Posterior urethral valve is the most common obstructive abnormality in male children affecting both Kidneys and likely arise from maldevelopment of the mesonephric duct. We report a case of posterior urethral valve in 4 year old male child with brief review of literature.
Child ; Child, Preschool ; Humans ; Kidney ; Male ; Wolffian Ducts

During the last 10 years, we have experienced 169 cases of congenital melanocytic nevi of the face at Seoul National University Children's Hospital. In these patients, various modalities of treatment have been used, including excision, staged excision, skin graft, local flap, and composite graft. Dermabrasion, electrocoagulation, and laser therapy were excluded because these were not definitive treatments. We reviewed over 169 cases based on the involved on the aesthetic units of the face and the length of the defect perpendicular to wrinkle lines. We have attempted to create a stadard for the selection of the appropriate treatment modality. Cases which involved orbital unit(38 cases), cheek(30 cases), and parotid-masseteric unit(18 cases) were analysed statistically. To avoid the statistical error, units of sufficient number of cases and involving only one unit were included. In each unit, we used Receiver Operator Characteristic Method to identify the turning points of the length of the defect perpendicular RSTL which decided the treatment modality. And we used t-test to show the statistical difference between the lengths of the defect perpendicular to RTSL in each modality. The turning point were 0.9-1.0 cm between excision/staged excision, 2.0 cm between staged excision/FTSG, in orbital unit, 1.3 cm between excision/staged excision in cheek unit, 1.6-1.9 cm between excision/staged excision in parotid-masseteric unit. And it was identified by ANOVA test and t-test that the above groups were statistically different. Till now, the treatment modality of the congenital melanocytic nevus was based on the experiences of the surgeon. But now, we have presented the stadard of the treatment according to the size in each aesthetic unit. Therefore we can choose the approproate treatment modality among the severals in accordance with the standards.
Cheek ; Child* ; Dermabrasion ; Electrocoagulation ; Humans ; Laser Therapy ; Nevus, Pigmented* ; Orbit ; Seoul ; Skin ; Transplants

Twenty one cases of adult tibial shaft fractures were fixed with flexible intramedullary nails at the Department of Orthopedic Surgery, Kang Nam General Hospital. The results are summerized as follows; l. Average healing time was 17 weeks. No case of nonunion was experienced. 2. As the operation was perfomed by closed method under fluoroscopic control, reduction of operation time is a major advantage. 3. Fixation was usually strong enough to allow immediate weightbearing and mobilization of the adjacent joints without external immobilization. 4. Three cases of delayed union and 2 cases of rotational malunion were experienced, but shortening and angulation were not so severe as to affect overall functional results. 5. In conclusion, Ender nailing is considered to be a valuable method in treating tibial shaft fractures. Even in cases with multiple injuries and in selected open cases, Ender nailing can be a saft procedure.
Adult ; Hospitals, General ; Humans ; Immobilization ; Joints ; Methods ; Multiple Trauma ; Orthopedics ; Tibial Fractures ; Weight-Bearing

In a murine model system, enhancement of the total IgA and rotavirus-specific IgA of suckling mice was measured by ELISA with the intestinal fluid following oral administration of murine rotavirus EC (EDIM-Cambridge) strain. In the EC strain-administered group, the geometric mean titers (GMT) of total IgAs were 512 and 91 at 1 and 2 week postinfection, respectively. On the other hand, the GMTs of the rotavirus-specific IgAs were 108 and 3 at the same periods, respectively. Thus increase in the total IgAs was 64 folds and that in the rotavirus-specific IgAs was 43 folds compared with the negative control group. As the maximal titers of both the total and rotavirus-specific IgAs were observed at 1 week decreasing until 2 weeks after infection, it is evident that the GMT of the total IgA implies that of rotavirus-specific IgA. In our ELISA system, whose specificity was verified by Western blot analysis, the total IgA in the administered group was determined to be 40-400 ng per 1 ml of the intestinal fluid. Therefore it is concluded that determination of the rotavirus-specific IgA in murine models can be a sensitive indication of rotavirus infection, and will be another promising tool in viral challenge experiments in vaccine development.
Administration, Oral ; Animals ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Hand ; Immunoglobulin A* ; Mice ; Mice, Inbred ICR* ; Rotavirus Infections ; Rotavirus* ; Sensitivity and Specificity

The purpose of this study is to examine how nutritionists, principals and parents evaluated the importance and priorities of different selection factors for food materials suppliers in an attempt to suggest how to ensure the best supplier choice, since the selection of the best supplier was mandatory for the successful TQM of school food services. This study especially aims to develop priority alternatives based on relative rather than absolute assignments on selection of suppliers for school food service materials. To apply AHP, the selection factors of a food materials suppliers were grouped into five categories, which included quality, service, reliability, hygiene and price. And the five categories involved 28 elements. As the result, quality was considered most crucial on the whole, followed by service, reliability, hygiene and price; and food labeling in the category of quality evaluated as that of first priority in the totality evaluation elements.
Dietary Sucrose ; Food Labeling ; Food Services ; Humans ; Hydroxyproline ; Hygiene ; Parents

Skin graft has been widely used for facial skin reconstruction. Inguinal area is the common donor site for full-thickness skin graft of various area. Especially for facial skin graft, retroauricular area or upper eyelid skin has been used as a donor site. But these donor sites have some limitations as perfect ones in terms of size, color and texture when applied onto facial area. Even retroauricular skin shows color and texture differences from normal facial skin after it is grafted. Authors performed expansion of the skin of preauricular area or forehead where minimal scars would come out after final operation. We harvested this expanded skin and performed skin graft following excision of nevus, poor scar, or hemangioma in face.We achieved satisfactory results in terms of color and texture by applying this method in 11 clinical cases; 4 cases of hemangioma, 4 nevus, and 3 cases of traumatic scar. Donor site scars were clinically inspicuous in all these 11 cases.
Cicatrix ; Eyelids ; Forehead* ; Hemangioma ; Humans ; Nevus ; Skin* ; Tissue Donors ; Transplants*

Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3%, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69%) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3%) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5%). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.
Child ; Hernia ; Hernia, Inguinal ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Retrospective Studies

Catheter related and perianal problems are common surgical complications encountered during the treatment of pediatric malignancies. However acute surgical abdominal emergencies are rare. The aim of this study is to review acute surgical abdominal complications that occur during the treatment of childhood malignancies. Out of a total of 1,222 patients who were newly diagnosed with malignant disease, between January 2003 and May 2008, there were 10 patients who required surgery because of acute abdominal emergencies. Their medical records were reviewed retrospectively. Hematologic malignancies were present in 7 patients (4 leukemia, 2 lymphoma, 1 Langerhans cell histiocytosis) and solid tumors in 3 patients (1 adrenocortical carcinoma, 1 desmoplastic small round cell tumor, 1 rhabdomyosarcoma). Seven patients had intestinal obstruction, two had gastrointestinal perforation and one, typhlitis. Intestinal obstructions were treated with resection of the involved segment with (N=2) or without (N=3) enterostomy. Two patients had enterostomy alone when resection could not be performed. Intestinal perforation was treated with primary repair. Typhlitis of the ascending colon was treated with ileostomy. Right hemicolectomy was necessary the next day because of the rapidly progressing sepsis. Three patients are now alive on chemotherapy and one patient was lost to followed-up. Among six patients who died, five died of their original disease progression and one of uncontrolled sepsis after intestinal perforation. Although rare, acute surgical abdominal complications can occur in childhood malignancies. Rapid and accurate diagnosis and appropriate operation are required for effective treatment of the complications.
Abdomen ; Adrenocortical Carcinoma ; Catheters ; Child ; Colon, Ascending ; Desmoplastic Small Round Cell Tumor ; Disease Progression ; Emergencies ; Enterostomy ; Hematologic Neoplasms ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Perforation ; Leukemia ; Lymphoma ; Medical Records ; Retrospective Studies ; Sepsis ; Typhlitis

PURPOSE: This study was performed to evaluate the radiotherapy effects on metastatic epidural cord compressions. MATERIALS AND METHODS: One hundred and thirty eight cases received palliative radio- therapy (30 Gy/10 fractions) with (15) or without (123) surgical decompression. Only 36% of cases were ambulatory before treatment and 34% of cases started treatment within 3 days after symptom onset. RESULTS: Ambulation was possible after radiotherapy in 38% of all patients and in 73% of cases who was ambulatory before treatment. But the treatment made ambulation possible for 18% of cases who was paraplegic before treatment. Complete response rate, partial response rate, minimal response rate, and progression after treatment were as follows; 7%, 37%, 53%, and 3% respectively for the motor function, 8%, 32%, 58%, and 2% respectively for the sensory function, and 17%, 17%, 65%, and 1% respectively for the autonomic function. Responses were not influenced by the primary tumor site, histology, or involved level of the spine. Good responses were associated with starting treatment within 3 days after symptom onset. CONCLUSION: Radiotherapy gave optimal palliative effects on metastatic epidural cord compression syndrome. Maximum responses or quality of life could be obtained from prompt treatment with awareness of this syndrome in cancer patients.
Decompression, Surgical ; Humans ; Quality of Life ; Radiotherapy* ; Sensation ; Spine ; Walking

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation