Congenital hypertrophic pyloric stenosis is the most common intra-abdominal disease required surgery during the first few months of life. The expression of pyloric stenosis is dependent upon the genetic influence of ancestors affected with the disease, as well as unknown environmental influences in the postnatal period. Pyloric stenosis has been reported in multiple sibs in a family, which suggests the genetic influence on the expression of this disease. Until now, the genetic influence is thought a sex-modified polygenic or multifactorial background which facilitates the expression of a common dominant gene. We experienced a case of congenital hypertrophic pyloric stenosis in a two siblings. The siblings suffered projectile vomiting for 2~4 days at 16 days old of age and 15 days old of age. After we confirmed the diagnosis by upper gastrointestinal series and abdominal sonogram, the Fredet-Ramstedt pyloromyotomy was done successfully. This case suggests the genetic influence on the expression of this disease.
Diagnosis ; Genes, Dominant ; Humans ; Pyloric Stenosis ; Pyloric Stenosis, Hypertrophic* ; Siblings* ; Vomiting

This study aimed to investigate the mechanism of action of baclofen on the detrusor muscle isolated from rat. Rats (Sprague-Dawley) were sacrificed by decapitation and exsanguination. Horizontal muscle strips of 2 mm x 15mm were prepared for isometric myography in isolated muscle chamber bubbled with 95% / 5%-OZ / CO2 at 371C, and the pH was maintained at 7.4 Detrusor strips. contracted responding to the.. electrical field stimulation (EFS) by 2 Hz, 2U msec, monophasic square wave of 60 VDC. The initial peak of EFS-Induced contraction was tended to be suppresed by a,p-methylene-adenosine 5'-triphosphate (mATP), a partial agonist of purinergic receptor, and baclofen, a GABAB receptor agonist (statistically nonsignificant). The late sustained contraction by EFS was suppressed significantly (p < 0.05) by additions of atropione, a cholinergic muscarinic receptor antagonist and baclofen. The adenosine 5'-triphosphate-induced contraction was completely abolished by mA TP but not by baclofen. In the presence of atropine, the subsequent addition of acetylcholine could not contract the muscle strips: but the addition of acetylcholine in the presence of baclofen evoked a contraction to a remarkable extent.
Acetylcholine ; Adenosine ; Animals ; Atropine ; Baclofen* ; Decapitation ; Exsanguination ; Hydrogen-Ion Concentration ; Myography ; Rats* ; Receptors, Muscarinic

Splenosis is defined as the autotransplantation of splenic tissue after a traumatic splenic injury or a splenectomy. It has often been mistaken as an endometriosis, an intraperitoneal carcinoma, a hemangioma and an accessory spleen. It is clinically significant in that it requires no treatment if it is asymptomatic. Here we report a case of 34 year-old woman who had a pelvic splenosis with cyclic abdominal pain for several years, which was initially misdiagnosed as ovarian dermoid cyst. At the time of exploration, a splenosis was observed in the pelvic cavity. After surgery, a multiple splenosis in the abdominal cavity was found through a Tc-99m heat denatured red blood cell scan. The removal of the splenosis in the pelvic cavity resulted in an improvement in her symptoms.
Abdominal Cavity ; Abdominal Pain* ; Adult ; Autografts ; Dermoid Cyst* ; Endometriosis ; Erythrocytes ; Female ; Hemangioma ; Hot Temperature ; Humans ; Spleen ; Splenectomy ; Splenosis*

The lung nodule is one of the pleuropulmonary menifestations in rheumatoid arthritis. We report here a case exhibiting hydropneumothorax due to a bronchoplerual fistula resulting from a ruptured rheumatoid lung nodule complicated with a aspergilloma in it. A 39 year-old man with rheumatoid arthritis was admitted because of cough for one month. Multiple subcutaneous nodules were noted and multiple lung nodules were seen on chest X-ray, Peripheral white cells were 9,600/mm3 with 1896 of eosinophils. The percutaneous needle aspiration biopsy of the largest lung nodule of right upper lobe showed massive necrosis without acid fast bacillus, fungus, or malignant cell. Three months after discharge, air-meniscus sign was seen on the biopsied lung nodule on X-ray. Five months later, the patient was readmitted due to dyspnea and chest pain and simple chest X-ray showed hydropneumothorax on the right side. The pneumothorax was not healed after closed thoracotomy and tube drainage, and high fever developed. The pleural fluid culture revealed Pseudomonas aeroginosa and Aspergillus fumigatus. Seventy days after admission, exploratory thoracotomy was done. Aspergilloma was found in the cavitated lung nodule which was ruptured into the pleural cavity through bronchopleural fistula.
Adult ; Arthritis, Rheumatoid* ; Aspergillus fumigatus ; Bacillus ; Biopsy, Needle ; Chest Pain ; Cough ; Drainage ; Dyspnea ; Eosinophilia* ; Eosinophils ; Fever ; Fistula* ; Fungi ; Humans ; Hydropneumothorax ; Lung* ; Necrosis ; Needles ; Pleural Cavity ; Pneumothorax ; Pseudomonas ; Thoracotomy ; Thorax

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

No abstract available.
Down Syndrome* ; Primary Myelofibrosis*

The most commonly reported sexual problems in diabetic women are sexual arousal disorder and a lack of vaginal lubrication. The aims of this study were to investigate the vaginal structural changes and expressions of TGF-beta1, Ec-NOS and estrogen receptor alphaby histochemistry, immunohistochemistry and Western blot analysis in diabetic and insulin-treated diabetic rats. The mean blood glucose levels were significantly increased in the diabetic rats (453+/-88.4 mg/dL)compared to the control group (79+/-6 mg/dL)and insulin-treated diabetic rats (56.7+/-0.6 mg/dL).The vaginal wall in control rat showed 6~11 layered stratified squamous epithelial lining and submucosal smooth muscle, connective tissue and vasculatures. In diabetic rat, the vaginal epithelium was reduced to 2~6 layers and the submucosal vasculatures were decreased n size and number.Collagen fibers were increased and irregularly distorted arrangement. Insulin-treated diabetic rat showed similar morphologic features as control rat.In diabetic rat, TGF-beta1 expression was upregulated by 1.65 times and Ec-NOS expression was 40% downregulated compared to control and insulin-treated diabetic rats in Western blot analysis. In control and insulin-treated diabetic rats, TGF-beta1 immunoreactivity was detected in fibroblasts and the collagen fibers, Ec-NOS immunoreactivity in the endothelial cells of blood vessels, and estrogen receptor alphaimmunoreactivity in the basal and intermediate cell layers of stratified squamous epithelium, smooth muscle fibers, and nerve fibers. In diabetic rat, expression of TGF-beta1, Ec-NOS, and estrogen receptor alphawas exhibited comparable cellular patterns of labeling, but signal intensity was increased in TGF-beta1 and decreased in Ec-NOS and estrogen receptor alpha. These results suggest that vaginal tissue fibrosis in diabetes mellitus may be caused by altered expression of TGF-beta1, NOS and estrogen. It also mplies that sexual arousal disorder and lack of vaginal lubrication in the diabetic women could be protected or delayed by controlling blood glucose levels.
Animals ; Blood Glucose ; Blood Vessels ; Blotting, Western ; Collagen ; Connective Tissue ; Diabetes Mellitus ; Endothelial Cells ; Epithelium ; Estrogen Receptor alpha ; Estrogens ; Female ; Fibroblasts ; Fibrosis ; Humans ; Immunohistochemistry ; Insulin* ; Lubrication ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide Synthase ; Rats* ; Sexual Dysfunctions, Psychological ; Transforming Growth Factor beta1 ; Vagina*

BACKGROUND: This study examined the effects of the method of delivery of brief advice on the readiness to change in at-risk drinkers. METHODS: The participants were 103 at-risk male drinkers who visited Chungnam National University Hospital for general health examinations. Baseline data on drinking behavior, readiness to change drinking behavior, and sociodemographic characteristics were obtained from a questionnaire. Family physicians gave two minutes of advice by telephone or in-person. The brief advice comprised a simple statement that the patient's drinking exceeded the recommended limits and could lead to alcohol-related problems. It also included advice to moderate one's drinking. One month later, the readiness to change was assessed again by telephone. The improvement in the readiness to change according to each method of delivery was investigated. RESULTS: Initially, among the 58-patient in-person advice group, 12 patients were in the precontemplation stage, 38 in the contemplation stage, and 8 in the action stage. One month after the advice was given to the patients, the distribution had changed significantly (P < 0.001) to 1, 21, and 36 patients, respectively. Among the 45-patient telephone advice group, 7 patients were in the precontemplation stage, 32 patients were in the contemplation stage, and 6 patients were in the action stage before the advice. The distribution had changed significantly (P < 0.001) to 1, 17, and 27 patients, respectively, 1 month after the advice. CONCLUSION: These results suggest that brief advice by family physicians is effective in improving the readiness to change of at-risk drinkers, regardless of the delivery method.
Counseling ; Drinking ; Drinking Behavior ; Humans ; Male ; Physicians, Family ; Telephone

PURPOSE: The high rate of road traffic crashes and rising medical costs are critical health care problems in Korea as well as in the United States. To reduce the medical cost of minor traffic accidents, we hypothesized that implementation of a 7-day critical pathway (CP) for minor car accident patients (MCP) would decrease medical costs and hospitalization time without lowering patient satisfaction level. METHODS: A pretest-posttest experimental design was used to verify the effects of CP on MCP, from June 1 to December 31, 2010. A 7-day admission schedule with daily predefined order communication system (OCS) order set was implementated for MCP. On the day of discharge, MCP completed a satisfaction survey, and the total medical cost and cost per day were calculated. Satisfaction with physician and nursing care were also surveyed using the Brief Encounter Psycho-Social Instrument-Korea tool. RESULTS: Overall rating did not differ in patients processed normally and using the CP, but length of admission was reduced in CP patients. Total medical costs were not different in either group but cost per day was higher in the CP group. Satisfaction with physicians, but not nurses, satisfaction was improved after CP implementation. CONCLUSION: A critical pathway for MCP reduces length of admission without decreasing patient satisfaction. Total medical costs are not changed after CP implementation but cost per day is significantly increased. Improved job satisfaction in physician but not for nurses was observed after CP implementation. It seems that CP is a effective tool for MCP.
Accidents, Traffic ; Appointments and Schedules ; Critical Pathways ; Delivery of Health Care ; Hospitalization ; Humans ; Job Satisfaction ; Korea ; Motor Vehicles ; Nursing Care ; Patient Satisfaction ; Research Design ; United States