A clinical review was made on 2,191 cases of general pediatric surgery under the age of 15 years which were operated upon at the Divisionof Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The number of operations in pediatric age were 13,144 (13.2%) out of total 99,555 operations at Chonnam University Hospital and the most prevalent age group was under 1 year of age (14.3%). The number of operations in Divisionof General Pediatric Surgery were 2,191 (16.7%) out of total 13,144 operations in pediatric age and the incidence of patients under 1 year of age in general pediatric surgery was 42.9% (941/2,191). The prevalent diseases under 1 month of age were anorectal malformations (20.6%) and hypertrophic pyloric stenosis (20.3%) and between 1 month to 1 year of age were inguinal hernia (32.4%) and intussusception (19.6%). The total motality rate in neonatal intensive care unit was 31.3%. Gastroschisis presented highest mortality.
Gastroschisis ; Hernia, Inguinal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intussusception ; Jeollanam-do ; Mortality ; Pyloric Stenosis, Hypertrophic

No abstract available.
Mesenteric Artery, Superior*

BACKGROUND: Although enriched broth cultures have been recommended as an adjuvant to the direct plating of tissue and body fluid specimens, the cost-effectiveness of broth cultures has been questioned in regard with the clinical significance of "broth only isolates(BOI)". The purpose of this study was to investigate the usefulness of thioglycollate broth(THIO) cultures. METHODS: We reviewed retrospectively results in the culture specimens of body fluids, tissue biopsies, and puses received during the month of July 1997. All specimens were inoculated into THIO in addition to agar plates. We reviewed the medical records of culture-positive patients to determine the clinical significance and relevance of their isolates. Clinically significant isolates were defined as those for which an appropriate antimicrobial therapy was done except one judged as contaminants by clinicians and clinically relevant isolates as the clinically significant one isolated first. RESULT: Of 2,008 specimens, 512(25.4%) from 365 patients grow 561 isolates 464 plate isolates and 97 BOI. Two hundred eighty nine(62.3%) of the 464 isolates from plate cultures were clinically significant, compared to only 12(12.4%) of 97 BOI (P<0.05). Only four (4.1%) BOI were clinically relevant, including one Pseudomonas aerugiosa from ascites. one Klebsiella pneumoniae and two Staphylococcus aureus from tissue specimens. CONCLUSION: A routine use of enriched broth culture rarely recover clinically relevant isolates. Considering the laboratory and medical costs of the recovery of contaminants and clinically irrelevant isolates, the enrichment broth cultures should be used more selectively.
Agar ; Ascites ; Biopsy ; Body Fluids ; Humans ; Klebsiella pneumoniae ; Medical Records ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus

No abstract available.
Choriocarcinoma* ; Female ; Ovary* ; Pregnancy

The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas. There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.
Antibodies, Monoclonal ; Apoptosis ; B-Lymphocytes ; Cell Survival ; Cytoplasm ; Genes, bcl-2 ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Proto-Oncogenes

Surgical method for blow out fracture of medial orbital wall is performed by medial canthotomy and subciliary incision or transconjunctival incision. However, these approaches can leave cosmetic problem due to skin incision and have a risk of infection and absorption of prosthetic implant for a large medial wall fracture. The authors performed endoscopic intranasal reconstruction of the isolated medial wall fracture in a case with significant functional impairment of extraocular muscle. After the incision of the middle turbinate, medial wall fracture was reconstructed with muco-periosteal flap under endoscopic control. We had a good result without intraoperative or postoperative complications caused by prosthetic implant. There was no disadvantage seen with the traditional approaches by medial canthotomy. Endoscopic intranasal reconstruction with muco-periosteal flap appears to be a new safe method for especially large defect.
Absorption ; Orbit* ; Postoperative Complications ; Skin ; Turbinates

A total of 28 patients of confirmed cerebral parenchymal cysticercosis was followed serologically by ELISA(enzyme linked immunosorbent assay) and clinically over 1 year after praziquantel treatment. The subjects were confined to pure cerebral parenchymal form of neurocysticercosis patients in order to evaluate the effect of praziquantel on specific IgG antibody level. The main clinical features were epilepsy and headache and the brain CT showed multiple low densities, cystic rnass, nodule and calcifications. The patients included in this study were categorized into 3 groups according to the follow-up period, namely, group I (1-2 years), group II (2-3 years) and group III(over 3 years). In serum, the post-treatment(last follow-up) anti-body levels were decreased to 71% in group I, 50% in group II and 52% in group III of pre-treatment levels. Also, in CSF, the post-treatment antibody levels were decreased to 81% in group I, 71% in group II and 33% in group III of pre-treatment levels. Eight patients(2 in group I, 3 in group II, 3 in group III) showed negative conversion of IgG antibody in both serum and CSF during follow-up period. All antibody levels in serum and CSF were expected to decline below negative range around 56-57 months after praziquantel treatment by simple linear regression analysis. However, in CSF, it took about 66-67 months for high pre-treatrnent titer patients above 0.8 to convert into negative range and about 34-35 rnonths for low pre-treatrnent titer ones below 0.8. In conclusion. It might be possible to differentiate serologically the early cured from the chronically ill patients uith slowly calcifying lesion by ELISA in neurocysticercosis, :which would be also helpful to determine the next treatment modality.
Brain ; Chronic Disease ; Cysticercosis* ; Enzyme-Linked Immunosorbent Assay* ; Epilepsy ; Follow-Up Studies* ; Headache ; Humans ; Immunoglobulin G ; Linear Models ; Neurocysticercosis ; Praziquantel*

PURPOSE: To compare the accuracy and clinical usefulness of various devices by measuring axial length, keratometry, and white-to-white. METHODS: In 64 eyes of 56 cataract patients, axial length was measured using Galilei™, Lenstar®, and A-scans, and keratometry was measured using Galilei™, Lenstar®, and ARK. In 86 eyes of 74 cataract patients, white-to-white was measured using Galilei™ and Lenstar®. RESULTS: The average axial length measurements using Galilei™, Lenstar®, and A-scans were significantly correlated (p < 0.001), but without a statistically significant difference (p = 0.611). The 95% agreement range was the smallest at 0.22 mm for the Lenstar® and A-scans. The average mean K using Galilei™, Lenstar®, and ARK were significantly correlated (p < 0.001), but without a statistically significant difference (p = 0.657). The 95% agreement range was relatively small at 1.83 D for Lenstar® and ARK. The average white-to-white using Galilei™ and Lenstar® were significantly correlated (p < 0.001), with a statistically significant difference (p = 0.011). The 95% agreement range was 2.20 mm. CONCLUSIONS: Axial length, keratometry, and white-to-white measured by different devices were highly correlated and were not statistically different; however, agreement was low between measurements. It is therefore important to consider these findings when using them equally.
Cataract ; Humans

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

Conjoined twins are one of the rarest and most challenging congenital anomalies in pediatric surgery. Successful surgical separation is more unusual, since the majority of conjoined twins are incapable of separating successfully. The timing of separation is variable, but separation is usually delayed until such infants are relatively mature (i.e, 9-12 months of age). Operative survival was 50% in those operated on in the neonatal period, but 90% in those of over 4 months of age. Our case was early separated beacase of one of the twins having heart problems. These twins were omphalopagus and shared only simple liver bridge without vascular and biliary communications. Surgical separation was undertaken successfully on the 11th day of life, so we describe our experience with the review of the relevant literatures.
Heart ; Humans ; Infant ; Liver ; Twins, Conjoined*