PURPOSE: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment. METHODS:From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed. RESULTS: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles. CONCLUSION: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy. (J Korean Pediatr Soc 2000;43:763-768)
Administration, Intravenous ; Atropine* ; Hospitalization ; Humans ; Infant ; Muscles ; Pyloric Stenosis, Hypertrophic* ; Spasm ; Vomiting

Extracorporeal shock wave lithotripsy monotheraphy was performed in 315 urinary stones from 278 patients with the Domestic SDS-2 lithotriptor using C-arm fluoroscopy between December 1991 and December 1994. Of 315 cases, renal stones were 150 cases(47.6%) and ureteral stones 165 cases(36.1%). No regional or general anesthesia was required but parenteral or oral analgesics were required in some patients. Among 315 cases who completed extracorporeal shock wave lithotripsy, the overall success rate of treatment was 90.5% with 92.4% in 5-9 mm, 94.8% in 10-19 mm, 89.7% in 20-29 mm and 61.5% over 30 mm or staghorn stones. Post lithotripsy complications were transient gross hematuria in 17.1%, renal colic in 11.4%, steinstrasse in 4.8%, petechia in 2.9% and fever in 1.9% and these complications were controlled with conservative treatment or repeated session of extracorporeal shock wave lothotropsy, percutaneous nephrodtomy, Double-J stent insertion or ureterolithotomy. We suggest that extracorporeal shock wave lithotripsy monotheraphy with the Domestic SDS-2 lithotriptor was considered to be effective and safe procedure for the initial treatment of urinary stones.
Analgesics ; Anesthesia, General ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Lithotripsy ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*

PURPOSE: A retrospective study on the usefulness of selective spinal nerve root block among lumbar herniated intervertebral disc (HIVD), spinal stenosis and postoperative syndrome over 10 years. MATERIAL AND METHOD: From a total 1195 patients, whose symptoms were not improved by conservative treatment, 505 treated by selective nerve root block were divided into 3 groups; 150 (29.7%) with HIVD, 313 (62.0%) with spinal stenosis and 42 with postoperative syndrome, and were followed up from Oct. 1992 to Dec 2001. The degree of pain and activity were evaluated by a visual analogue scale method at the out-patient department or through telephone interviews. RESULTS: The end-results of selective spinal nerve root block, with more than 50% reduction in pain occurred in 380 (75.3%) of the 505 patients. The effectiveness was greater in young patients with HIVD than elderly patients with spinal stenosis. After discharge, 160 patients (31.7%) needed no other treatment: 14 (31.0%) with an extrusion type HIVD and 17 (20.0%) with spondylolisthesis. The only 98 patients (19.4%) needed a surgical procedure after selective spinal nerve root block. CONCLUSION: Selective spinal nerve root block in patients with lower back and radiating pain is a valuable conservative treatment to quickly improved symptoms and avoid surgical procedures and the continuous administration of drugs.
Aged ; Humans ; Intervertebral Disc ; Interviews as Topic ; Outpatients ; Retrospective Studies ; Spinal Nerve Roots* ; Spinal Nerves* ; Spinal Stenosis ; Spondylolisthesis

The pituitary gland develops from two different parts of the brain. The anterior pituitary gland originates from the Rathke pouch and the posterior one from the infundibulum. Therefore, the pathologic findings of congenital hypopituitarism can be different in each case. Congenital hypopituitarism is a rare disorder. The characteristic clinical features of the affected newborns are prolonged jaundice, persistent or recurrent hypoglycemia without hyperinsulinism and microphallus. Their genitalia are usually underdeveloped and sexual maturation may be delayed or absent. In adulthood, patients retain childish feature, short stature with normal body proportion. We experienced a case of congenital hypopituitarism in a 12-year-old female patient with short stature and delayed sexual maturation(Tanner stageI). The endocrinological studies revealed growth hormone, FSH, LH and TSH deficiencies. Magnetic resonance imaging indicated a hypoplastic anterior pituitary and an ectopic posterior pituitary gland located within the tuber cinereum of the hypothalamus.
Brain ; Child ; Female ; Genitalia ; Growth Hormone ; Humans ; Hyperinsulinism ; Hypoglycemia ; Hypopituitarism* ; Hypothalamus ; Infant, Newborn ; Jaundice ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior* ; Sexual Maturation ; Tuber Cinereum

The pituitary gland develops from two different parts of the brain. The anterior pituitary gland originates from the Rathke pouch and the posterior one from the infundibulum. Therefore, the pathologic findings of congenital hypopituitarism can be different in each case. Congenital hypopituitarism is a rare disorder. The characteristic clinical features of the affected newborns are prolonged jaundice, persistent or recurrent hypoglycemia without hyperinsulinism and microphallus. Their genitalia are usually underdeveloped and sexual maturation may be delayed or absent. In adulthood, patients retain childish feature, short stature with normal body proportion. We experienced a case of congenital hypopituitarism in a 12-year-old female patient with short stature and delayed sexual maturation(Tanner stageI). The endocrinological studies revealed growth hormone, FSH, LH and TSH deficiencies. Magnetic resonance imaging indicated a hypoplastic anterior pituitary and an ectopic posterior pituitary gland located within the tuber cinereum of the hypothalamus.
Brain ; Child ; Female ; Genitalia ; Growth Hormone ; Humans ; Hyperinsulinism ; Hypoglycemia ; Hypopituitarism* ; Hypothalamus ; Infant, Newborn ; Jaundice ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Gland, Posterior* ; Sexual Maturation ; Tuber Cinereum

BACKGROUND: Adequate exposure of skull base lesion and intraoral lesion occupying the posterior oral cavity, base of tongue, tonsil, superior hypopharynx, anterior skull base, and infratemporal space for wide-field primary surgical resection is critical to tumor ablation. The division of mandible for resection of tumor was first undertaken by Roux in 1836, and many studies renewed the interest of mandible sparing procedure for surgical treatment of oropharyngeal carcinoma. OBJECTIVES: Mandibular swing approach for gaining access to oral cavity, oropharynx, and skull base for excision of tumor, provides excellent exposure with low complication rate when there is intervening grossly normal tissue between the tumor and bone. We studied mandibular swing approach with our surgical experience, with special emphasis on its subtypes related to osteotomy sites and forms. MATERIALS AND METHOD: The records of 20 patients underwent mandibular swing approach at Hanyang University Hospital, were studied by chart review. The patients were retrospectively reviewed to assess age, sex, tumor site origin, stage of disease, types of neck dissection and methods of the reconstruction, types of the mandibular osteotomies, and difference of complication rates between symphyseal and parasymphyseal osteotomy. RESULTS: Post-operative complications occured in 6 patients(30%). But osteotomy related complication rate was 15%. Complications of osteotomy site occurred at a rate of 20% in the symphyseal osteotomy group, but no complications arose in parasymphyseal osteotomy group. CONCLUSIONS: We believe that, if the mandible is clinically and radiologically clear of malignant involvement, midline mandibulotomy is more feasible surgical approach method for treatment of oral cavity, oropharyngeal, skull base lesion.
Humans ; Hypopharynx ; Mandible ; Mandibular Osteotomy ; Mouth* ; Neck Dissection ; Oropharynx* ; Osteotomy ; Palatine Tonsil ; Retrospective Studies ; Skull Base* ; Skull* ; Tongue

Gastric sarcoidosis is a rare disease accounting for 0.1~0.9% of all sarcoidosis cases. It presents either as a systemic disease or as an isolated finding. Diagnosis is established with biopsy of a lesion. It is important to distinguish between sarcoidosis and a sarcoid-like reaction, which can be caused by Crohn's disease, foreign body reaction, fungal infection, tuberculosis, or malignancy. We report a 60-year-old woman with both gastric and pulmonary sarcoidosis.
Biopsy ; Crohn Disease ; Diagnosis ; Female ; Foreign-Body Reaction ; Humans ; Middle Aged ; Rare Diseases ; Sarcoidosis ; Sarcoidosis, Pulmonary* ; Stomach ; Tuberculosis

We describe a rare case of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) associated with a six-year history of autoimmune pancreatitis, which was controlled by steroid treatment. The patient presented with multiple, cervical and thoracic lymphadenopathy and abnormal, nodular opacities in the lung. Histologically, Rosai-Dorfman disease with numerous IgG4-positive cells was identified in a subcutaneous lymph node in the patient's left forearm. The patient recovered uneventfully with steroid treatment.
Forearm ; Histiocytosis, Sinus ; Humans ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Pancreatitis

PURPOSE: The objective of this study was to develop a fatty acid database (DB) for estimation of intake levels of fatty acids in the Korean population, using data from the Korea National Health and Nutrition Survey (KNHANES). METHODS: Analytical values of fatty acids in foods were collected from food composition tables of national institutions (National Fisheries Research & Development Institute, Rural Development Administration), Japan Ministry of Education, Culture, Sports, Science and Technology, US Department of Agriculture, and journal articles that previously reported analytical fatty acid content of some Korean foods. The coverage of fatty acids was C14:0, C16:0, C18:0, C18:1, C18:2 n-6, C18:3 n-3, C20:5 n-3 (EPA), C22:6 n-3 (DHA), SFA, MUFA, and PUFA (n-3, n-6, n-9). The fatty acids DB covered a total of 5,144 food items used in the KNHANES nutrition survey. The food items were preferentially filled with analytical values of the collected data source. An analytical value for each food item was selected based on the priority criteria and the quality evaluation of data sources. Missing values were replaced with calculated or imputed values using the analytical values of similar food items from the data source. RESULTS: A total of 1,545 analytical values, 2,589 calculated values, and 1,010 imputed values were included in the fatty acid DB. The developed fatty acid DB was applied to 2,112 food items available for 2011 KNHANES data. Mean intake levels of total fatty acids and saturated fatty acids were 40.3 g/day and 13.2 g/day, respectively. The estimation of total fatty acid intake was 84.3% (men 83.2%, women 86.0%) of daily total fat intake. CONCLUSION: This newly developed fatty acid DB would be helpful in determining the association of fatty acids intake and related health concerns in the Korean population.
Agriculture ; Information Storage and Retrieval ; Education ; Fatty Acids* ; Female ; Fisheries ; Humans ; Japan ; Korea ; Nutrition Surveys* ; Social Planning ; Sports

No abstract available.
Abdominal Pain/etiology ; Aged, 80 and over ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Female ; Humans ; Ileal Diseases/etiology/radiography/surgery ; Intestinal Obstruction/*etiology/radiography/surgery ; Tomography, X-Ray Computed ; Treatment Outcome