No abstract available.
Mesenteric Artery, Superior

Tracheal agenesis with bronchoesophageal fistula should be suspected in any newborn who is cyanotic at birth, has an absent cry, and cannot be intubated but shows some improvement when ventilated by bag and mask. It is important to make the diagnosis as soon as possible because esophageal intubation or a distal tracheostomy may be the only method to provide an airway while other measures and/or diagnostic confirmation are being sought. We experienced a case of complete tracheal agenesis with carinoesophageal fistula, cloacal anomalies in a male neonate.
Diagnosis ; Fistula* ; Humans ; Infant, Newborn ; Intubation ; Male ; Masks ; Parturition ; Tracheostomy

OBJECTIVE: To investigate whether polymorphism of gene encoding COMT is associated with the risk of endometriosis in Korean women. METHODS: We investigated 136 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 251 control group women who were surgically proven to have no endometriosis. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine each participant's COMT genotype. RESULTS: The distribution according to NIaIII genetic polymorphisms of COMT were as follows. COMT HH, COMT HL, and COMT LL genotypes were 56.6% (77 women), 34.6% (47 women) and 8.8% (12 women) in the study group and 50.6% (127 women), 39.4% (99 women) and 10.0% (25 women) in the control group. There was no significant difference between the study group and the control group. CONCLUSION: The results suggest that COMT genetic polymorphism may not be associated with the development of endometriosis in Korean women.
Endometriosis* ; Female ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

BACKGROUND: Prolotherapy is a therapeutic procedure used for chronic musculoskeletal and arthritic pain. It involves injecting an irritant solution to pain sites and causes patient discomfort, which can lead to treatment discontinuation. Remifentanil is an ultra short-acting micro-opiate receptor agonist that permits a rapid transition from intense analgesia to a minimal residual effect. Here, we evaluated the effect of remifentanil as a preparative medication for ambulatory prolotherapy. METHODS: Eighty patients taking prolotherapy were assigned into three groups for pre-therapeutic injections: remifentanil 0.1 microgram/kg/min alone (Group R), remifentanil 0.05 microgram/kg/min with midazolam 2 mg (Group M), and normal saline (Group C). Pain and sedation scores, blood pressure, pulse oxygen saturation, heart rate, satisfaction score, and time to discharge were measured. RESULTS: Pain scores in groups M and R were lower than group C during and after prolotherapy. The sedation score of group M was higher than groups R and C. Nine patients in group R experienced dizziness during prolotherapy. In group M, 8 patients experienced dizziness and 2 patients experienced nausea. There was no difference in time to discharge among all groups. Satisfaction scores in group M (7.3 +/- 0.8) and group R (7.0 +/- 0.8) were higher than that of group C (5.3 +/- 0.6). CONCLUSIONS: Remifentanil and remifentanil/midazolam effectively reduce the pain produced by prolotherapy.
Analgesia ; Anesthesia ; Blood Pressure ; Dizziness ; Heart Rate ; Humans ; Midazolam ; Nausea ; Outpatients ; Oxygen ; Piperidines

Ligamentum flavum (LF) is yellowish ligament tissue connecting the lamina of adjacent vertebra. Degenerative changes in the spine cause the hypertrophy of LF and facet joint and disc bulging and herniation. These changes results in a narrowing of the spinal canal. Neural decompression surgery by removing the hypertrophied lamina, LF and disc pathologies has been considered as successful treatment method in lumbar spinal stenosis. This surgery has showed relatively satisfactory clinical results and has increased life-expectancy in elderly patients. However, issues about post spinal surgery syndrome and re-stenosis after the surgery also have been reported. Because LF is one of the main mechanisms of spinal stenosis, accurate understanding about pathologic mechanism on the LF hypertrophy may suggest alternative treatment methods such as medical treatment or less invasive treatment than surgical decompression can be considered. Hypertrophy of the ligamentum flavum is generated from increase of collagen synthesis, fibroblast proliferation, and fibrosis caused by 1) the expression of growth factors (TGF-beta1 etc.) stimulated by the repeated mechanical tension, 2) inflammatory cytokines from spinal facet joint structure and LF 3) delayed cell death, and 4) inflammatory cytokine from hypertrophied and degenerated LF itself. After the middle ages, gradual and partial inhibition of LF hypertrophy can be expected by administration NSAIDs or selective cyclo-oxygenase-2 inhibitors because these drugs may cause reduction of the increased cytokines. Also, relaxin can be another new treatment material for spinal stenosis by the mechanism of melting hypertrophied LF and reducing synthesis of collagen.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Cell Death ; Collagen ; Cytokines ; Decompression ; Decompression, Surgical ; Fibroblasts ; Fibrosis ; Freezing ; Humans ; Hypertrophy* ; Intercellular Signaling Peptides and Proteins ; Ligaments ; Ligamentum Flavum* ; Pathology ; Relaxin ; Spinal Canal ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

PURPOSE: Infantile spasms are considered an age-specific and malignant epilepsy. It is not controlled easily by general anticonvulsants. Therefore, this study aimed to assess vigabatrin(VGT) efficacy in infantile spasms. METHODS: From January 1992 to December 1995, 35 children with infantile spasms, who were diagnosed at Kyung Hee University Hospital and treated vigabatrin, were analyzed retrospectively. RESULTS: The ratio of male to female was 1.7 : 1.2. Mean age at onset of infantile spasms was 7.6+/-3.4 months old and mean duration from onset of the disease to the beginning of the treatment was 2.4 months. Mean duration of vigabatrin treatment was 24.2 months. The most common type of infantile spasms was the flexion type with 26 cases(74.3%). Cryptogenic group had 13 cases and symptomatic group 22 cases. The most common causes were tuberous sclerosis, agyria-pachygyria, brain atrophy and hygroma(each are 4 cases). Among vigabatrin monotherapy(15 cases), complete cessation of seizure were 2 cases and 99-75% seizure reduction was 6 cases and among vigabatrin add-on therapy(20 cases), complete cessation was 4 cases and 99-75% seizure reduction was 6 cases. The most common combined anticonvulsant used was prednisolone. CONCLUSION: The effectiveness of vigabatrin in infantile spasms was good due to more than 75% reduction in seizure frequency in 51.4% of cases. Vigabatrin should be used in refractory infantile spasms.
Anticonvulsants ; Atrophy ; Brain ; Child ; Epilepsy ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Prednisolone ; Retrospective Studies ; Seizures ; Spasms, Infantile* ; Tuberous Sclerosis ; Vigabatrin*

PURPOSE: To compare clinical outcomes after management with bed rest versus cerclage for treatment of amniotic sac bulging in the second trimester. METHODS: Women with cervical incompetence with membranes at or beyond a dilated external cervical os, before 27weeks of gestation, were treated with bed rest or emergency cerclage. We analyzed the pregnancy outcome retrospectively. 25 women underwent an emergency cerclege and 35 women underwent the bed rest. RESULTS: Gestational age at time of diagnosis was 22.40 weeks in the emergency cerclage and 22.39 weeks in the bed rest group. Mean interval from diagnosis until delivery was 8.65 weeks in the emergency cerclage group and 1.18 weeks in the bed rest group (p<0.001). Mean gestational age at delivery was 31 weeks in emergency cerclage group and 23.74 weeks in the bed rest group (p<0.001). Preterm delivery before 26 weeks and 34 weeks of gestation were significantly lower in the emergency cerclage group (p<0.001). Perinatal mortality was 17.4% in the emergency cerclage group and 48.6% in bed rest group (P=0.026). CONCLUSION: Emergency cerclage reduced preterm delivery before 26 and 34 weeks and improved perinatal outcome compared with bed rest treatment.
Bed Rest ; Emergencies ; Extraembryonic Membranes ; Female ; Gestational Age ; Humans ; Membranes ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies

Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the subpulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.
Diagnosis, Differential ; Mediastinal Cyst* ; Mediastinum ; Pericardium ; Thoracoscopy

Feeding gastrostomy is widely used for children with feeding impairment. The replacement of gastrostomy tube is known as an easy and safe procedure. However, various complications associated with replacement of gastrostomy tube were reported, including fistula disruption and colo-cutaneous fistula. For replacement of gastrostomy tube in small children with small stomach, special cautions are needed. Here, we report a rare case of duodenal perforation as an acute complication after the replacement of gastrostomy tube for a 33-month-old girl.
Child ; Child, Preschool ; Female ; Fistula ; Gastrostomy* ; Humans ; Stomach

No abstract available.
Child* ; Humans ; Proteinuria*