Although alpha2-adrenoceptor agonists are widely used as postoperative sedatives in adults, the postoperative effects in pediatric patients with secondary pulmonary arterial hypertension (PAH) due to congenital heart disease are not well known. We experienced a case of successful ventilator weaning with continuous intravenous administration of dexmedetomidine (DEX) after surgical correction in a 46-month-old child with congenital ventricular septal defect (VSD) with severe PAH. She underwent VSD closure on cardiopulmonary bypass (CPB). After successful weaning from the CPB, hemodynamics and oxygenation were stabilized on DEX and nitroglycerin in the intensive care unit. The patient was successfully weaned from the ventilator 46 hours after surgery. The transthoracic echocardiogram two weeks after surgery showed a closed VSD with no residual shunt and trivial tricuspid regurgitation (Vmax = 2.5 m/sec) without PAH.
Administration, Intravenous ; Adult ; Cardiopulmonary Bypass ; Child* ; Child, Preschool ; Dexmedetomidine* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Hypertension* ; Hypnotics and Sedatives ; Intensive Care Units ; Nitroglycerin ; Oxygen ; Tricuspid Valve Insufficiency ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

Repairing large incisional hernia with abdominal wall reconstruction is a technically challenging problem for surgeons. We report our experience of large midline incisional hernia which was repaired successfully with components separation technique. A patient with incisional hernia, 35 x 20 cm in size, underwent operation following standard components separation technique. The aponeurosis of the external abdominal oblique muscle was longitudinally transected from the rectus sheath, and the external abdominal oblique muscle was separated from the internal abdominal oblique muscle. With further separation of the posterior rectus sheath from the rectus abdominis muscle, closure of the abdominal wall was attained without tension. The post-operative course was uneventful with minor wound seroma. The patient discharged safely, and no further complication in terms of recurrence and wound problem has occurred. Components separation technique could be a possible and effective treatment option for repair of large abdominal wall defect.
Abdominal Wall ; Hernia ; Hernia, Ventral ; Humans ; Muscles ; Rectus Abdominis ; Recurrence ; Seroma

No abstract available.
Colon, Ascending*

Reiters syndrome is a clinical triad of arthritis, urethritis and conjunctivitis, but the characteristic mucocutaneous lesions occur frequently enough to be included in this syndrome. This applies to the initial stage of the disease, in which the arthritis usually, but by no means invariably, comes triad, i.e. after the urethritis and conjunctivitis have made their apperance. In most instances the arthritisis is of subacute onset, reaching its full intensity within a few weeks. Some 50% of the patients suffer from recurrences of the arthritis. The chronic progressive polyarthritis occuring in Reiters syndrome has severe functional and anatomical repercussions. Here we report a case of Reiters syndrome in a 14 year old middle school boy. He had classical characteristic triad of arthritis, nonspecific urethritis and conjunctivitis. He had pyuria in first fewdays after onset and the arthritis of acute onset, reaching its full intensity within two weeks and then followed by conjunctivits. A review of literature was included.
Arthritis ; Conjunctivitis ; Humans ; Male ; Pyuria ; Recurrence ; Urethritis

No abstract available.
Mental Health*

No abstract available.
Aged* ; Humans

The distribution and type of the whorl on headhair and pubic hair were observed for Korean male youths at physical examination of freshman students of our university. I) In the observation on the whorl on headhair for 1293 male youths, following results were obtained. a) i) The single whorl was found 93.89% of the case. ii) The double whorl was found 5.49% of the case. iii) The triple whorl was found 0. 62% of the case. b) The most of the whorl situated on median sagittal line of the head. It occurs more often on the right side (30.4%.) than on the left (15.8%). c) The single whorl in the clockwise direction predominates over the counterclockwise. d) It is found in 52% of all cases that position double whorls had showed the one on the right side and the other on the left. And the double whorl showed the combination of spiral opposing directions in more than 80% II) In the observation on pubic hair of 6131 Korean male youths, following results were obtained. a) Below 18 years old: i) The horizontal type was found in 78.6% ii) The sagittal type was found in 6.3% iii) The acuminate type was found in 11.0%. iv) The disperse type was found in 3.4%. b)Over 19 years old: i) The horizontal type was found in 71. 6% ii) The sagittal type was found in 8. 5% iii) The acuminate type was found in 14.7% iv) The disperse type was found in 4. 9% c) The 0,75% of all cases can not be found pubic hair below 19 years old, the 0, 25% of the case can not be found pubic hair between 20-24 years old and 0.34% of total case (6131) whose age are ranging 17 years old to 24 years old were found bald pubic hair.
Adolescent* ; Hair* ; Head ; Humans ; Male ; Physical Examination ; Postal Service* ; Young Adult

No abstract available.
Education*

This research was undertaken to explore the degree of clinic utilization, medical cost, and disease patterns in a Korean rural area. The Kojedo Project was selected because it is one of many 'Front Line' medical facility, offering readily accessable primary care to the logical population, but with a particular emphasis on simple treatment and public health measures. During 1973, 14,808 patients visited the clinic from which 3,621 were selected as a sample for analyzation, the result was as follows; 1. Utilization, by geographical distribution, was highest in 'A Zone' the area closest to the clinic, with 46 percent of the population of that area making use of the facilities. 2. Utilization, by sex and age distribution, was higher for males less than one year old (50 males: 37 females), one to four year (17 riales: 7 females) and over 55 years(19 males: 15 females), and higher for females in the 15-34 years age bracket(12 female: 10 male). 3. Utilization, per two month period, was highest in August-September (19 percent of toal), 4 and lowest in the coldest and least busy months, December and January (14 percent). 4. The average charge per visit was W780; average payment was W686 (88% of the charge). The charge increased in proportion to the distance between the patient's home and the clinic: D Zone; W 1,108, C Zone; W 1,030, B Zone; W 970, A Zone; W769. 5. Medical charge by sex and age distribution, was higher for males in all but the less than one year and one to four year brackets, charges(W1,145) weme highest in the 35-54 years age bracket, lowest (W 401) in the less than one year bracket. 6. Disease patterns, by major division, showed highest frequency (16.8%) in the infection and parasitic category, folinwed, consecutively, by Respiratory System, Digestive System and Skin, Nail, Hair and Subcutaneous Tissues. 7. The most common cause of clinic visits based on the WHO Classification, was Pulmonary Tuberculosis, followed by, consecutively, Common TCold and Preventive Inoculation and Vaccination. 60.3% of the total clinic visits involved the twenty most common disease of the WHO List. 8. Medical charge, by disease category, was highest for 'Other disease of GUT' (W927), followed by Pulmonary Tuberculosis (W921), and lowest for Preventive nIoculation and Vaccinatioir (W259). 9. Continous visits were most common for Pulmonary Tuberculosis, Hypertensive Diseases and Peptic Ulcer and Complications.
Age Distribution ; Ambulatory Care ; Classification ; Digestive System ; Female ; Hair ; Humans ; Logic ; Male ; Peptic Ulcer ; Primary Health Care ; Public Health ; Respiratory System ; Skin ; Subcutaneous Tissue ; Tuberculosis, Pulmonary ; Vaccination

There have been so many misperceptions and prejudices against mental illness in our society. The wrong perception and prejudice against mental illness infringe on basic human right to receive proper medical care. Thoughts such as 'mental illness is rare', 'it is incurable', or 'psychiatric patients are weird, violent and harmful to others' are typical stereotypes of mistaken beliefs about mental illness. Scientific studies conducted throughout the world provide the opposite of these views. To reduce misunderstanding and stigma of mental illness, it is important to lead the public to recognize the mental illness is a disease of the brain to be treated, and that it can be treated effectively. To achieve this aim, proactive promotion by government and non-government organizations including medical professionals is required. In addition, vigorous scientific investigations should continue to delineate the pathophysiology of mental illness and establish effective treatment thereof.
Brain ; Human Rights ; Humans ; Prejudice