Laparascapic Cholecystectomy is a recentely rapidly emerged, minimally invasive procedure whereby the gallbladder is removed using laparoscopic techniques. The procedure offers the patient reduced hospital stay, faster to work, less pain, less complication, less expensiveness, and improved cosmetic results over the traditional open cholecystectomy. (continue...)
Cholecystectomy* ; Cholelithiasis* ; Gallbladder ; Humans ; Laparoscopy* ; Length of Stay

No abstract available.
Fingers* ; Replantation*

Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.
Age Distribution ; Asthma ; Breast ; Child, Preschool ; Classification ; Cough* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Dyspnea ; Egg White ; Eosinophilia ; Fees and Charges ; Female ; Fever ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk ; Pediatrics ; Pulmonary Atelectasis ; Respiratory Sounds ; Sinusitis ; Thorax

Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin(IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of phototherapy, IVIG was given at a dose of 1g/kg for 6 hours. In all cases, bilirubin levels declined within 12 hours after LVIG therapy, and to rebound effect was seen, No side effects of IVIG treatment were observed. We suggest that high-dose IVIG therapy may be useful in the treatment of hyperbilirubinemia due to ABO incompatibility, and reduce the need for exchange transfusion.
Bilirubin ; Blood Group Incompatibility ; Diagnosis ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Immunoglobulins, Intravenous* ; Infant ; Infant, Newborn ; Phototherapy

PURPOSE: Acute pyelonephritis of growing kidneys may result in renal scarring. TGF-beta, inflammatory cytokine, has been suggested to play an important role in promoting renal scarring through apoptosis, suppression of cellular proliferation and fibrosis. We observed the effects of a potent anti-inflammatory agent, methylprednisolone on apoptosis and renal scarring in experimentally induced acute pyelonephritic weaning rats. MATERIALS AND METHODS: To induce ascending pyelonephritis a saline solution containing Escherichia coli type ATCC No. 25922, pili-form (107 bacteria/mL) was infused into the bladder through the 16-guage silicone cannula for 48 hours to 102 three-week-old Sprague-Dawley rats (50-60g). Experimental groups were divided into three groups according to the treatment protocols, group I (ceftriaxone only, n=31), group II (methylprednisolone+ceftriaxone n=28), control group (n=43) was not treated. Histopathologic scores of inflammatory changes, fibrosis and tubular atrophy, the apoptosis index and TGF-beta1 expression score were observed at post-infection 1 and 3 week. Datas were analysed using ANOVA test and P value below 0.05 was interpreted as significant. RESULTS: The mortality rate (21.4%) of group II was not different to the control group (41.9%) and group I (32.3%). The inflammatory score of group II (0.8+/-0.87) at week 1 was significantly lower than those of the control group (2.3+/-0.87) and Group I (1.7+/-0.79) (P<0.05). Apoptosis index of group II (2.9+/-2.15) at week 1 was significantly lower than (10.0+/-0.95) and group 1 (8.3+/-2.53) (P<0.05). TGF-beta1 expression score of group II (0.8+/-0.72) at week 1 was significantly lower than those of the control group (1.9+/-0.68) and group I (1.8+/-0.60) (P<0.05). The fibrosis score of group II (1.1+/-0.10) at week 3 was significantly lower than that of the group I (1.8+/-0.83) (P<0.05). CONCLUSION: Combined treatment with methylprednisolone and ceftriaxone reduced inflammation, fibrosis, apoptosis and TGF-beta expression in acute pyelonephritic weaning rats, compared to ceftriaxone alone. Anti-inflammatory agent supplemented to antibiotics could prevent renal scarring more effectively.
Animals ; Anti-Bacterial Agents ; Apoptosis* ; Atrophy ; Catheters ; Ceftriaxone ; Cell Proliferation ; Cicatrix* ; Clinical Protocols ; Escherichia coli ; Fibrosis ; Inflammation ; Kidney ; Methylprednisolone* ; Mortality ; Pyelonephritis ; Rats* ; Rats, Sprague-Dawley ; Silicones ; Sodium Chloride ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Urinary Bladder ; Weaning*

No abstract available.
Pelger-Huet Anomaly*

In 97 cases of uncomplicated Cesarean section proceeding under 0.5% fluothane anesthesia with N2O and O2, 2.5% Pentothal sedium(clinical induction doses) was enough until umbilical cord clamp without any supplemental doses but muscle relaxation from succinylcholine might not be potentiated with 0.5% fluothane. On the other hand, Apgar score and postpartum uterine contractility was depending upon duration of anesthesia but it was not so serious problem. Also, anesthesia induction and recovery was rapid, and post operative pulmonary and other complication, even vomiting, did not occur. Conclusively, it is interesting that low concentration of fluothane with nitrous oxide are probably ideal anesthesia method for Cesarean section.
Anesthesia* ; Apgar Score ; Cesarean Section* ; Female ; Halothane* ; Hand ; Muscle Relaxation ; Nitrous Oxide ; Postpartum Period ; Pregnancy ; Succinylcholine ; Thiopental ; Umbilical Cord ; Vomiting

BACKGROUND: Piebaldism is an uncommon congenital disease inherited in autosomal dominant pattern. It is characterized by stable leukoderma with white forelock and vitiligo-like amelanotic macules usually containing a few normally pigmented or hyperpigmented macules. There have been a few case reports, but no clinical study in Koreans. OBJECTIVE: The purpose of this study was to investigate characteristic clinical features in Korean patients with piebaldism different from that of Caucasian. METHODS: We evaluated 11 patients with piebaldism using retrospective method and telephone survey in regard to sex, family history, clinical features such as distribution of hypopigmented patches, white forelock, normo- or hyperpismented macules within hypopigmented patches, hyperpigmented macules in normal skin, associated systemic disease, and effect of treatment. RESULTS: Ten patients showed autosomal dominant features but one occurred sporadically. The ratio of male to female was 3:8, and only 6 patients had white forelock. The most common site of hypopigmented patches was the lower leg(in all patients), followed by abdomen, left foot and left buttock, and chest. All patients had normo- or hyperpismented macules in hypopigmented patches, and 4 had hyperpigmented lesion in normal skin. Down's syndrome was associated in one case. We treated 3 cases with epidermal graft. CONCLUSION: Most cases were consistent with other western reports. But our patients revealed female predominance(3:8), lower incidence of white forelock(about 55%), frequent lower leg involvement(100%), and uncommon distribution of skin lesion such as foot and buttock. These differences reflected characteristic clinical features of piebaldism in Koreans different from those of Caucasians.
Abdomen ; Buttocks ; Down Syndrome ; Female ; Foot ; Humans ; Incidence ; Leg ; Male ; Piebaldism* ; Retrospective Studies ; Skin ; Telephone ; Thorax ; Transplants

The authors have experienced a case of acute hyperpyrexia with convulsion during diethyl ether anesthesia, which is rare and its etiology not well known.
Anesthesia* ; Ether* ; Seizures

Early-onset childhood sarcoidosis is a unique form of the disease characterized by the triad of rash, uveitis, and arthritis in patients presenting before age 4 years. We report a case of early onset childhood sarcoidosis in a 4-year-old girl. She presented with fever, right ankle joint swelling, multiple skin lesions on whole body and was diagnosed as juvenile rheumatoid arthritis in padiatric department. She was transferred to dermatologic department for skin evaluation, histological investigation revealed well-circumscribed, non-caseating naked granuloma with epitheloid cells, histiocytes, lymphocytes on the upper dermis. Laboratory evaluation, chest X-ray, and ophthalmologic evaluation are all within normal limit. She is treated with systemic steroid, methotrexate, non-steroidal anti-inflammatory drugs and follow up evaluation will be planned for possible eye involvement.
Ankle Joint ; Arthritis ; Arthritis, Juvenile ; Child, Preschool ; Dermis ; Exanthema ; Female ; Fever ; Granuloma ; Histiocytes ; Humans ; Lymphocytes ; Methotrexate ; Sarcoidosis* ; Skin ; Thorax ; Uveitis