Lymphangiomas or cystic hygromas are quite commonly seen in children. During a 22-year period, from January 1980 to December 2001, 117 patients with lymphangioma were treated and followed in the Department of Pediatric Surgery at Hanyang University Hospital. The male-to-female ratio was 1.9:1(77:40) with a male preponderance. As for the age incidence at time of diagnosis, 10(8.5 %) patients were noted under 1 month of age, 37(31.6%) were between 1 month and 1 year of age, 12(10.3%) between 1 and 2 years of age, so 59(50.4%) were under 2 years of age. Sixty one (52.1%) lymphangioma-cases were located in the neck, including one case at the nape. Axilla was the second in frequency and the rest were scattered at various sites. The intrascrotal lymphangioma is very rare but we have experienced one case of primary intrascrotal lymphangioma. Eighteen (15.4%) cases were located in the intraabdominal area, 10 in the mesentery, 2 in the greater omentum and 6 in the retroperitoneum. The chief complaints of intraabdominal lymphangioma were abdominal pain, intestinal obstruction, inguinal hernia, palpable mass, and/or abdominal distension. Among 77 histologically proven cases, 14 cases were cavernous lymphangiomas and the rest were cystic lymphangiomas. Bleeding in the lymphangioma was noted in 20(17.1%) cases of all. As for the treatment, a complete excision was performed in 77(65.8%) patients and $AgNO_3$ sclerotherapy after incomplete excision was performed in 23(19.7%). Picibanil (OK-432) sclerotherapy was performed in 17(14.5%) patients. Recurrence rate was 7.7 % and mortality occurred in one case who had a large neck lymphangioma extending into the mediastinum.
Untreated cryptorchidism contributes to infertility and may play a role in increasing the risk of malignancy. The appropriate time of operation was considered before school age in 1970s, 2 years of age in 1980s, and between 1 and 2 years of age from 1990s to present time. Orchiopexy is the most common operation for congenital urological problem of children. We analyze our experience of orchiopexies to evaluate the results and to identify the role of the pediatric surgeon. We reviewed the medical records of 91 patients who underwent orchiopexy from January 1996 to December 2007. The patient age at orchiopexy were as follows: 48 cases (52.7 %) under 2 years of age, 24 cases (26.4 %) between 3 and 5 years, 16 cases (17.6 %) between 6 and 10 years, and 3 cases (3.3 %) over 11 years. Location of testes was preperitoneum in all 91 cases. There were 84 unilateral and 7 bilateral cases. Among the unilateral cases, the undescended testes were on right side in 54 cases and on the left side in 30 cases. The surgical procedure employed in all cases was trans-inguinal orchiopexies. Seventy-nine patients had excellent results. There were 12 complications; 5 cases of wound infection and 7 cases of temporary incomplete descent. Seven cases of incomplete descent have become normal from 3 to 6 months after orchiopexy. According to our results, 43 cases (47.3 %) underwent orchiopexies over 2 years of age. In conclusion, orchiopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. We suggest that pediatric surgeons should educate their primary care physicians and parents concerning the potential complications of cryptorchidism and the appropriate time of operation.
Objective : The effect of Ulmus davidiana Planch(UD), which has long been known to have anti-inflammation and protective effects on damaged tissue, inflammation and bone among other functions, on the development of type II collagen (CII)-induced arthritis (CIA) in rats was studied. Methods : Male rats were immunized with an emulsion of $200\;{\mu}g$ of CII and complete Freund's adjuvant (CFA). The rats were then given intraperitoneal stimulation of Ulmus davidiana Planch herbal acupuncture(UDHA)or saline during the experiment. When compared with rats treated with saline as control, UDHA at doses of more than $20{\mu}g/100\;g$ rat once a day for 7 days inhibited the ability of inguinal lymph node cells to produce T cell cytokines interleukin-2, interleukin-6, $IFN-{\gamma}$ when the cells were obtained from rats 14 days after immunization and cultured in vitro with CII. Results : When rats were injected intraperitoneally, UD -treated group and control group rats did not differ significantly when low doses of UD was given to rats. Conclusion : The recommended dose of UD in the management and treatment of rat CIA will be more than $20{\mu}g/100\;g$, which is two-firth of human therapeutic dose. From the results, it was concluded that the effect of UDHA is dependent of dosage.
Objective : The effects of SP6(Sanyinjiao, 三陰交) acupuncture stimulation on bladder parasympathetic nerve activity (PNA), tibial nerve activity (TNA) as well as blood pressure were examined in anesthetized rats and the results are as follows. Methods : The parasympathetic nerve leading to the bladder was exposed retroperitoneally, and the tibial nerve in the hindlimb was exposed through inguinal area. PNA and TNA were recorded using a bipolar platinum-iridium wire electrode and it was connected to preamplifier. Blood pressure was measured using cannula that was inserted into femoral artery and was recorded with blood pressure sensor that is connected with transducer amplifier. The mean value of all parameters measured for 30 seconds before the stimulation was expressed as 100%. An acupuncture needle was inserted into the SP6 region to a depth of 4 mm. Results : Under intact state (IS), acupuncture stimulation for 120 seconds induced significant increase of PNA which was accompanied with decrease of blood pressure. At the same time, TNA showed temporary increase only with acupuncture stimulation. In 4 mg/kg of naloxone-administrated state (NAS), significant decrease of PNA was seen and it was accompanied with increase of blood pressure. TNA also showed temporary increase only with acupuncture stimulation under the NAS just like the IS. Conclusion : consider that SP6(Sanyinjiao, 三陰交) acupuncture stimulation activated parasympathetic nerve and caused vasodilation to lead into the diuresis, but naloxone reversed the effect of acupuncture for antidiuresis.
Clinical experiences of 833 hydrocele children presented at Hanyang University Hospital, of whom 456 children were operated by one pediatric surgeon from September 1979 to December 1993, were analyzed. Eight hundred and twenty three children were boys(right 476, left 279, bilateral 49, and unknown 19), and 10 were girls(8 right and 2 left). Operation was performed on 446 boys and all girls. Of boys diagnosed before the age of 6 months, 15.6% was operated and 68.7% of those after 6 months of age was operated. Among the boys operated after 2 years old, 16.5% had had hydrocele before 6 months of age, 20.4% before 1 year old and 34.6% before 2 years old. On the other hand, 28.8% of boys diagnosed after 2 years of age did not undergo hydrocelectomy. Sixteen children with hydroceles had contralateral hernias at the same time. After repair of unilateral hydroceles, contralateral hydroceles developed in 7 and hernias in 3 children. After disappearance of unilateral hydroceles, it reappeared at the same site in 4 and contralateral hydroceles or hernias developed in 2 children each. Hydroceles converted to hernias in 6 children before treatment. Hydroceles developed after ventriculo-peritoneal shunt in 5 children. The pathophysiology of hydrocele and inguinal hernia seems to be the same because of the similar distribution of onset age between them but hydrocele has various clinical courses. The results that 34.6% of boys operated after 2 years old had had hydrocele before 2 years of age and 28.8% of boys diagnosed after 2 years old did not undergo hydrocelectomy could not imply the proper age when hydrocelectomy could be performed. But operative repair of hydroceles after the age of 6 months seems to be recommendagle.
Bae, Byoung Man;Eo, Su Rak;Kim, In Kyu;Koh, Sung Hoon;Jones, Neil F.
Archives of Plastic Surgery
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v.34
no.1
/
pp.64-69
/
2007
Purpose: The key of treatment in syndactyly is to separate the fused digits safely, and to create a normal web space with enough cutaneous coverage. Despite many techniques have described the correction of syndactyly, skin graft still remains the annoying one. We designed the pentagonal flap from hand dorsum to reconstruct the web space reliably and try to minimize the need for skin graft. Methods: Between July 2003 and August 2005, six cases of syndactyly were corrected at UCLA Medical Center and Hallym University Sacred Heart Hospital using dorsal pentagonal flap for web space reconstruction and straight incisions for the sides of digits to minimize the need for skin graft. The proximal edge of the pentagonal flap was designed in V shape to allow for easy closure of the donor site after advancement. The pentagonal flap was advanced volarly with the underlying dermofat tissues to form a digital web. In some cases, skin defects were unavoidable and covered with full thickness skin graft from the inguinal area. Results: Syndactyly were seen in 4 cases of Apert syndrome, 1 postburn scar webbing with PIP joint contracture and 1 recurrence after the incomplete reconstruction. In all Apert syndrome, straight line incision was used along the sides of the fingers and skin graft was needed. But, in 2 cases of incomplete type, we could save the need for skin graft only for the correction of syndactyly. We could get a good looking web space without any complications such as flap or graft loss. Conclusion: As a modification of Sherif's V-Y dorsal metacarpal flap, we believe pentagonal flap could be one of the easiest and safest way to reconstruct the web space of syndactyly in functional and cosmetic standpoint.
Canine juvenile cellulitis (CJC) is a well-recognized lymphocutaneous disease that is seen in young dogs. CJC seemed to be immunologic disorder and may have a hereditary aspect. Exact pathogenesis and cytokine regulation on the immune system of CJC are not clear. CJC was diagnosed in two puppies hospitalized in Veterinary Teaching Hospital of Chungbuk National University. To investigate the cytokine regulation on CJC, RT-PCR was performed with CJC affected dogs. RT-PCR 1 was performed with whole blood sample (CJC-B) and fine needle aspirates of the inguinal lymph node (CJC-LN) from case 1-dog, which included $TNF-\alpha,$$IL-1\beta,$$IFN-\gamma,$ IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12 and $\beta-actin.$ Blood sample from a normal dog (N-B) served for a negative control of RT-PCR 1 (case 1). $IFN-\gamma,$ IL-2, IL-4, IL-5, IL-8, IL-10 and IL-12 transcripts were not expressed in all sample. $TNF-\alpha$ and $IL-1\beta,$ were not transcripted from CJC-B but from CJC-LN. On RT-PCR 2 (case 2), submandibular lymph node aspirates were used and $TNF-\alpha,$ IL-10, $IFN-\gamma$ and $IL-1\beta$ were expressed. $TNF-\alpha,$ 1L-10 and $IFN-\gamma$ were secreted from activated macrophages enhance the inflammation in tissue. These results imply that abnormally increased macrophages secret $TNF-\alpha$ and $IL-1\beta$ in the affected lymph nodes, which attract neutrophils and cause inflammation in CJC.
This study describes pathological, immunohistochemical, and bacteriological findings in adult dogs and fetuses naturally infected with Brucella (B.) canis. A total of 42 dogs including 40 dogs and 2 aborted fetuses were examined. The most common gross lesions in infected dogs were swelling of lymph nodes and spleen. The testes showed marked swelling with multifocal to diffuse reddish discoloration. The most significant histopathological lesions were observed in the placenta. Placental trophoblasts were markedly hypertrophied due to the accumulation of intra-cellular gram-negative bacteria. Lymphocytic inflammation of varying severity was observed in the reproductive organs such as male testis, epididymis, and prostate gland and female uterus. Strong immunolabelling was observed in the cytoplasm of most trophoblasts in the placental tissues using immunohistochemistry. However, immunohistochemical staining did not demonstrate any organisms in other organs of dogs and fetuses. B. canis isolates were most frequently obtained from the whole blood (82.5%) and superficial inguinal lymph node (77.5%) in both sexes. In addition, the isolation rate was higher in male genital organs than in those of females. Hence, management of male dogs is most important because infected dogs can play a role as carriers.
Kim, Rae-Oh;Cho, Kyoung-Suok;Yoo, Do-Sung;Huh, Pil-Woo;Park, Chun-Kun;Kim, Dal-Soo;Kang, Jun-Ki
Journal of Korean Neurosurgical Society
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v.29
no.4
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pp.555-558
/
2000
Crowth of an angiolipoma of the central nervous system is rare. Only about 60 cases were searched in the literature. We report one case of spinal angiolipoma recently treated in our institution. A 67-year-old man was admitted because of burning sensation on the both lower extremities and paraparesis. He felt burning sensation on the both great toes and it progressively involved to thighs and inguinal area during the past 1 year which gradually worsened. MR image showed a spinal mass lesion at the level of T4 to T6. The lesion was isodense and hyperdense in periphery on T1-weighted image and hyperintense on T2-weighted image. The tumor was located on the posterior area of the spinal cord and markedly enhanced after intravenous Gd-DTPA. At the operation, a soft, dark-red mass was totally removed. On histological examination, the tumor was shown to be mainly composed of mature fatty cells and numerous blood vessels with enlarged lumens. Postoperative course was uneventful and the symptoms improved gradually.
Journal of mucopolysaccharidosis and rare diseases
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v.2
no.2
/
pp.43-45
/
2016
Whole body energy balance is achieved through the coordinated regulation of energy intake and energy expenditure in various tissues including liver, muscle and adipose tissues. A positive energy imbalance by excessive energy intake or insufficient energy expenditure results in obesity and related metabolic diseases. Although there have been many obesity treatment trials aimed at the reduction of energy intake, these strategies have achieved only limited success because of their associated adverse effects. Serotonin is among those traditional pharmacological targets for anti-obesity treatment because central 5-HT functions as an anorexigenic neurotransmitter in the brain. Thus, there have been many trials aimed at increasing the activity of 5-HT in the central nervous system, and some of the developed methods are already used in the clinical setting as anti-obesity drugs. However, recent studies suggest the new functions of peripheral serotonin in energy homeostasis ranging from the endocrine regulation by gut-derived serotonin to the autocrine/paracrine regulation by adipocyte-derived serotonin. Pharmacological inhibition of 5-HT synthesis leads to inhibition of lipogenesis in epididymal white adipose tissue (WAT), induction of browning in inguinal WAT and activation of adaptive thermogenesis in brown adipose tissue (BAT). Fat specific Tph1 knock-out (Tph1 FKO) mice exhibit similar phenotypes as mice with pharmacological inhibition of 5-HT synthesis, suggesting the localized effects of 5-HT in adipose tissues. In addition, Htr3a KO mice exhibit increased energy expenditure in BAT and Htr2a KO mice exhibit the decreased lipid accumulation in WAT. These data suggest the clinical significance of the peripheral serotonergic system as a new therapeutic target for anti-obesity treatment.
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