No abstract available.
Blood Pressure* ; Humans ; Infant, Newborn*

Acute necrotizing encephalopathy is a recently established disease entity, proposed by Mizuguchi et al in 1995, that shows a characteristic symmetric and multifocal involvement of both thalamus, brainstem tegmentum, cerebral periventricular white matter, and cerebellar medulla. It is known to be prevalent in Japan and other Far Ease countries. The etiology of the acute necrotizing encephalopathy remains unknown. The typical course of acute necrotizing encephalopathy is the development of the irreversible neurologic symptoms related to brain lesions. The diagnosis can be made on the basis of the combination of a typical clinical profile and characteristic radiologic findings. We experienced a first case of acute necrotizing encephalopathy in a 9 month old boy in Korea. We report this case with the brief review of related literatures.
Brain ; Brain Stem ; Diagnosis ; Humans ; Infant ; Japan ; Korea ; Male ; Neurologic Manifestations ; Thalamus

No abstract available.
Blood Pressure* ; Humans ; Infant, Newborn*

Epididymal abnormalities have long been found in conjunction with undescended testis. Undescended testis with a patent processus vaginalis are associated with epididymal abnormalities, but the incidence of epididymal abnormalities in descended testis with a patent processus has not been reported. We analyzed the patency of processus vaginalis and epididymal abnormalities of 37 patients(41 testes) treated for undescended testes and 78 patients(79 testes) treated for hydrocele. Epididymal abnormalities ranged from simple epididymal elongation, epididymal angulation, disruption between testis and epididymal tail to more complex forms, such as epididymal/vasal atresia, complete disruption between the testis and epididymal head. Among 38 undescended testis with patent processus vaginalis 27(71%) had an epididymal abnormalities compared to 12 of 37(32%)hydroceles with patent processus vaginalis(P<0,05), and 12 of 38(329b) undescended testis with patent processus vaginalis had complex epididymal abnormalities(epididymal head separation and epididymal atresia) compared to 2 of 37(5%) hydroceles with patent processus vaginalis (p<0.05). Among 37 hydroceles with patent processus vaginalis 12(32%) had an epididymal abnormalities compared to 2 of 37(5%) hydroceles with incompletely patent processus vaginalis(P<0.05). These data suggest that epididymal abnormalities probably contribute to both testicular maldescent and closure of processus vaginalis.
Cryptorchidism* ; Head ; Incidence ; Male ; Testis

Cleft lip is one of the most common congenital deformities in craniofacial region. However, despite many reports on the outcome of various surgical techniques from individual medical centers, the evaluation of the outcome has been based on the subjective observation. Therefore, developing a new technique of objective and scientific evaluation for the nasal deformity of secondary cleft lip and nasal deformity is important to improve the management of the cleft lip patients. The authors have proposed a new scoring model to evaluate objectively the nasal deformity. The authors put 'x' axis on the nostril sill of noncleft side and 'y' axis on nasal tip at a right angle to x axis. The nostril of noncleft side was turned around the y axis to form the mirror image on the cleft side, and following four parameters were recorded: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) the overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. The post-surgery images were evaluated by the three plastic surgeons, using the scale of 5 percentiles. The four parameters of each image were measured using a newly developed software and correlation coefficients of each parameter and the evaluation scale by the surgeons were obtained. Among the scores from scoring model, errors greater than 10 percents were found only in 2 of 14 cases (2/14=14%), but among the scores from examiners, errors of greater than 10 percents were 4 from 14 cases (4/14=29%). Based on the results, deviation among the individual examiners can be reduced using the objective evaluation program developed in this study. The correlation coefficients between the normalized overlap area (0.78) and the distance between the centers of two nostrils (-0.82) with the evaluated scale by surgeons were high. However, the relative area and the degree difference of two nostril axis were found to be not such a good parameters in the evaluation of the nasal deformity. We developed scoring model from analysis of nostril shape and neural network which is able to evaluate cleft lip nasal deformity objectively after selection of proper parameters.
Axis, Cervical Vertebra ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Nose*

BACKGROUND: Cystic neoplasms of pancreas comprise pathologically heterogeneous groups of tumors with many shared clinical features. Although relatively uncommon, they have a very important place in the surgical pathology of the pancreas because of their high cure rate and their potential confusion with far more common pancreatic pseudocysts. METHODS: We analysed clinical features of 23 patients with pancreatic cystic neoplasm that we treated within 8-years` period (13 women, 10 men, mean age; 47.2 years old) The cystic neoplasms of pancreas comprise 5 serous cystadenoma, 3 benign mucinous cystic tumor, 3 borderline malignancy of mucinous cystic tumor and 4 mucinous cystadenocarcinoma, 4 papillary cystic tumor, 1 cystic teratoma, 1 cystic mesothelioma, 1 lymphoepithelial cyst. 1 mucinous ductal ectasia. RESULTS: Mean tumor size was 6.8cm(3 to 15cm). 73.9 percent had abdominal pain and 26.1 percent had abdominal mass. Computed tomography, ultrasonography and MRI were useful in detecting cystic mass in all cases but was not reliable to distinguish serous from mucinous tumor, benign from malignant. For the treatment of the tumor, 17 distal pancreatectomy with splenectomy, 1 distal pancreatectomy with spleen preserving, 1 proximal pancreatic resection, 2 local excision of pancreas and 1 PPPD were performed. During the period of follow up (mean: 29 months) after surgical resection, 1 recurrence occurred in the patient who underwent local excision for mucinous cystic tumor showing borderline malignancy on histologic finding. All the patients are alive except 2 patients who were lost to follow-up. CONCLUSION: Pancreatic cystic neoplasms are rare and their prognosis are acceptable when they are treated early and properly. So early detection and surgical treatment is the mainstay of management of cystic neoplasm of pancreas.
Abdominal Pain ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Serous ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Male ; Mesothelioma, Cystic ; Mucins ; Pancreas* ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pathology, Surgical ; Prognosis ; Recurrence ; Spleen ; Splenectomy ; Teratoma ; Ultrasonography

No abstract available.
Catheters* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Fetal Therapies* ; Lung*

BACKGROUND: This study investigated the effects of the K+ channel opener, pinacidil on hypoxic pulmonary vasoconstriction in isolated perfused rabbit lungs. In order to evaluate the vasodilatation mechanism of K+ channel opener, we also studied the effects of two K+ channel blocker, tetraethylammonium (TEA), a Ca2+ activated K+ channel blocker and glibenclamide (GLB), an ATP-sensitive K+ channel blocker. METHODS: Isolated lungs from white rabbits were ventilated with a normoxic gas (21%O2-5%CO2-74%N2) and a hypoxic gas (3%O2- 5%CO2-92%N2) alternatively, and then perfused with blood-containing perfusate solution. After a hypoxic pressor response (HPR) had been obtained, various drugs were added to the perfusate reservoir to achieve the predetermined circulating concentration, and the influences of the drugs on HPR were then tested. RESULTS: Pinacidil (0.3-6.0 mcM) produced a dose-dependent pulmonary vasodilation on hypoxic ventilation challenge. TEA (1 mM) caused pulmonary vasoconstriction in normoxic ventilation and potentiated a hypoxic pressor response. When the hypoxic pressor response was potentiated by TEA, pinacidil (1.0, 3.0 mcM) reduced the contraction, but GLB did not cause pulmonary vasoconstriction under normoxic ventilation, potentiate a hypoxic pressor response. CONCLUSIONS: Piacidil is capable of opposing the pulmonary responses of acute hypoxia. Moreover the effects of TEA and GLB suggest that HPV might be mediated through Ca2+ activated K+ channels, not through ATP-sensitive K+ channels.
Anoxia ; Glyburide* ; Lung* ; Pinacidil* ; Potassium Channels, Calcium-Activated ; Rabbits ; Tea ; Tetraethylammonium ; Vasoconstriction* ; Vasodilation ; Ventilation

Proximal gastrectomy (PG) has been tried as a function-preserving surgery for management of early upper gastric cancer. However, Reflux symptoms and stricture limit its applicability. We designed an anastomosis between the distal part of the posterior esophageal wall and the proximal part of the anterior wall of the stomach to make an anti-reflux mechanism. We named it the SPADE operation owing to its spade-like shape and because it is an acronym for a spade-shaped esophagogastrostomy after PG, which creates a partially duplicated esophagogastric wall. This video illustrates the case of a 74-year-old man diagnosed with early gastric cancer in the high body of the stomach along the greater curvature. We performed a totally laparoscopic proximal gastrectomy and a SPADE operation. He was discharged on the 7th postoperative day with an uneventful postoperative course and resumption of diet without reflux symptoms.
Aged ; Constriction, Pathologic ; Diet ; Gastrectomy* ; Gastroesophageal Reflux ; Humans ; Stomach ; Stomach Neoplasms

No abstract available.
Sepsis*