• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1422-1425
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• 2002

Subcutaneous fat necrosis in neonates is a rare disease characterized by skin lesions, which may be single or multiple, poorly circumscribed and often tender erythematous nodules or plaques on cheeks, buttocks, back, arms, and thighs. These symptoms are usually self-limited; resolution occurs over a period of weeks to months. Subcutaneous fat necrosis affects full term and healthy-appearing infants who have experienced perinatal distress such as hypoxic insult, birth trauma and hypothermia. Most skin lesions appear within the first two weeks of life. We experienced a case of subcutaneous fat necrosis in a neonate with hypoxic insult and report the case with a brief review of the literature.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.8.2-8
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• 1978

This paper was designed to investigate the causes of child hearing loss which is essential to language development especialy in young childhood. Accurate history taking, precise otolaryngological examination and impedence audiometry were performed on 185 hard of hearing children under age 5 during last 8 months and investigated its causes. The results were as follows: 1. Infections diseases were the most common causes of sensorineural hearing loss (44/123cases, 30.1%), and mother's condition during pregnancy the second, and birth injury or head trauma the third. 2. Acute or chronic ear ear diseases were the most common causes of counductive hearing loss (32/62, 51.6%), frequent URI the second (19/62, .30.6%), and adenoid vegetation the third (7/62, 11.3%). 3. The majority of causes of child hearing loss under age 5 was exogenous (179/185 cases, 96.8%), and the minority was endogenous (6/185 cases, 3.2%).

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.35-40
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• 1998

The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.388-395
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• 1996

Congenital muscular torticollis(CMT) is a disorder characterized by shortening of at least one of the cervical muscles and tilting of the head to opposite side. The most commonly affected muscle is the sternocleidomastoid muscle. Pathogenesis and etiology of congenital muscular torticollis were not clearly identified, but considered as fetal malposition, birth trauma, vascular accident, heredity, infection and CNS pathology. Untreated congenital muscular torticollis often causes facial asymmetry and This is the rasult of tensional rotation of the face toward affected side. So early treatment may prevent facial and neck asymmetry and limitation of neck movement. There are many treatment methods in CMT, including conservative and operative method, but presently Bipolar release and Z-Plasty of SCM muscle has been introduced when the conservative treatment had failed. The benefits of this method are to preservation of the normal Neck V-contour and improvement of the neck motion. We treated CMT using Bipolar release and Z-plasty in two patients. After that the patients improved on the range of neck motion and maintained the normal V-conture of the neck, so we report two cases of CMT with literatures.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.512-518
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• 2002

Purpose : Cerebral palsies are the most common and severe motor disabilities in childhood. There is currently increased interest in their occurrence and patterns of likely cause for a variety of reasons. Therefore, a retrospective study was carried out to understand the clinical features of cerebral palsy. Methods : A retrospective chart review was conducted of all children with cerebral palsy who were diagnosed at St. Benedict Hospital between March 1999 and March 2001. Results : Cerebral palsy patients were classified into 6 major groups. Of six groups, spastic diplegia is the most common type of cerebral palsy(55.3%). The risk factors of cerebral palsy were placenta previa(1 case), placenta abruption(1 case), cytomegalovirus infection(1 case), prematurity (53 cases), neonatal asphyxia(12 cases), dystocia(2 cases), breech delivery(1 case), multiple birth(5 cases), head trauma(3 cases), meningitis(2 cases) and unknown(26 cases). Among the 59 in the preterm group, 37 patients showed MR or CT images of periventricular leukomalacia. Among the 44 in the term group, 15 patients showed MR or CT images of atrophy. Among 103 patients, 29 patients(28.2%) had a seizure disorder. Conclusion : It is very importent to understand the clinical features and risk factors of cerebral palsy for physicians to diagnose and manage cerebral palsy patient.

• Neonatal Medicine
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• v.18 no.1
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• pp.14-22
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• 2011

Neonatal bleeding is a common problem encountered in nursery rooms or neonatal intensive care units, especially among premature infants. Furthermore, owing to recent remarkable improvement of neonatology, survival rates of preterm neonates have increased; hence, neonatal bleeding cannot be emphasized enough. Since the total blood volume of neonates is small, bleeding can be one of the causes of morbidities and mortalities. Therefore, rapid diagnosis and immediate therapy is urgently needed. The patient's medical history including a familial history of a bleeding disorder or of a previously affected infant who suffered from bleeding along with maternal and neonatal drugs can provide important diagnostic clues. Presence of bleeding with or without petechiae and ecchymoses in a healthy term or late preterm infant with thrombocytopenia but normal prothrombin time and activated partial thromboplastin time strongly suggests a congenital bleeding disorder. For a sick infant who is bleeding from multiple sites, an acquired disorder such as disseminated intravascular coagulation is suspected. Intracranial hemorrhage in term or late preterm infants without a history of birth trauma is highly suggestive of coagulation disorders. The purpose of this review is to summarize recent advances in diagnostic methods is as well as basic concepts of neonatal hemostatic disorders. First, an outline of background information will be presented followed by a discussion of primary and secondary hemostatic disorders as well as inherited and acquired disorders.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.255-265
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• 2000

The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.205-215
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• 2008

The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.