas (0.9%), two hydroceles (0.6%), six patients with persisting groin pain for more than a month (1.8%), one foreign body granuloma, one urinary retention, and one testicular atrophy. There were no recurrences or operative deaths. CONCLUSION: Lichtenstein's tension-free hernioplasty is an easy and simple technique with less pain, minor complications and only rare instances of recurrence. This procedure can be performed on a same-day basis under local anesthesia. Lichtenstein repair may be the most promising technique for the repair of groin hernias.
Analgesics ; Anesthesia, Local ; Atrophy ; Granuloma, Foreign-Body ; Great Britain ; Groin* ; Hematoma ; Hernia* ; Herniorrhaphy ; Humans ; Length of Stay ; Male ; Postoperative Period ; Recurrence ; Retrospective Studies ; Seroma ; United States ; Urinary Retention

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*

Cough is a physiological defense reflex for protecting the airways from aspiration and irritation. Thus, roles of environmental triggers are postulated in the pathogenesis of chronic cough. There are several lines of epidemiological evidence demonstrating the relationships between environmental irritant and pollutant exposure and chronic cough. However, positive findings from cross-sectional studies just reflect the protective nature of cough but may not properly address the true impact of environmental triggers. If harmful inhalation is repeated, cough may be seen as chronic but indeed is protective in nature. Therefore, long-term residual outcomes would be the key for understanding the effects of environmental triggers on chronic cough. The present review aims to summarize the associations between chronic cough and environmental pollutants or irritant exposure, with a focus on the long-term residual effects of (1) chronic persistent exposure and (2) acute high-intensity exposure on chronic cough, and also to examine (3) whether childhood irritant/pollutant exposure may increase the risk of chronic cough in adulthood.
Cough ; Cross-Sectional Studies ; Environmental Pollutants ; Epidemiology ; Hypersensitivity ; Inflammation ; Inhalation ; Reflex

No abstract available.

Lymphangioma circumscriptum is a rare disease and the lesions are indistinguishable, clinically and histologically, from lymphangiectasis. The only difference is that lymphangiectasis is usually bilateral and develops in adult or late life, ie, condary to irradiation, surgical interruption, or some malignancies, but lymphangioma circumscriptum is congenital disease or develops soon after birth.
Adult ; Humans ; Lymphangiectasis ; Lymphangioma* ; Parturition ; Rare Diseases

Spondylometaphyseal dysplasia (SMD) is an extremely rare, which affects the spine and metaphy-ses of the tubular bones on terms of enchondrogenesis. Children who had Kozlowski dwarfism, type of SMD are not recognized until they reach school age since they have normal clinical feature, weight and size in early childhood. Authors experienced a typical case of Kozlowski type of SMD in a 10 years old male who had i) generalized platyspondyly with anterior tapering of vertebrae ii) generalized metaphyseal dysplasia iii) minimal changes in the carpal and tarsal bones. This case is to be reported with review of references.
Child ; Dwarfism ; Humans ; Male ; Spine ; Tarsal Bones

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

Aneurysmal benign fibrous histiocytoma, which is a rare variant of benign fibrous histiocytoma, usually occurs as a solitary nodule on the limbs of young to middle aged adults. The clinical diagnosis of fibrous histiocytoma is seldom considered in the differential disgnosis, which may include malignant melanoma, hemangioma, neurorfibroma, and nonspecific cyst. Histopathologically, aneurysmal benign fibrous histiocytoma is characterized by the presence of large blood-filled tissue space which is surrounded by histiocyte, fibroblast, hemosiderin pigment, and capillaries. We report a case of aneurysmal benign fibrous histiocytoma in a 15-year-old boy, who had a solitary nodular lesion on the left knee for a 2 year duration.
Adolescent ; Adult ; Aneurysm* ; Capillaries ; Diagnosis ; Extremities ; Fibroblasts ; Hemangioma ; Hemosiderin ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Knee ; Male ; Melanoma ; Middle Aged

BACKGROUND: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. MATERIAL AND METHOD: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. RESULT: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was 30+/-21 days. All the patients were followed up for 626+/-542 days without reoperation or other problems. CONCLUSION: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.
Aorta ; Aortic Diseases ; Circulatory Arrest, Deep Hypothermia Induced ; Hematoma ; Hemorrhage ; Humans ; Male ; Paraplegia ; Renal Dialysis ; Renal Insufficiency ; Reoperation ; Respiratory Insufficiency ; Ventilators, Mechanical ; Wound Infection