• Childhood Kidney Diseases
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• 제7권1호
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• pp.103-105
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• 2003

저자들은 고환초막강내의 농양(감염성 음낭수종)에 의한 발열과 보챔, 음낭부종으로 내원한 신생아에서 조기진단 및 적절한 치료로 성공적으로 회복된 1례를 경험하였으며 감염성 음낭수종은 신생아에서 드물지만 조기에 정확하게 진단되어 질 때, 그리고 고환, 부고환에 영향을 끼치지 않았을 경우 단지 배액술과 항생제 치료만으로도 성공적으로 치료할 수 있음을 보고하는 바이다.

• 간호행정학회지
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• 제5권3호
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• pp.547-561
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• 1999

The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

• Advances in pediatric surgery
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• 제13권2호
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• pp.212-216
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• 2007

Migration of a peritoneal catheter of a ventriculoperitoneal shunt into the scrotum is a rare complication. We treated a case of catheter migration in the scrotum. A 12-year old boy, who had had a ventriculoperitoneal shunt at the age of 4 months due to neonatal hydrocephalus, visited the outpatient clinic because of a right inguinal hernia. On physical examination, a firm mass was found in the left scrotum. Pelvic X-ray demonstrated a coiled catheter in the left scrotum. The catheter was successfully removed by exploring the left patent processus vaginalis after high ligation of the hernia sac. This case suggests a suction action of the patent processus vaginalis and the possibility of catheter migration long after shunt catheter insertion.

• Clinical and Experimental Reproductive Medicine
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• 제38권2호
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• pp.115-118
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• 2011

A 58-year-old woman who presented with inguinal hernia for the first time was diagnosed as seminoma and complete androgen insensitivity syndrome (CAIS). The patient received a late diagnosis, and therefore she could not take a proper management. CAIS is a rare X-linked recessive disease with an XY karyotype that is caused by androgen receptor defects. It usually present with primary amenorrhea or inguinal hernia. The risk of malignant transformation of undescended testis increases with age, thus gonadectomy should be performed after puberty. We present a case of large advanced seminoma in a woman with CAIS who was neglected and diagnosed lately.

• Neonatal Medicine
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• 제15권1호
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• pp.80-83
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• 2008

목 적 : 서혜부 탈장은 소아에서 비교적 흔하지만, 여아 탈장의 15-31%를 차지하는 난소 탈장은 아직까지 정립된 치료 원칙이 없고 국내에서는 질병의 경과에 대한 보고가 없다. 이에 연구자들은 난소 탈장 환아들의 특성과 임상 경과에 대하여 알아보고자 하였다. 방 법 : 2001년 3월부터 2007년 2월까지 관동대학교의과대학 제일병원에서 난소 탈장으로 진단받은 1세미만 여아 8명을 대상으로 환아들의 재태 연령, 출생체중, 난소 탈장 발견시기와 주 호소, 수술 시기 및 수술법, 수술 후 합병증 여부, 현재의 상태, 서혜부 초음파결과를 의무기록지와 전화 통화를 통해 후향적으로 조사하였다. 난소 탈장은 서혜부 종괴 여부와 초음파 검사 결과 난소가 서혜부에 위치하는 경우에 진단하였다. 결 과 : 환아들의 재태 연령은 $32^{+5}-40^{+1}$주 범위였으며, 이 중 37주 미만 미숙아는 4명(50%)이고, 출생체중은 1,600-3,505 g 범위였다. 대상 환아 중 7명(87.5%)은 좌측 난소 탈장이 있었으며, 1명(12.5%)은 우측에 난소 탈장이 있었다. 종괴를 발견한 시기는 생후 13-144일 사이로 다양하였으며, 수술 받은 환아들의 수술시기는 생후 50${\pm}$15일(35-65일)이었다. 현재까지 8명중 5명이 탈장 봉합술을 시행 받았으며, 합병증은 없었다. 수술을 시행하지 않은 3명은 경과 관찰 중에 수술없이 저절로 정복되었으며, 종괴가 사라진 나이는 생후121${\pm}$46일(70-161일)이었고, 관찰 기간 중(69-1,925일)감돈이나 재발은 없었다. 결 론 : 미숙아 여아인 경우 탈장의 빈도가 만삭아에 비해 높으므로 신체 검진을 통한 대음순 종괴의 발견이 중요하며, 초음파 검사를 통하여 확진한다. 소아의 난소 탈장은 아직까지 일관된 치료 방침이 없고, 외과의 의견을 따라 가능한 한 빠른 시일 내에 수술을 시행하였었기에 경과를 제대로 알 수 없었으나, 저자들이 경과 관찰을 하던 3명의 여아에서 생후 6개월 이내에 난소탈장이 저절로 정복되는 예를 경험하였고, 관찰 기간동안 재발은 없었다. 난소 탈장의 환자를 대상으로 추적관찰을 하여 적절한 치료 방침을 마련하여야 하겠다.

• Journal of Chest Surgery
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• 제15권2호
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• pp.230-237
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• 1982

Malignant hyperthermia has been reported by many authors since Denborough [1960] first described concerning anesthetic death in a family. Malignant hyperthermia is characterized by a hypermetabolic state [tachycardia, tachypnea, hypercarbia, hypoxia, cyanosis, hypotension, high fever and muscle rigidity] and is related to a hereditary defect of skeletal muscle. In susceptible individuals, it is triggered by potent inhalational anesthetics, depolarizing muscle relaxant [Succinylcholine], amide type local anesthetics [prototype lidocaine] and occasionally by stress due to emotional and environmental factors. Unrecognized and untreated malignant hyperthermia is associated with a very high mortality rate. Recently authors have experienced malignant hyperthermia in 5 year old male child who was diagnosed to have patent ductus arteriosus and interatrial septal defect associated with congenital physical deformities such as short stature, hypotrophic muscles and genu valgus deformity of lower extremity, indirect inguinal hernia and Ramphant caries.

• Journal of Chest Surgery
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• 제23권5호
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• pp.1027-1034
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• 1990

Pectus excavatum, commonest developmental anomaly of chest wall, is manifested by depression of the sternum and lower costal cartilages that is of surgical interest. From 1982 through 1990, fifteen patients have undergone surgery for treatment of pectus excavatum and treated by Ravitch operation: 5, Modified Ravitch operation; 4, Wada operation, 1 and Modified Wada operation, 5. There was familial history of pectus excavatum in 3 patients. Associated congenital anomaly were seen in 6 patients; scoliosis in 3 patients, right inguinal hernia in 1, polydactyly in 1 and patent ductus arteriosus in 1 patent. Postoperative minor complications were developed in 3 cases; pneumothorax, 2 cases; pleural effusion, 2 cases; wound infection and dehiscence, 1 cases; pressure sore due to strut malposition, 2 cases; flail chest and 2 cases; seroma. The incidence of the postoperative complications were more common in cases who were treated by metal strut, pin or other prosthetic materials for supporting the chest wall integrity than the standard corrective procedure. All cases have no recurrence of chest wall depression and operative death.

• Advances in pediatric surgery
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• 제20권1호
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• pp.1-6
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• 2014

Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

• Neonatal Medicine
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• 제18권2호
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• pp.337-344
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• 2011

목적: 신생아 시기에 수술적 치료를 한 위장관계 질환과 저체중 출생아에서 발생 빈도가 높은 위장관계 질환에 대한 이해를 높이고자 한다. 방법: 2008년 1월부터 2010년 12월까지 부산대학교병원과 부산대학교 어린이병원 신생아실에 입원한 환아 중 위장관계 질환으로 진단되고 외과적 치료를 받은 125명과 괴사성 장염과 서혜부 탈장으로 진단받은 환아 40명을 대상으로 원인 질환 및 빈도, 출생력, 성별, 동반 기형과 혈청학적 결과를 살펴보았다. 결과: 괴사성 장염과 서혜부 탈장을 제외한 총 125명 환아 중에서 항문 직장 기형이 가장 흔하였고, 남성이 우세하였다. 24명(19.2%)에서 타기형이 동반되었고 수신증, 선천성 심장 기형이 많았으며, 항문 직장 기형에서는 43.9%에서 동반 기형이 있었다. 출생체중을 보면 괴사성 장염의 경우 76.0%가 1,500 g 미만으로 대부분을 차지하였다. 술 후 완전 장관 영양까지의 기간은 괴사성 장염이 평균 30.8일로 가장 길었다. 술 후 합병증은 담즙정체증, 패혈증과 유착 등이 있었다. 괴사성 장염을 제외한 위장관계 질환으로 수술적 치료를 받았던 환자들은 1.6%의 사망률을 보였으며 수술적 치료를 받은 괴사성 장염의 사망률은 18.8%였다. 괴사성 장염의 수술군에서 보존적 치료군보다 직접 빌리루빈이 의미있게 더 높았다. 결론: 수술적 치료를 받은 위장관 질환의 생존율은 높고 수술적 치료의 성과도 우수하였다. 괴사성 장염 환아 중 수술군에서 직접 빌리루빈이 유의하게 더 높았다.

• 대한유전성대사질환학회지
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• 제14권2호
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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.