Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of 1 nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.
The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative -patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better
From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years (range from 30 to 71 years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarction history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients (40%) were hypercholesterolemia, 38 patients (60%) have smoking history and 19 patients (30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessel disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis (mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia (7 cases), wound infection (5 cases), perioperative myocardial infarction (4 cases), reoperation for bleeding control (4 cases) and stroke (4 cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp time (>2 hours) were found to be predective factor of morbidity and old age (>65 years) was found to be predective factor of mortality
Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and bone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient are remained back pain. According to above results we concluded that anterolateral internal fixation combined.with bone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.
Extravasation of toxic chemotherapeutic 'agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and 11 were 20 mice treated dimethyl sulfoxide and sodium.
To evaluate the effect of low lactose special formula (MF-1) for the treatment of acute diarrhea, we studied thirty nine infants who were admitted with acute diarrhea to the Department of Pediatics Yeungnam University Hospital. 39 infants of under 6 months of age who had been fed on formula feeds were randomly allocated to receive either a diluted regular formula milk or a low lactose special formula. Each infant received intravenous rehydration during fasting for 6-12 hours. Group 1 (n=15) was fed half strength of regular formula (80-100 cc/kg/day) for the first 24 hours, three quarters strength formula (100-120 cc/kg/day) for the next 24 hours, and continued feeding with the full strength regular formula milk. Group 2 (n=24), who fed the same amount of milk as Group 1, continued feeding with the full strength low lactose special formula from the start of feeding. Male to female sex ratio was 1.6 to 1. The characteristics of infants on admission were comparable in the age, the duration of diarrhea and the stool frequency before admission, the degree of dehydration. There were no significant differences in the duration of hospitalization, changes in stool weight and stool frequency after admission between two groups (p>0.05). The Body weight and skin fold thickness were increased in group 2 who fed low lactose formula, but those who fed diluted regular formula showed reduction of body weight and skin fold (64.2±51.4 g vs -11.4±52.2 g, 0.6±0.8 mm vs -0.1±0.3 mm respectively) during hospitalization (p<0.05). We conclude that low lactose special formula milk can be recommended instead of diluted regular formula for acute diarrhea treatment in infants
INTRODUCTION: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. MATERIALS AND METHODS: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. RESULTS: physical activity and weight were significant contributors. Physical activity is most the largest contributor. CONCLUSIONS: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.
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This study was carried out to develop a Korean language version of Zung's self-rating anxiety scale(SAS) from august, 1994 to September, 1996. The subjects consisted of 205 normal control subjects from the general population group, and 97 subjects with anxiety disorders. These 97 subjects were chosen from a group by the structured clinical interview for DSM-IV of in patients and out patients. Both normal control subjects and anxiety disorder subjects were drawn utilizing a cluster of sampling methods. In order to analyze the data on anxiety scores, Pearson's product moment correlation coefficient method was carried out, as well as reliability, factor analysis and discrimina;it function analysis, utilizing the SPSS/PC+ program. The results obtained were - as follows: The mean average of the total anxiety scores were 32.36 + 6.35 for the normal control subjects and 50.53 + 7.67 for anxiety disorder subjects. Test-retest reliability(coefficient r=0.98, p < 0.001), and internal consistency(coefficient r=0.96, p < 0.001) were satisfactory. Factor analysis using oblique technique rotation yielded four factors. _ The . normal control subjects scored higher concerning the symptoms such as sweating, restlessness, apprehension, insomnia and dyspnea, and lower for faintness, mental disintegration, paresthesia, dizziness and .tremor. On the other hand, for the anxiety disorders, apprehension, restlessness, sweating, dyspnea and insomnia scored higher, and lower for faintness, paresthesia, nightmare, dizziness and tremor.
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Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.
Hepatic masses show different enhancing patterns in N bolus computed tomography: Hepatocellular carcinoma shows high-attenuation in the early enhancing phase and low-attenuation in the late enhancing phase, hemangioma shows peripheral dot-like high-attenuation in the early enhancing phase and central high-attenuation in the late enhancing phase, and metastatic cancer and cholangiocelluar carcinoma show peripheral high-attenuation rim in the early enhancing phase and central portion gradulally high attenuation in the late enhancing phase. but sometimes enhancing patterns of the hepatic masses are confuse. To evaluate the significance of the AFP level and HBsAg in differentiation of the hepatic masses, we retrospectively analyzed AFP level and HBsAg' in 228 pathologically or radiologically confirmed hepatocellular carcinomas, and 137 pathologically nonhepatocellular cacinomas. The results were as follows In hepatocellular carcinoma, AFP level above 20ng/ml was 77.8% and HBsAg positve was 72.6%. In nonhepatocellular carcinoma, AFP level above 20ng/ml was 3.7% and HBsAg positve was 16.1%. We concluded that AFP level and HBsAg are helpful to distinguish hepatocellular carcinoma from nonhepatocellular carcinoma, when IV bolus computed tomogram finding is uncertain.