No abstract available.
Pseudomyxoma Peritonei*

No abstract available.
Adenocarcinoma* ; Cervix Uteri* ; Fallopian Tubes* ; Female

No abstract available.
Extremities* ; Sarcoma*

Ultrasonographic findings in 34 cases of primary hepatoma, and 18 cases of secondary hepatoma, which had been proved histopathologically or suspected clinically and ultrasonographically, were reviewed. The results were summarized as follows. 1. Among 52 cases, 40 cases were male and 12 cases were female. The male predominent than the female with the ratio of 4:1. In 52 cases, 40 cases (77%) of the patients were between 41 years and 60 years.2. The most common ultrasonographic finding of hepatoma was discrete homogeneous hyperechoic mass. 3. Primaryhepatomas were usually solitary and relatively large, while secondary hepatomas were usually multiple andrelatively small. 4. Hepatitis, liver cirrhsis, and clonorchiasis were more common in primary hepatomas than secondary hepatomas.
Carcinoma, Hepatocellular ; Clonorchiasis ; Female ; Hepatitis ; Humans ; Liver ; Male

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

Human orthotopic liver transplantation was first attempted in 1963. Living related liver transplantation has been introduced by Raia in 1988. In children, biliary atresia is the leading indication of living related liver transplantation. We performed 2 cases living related liver transplantation on May, 1996. The donors were 32 and 30 year old father, recipients were his 3 year old son and 4 year old daughter. The causes of liver failure were drug induced fulminant hepatitis and recurrent cholangitis due to biliary atresia. The first case was incompatible of ABO blood typing, donor AB(Rh+) and recipient B(Rh+). The ABO incompatible donor was performed preoperatively plasmapheresis. After left lateral segmentectomy of donor and total hepatectomy of recipient, donor liver was orthotopically transplanted. The average operation time of donor and recipient were 8 hours and 12.5 hours. The amount of transfusion in donor and recipient were average 2 pints and 2.5 pints. The perioperative immunosuppression was maintained with prednisone, azathioprine and cyclosporin, but 1st case was changed from cyclosporin to OKT3 on postoperative 9th day. The postoperative complications of recipient were pulmonary edema, bacterial and fungal infection. The donors were discharged on postoperative 8th and 9th day. The first case patient was discharged postoperative 42th day due to respiratory complication. The 2nd recipient was discharged postoperative 22th day. We suggested that living related liver transplantation is good modality for resolving the graft shrtage in pediatric liver transplantation.
Adult ; Azathioprine ; Biliary Atresia ; Blood Grouping and Crossmatching ; Child ; Child, Preschool ; Cholangitis ; Cyclosporine ; Fathers ; Hepatectomy ; Hepatitis ; Humans ; Immunosuppression ; Liver Failure ; Liver Transplantation* ; Liver* ; Mastectomy, Segmental ; Muromonab-CD3 ; Nuclear Family ; Plasmapheresis ; Postoperative Complications ; Prednisone ; Pulmonary Edema ; Tissue Donors ; Transplants

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.
Anti-Bacterial Agents ; Body Weight ; Catheterization, Central Venous ; Catheters ; Child ; Cosmetics ; Humans ; Infusions, Intravenous ; Jugular Veins ; Neck ; Parenteral Nutrition, Total ; Subclavian Artery ; Veins ; Venous Cutdown

Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70%. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48%) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52%) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.
Abdominal Pain ; Fever ; Humans ; Intussusception ; Liver ; Lymphoma ; Meckel Diverticulum ; Peutz-Jeghers Syndrome ; Polyps ; Purpura, Schoenlein-Henoch ; Vomiting

Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3%, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69%) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3%) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5%). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.
Child ; Hernia ; Hernia, Inguinal ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Retrospective Studies