• Title/Summary/Keyword: 임상 경과

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Meconium Obstruction in Neonates-Clinical Characteristics and Treatment (태변성 장 폐쇄의 임상적 특성 및 치료)

  • Chang, Eun-Young;Lee, Mi-Jung;Kim, Myung-Joon;Shin, Jae-Ho;Chang, Hye-Kyung;Han, Seok-Joo;Oh, Jung-Tak
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.15-22
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    • 2011
  • Meconium obstruction (MO) in neonates arises from highly viscid meconium and the poor motility of the premature gut. Recently the incidence of the MO in neonates has been Increasing, but, the diagnosis and treatment of this disease have not yet been clarified. Between March 2004 and April 2010, 24 neonates were treated for MO at Severance Children's Hospital. Their clinical characteristics and treatment were reviewed retrospectively. Twenty neonates were diagnosed with MO and 4 neonates were diagnosed with Hirschsprung's disease (HD). The mean birth weight and gestational age of the 20 neonates with MO were $1.45{\pm}0.90kg$ and $31.1{\pm}4.6$ weeks, respectively. Thirteen neonates (65 %) diagnosed with MO weighed less than 1.5 kg and 10 neonates (50 %) weighed less than 1 kg. Half of the neonates with MO were treated by non-operative methods and the other half were treated by operative methods. Compared with the group that weighed over 1.5 kg, the group that weighed less than 1.5 kg were more frequently operated upon (61.5% vs. 28.5%), and contrast enemas were performed later and more frequently. Also the group that weighed less than 1.5 kg had a higher mortality rate (15.4% vs. 0%). Three of the four neonates with HD were diagnosed with long-segment aganglionosis. In conclusion, MO occurred in very low birth weight neonates more often and must be differentiated from HD. Also, MO in very low birth weight neonates should be treated with special attention due to more a complicated clinical course.

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A Statistical Study on Characteristics and Treatment of Child and Adolescent Patients with Tooth Impaction (소아·청소년 환자의 매복치 특성과 치료에 관한 연구)

  • Jo, Wansun;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.306-313
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    • 2014
  • Impacted teeth are teeth with a delayed eruption time or that are expected to erupt incompletely. Those teeth can cause a series of potential problems such as root displacement and resorption, periodontal problems in adjacent teeth, referred pain and the formation of cysts and odontogenic tumors. The purpose of this study was to investigate characteristics and treatment of child and adolescent patients younger than 15 years of age that were diagnosed with an impacted tooth who visited the Chosun University Dental Hospital. The impacted tooth, its etiology, treatment and traction period were surveyed through electric medical records, radiographs in 335 patients. We excluded the impacted third molar, supernumerary and deciduous teeth from this study. The most frequently impacted teeth are upper canine, followed by the upper incisor. The most common etiologies of impaction were an abnormal eruption pathway and localized pathologic lesions. The treatment of an impacted tooth was mostly orthodontic traction. The traction period was relatively short in cases with distinct obstacles, with an impacted upper incisor and if patients were younger. An orthodontic traction is considered to be more unfavorable if the patient gets older. Therefore, an early diagnosis and a precise treatment plan through a regular check-ups are mandatory.

Sleep-Related Respiratory Disturbances (수면과 관련된 호흡장애)

  • Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.55-64
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    • 1995
  • During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.

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The Effect of Left Subclavian Artery Coverage During Endovascular Repair of the Thoracic Aortic Aneurysm on Cerebral Hemodynamics: Two Cases of Flow Measurement by using 2D Phase Contrast Magnetic Resonance Imaging (흉부대동맥류의 혈관내치료 도중 좌측 쇄골하동맥 폐색이 뇌혈류역동에 미치는 효과: 2차원 위상차 대조 자기공명영상을 이용한 혈류 측정 2례 보고)

  • Baek, Seung-Hoon;Youn, Sung-Won;Kim, Ho-Kyun;Kwon, Oh-Choon;Lee, Sub;Lee, Jong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.159-168
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    • 2012
  • The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

Arthroscopic Shaving Cystectomy of Popliteal Cyst by using Posteromedial Portal (관절경적 후내측 도달법을 이용한 슬와 낭종의 절삭 절제술)

  • Kwak, Kyoung-Duck;Ahn, Sang-Min;Baek, Seung-Il;Jung, Chan-Jong;Roh, Jae-Su
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.153-158
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    • 2006
  • Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

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A Case of Raine Syndrome (Raine 증후군 1례)

  • Park, Hye Jin;Lee, Jeong Jin;Seo, Jeong Sik;Kim, Hyo Jin;Choi, Je Yong;Lee, Jun Hwa;Nho, Un Seok;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.91-94
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    • 2003
  • Raine syndrome was described as an unknown syndrome in 1989. It is characterized by severe craniofacial anomalies with microcephaly, hypoplastic nose, depressed nasal bridge, exophthamos/protosis, gum hypertrophy, cleft palate, low-set ears, small mandible, narrow chest, wide cranial sutures and choanal atresia or stenosis, by generalized osteosclerosis with subperiosteal thickening of ribs, clavicles and diaphysis of long bones, and by intracranial calcifications in the particularly periventricular area. It undergoes an autosomal recessive inheritance. Twelve cases of Raine syndrome have been reported in the literature. However, a case of Raine syndrome in Korea has not been reported yet. Therefore, we describe a female newborn with Raine syndrome with a brief review of the literatures.

Tooth size and arch parameters of normal occlusion in a Iarge Korean sample (한국인 정상교합자의 치아크키와 치열궁 계측치에 관한 연구)

  • Lee, Shin-Jae;Moon, Seong-Cheol;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.473-480
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    • 2004
  • The aim of this study was to establish normative data on the tooth size and arch parameters of Koreans with normal occlusion, This study employed the dental casts of 296 (male: 179; female 117) normal occlusion samples, who were selected from 15,836 adults through a community dental health survey. The mesiodistal diameters of teeth, arch width, and arch length were measured by digital electronic calipers(accurate to 0.01 mm) and Bolton's indices as well as intermaxillary arch width ratios were calculated. In order to ensure reliability, intra- and inter-examiner error were evaluated. Although our dimensional data showed overt differences between genders, the indices and intermaxillary ratios evaluated were the same. The resultant data obtained were compared with the previous data to reveal whether any changes have occurred over the time. The clinical implication of the present findings was also discussed. This biometric study seemed to provide a clinically applicable diagnostic criteria for an individual malocclusion patient.

A Case of Metastatic Oral Carcinoma from Rectal Cancer (직장암 유래 전이성 구강 암종의 진단예)

  • Shin, Keum-back;Kang, Kee-hyun;Chae, Gyu-sam
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.171-179
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    • 1999
  • The authors experienced a oral carcinoma involving the medial cortex of the right ramus of mandible and the left side of the maxilla which was metastasized from primary rectal adenocarcinoma based on the comprehensive evaluation of data obtained from (1) the past medical history of primary rectal adenocarcinoma, (2) the computerized tomographic views of the homogeneous mass on the anteromedial region of the right ramus of mandible destructing the medial cortex of the right ramus of mandible, and the irregular mass around the clivus spreading into the sphenoid sinus and destructing the left side of the maxilla ; the bone scanning of hot spots on the nasal region and the left side of maxilla ; the posteroanterior chest radiographic view of multiple nodular radiopacities on the lung, (3) the retrospective review of the sonographic view of a hypoechoic, well-demarcated, target-like mass with central hyperechoic focus on right lobe of liver in a Korean female of 49-year-old who complained the ptosis of left eyelid, the swelling on left zygomatic area, the left facial paralysis, the facial asymmetry and a round-shaped, elevated lesion with a hematoma on the mucosa covering the right ramus of mandible.

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Efficient Gene Delivery into Hematopoietic Stem Cells by Intra-Bone Marrow Injection of Retrovirus (IBM 이식을 통한 골수 조혈 줄기 세포에의 효과적인 유전자 도입)

  • Lee, Byun-Joo;Lee, Yong-Soo;Kim, Hye-Sun;Kim, Yu-Kyung;Kim, Jae-Hwan;Park, Jin-Ki;Chung, Hak-Jae;Chang, Won-Kyong;Kim, Dong-Ku
    • Reproductive and Developmental Biology
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    • v.32 no.1
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    • pp.9-14
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    • 2008
  • Efficient gene transfer into hematopoietic stem cells is a great tool for gene therapy of hematopoietic disease. Retrovirus have been extensively used for gene delivery and gene therapy. However, current in vitro gene transfer has some obstacles suck as induction of differentiation loss of self-renewal capacity, and down-regulation of homing efficiency for in vitro hematopoietic stem cells transplantation. To overcome these problems, we developed efficient in vitro retroviral transfer technique by direct intra-bone marrow injection (IBM). We identified effective retrovirus gene transfer in bone marrow hematopoietic cells in vitro. Two weeks after retrovirus transfer via IBM injection, we observed stable EGFP gene expression in bone marrow, lymph node, spleen, and liver cells. In addition, $6.4{\pm}2.7%$ of hematopoietic stem/progenitor cells were expressed EGFP transgene from flow cytometry analysis. Our results demonstrate that in vitro retrovirus gene transfer via IBM injection can provide a viable alternative to current or moo gene transfer approach.

Diamond-Blackfan anemia: long-term follow-up of six cases (Diamond-Blackfan 빈혈: 6예 장기간 추적관찰보고)

  • Son, Young Jun;Baek, Hee Jo;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1211-1216
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    • 2008
  • Purpose : Diamond-Blackfan anemia (DBA) is a rare heterogeneous genetic disorder of infancy and early childhood. It is characterized by red cell aplasia, congenital anomalies, and a predisposition to cancer. Corticosteroids and red cell transfusions are the mainstays of therapy. We describe our experience of 6 cases of DBA that were encountered over a period of 16 years. Methods : Medical records of 6 patients diagnosed to have DBA and admitted to the Chonnam National University Hospital between 1992 and 2008 were retrospectively reviewed. Results : Three patients were males. The age at diagnosis ranged from 3 to 18 months (median, 5.5 months). Heart defects were observed in 4, polydactyly in 2, and strabismus in 1 patient. The median number of transfusions was 3 (range, 2-8). All patients responded to initial treatment with steroids and had a hemoglobin level ${\geq}9g/dL$ with a median of 12.5 days (range, 7-22 days). Three patients are currently not receiving steroid therapy. A minimum dose of oral prednisolone (<5 mg per day) was required to maintain hemoglobin ${\geq}9mg/dL$ in 3 cases. Red cell transfusion was infrequently required in 1 patient. In the median follow-up of 14 years, there was no development of malignancy. No significant side effects of steroids were found, except for short stature in 2. Conclusion : The majority of DBA patients achieved complete response and under maintenance therapy with low dose of steroids. Close observation is needed to monitor steroid side effects, cardiac function, and development of malignancy. A nation-wide survey is necessary to further characterize this rare disease in Korean children.