Morgagni hernia is an uncommon finding in adult and rarer still in infants and children, adn they say that Morgagni hernia occur about one in every 300 diaphragmatic hernias diagnosed. This paper presents a 16 months old Korean male infant with symptomatic Morgagni's hernia in whom the diagnosis was established during the course of treatment of upper respiratory tract infection and who were operated successfully. This well nourished patient was admitted with the chief complaints of mid dyspnea, coughing and restlessness for 2 days. During treatment and investigation we detected a peristaltic sound in the right side lung field and confirmed it as Morgagni hernia by chest X-ray and barium swallowing. We performed corrective surgery through a midline supra-umbilical incision. As opened the peritoneum, transverse colon was gushed out, which suspected as herniated intestinal loop. After well mobilization of visible bowel, hernia sac was notified from the anterior portion or right crus of diaphragm. The hernia was reduced very easily. The patient made an uninterrupted recovery and on the 8th post-op. day, he went to home with symptom-free state. We made a brief literature review.
Adult ; Barium ; Child ; Colon, Transverse ; Cough ; Deglutition ; Diagnosis ; Diaphragm ; Dyspnea ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Infant* ; Lung ; Male ; Peritoneum ; Psychomotor Agitation ; Respiratory Tract Infections ; Thorax

Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.
Adult ; Aged ; Appendectomy ; Appendicitis ; Child ; Emergencies ; Female ; Humans ; Incidence ; Male ; Retrospective Studies

Between 1986 and 1990, four children with recurrent CNS leukemia who had previous CNS prophylaxis therapy were treated with intermittent central nervous system irradiation and intrathecal chemotherapy (IIIC). There was no isolated CNS recurrence. One patient died form bone marrow relapse. Three patients are alive without evidence of disease for 3E3/12 year to 3E6/12 year after the diagnosis of recurrence of CNS leukemia. This experience suggests that IIIC may be an effective treatment for preventing the recurrence of CNS leukemia without any serious side effects.
Bone Marrow ; Central Nervous System* ; Child* ; Diagnosis ; Drug Therapy* ; Humans ; Leukemia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence

We performed this study to evaluate the therapeutic responses of bone marrow transplantation and immunosuppressive therapy for aplastic anemia in 103 cases (68 severe and 35 moderate). Among them, 15 cases with severe aplastic anemia having HLA-identical sibling donor underwent bone marrow transplantation, and cases(53 severe and 35 moderate cases)without available HLA-identical sibling donor had received immunosuppressive therapy using antilymphocye globulin and cyclosporin-A. The results were as follows; 1) For cases given bone marrow transplantation, successful engraftment was accomplished in all cases, but 2 cases showed rejection and 1 case died of thrombotic thrombocytopenic purpura (TTP), resulting 80% disease-free survival rate. acute graft-versus-host disease above grade II was noted in 2 cases and chronic graft-versus host disease was seen in other 2 cases. The most common pathogenic organism in post-transplantation infection was Herpes zoster (6 cases), and one each cases of Herpes simplex, candidiasis, measles and hemorrhagic cystitis developed. 2) Among 88 cases of receiving immunsouppressive therapy, complete response was seen in 26 cases (29.5%) and partial respones in 37 cases (42.0%), resulting 71.6% of overall response rate and recurrence rate was 19.5% (12 cases). In 53 severe cases, complete response was seen in 9 cases (17.0%) and partial response in 25 cases (47.2%), resulting 64.2% of overall response rate. In 35 moderate cases, complete response was seen in 17 cases (48.6%) and partial response in 12 cases(34.3%), overall response rate was 82.9%. All initial responses were seen within 6 months post-treatment period, and the time interval to initial response was 8 to 162 days (median; 53 days). There was no sex difference concerning response rate, however, partial response was predominant in male and more complete response in female. The complications of immunosuppressive therapy were thrombocytopenia (93.2%), fever (67.7%), hypertension (50.0%), skin eruption (45.8%), gingivitis (17.0%). In conclusion, our date suggest that bone marrow transplantation is preferred initial treatment modality to immunosuppressive therapy in severe aplastic anemia patient with HLA-identical sibling donor, and immunosuppression is a satisfactory alternative therapy for children with severe aplastic anemia in the absence of HLA-identical sibling and for whom with moderate aplastic anemia.
Anemia, Aplastic* ; Bone Marrow Transplantation ; Candidiasis ; Child ; Cystitis ; Disease-Free Survival ; Female ; Fever ; Gingivitis ; Graft vs Host Disease ; Herpes Simplex ; Herpes Zoster ; Humans ; Hypertension ; Immunosuppression ; Male ; Measles ; Purpura, Thrombotic Thrombocytopenic ; Recurrence ; Sex Characteristics ; Siblings ; Skin ; Thrombocytopenia ; Tissue Donors

Alloantibodies against RBCs after transfusion of only platelet products are rarely reported except for RhD mismatched platelet transfusion. We report a case of anti-E antibody developed after transfusion of platelet concentrates. The patient was a 27- month male infant with idiopathic thrombocytopenic purpura and was treated with IV immunoglobulin and IV Rh immunoglobulin. Anti-E antibody was detected after transfusion of 18 units of platelet concentrates for about 40 days. RBC alloimmunization was developed after transfusion of platelet products, which suggests platelet transfusion may be cause of RBC alloimmunization in childhood.
Blood Platelets* ; Humans ; Immunoglobulins ; Infant ; Isoantibodies ; Male ; Platelet Transfusion ; Purpura, Thrombocytopenic, Idiopathic*

PURPOSE: To compare the 1-year outcome of 1.8 mm and 2.2 mm microcoaxial cataract surgery (MCCS) versus 2.75 mm conventional cataract surgery (CCS). METHODS: The present study evaluated 120 eyes (40 eyes in each group). The mean ultrasound power, ultrasound time (UST), and cumulative dissipated energy (CDE) were measured preoperatively and at 1 day, 1, 2, 6 months, and 1 year postoperative. Visual acuity, number of corneal endothelial cells, and surgically induced astigmatism (SIA) were compared. RESULTS: In LOCS III NO4, 1.8 mm MCCS showed a statistically higher ultrasound time (p-value = 0.031) and CDE (p-value = 0.029), and the day 1 corneal thickness increase was relatively higher in 1.8 mm MCCS (p-value = 0.043) than other two groups. There were no differences in postoperative 1 year visual acuity or number of corneal endothelial cells among the groups. SIA was significantly lower in 1.8 mm and 2.2 mm MCCS compared to that of the conventional treatment (p-value = 0.046). CONCLUSIONS: There were no differences in postoperative 1 year mean endothelial cell density or corrected visual acuity between 1.8 and 2.2 mm MCCS and CCS at all cataract densities. The 1.8 mm and 2.2 mm MCCS techniques were as safe and effective as CCS, and SIA in 1.8 mm and 2.2 mm MCCS was significantly lower than that of CCS.
Astigmatism ; Cataract ; Endothelial Cells ; Eye ; Visual Acuity

PURPOSE: To evaluate the factors affecting corneal endothelial cell loss after penetrating keratoplasty in a long-term follow-up. METHODS: Donor age, post-mortem time, storage time, underlying disease, elevation of IOP after surgery, underlying glaucoma, and trephine size were analyzed in 76 eyes. Postoperative corneal endothelial density was measured after 1, 3, 6, and 12 months. Patients who experienced graft rejection were excluded. RESULTS: Donor age and endothelial loss were correlated in all patients (t-value = 1.98); however, post-mortem time and storage time were not statistically significant (t 2 < 2). Endothelial cell loss was more severe in the bullous keratopathy patient group than it was in the keratoconus patient group, but this difference was not statistically significant (p-value = 0.154). The number of anti-glaucomatous eye drops showed positive correlation with the declining rate of endothelial cells (t-value = 1.975). Existence of glaucoma diagnosed before surgery did not statistically influence endothelial cell loss. Additionally, in the bullous keratopathy patient group, an inverse correlation between endothelial cell loss and trephine diameter was observed (t-value = -2.859). CONCLUSIONS: Old donor age, small trephine size in bullous keratopathy, and post-operative IOP elevation are risk factors for increased endothelial cell loss following penetrating keratoplasty.
Corneal Endothelial Cell Loss ; Endothelial Cells ; Eye ; Glaucoma ; Graft Rejection ; Humans ; Keratoconus ; Keratoplasty, Penetrating ; Ophthalmic Solutions ; Risk Factors ; Tissue Donors

Intratesticular varicocele is a rare entity and refers to a dilated intratesticular vein radiating from the mediastinum testis into the testicular parenchyma. A 22-year-old man was admitted to our hospital with left testicular pain. On physical examination, a grade III varicocele was noted on the left side. Gray-scale ultrasound and color Doppler ultrasound examinations revealed intratesticular and extratesticular varicocele. The patient underwent spermatic vein ligation by open modified Palomo varicocelectomy.
Humans ; Ligation ; Mediastinum ; Physical Examination ; Testis ; Varicocele ; Veins ; Young Adult

Rhabdomyolysis is an acute disorder resulting from skeletal muscle injury in which intracellular contents are released into extracellular space and plasma. The condition may result from drug or alcohol overdose, infection, crush injuries, collagen disease, or intensive exercise. We report two cases of acute rhabdomyolysis resulting from CO poisoning and alcohol overdose, and discuss the MRI and ultrasonographic findings.
Collagen Diseases ; Extracellular Space ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Plasma ; Poisoning ; Rhabdomyolysis*