• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.229-235
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• 2016

Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide concern. We present a case of a 12-year-old child with IE of the native mitral valve due to MRSA infection after an invasive dental procedure. Based on the clinical symptoms and the presence of cerebrospinal fluid pleocytosis, the patient was initially diagnosed with presumed bacterial meningitis and treated with empiric antibiotics. On the third day of hospitalization, MRSA was cultured from the initial blood samples and vegetation was observed on the mitral valve during an echocardiogram, findings which are compatible with a diagnosis of IE. The revised guidelines for antibiotic prophylaxis for the prevention of IE advise that IE prophylaxis for dental procedures is reasonable only for patients with underlying cardiac conditions, who are at the highest risk of adverse outcomes from IE. However, in this case, the patient had no high risk factors indicative of IE prophylaxis, except for mitral valve prolapse. She had no recurrence of IE over a follow-up period of 12 months.

• Korean Journal of Veterinary Research
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• v.44 no.1
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• pp.121-124
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• 2004

Horses that have been retired from racing or imported from abroad are retired as broodmares. Whether at private farms or government institutes they are bred to stallions with the aim of improving fertility and enhancing the breed. Accidental deaths as a result of surgical or obstetrical complications lead to decreased productivity and economic losses to the horse breeding industry. Intussusception of the uterine horn is a frequent complication of the equine and bovine species, but rarely seen in other species. The most common causes are thought to be tearing of the placenta which is suspended from the uterus and ovaries and the weight of the placenta. Expulsion of the embryonic membranes is also thought to be a contributing factor. If symptoms are minor and treatment affected quickly, the problem will likely resolve itself. In more severe cases the uterus will prolapse completely. This case study was observed in a Thoroughbred broodmare. After treatment of dystocia, the broodmare could not stand up. She became dehydrated, collapsed, suffered colic and was euthanised. In this case was observed serious swelling vulva and perineal region by morphology, and there was seldom ascites and unusual view in thoracic and abdominal cavity after opening abdomen. However, intussusception of uterine horn involuted left uterine horn into the uterine body was observed.

• CELLMED
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• v.6 no.1
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• pp.4.1-4.7
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• 2016

Dysmenorrhoea is the most important under diagnosed and undertreated gynaecologic disorder of all menstrual complaints. It affects 50% women of childbearing age and has a major impact on health and societal costs worldwideespecially in developing countries. Therefore, a literary exploration of traditional sources for aetiopathogenesis and clinical features of usr-i-tamth (dysmenorrhoea) were reviewed to correlate with contemporary knowledge.The traditional Unani sources viz., Al Hawi fi'l Tibb (Continens Liber),Tarjuma Kamil al-Sana'a al-Tibbiyya, Al-Qanun fi'l Tibb (Canon of Medicine), Dhakhira Khawarizam Shahi, Tibb-i-Akbar, Iksir-i-A'zam, Kitab al-Kulliyyat, and Kulliyyat-i-Qanun were reviewed. Further, recent studies in the contemporary era were also browsed on the website. The causes of usre-i-tamth as per classical sources are distemperament, uterine diseases (atresia, inflammation, amenorrhoea, cancer, prolapse, ulcer, tenuous morbid matter, and cervical obstruction), psychological disturbances, environmental factors, menstrual irregularities, obesity and young age. Recent studies also prove that obesity, psychological disturbance, menstrual irregularities, environmental factors, uterine diseases and young age lead to dysmenorrhea.Unani classical sources are very much enriched with the informative knowledge related to menstruation and uterine pain/dysmenorrhoea and recent studies in contemporary proves the same. Hence, implementation of the traditional system of medicines in present-day era may play a vital role to restore health in a holistic way.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.48-52
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• 2017

Background The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. Methods From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. Results All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. Conclusions Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.

• Journal of Genetic Medicine
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• v.13 no.1
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• pp.41-45
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• 2016

Marfan syndrome (MFS) is an inherited connective tissue disorder with a mutation in the fibrillin-1 (FBN1) gene. Fibrillin is a major building block of microfibrils, which constitute the structural component of the connective tissues. A 10-year-old girl visited our hospital with the chief complaint of precocious puberty. According to her medical history, she had a pulmonary wedge resection for a pneumothorax at 9 years of age. There was no family history of MFS. Mid parental height was 161.5 cm. The patient's height was 162 cm (>97th percentile), and her weight was 40 kg (75th-90th percentile). At the time of initial presentation, her bone age was approximately 11 years. From the ophthalmologic examination, there were no abnormal findings except myopia. There was no wrist sign. At the age of 14 years, she revisited the hospital with the chief complaint of scoliosis. Her height and weight were 170 cm and 50 kg, respectively, and she had arachnodactyly and wrist sign. We performed an echocardiograph and a test for the FBN1 gene mutation with direct sequencing of 65 coding exons, suspecting MFS. There were no cardiac abnormalities including mitral valve prolapse. A cytosine residue deletion in exon 7 (c.660delC) was detected. This is a novel mutation causing a frameshift in protein synthesis and predicted to create a premature stop codon. We report the case of a patient with MFS with a novel FBN1 gene missense mutation and a history of pneumothorax at a young age without cardiac abnormalities during her teenage years.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.3
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• pp.178-184
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• 2013

Purpose: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. Methods: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. Results: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. Conclusion: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.743-749
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• 2009

Purpose: Many researches about various surgical method for blepharoptosis have already been introduced. But researches for complications after blepharoptosis correction is relatively insufficient. So, this study was performed to recognize common complications that arised depending on the severity of blepharoptosis, levator function and surgical method. Methods: 250 patients who have underwent surgical treatment for blepharoptosis from 1987 to 2006 were employed in this study. Patients were categorized by severity of blepharoptosis, levator function and surgical method that has been used. Complications after blepharoptosis correction were analyzed. Result: Total of 64 patients had occurred complications, the specifics are as following; undercorrection 22, asymmetry 13, overcorrection 12, lagophthalmos 4, abnormal eyelid contour 4, exposure keratitis 3, ectropion 2, inclusion cyst 2, infection 1 and conjunctival prolapse 1. Among above patients, 3 patients had two kinds of complications. 21 patients was underwent secondary surgery due to complication. Conclusion: Evaluating the outcomes of the secondary surgery, the early correction was better than the late correction. The most of the complications were recovered through conservative and surgical treatments. The most of the complications (47 patients) were undercorrection, asymmetry, overcorrection and took 73.4% of the total complications. The more severe the blepharoptosis and the more poor the levator function, the rate of complications were higher. According to the operation methods, most complications were occurred in levator operation, frontalis transfer and OOM flap.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.2
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• pp.156-162
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• 2014

A 25-month-old boy was referred to the hospital due to large head detected on routine physical examination. At visit, dysmorphic facial appearances, including broad nose, prominent forehead, and coarse face, were noted. Nasal obstruction with nasal voice, prominent adenoids, and bilateral middle ear effusions were detected. His abdomen was distended, and liver and spleen were palpated about 3 finger and 2 finger breadths, respectively. He was operated for bilateral inguinal hernias. The motion of both elbow joints was mildly limited on supination and pronation. Urinary level of glycosaminoglycan was elevated and the enzyme activity of iduronate sulfatase in leukocytes was decreased. The mutational analysis of the gene iduronate 2-sulfatase (IDS) revealed c.263G>A (p.Arg88His) mutation. His developmental scale showed delayed development and there was cardiac valvular involvement (tricuspid regurgitation and mitral valve prolapse). After the diagnosis of Hunter syndrome, enzyme replacement therapy started on a weekly basis without progression of any clinical features. Here we report a case of early diagnosed Hunter syndrome detected by large head on routine examination. Thus, it is important to associate Hunter syndrome in the patient with large head especially, if there is the history of bilateral inguinal hernia and prominent adenoids to increase the possibility of early diagnosis and treatment.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.11-15
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• 2002

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation, Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required, Sigmoid loop colostomy is preferred whenever possible.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.632-636
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• 2009

Three dogs presented to the Veterinary Medical Teaching Hospital of the University of Konkuk and Hangang Animal Hospital with a history of perineal swelling. No tenesmus, stranguria, or any clinical signs other than the swelling was observed by the owners in three dogs. On physical examination, the swelling was observed unilaterally in two dogs and bilaterally in a dog. Digital palpation to the swelling confirmed reducible perineal herniation in two dogs and irreducible perineal herniation in a dog. Plain radiographs revealed that no pelvic or abdominal contents other than the fat were displaced into subcutaneous perineal region in three dogs. Internal obturator transposition herniorrhaphy was performed for correction of perineal herniation in three dogs. Contralateral herniation involving fat was noted after surgery in a dog. The follow-up information was based on physical examination by veterinarians or telephone interview with owners. The owners reported that there was no evidence of complications related to surgery such as sciatic nerve injury, rectal prolapse, wound dehiscence, or perineal hernia recurrence in all dogs.