No abstract available.
Meningitis* ; Meningitis, Viral*

No abstract available.
Sterilization, Tubal*

Unilateral nevoid telangiectasia was first described by Blaschko in 1899. Since then there have been fewer than 100 reported cases. This rarely reported disorder consists of multiple telangiectasias primarily located unilaterally in the C3-T1 dermatomes. We describe unilateral nevoid telangiectasia in 13-year-old boy with association with increased estrogen level in puberty.
Adolescent ; Estrogens ; Humans ; Male ; Puberty ; Telangiectasis*

Opioid analgesia is the primary pharmacologic intervention for managing pain. However, opioids can cause various adverse effects including pruritus, nausea, constipation, and sedation. Respiratory depression is the most fatal side effect. Therefore, cautious monitoring of respiratory status must be done after opioid administration. Here, we report a patient who suffered from respiratory depression with deep sedation and aspiration pneumonitis after intrathecal morphine administration.
Analgesia ; Analgesics, Opioid ; Constipation ; Deep Sedation ; Humans ; Morphine ; Nausea ; Pneumonia ; Pruritus ; Respiratory Insufficiency

During pregnancy profound immunologic, metabolic, endocrine, and vascular changes occur. Because of these changes, some diseases are affected by pregnancy. These diseases can aggravate or improve during pregnancy. Lymphomatoid papulosis is a continuing self-healing eruption whose lesions are clinically benign but histologically contain malignant-appearing cells. We report a case of lymphomatoid papulosis which developed in 30-year-old pregnant woman. And we discussed the possible association between lymphomatoid papulosis and pregnancy.
Pregnancy ; Female ; Humans

PURPOSE: We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment. METHODS: We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000. RESULTS: The mean annual incidence was 36.1+/-11.1 cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was 2.4+1.7 years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated(400-500 mg/dayX4-5 days, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case. CONCLUSION: In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.
Child ; Coronary Vessels* ; Epidemiologic Studies* ; Epidemiology ; Female ; Humans ; Immunoglobulins, Intravenous ; Incidence* ; Korea ; Male ; Medical Records ; Mucocutaneous Lymph Node Syndrome ; Recurrence ; Retrospective Studies ; Siblings

Surgeons are often faced with the problem of bowel obstruction in a patient who has previously undergone operation for malignant disease. Mechanical obstruction secondary to recurrent carcinoma is associated with poor survival. Surgical attempts to relieve malignant obstruction have significant morbidity and mortality rates and limited success in resolving symptoms. Then there is a temptation to assume that the obstruction is due to advanced malignancy and that death is inevitable. But a benign, correctable cause of obstruction will be found in about 25% of these patients. For this study, we had selected 63 cases of small bowel obstruction in patients with a previous operation for cancer which were admitted at Korea University Hospital between 1990 to 1995. The 43 men and 20 women had a mean age of 55.5 years. Forty one cases(65%) had obstruction due to recurrent carcinoma. The location of primary malignancies were as follows: 47 of the patients(74.6%) had adenocarcinoma of the stomach, 16 patients(25.4%) had adenocarcinoma of the colorectum. The median interval from the original operation for the malignancies until the development of bowel obstruction was 17.5 months. In our study, the small bowel obstruction due to recurrent carcinoma was frequently predicted when ascites and pleural effusion were present. We concluded that patients with no known recurrence or a short interval to the development of mechanical obstruction should be aggressively treated with surgery and for patients with known abdominal recurrence in whom nonoperative therapy fail, the surgical palliation are inevitable.
Adenocarcinoma ; Ascites ; Female ; Humans ; Korea ; Male ; Mortality ; Pleural Effusion ; Recurrence ; Stomach

Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for the achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.
Abdominal Wall ; Dilatation ; Esophageal Achalasia* ; Fundoplication ; Humans ; Laparoscopy ; Patient Satisfaction ; Surgical Procedures, Minimally Invasive ; Thoracotomy

Human orthotopic liver transplantation was first attempted in 1963. Living related liver transplantation has been introduced by Raia in 1988. In children, biliary atresia is the leading indication of living related liver transplantation. We performed 2 cases living related liver transplantation on May, 1996. The donors were 32 and 30 year old father, recipients were his 3 year old son and 4 year old daughter. The causes of liver failure were drug induced fulminant hepatitis and recurrent cholangitis due to biliary atresia. The first case was incompatible of ABO blood typing, donor AB(Rh+) and recipient B(Rh+). The ABO incompatible donor was performed preoperatively plasmapheresis. After left lateral segmentectomy of donor and total hepatectomy of recipient, donor liver was orthotopically transplanted. The average operation time of donor and recipient were 8 hours and 12.5 hours. The amount of transfusion in donor and recipient were average 2 pints and 2.5 pints. The perioperative immunosuppression was maintained with prednisone, azathioprine and cyclosporin, but 1st case was changed from cyclosporin to OKT3 on postoperative 9th day. The postoperative complications of recipient were pulmonary edema, bacterial and fungal infection. The donors were discharged on postoperative 8th and 9th day. The first case patient was discharged postoperative 42th day due to respiratory complication. The 2nd recipient was discharged postoperative 22th day. We suggested that living related liver transplantation is good modality for resolving the graft shrtage in pediatric liver transplantation.
Adult ; Azathioprine ; Biliary Atresia ; Blood Grouping and Crossmatching ; Child ; Child, Preschool ; Cholangitis ; Cyclosporine ; Fathers ; Hepatectomy ; Hepatitis ; Humans ; Immunosuppression ; Liver Failure ; Liver Transplantation* ; Liver* ; Mastectomy, Segmental ; Muromonab-CD3 ; Nuclear Family ; Plasmapheresis ; Postoperative Complications ; Prednisone ; Pulmonary Edema ; Tissue Donors ; Transplants

Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients' ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68 %), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufficiency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) ; type II, 24 patients(55%) ; type III, 4 patients (9%) ; and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring annuloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae trans- position(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07 +/- 0.11 cm2, mean +/- standard error), improved ventricular contractility in 41 patients(93%), absence of MR in 23(53%), trace MR in 18(42%), and grade II MR in 2 patients(5%).
Echocardiography ; Follow-Up Studies ; Heart ; Heart Valve Diseases* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Mitral Valve Annuloplasty ; Mitral Valve Stenosis ; Papillary Muscles ; Reoperation