PURPOSE: There have been many accidental ingestions of strong acid or alkali in early childhood. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis. However there have been few endoscopic studies on caustic esophagitis in children. The aim of this study was to review the contribution of the endoscopy to the diagnosis and management of eosphageal stricture and to search for the guidline of the proper management. METHODS: We carried out the retrospective study on 15 children who admitted to Seoul National University Children's Hospital after accidental ingestion of caustic agents from the March 1990 to July 1995. They all underwent flexible gastrofiberoscopy to predict the complication of the caustic esophagitis. RESULTS: The early gastrofiberoscopy showed that the 2nd degree esophageal injury was most common and the majority of patients had diffuse, not localized esophagitis. The incidence of the late occurance of the esophageal stenosis was higher in patients who showed more severe degree of the esophageal mucosal damage on the early endoscopic examination. After the detection of esophageal stenosis on follow up esophagographic examination, 7 children were initially managed with balloon dilatation : Only 2 of them were successfully treated and 5 of them showed poor response to dilatation and finally treated with surgical correction. One child was successfully treated with surgical correction without trial of esophageal balloon dilatation. One child with mild esophageal stenosis improved clinically with supportive care only including antibiotics, steroid therapy, hyperalimentation etc. CONCLUSIONS: The early gastrofiberoscopic examination immediately after the accident is essential for predicting the late occurance of the esophageal stenosis. Esophageal stenosis could be successfully treated with esophageal balloon dilatation and/or surgical correction with caustic esophagitis in childtren.
Alkalies ; Anti-Bacterial Agents ; Child* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Eating ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Follow-Up Studies ; Humans ; Incidence ; Retrospective Studies ; Seoul

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

No abstract available.
Magnetic Resonance Imaging* ; Spinal Cord*

No abstract available.
Child* ; Humans ; Lupus Nephritis*

Plate fixation is being regarded as one of the reliahle fixation method in the management of tibial fractures. But this technique may leave many complications including infection. However, delayed local infection which developed several weeks after open reduction on the tibia has been rarely described as a complication in the literatures. The purpose of this study is to evaluate the contributing factors to the delayed locaI infection in tibial fracture treated with plate fixation. Authors reviewed and analyzed the 60 cases of tihial fracture that were treated with plate and screws from 1989 to 1996. Analyses dealt with fracture classification, laboratory and radiographic findings and the site of plate application. We defined a delayed local infection as a condition in which patient has infection signs on Jaboratory and physical examination at or over 8 week post-operation without any evidence of osteomyelitis on plain radiographs. We found 7 cases of delayed local infection out of 60 tibial fractures from 8 to 21 weeks postoperatively with an average of 14.1 weeks. All the 7 cases that had been treated with plate on medial aspect of tibia were treated by administration of antibiotics without surgery such as debridement or removal of hardwares. Authors concluded that the medial plating was the most important factor of the development of delayed local infection(Z=1.78).
Anti-Bacterial Agents ; Classification ; Debridement ; Humans ; Osteomyelitis ; Physical Examination ; Tibia ; Tibial Fractures*

Popliteal artery entrapment syndrome (PAES) is a rare vascular disorder characterized by the compression of the popliteal artery behind the knee, primarily affecting physically active individuals. This is a case of a 36-year-old man who presented with a 1-week history of sudden-onset left leg pain. Diagnostic evaluation, including physical examination, color duplex ultrasonography, computed tomography, and magnetic resonance imaging, revealed a popliteal artery pseudoaneurysm caused by type 5 PAES. The patient underwent surgical exploration to release the entrapment, followed by an interposition graft with the ipsilateral great saphenous vein. Patient postoperative recovery was uneventful, with significant symptomatic improvement. This case underscores the significance of considering PAES as a differential diagnosis in young patients with popliteal artery aneurysms and highlights the necessity for prompt diagnosis and treatment to prevent limbthreatening complications.

Considering the recent advancements in endovascular management of aortoiliac aneurysms, the use of an iliac branch device (IBD) to preserve pelvic blood flow and reduce complications caused by embolization of the internal iliac artery (IIA) is recommended by various guidelines. Although the outcomes reported following IBD placement are mainly positive and durable, IBD-specific complications such as a type Ic endoleak and associated reintervention may occur. Moreover, only one IBD device and one type of balloon-expandable bridging stent graft for IIA are currently available on the domestic market. Here we present two cases of type Ic endoleak following IBD placement. In both cases, IIA diameter was slightly larger than the basic instructions for use. Notably, the initial procedures were considered successful; however, type Ic endoleaks were detected on 1-month follow-up imaging. This finding emphasizes the need for a precise preoperative evaluation, intraoperative manipulation, and postoperative follow-up.

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

No abstract available.
Dermoscopy ; Melanoma*

A 6-month-old female infant pre~sented with multiple, slightly depressed pea-sized erythematous macules on. the abdomen and the chest since birth, which together with obese, short stature, short neck, and round face suggested Albrights hereditary osteodystrophy(AHO). Some of the lesions were palpable as hard nodules or plaques in deep dermis. After 3 months follow up, the erythem- atous hue faded out, subcutaneous nodules and plaques enlarged. Skin biopsy specirnen demonstrated a bone formation in deep dermis. Serum calcium and phosphorus levels were lower and upper normal ranges, respectively and serum parathyroid hormone was increased in 69.1 pg/ml (normal, 9-55pg/ml). As pseudohypoparathyroidism including this case mostly exhibit characteristic morphologic features of AHO, the subcutaneous ossification may be a presenting feature.
Abdomen ; Biopsy ; Calcium ; Dermis ; Female ; Follow-Up Studies ; Humans ; Infant ; Neck ; Osteogenesis ; Parathyroid Hormone ; Parturition ; Phosphorus ; Pseudohypoparathyroidism* ; Reference Values ; Skin ; Thorax