To determine the impact of intake large amount whole cow's milk (WCM) on iron status during early childhood (18~36 months), selected indices of complete blood count(CBC) and iron status were compared between the WCM large amount intake group (n=20)and small amount intake group (n=20). WCM large amount intake children's mean hemoglobin and mean hematocrit were 9.6+/-1.7 g/dL and 30.8+/-4.5% respectively. These range of peripheral blood with other indices of CBC disclosed the hypochromic microcytic anemia. WCM large amount intake children's some indices of CBC-hemoglobin, hematocrit, MCV, MCH-were significantly lower than those of small amount intake children (P<0.01). WCM large amount intake children had significantly lower mean iron, transferrin saturation and ferritin (P<0.01) and greater mean total iron binding capacity (P<0.05) than did small amount intake children. It is concluded that intake large amount of WCM for long duration impacts on the iron status of 18~36 months old children disadvantageously. It should be avoided for the protection of irreversible recognitive impairment and behavioral change.
Anemia ; Anemia, Iron-Deficiency ; Child ; Ferritins ; Hematocrit ; Humans ; Iron* ; Milk* ; Transferrin

No abstract available.
Thanatophoric Dysplasia*

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

Extra-articular tenosynovial giant cell tumor (TS-GCT) in retropharyngeal space is a rare case. We found only two case reports in the literature, in which one was located in retropharynx or prevertebral space of the cervical spine. We describe a rare case of TS-GCT in the retropharynx, which was initially misdiagnosed as oropharyngeal cancer. Furthermore, we want to assure that extraarticular diffuse type TS-GCT should be considered in the differential diagnosis of lesions showing low signal intensity in MRI scan.
Diagnosis, Differential ; Giant Cell Tumors ; Giant Cells ; Magnetic Resonance Imaging ; Oropharyngeal Neoplasms ; Spine

Purpose: The post-operative quality of life (QoL) is a significant concern for patients undergoing gastrectomy. Unlike subtotal gastrectomy, the detailed aspects of QoL involving the ability to perform everyday activities that reflect physical, psychological, and social well-being; and satisfaction with levels of functioning and control of the disease after total gastrectomy remain poorly investigated. Materials and Methods: We enrolled 170 patients who underwent total gastrectomy for gastric carcinoma and completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaires (QLQ) C30 and STO22 preoperatively and post-operatively at 1, 6, and 12 months. We investigated the QoL change in terms of the minimally important difference (MID), which refers to a score change patients would perceive as clinically important (effect size >0.5). Results: At 1-month post-surgery, MID in global health, physical, social, role, emotional, and cognitive functions was observed at 44.0%, 68.0%, 42.7%, 38.7%, 32.0%, and 16.0% respectively. Of QLQ-C30 symptoms, MID was frequently observed in appetite (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (74.1%), dysphagia (63.5%), pain (51.8%), and anxiety (50.6%). At 12 months post-surgery, MID in global health, physical, role, cognitive, social, and emotional functions was 32.9%, 58.8%, 42.4%, 40.0%, 36.5%, and 17.6%, respectively. Of QLQ-C30 symptoms, MID was frequently observed in diarrhea (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (63.5%), dysphagia (52.9%), body image (55.3%), pain (55.3%), and anxiety (51.8%). Male sex, comorbidity, D2 lymphadenectomy, and post-operative morbidity were associated with MID in global health at 12 months post-surgery. Conclusion This study provides information about the detailed aspects of impairment in various functions and symptoms of QoL after total gastrectomy. This information can be used to develop a tailor-made management plan for QoL.

No abstract available.
Carcinoma, Small Cell* ; Prognosis*

PURPOSE: The purpose of the study is to investigate the relationship between total serum bilirubin(TSB) and transcutaneous bilirubinometry(TcB) in neonates with jaundice. METHOD: TcB from various sites(forehead, sternum, abdomen, buttock, hand, dorsalis-pedia) was measured using a JM-102 in a total of 102 neonate, 42 female and 60 male, with the mean 37.5 gestational week and the mean 2,903 gram of birth weight, as well as TSB from capillary punctures. RESULT: The mean bilirubin was 11.73 in serum, 20.55 on the forehead, 17.23 on the sternum, 16.19 on the abdomen, 18.22 on the buttock, 15.83 on the hand and 15.49 on the dorsalis-pedia. The relationship between TSB and TcBs were formulated by simple regression with 0.406 < r < 0.668(p < .000). A higher relationship was revealed between TSB and TCB at the forehead in infants of full-term, ABO incompatibility, and Hb greater than 16 mg/dl(r = 0.725, 0.790, and 0.717, retrospectively). Phototherapy altered the measurement of TcB per site. CONCLUSION: TcB on the forehead is a reliable, noninvasive and convenient measurement of TSB in normal infants(Institutions need to establish quantitative equations representing the specific relationship between TSB and TCB according to the hemodynamic problems of infants such as ABO incompatibility, or low Hb).

Phytolacca americana poisoning is a benign plant intoxication that causes gastrointestinal symptoms, including abdominal cramps, vomiting, diarrhea, and gastrointestinal bleeding. Other signs and symptoms include diaphoresis, salivation, visual disturbance, and seizures or mental changes. We report two cases of patients who experienced confusion and abdominal pain, vomiting, and hematemesis after oral ingestion of pokeweed. A 60-year-old female with confusion and a 67-year-old female with abdominal pain, vomiting, and diarrhea were admitted to the emergency department after pokeweed poisoning. After supportive treatment of hydration and gastrointestinal medication, the two patients showed full recovery within 24 h and were discharged from the hospital.
Abdominal Pain ; Aged ; Colic ; Diarrhea ; Eating ; Emergencies ; Female ; Hematemesis ; Hemorrhage ; Humans ; Middle Aged ; Phytolacca ; Phytolacca americana ; Plant Poisoning ; Plants ; Salivation ; Seizures ; Vomiting

PURPOSE: Urethral catheterization is a commonly done, painful procedure, but few studies have evaluated the use of topical anesthesia prior to catheterization. This study was designed to assess the effect of topical anesthetics (2% lidocaine gel) prior to uretheral catheterization. METHODS: This study was a prospective, randomized, case-controlled trial conducted in an emergency department of a university teaching hospital. The 54 subjects were alert, cooperative male adults. Patients in the experimental group were catheterized after injection of topical lidocaine gel in their urethras, and a wait of 3 minutes. Patients in the control group were catheterized with a urethral catheter that was coated by plain lubricant. After each procedure, the patients indicated their subjective assessment of pain on a 100 mm visual analog scale (VAS). We assessed VAS at 4 times: during the procedure, at the end of the procedure, and at 3 and 6 hours after the procedure. SPSS 17.0 was used for statistical analysis. RESULTS: The 54 patients were evenly distributed between the 2 study groups. Mean age was 50 years (range 28-71) in the control group, and 54 years (range 27-70) in the experimental group. The mean reduction in VAS values in the experimental group was 27 mm during the procedure, and 23 mm at 6 hours after the procedure. CONCLUSION: Use of a topical lidocaine gel during urethral catheterization results in significant reduction in pain compared to topical lubricants. This benefit is provided both during the procedure as well as up to 6 hours after the procedure.
Adult ; Anesthesia ; Anesthesia, Local ; Anesthetics ; Case-Control Studies ; Catheterization ; Catheters ; Emergencies ; Hospitals, Teaching ; Humans ; Lidocaine ; Lubricants ; Male ; Prospective Studies ; Urethra ; Urinary Catheterization ; Urinary Catheters

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) has been well controlled with otolith reposition therapy. Posterior canal is known as the most common site of BPPV. The purpose of this study was to study the therapeutic result of reposition therapy in posterior canal BPPV, to investigate the unusual cases such as recurred cases and type changed cases during the reposition maneuver, and to figure out the therapeutic strategy. MATERIALS AND METHODS: One hundred and ten patients diagnosed posterior canal BPPV were included in this study. Epley maneuver was performed once a day until nystagmus disappeared. We analyzed the number of treatment, changing type, recurrence and the relationship between recurrence and age or sex of patients. RESULT: All cases except 2 were recovered by Epley maneuver. In 11 cases, the type of disease was changed, and the treatment of these cases were changed according to new type and origin. Overall recurrence rate was 15%, and they were completely treated with reposition therapy. There was no correlation between recurrence and age, sex of patients. CONCLUSION: All most cases were cured with Epley maneuver. The type of the disease was possibly changeable. Recurrence rate was relative high, and close follow up was required.
Follow-Up Studies ; Humans ; Otolithic Membrane* ; Recurrence ; Semicircular Canals* ; Vertigo