Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

We present a case of multiple trichoepithelioma associated with milia. A 12-year-old girl developed symmetrically distributed, numerous, skin-colored papules on her face, some of which were studded with milia-like whitish materials. Histopathological findings of these lesions revealed the typical findings of trichoepitheliomas with overlying milia in the upper dermis.
Child ; Dermis ; Female ; Humans

PURPOSE: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) and compared their results. METHODS: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. RESULTS: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the non-intrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFT-GIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. CONCLUSION: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.
Adolescent ; Child ; Follow-Up Studies ; Humans ; Interferon-gamma Release Tests ; Korea ; Latent Tuberculosis ; Outpatients ; Skin ; Skin Tests ; Tuberculin ; Tuberculosis

In performance of total hip replacement in the cases of acetabular deficiency, a few authors suggest cement inforcement with screws fixation or bone graft with resected femoral head for repair of it. In our cases another problem was loss of femoral head with acetabular deficiency, therefore resected femoral head could not be used. Our solution to this problem is to use the ilium, as a bone graft and to attach it to the acetabular wall to provide bone stock for the reconstruction. In six hips followed for over one year, all grafts appeared to be united and none showed evidence of resorption. All hips are functionally good and no case shows loosening.
Acetabulum ; Arthroplasty, Replacement, Hip ; Head ; Hip ; Ilium ; Transplants

PURPOSE: The aim of the present study was to investigate the effect of single dose imipramine on nocturnal urine output in patients with nocturnal enuresis. METHODS:A total of 6 monosymptomatic enuretic patients of more than 5 years of age were enrolled in this study. We measured nocturnal urine output, urine osrnolality, creatinine clearance, osmolal clearance, excretion rate of solutes, fractional excretion of sodium and potassium, and plasma vasopressin with and without a single oral dose of imipramine(lmg/kg of body weight) at 8 p.m. RESULTS: The administration of imipramine was followed by a significant decrease in noctumal urine output(P=0.02). Urine osmolality was not significantly increased(P>0.05), but osmolal clearance was significantly decreased during imipramine medication(P=0.03). Urinary excretion rate of sodium and potassium showed a statistically insignificant trend toward lower values during imipramine administration in nocturnal enuretics. Fractional urinary excretion of sodium and potassium was significantly decreased during imipramine medication(P<0.05). There was no significant difference in plasma vasopressin level and creatinine clearance in nocturnal enuretics after imipramine. CONCLUSION: Imipramine has a vasopressin independent antidiuretic effect in patients with nocturnal enuresis. The antidiuretic effect of imipramine can be attributed prirnarily to increased a-adrenergic stimulation in the proximal tubules with secondary increased urea and water reabsorption more distally in the nephron. (J Korean Pediatr Soc 2000;43:792 - 797)
Antidiuretic Agents ; Creatinine ; Enuresis ; Humans ; Imipramine* ; Nephrons ; Nocturnal Enuresis* ; Osmolar Concentration ; Plasma ; Potassium ; Sodium ; Urea ; Vasopressins

Cutis verticis gyrata(CVG) is an unusual conformation of the scap characterized by the presence of folds and furrows due to thickening of the corium and the subutlneous tissue. In sccordance with etiological factor and associated findings, CVG occurs as primarary disease or secondary to a variety of local or systemic diseases. Cerebriform intradermal nevus(CIN) is a cause of CVG that can usually be recognized clinically and for a certainty histologically. We report two cases of CVG due to CIN. Not only did they have CVG due to CIN on the scalp, but also they had associated congenital nevi on the face and whole boispy, respectively.
Dermis ; Nevus ; Nevus, Intradermal* ; Scalp

No abstract available.
Graft vs Host Disease*

No abstract available.
Arteriovenous Fistula*

No abstract available.
Colon, Ascending* ; Leiomyosarcoma*

Until recently, cranial base tumors or midfacial tumors were deemed unresectable due to an inability to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. With refinements in CT and NMR scanning, as well as the development of craniofacial technique, reconstruction has become absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, free tissue transfer was an effective alternative because it can provide a large amount of well-vascularized tissues arts reliable separation of the intracranial space from bacterial flora of the upper airway. Microvascular free tissue transfer was used in 15 patients at our center to reconstruct the cranial base and/or midfacial defects. Of these 12 were free rectus muscle flaps, 2 were free latissimus dorsi muscle flaps, 1 was a free scapular osteocutaneous flap and 1 was a free scapular fasciocutanegus flap. There were 2 cases of total flap loss. In those cases, revisions were performed using latissimus dorsi muscle free flap in one case and STSG in the other. One patient had a postoperative cerebrospinal fluid leak which was spontaneously resolved by conservative management. The large complex defects were successfully reconstructed by one-stage operation and the functional and esthetic results wee satisfactory with acceptable complication rates.
Cerebrospinal Fluid ; Free Tissue Flaps ; Humans ; Skull Base* ; Superficial Back Muscles