Examination of the morphology of red blood cells in the urine has been shown to be a promising adjunct in determining whether hematuria represents glomerular or nonglomerular bleeding. This is due to distortion of RBCs as they Pass across the basement membrane of the glomerular capillaries. It is concluded that is method can greatly help the clinician in distinguishing between glomerular and nonglomerular bleeding in patients with hematuria and channeling such patients toward the most appropriate investigations. We have experimented dysmorphic red blood cells that 5 patients of the hematuria are distorted with irregular outlines and often have small blobs extruding from the red cell membrane. Tried urinary sediments were seen with phase contrast microscope and confirmed scanning electron microscope. There are seen acanthocytes, anulocytes, ghost cells and sphero-echinocytes in dysmorphic erythrocytes. Clinical diagnosis was referred from the result of the biopsy-proven. Scanning electron microscopic findings of the hematuria are good diagnostic tool that disclose in distorted red blood cells from patients with glomerular disorders.
Journal of the korean academy of Pediatric Dentistry
/
v.38
no.1
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pp.95-100
/
2011
Fibrodysplasia ossificans progressiva(FOP) is characterized by episodes of permanent heterotopic ossifications of soft tissues throughout the body. FOP is inherited in an autosomal dominant pattern, but most cases result from new mutations in the ACVR1 gene. Even minimal trauma can cause permanent ossifications of soft tissues and give rise to complications following routine dental care. Dental block anesthesia, severe stretching of the jaw and biopsies are all contraindicated in children with FOP. There is no effective treatment. Since the prevalence of FOP is very low and most patients with FOP are misdiagnosed during childhood, they undergo dangerous and unnecessary treatment that can lead to permanent harm. For patients with FOP, early diagnosis and prevention of complications are most important. This study aims at contemplating the characteristic features and consideration factors for the dental treatment of FOP patients in relation to the case of an eight years-and-one month old boy who was referred to Pediatric Dentistry due to prolonged retention of mandibular right and left deciduous central incisors after being diagnosed with sporadic FOP at Pediatric Orthopaedics, Seoul National University Hospital, and received dental treatment without the exacerbation of the FOP symptoms.
Purpose: Nurse educators can use film effectively to promote nursing students' motivation and indirect experiences. The purpose of this study was to develop a teaching-learning design using films based on Kolb's experiential learning model for understanding of child growth and development, and to evaluate students' satisfaction with cinenurducation according to learning type and content. Methods: Participants were seventy-four first year nursing students in the spring semester of 2013 at a private university located in Busan. In each class, participants watched film, participated in peer-to-group discussion and an educator's lecture, and wrote a composition based on Kolb's four learning stages. After class, participants filled out a questionnaire developed by the researchers. Results: Results showed a high satisfaction with cinenurducation regardless of learning type and content concerning child growth and development. Advantages of cinenurducation included it being "fun and interesting," "helpful to understand the characteristics of children," and "develop critical thinking through discussions." Disadvantages included "length of time needed," and "burdensome." Conclusion: Films are advantageous in that they provide indirect experience for nursing students. Selection of appropriate films and evaluation of learning goal achievements are important to maximize the effectiveness of cinenurducation.
Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than 5 years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% (p<0.01, p<0.01). Patency and pegnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence (p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vas (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively (p>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and vasal ooze with surgical skills.
The purpose of this study was to evaluate the efficacy of the newly-developed $Qraypen^{TM}$ (All In One Bio, Korea) system for the diagnosis of early proximal caries by comparing it with the conventional methods of visual inspection and periapical radiography. This study was carried out from July 2015 to April 2016 targeting 32 children aged 7~12 years who visited Y-Dental Clinic for school oral health examinations. Two investigators selected and examined a total of 153 primary molars that had not undergone restorative treatment. Comparisons were carried out between visual inspections, readings of posterior periapical radiography images, and readings of $Qraypen^{TM}$ images. This study revealed that the percentage of interproximal surfaces of primary molar teeth without caries incidence was 83.7% using $Qraypen^{TM}$ imaging and 84.9% using visual inspection and periapical radiography. The differences between the two methods were not statistically significant. Thus, $Qraypen^{TM}$ is expected to be a useful and convenient auxiliary diagnostic device that can facilitate the detection of hidden proximal caries in primary molars.
Shim, So Yun;Heo, Mi Young;Kim, Hae Soon;Sonh, Sejung
Clinical and Experimental Pediatrics
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v.45
no.10
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pp.1273-1277
/
2002
Purpose : To determine clinical features, laboratory findings and cardiac abnormalities of highdose immune globulin(IVIG) retreatment in patients with Kawasaki disease, and to report effectiveness of retreatment. Methods : Retrospective study of 174 children diagnosed with Kawasaki disease at Ewha Mokdong hospital from March, 1999 to July, 2001. Results : Twenty(11.5%) of 174 patients were retreated with high-dose IVIG. After this, only two patients(1.1%) did not respond to IVIG retreatment. Patients with failure to respond to initial IVIG did not differ from the patients who responded to a single course of IVIG in sex, age, days of fever at initial IVIG and clinical characteristics. Compared with responders with single IVIG treatment, the patients who were retreated had significantly lower albumin(3.7 vs 3.4 g/dL, P < 0.05), higher ALT(118.2 vs 229.3 U/L, P < 0.05) and CRP(8.9 vs 13.3 mg/dL, P < 0.05). On echocardiography, patients who recieved IVIG retreatment were significantly more likely to have caronary abnormalities(45.0% vs 13.6%, P < 0.05). Conclusion : Retratment with IVIG for persistent or recurrent fever was safe and effective.
Jung, Young-Soo;Lee, Gyu-Tae;Jung, Hwi-Dong;Mulliken, John B.
Maxillofacial Plastic and Reconstructive Surgery
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v.34
no.2
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pp.133-139
/
2012
This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.
The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1 %) were males and 14 (35.9 %) were females. Thirty patients (76.9 %) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7 %. Twenty-seven patients (69 %) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83 %) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.
Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.
The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotrans-mitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO₂. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25% sucrose). Collected data were analyzed with the SAS program using X²-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25% sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO₂: The SaO₂ score of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO₂ score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.
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