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

A study was carried out in 81 retreatment patients with sputum positive pulmonary tuberculosis who had previously been treated with first-line drugs for more than one year at Health Center. The Fallowing results were obtained; 1. Of the total 81 case of retreatment patients, male patients occupied 63(77.8%) and 18(22.20%a) were female. Age group of 30-,-49 years was 54.3% of total cases. 2. By extent of disease, moderate advanced cases were 53.1% and far advanced cases were 35.8%. 3. Of 81 patients admitted to the study, 65(80.3%) completed 1 year treatment 16(19.7%) patients discharged prematurely before 1 year. 4 patients terminated their treatment during 9-11 months after registration. 4. Completment rate of chemotherapy was highest (90%) at age of under'. 30 years. 5. Intractable patients with persistant positive sputum test for A.F.B. even after 12 months of retreatment were occupied 9(13.8%) of total retreatment cases.
Drug Therapy ; Female ; Humans ; Male ; Retreatment* ; Sputum ; Tuberculosis, Pulmonary*

Antral web is a very rare cause of vomiting in child, known to be a congenital disorder caused by incomplete recanalization of embryonic foregut, and in almost cases treated surgically. Author experienced a case of antral web in a 4-year-old boy who had suffered from severe abdominal pain for 2 months, in whom erosive duodenitis was noted on endoscopic examination. The patient became symptomfree after 1 week of conservative treatment for duodenitis. No specific therapy was not required for the antral web. Author concluded that surgical treatment is indicated for the clinically severe cases.
Abdominal Pain ; Child* ; Child, Preschool ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Duodenitis ; Humans ; Male ; Vomiting

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

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

No abstract available.
Maxillary Sinus* ; Wegener Granulomatosis*

No abstract available.