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

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

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

Due to its safety and softness, autologous fat transplantation has been commonly performed for soft tissue correction. However, the injected fat is absorbed resulting in the reduction of volume of the graft by 40- 60% within a few months. Thus, there was an attempt to use adipocytes differentiated from preadipocytes in vitro for transplantation. Differentiated adipocytes were biocompatible and matured with gradual volume increase at transplantation site in clinical study(unpublished data). In addition, they did not induce immune rejection in response to nonself lymphocytes in a mixed lymphocyte reaction(MLR)(unpublished data). The purpose of this study is to differentiate mouse preadipocytes following labeling into adipocytes to establish an animal model for allogenic transplantation. Preadipocytes isolated from inguinal and retroperitoneal fat pad of C57BL/6 mice were proliferated with growth medium by passage 3 and differentiated into adipocytes with different culture conditions after labeled with BrdU. At most suitable conditions, above 90% of preadipocytes were differentiated and BrdU labeling did not affect differentiation rate and function of differentiated adipocytes. These results demonstrate that BrdU-labeled adipocytes resulting from this in vitro differentiation protocol are useful for allogenic transplantation study.
Adipocytes ; Allografts ; Animals ; Bromodeoxyuridine ; Intra-Abdominal Fat ; Lymphocytes ; Mice* ; Models, Animal ; Transplants

Nowadays in the field of plastic surgery, operations with no general anesthesia have been much increased, using daily surgery center. We used "Propofol TCI system" to control exact target concentration of conscious sedation and to reduce any systemic complication of the other local anesthetics. Twenty of ASA Class I or II patients were scheduled for elective surgery using Diprifusor(R) TCI system at 0.8-1.9 ug/ml target concentration. We estimated the proper target concentration, time of awakening, postoperative patient satisfaction and presence of postoperative amnesia. All the patients was satisfied except one patients who underwent nasal tip plasty. The target concentration of the conscious sedation varies with age and the type of operation but average concentration was 1.4-1.6 ug/ml. The average time of awakening, which we estimated by the time of eye opening was 2.6 minutes. Postoperative systemic complication and unusual vital sign were not present. We present here our satisfactory results using propofol infused by TCI(Target controlled infusion) system. This system is called 'Diprifusor(R)' and has a benefit of excellent sedative effect, low complication rate, safety, and rapid awakening time which enables the patient to return to his normal life cycle.
Amnesia ; Anesthesia, General ; Anesthesia, Intravenous* ; Anesthesia, Local* ; Anesthetics, Local ; Conscious Sedation ; Humans ; Hypnotics and Sedatives ; Life Cycle Stages ; Patient Satisfaction ; Propofol* ; Surgery, Plastic* ; Vital Signs

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*

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

Although Nd:YAG laser(1064nm) showed good reduction effects on treatment of cutaneous hemangioma, its use was limited because of non-selective laser absorption and complications such as scar formation. So, we applied different modalities of Nd:YAG laser for more effective and safe treatment. We applied Nd:YAG laser to 9 patients with hemangioma on upper eyelid, cheek, back, arm, and parotid area from February, 1999 to February, 2002. The age at treatment ranged from 4 months to 4 years. Nd:YAG laser was irradiated both inside of the hemangioma by using a bare fiber through a 16G Tefflon cannula and outside of it by cooling the skin with a ice-cube. Nd:YAG laser was irradiated directly into the lesion through the bare fiber and safely to the skin through the ice cube. The mean number of treatment was 1.8, and the time interval between the next treatment was 4.5 months. The mean follow-up period was 13.5 months. Six patients showed almost full regression. Two patients had surgical excision after laser treatment, and one showed slow regression to be in the clinical observation.
Absorption ; Arm ; Catheters ; Cheek ; Cicatrix ; Eyelids ; Follow-Up Studies ; Hemangioma* ; Humans ; Ice ; Skin