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

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

After the percutaneous transarterial technique was introduced by Seldinger in 1953, the percutaneous transcatheter embolization technique was developed. Autologous clot, first used by Doppman in 1968 to occlude a spinal arteriovenous malformation, was quickly adopted for management of gastrointestinal hemorrhage, genitourinary hemorrhage, traumatic hemorrhage, and hemoptysis. The notable improvement of the angiographic techniques rendered the interventional treatment the mainstay in the management of bleeding. Interventional treatment can be a life-saving procedure for massive bleeding or an important adjunct in reducing blood loss during operation and occasionally radical treatment of bleeding diseases. The goal of embolotherapy is to reduce the pulse pressure in the bleeding artery while maintaining an enough collateral flow to preserve the tissue viability. A variety of embolic materials have been proved safe and effective. Gelfoam pledget, polyvinyl alcohol, and coil are most commonly used. Gelfoam powder, extremely small polyvinyl alcohol, and absolute alcohol should be used carefully because of the risk of mucosal ischemia and necrosis.
Arteries ; Arteriovenous Malformations ; Blood Pressure ; Embolization, Therapeutic ; Ethanol ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemoptysis ; Hemorrhage* ; Ischemia ; Necrosis ; Polyvinyl Alcohol ; Tissue Survival

No abstract available.
Aged* ; Humans

No abstract available.
Mental Health*

No abstract available.
Fever* ; Hip* ; Humans ; Male*

No abstract available.
Humans