• Title/Summary/Keyword: Pediatric age

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Caudal Anesthesia for pediatric Inguinal Region Surgery (유.소아 서혜부 수술을 위한 미추마취)

  • Lee, Kyeung-Sook;Park, Dae-Pal
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.127-131
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    • 1990
  • Pediatric caudal anesthesia was done in 50 infants and children under 10 years of age, who were to undergo surgery of inguinal region. All cases were given 10mg/kg body weight of 1% lidocaine solution with epinephrine 1:200,000. The results were as follows : 1) Pediatric caudal anesthesia was simple, easy and reliable in technique. 2) Additional intravenous administration of Ketamine or pentothal sodium was needed. ie, to provide a more cooperative state. 3) Anesthetic effect was judged very Excellent. 4) Cardiovascular and respiratory changes were minimal. Author's came to conclusion that caudal anesthesia for pediatric inguinal region surgery is reliable, simple in technique, favorable to surgeon, and is considered to be a good technique for pediatric anesthesia.

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Clinical Pearls and Advances in Molecular Researches of Epilepsy-Associated Tumors

  • Phi, Ji Hoon;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.313-320
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    • 2019
  • Brain tumors are the second most common type of structural brain lesion that causes chronic epilepsy. Patients with low-grade brain tumors often experience chronic drug-resistant epilepsy starting in childhood, which led to the concept of long-term epilepsy-associated tumors (LEATs). Dysembryoplastic neuroepithelial tumor and ganglioglioma are representative LEATs and are characterized by young age of onset, frequent temporal lobe location, benign tumor biology, and chronic epilepsy. Although highly relevant in clinical epileptology, the concept of LEATs has been criticized in the neuro-oncology field. Recent genomic and molecular studies have challenged traditional views on LEATs and low-grade gliomas. Molecular studies have revealed that low-grade gliomas can largely be divided into three groups : LEATs, pediatric-type diffuse low-grade glioma (DLGG; astrocytoma and oligodendroglioma), and adult-type DLGG. There is substantial overlap between conventional LEATs and pediatric-type DLGG in regard to clinical features, histology, and molecular characteristics. LEATs and pediatric-type DLGG are characterized by mutations in BRAF, FGFR1, and MYB/MYBL1, which converge on the RAS-RAF-MAPK pathway. Gene (mutation)-centered classification of epilepsy-associated tumors could provide new insight into these heterogeneous and diverse neoplasms and may lead to novel molecular targeted therapies for epilepsy in the near future.

Characteristics of Children Admitted to a Pediatric Emergency Department Following an Accident (사고로 소아응급실을 내원한 아동에 대한 실태 고찰)

  • Yun, O Bok;Kang, Hae Sook
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.79-91
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    • 2009
  • Purpose: The purpose of this study was to describe the characteristics of children who visited the pediatric emergency department (PED) following an accident. Method: Data were obtained from the medical records of 4,010 children who visited the PED from January 1, 2004 through December 31, 2006. Data were analyzed using SPSS WIN 13.0 version. Results: The percentage of children who visited the PED for treatment following an accident was 14.9%. There were more boys (63.5%) than girls. The largest age group for children visiting the PED was preschool aged children. Slip downs were the most frequent accident (37.1%). The face was the most frequently injured area of the body (26.0%). Most (93.3%) of the children who visited the PED were classified as non-emergency, 6.5% as emergency and 0.2% as urgent. About 70.0% of children were examined and 50% of children were medicated. Fifty percent stayed in the PED department for less than 2 hours, and 88.0% of children were discharged to home. Nine percent were admitted, and 2.2% were transferred to other hospitals. Conclusion: The results of this study suggest the need for accident prevention education for parents, and the need to develop effective education for clinical nurses working in PED.

Nasotracheal intubation in pediatrics: a narrative review

  • Jieun Kim;Sooyoung Jeon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.2
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    • pp.81-90
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    • 2024
  • Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

Clinical Characteristics of Pandemic Influenza A (H1N1) 2009 Pediatric Infection in Busan and Gyeongsangnam-do: One Institution

  • Lee, Myung-Chul;Kim, Hye-Young;Kong, Seom-Gim;Kim, Young-Mi;Park, Su-Eun;Im, Young-Tak;Park, Hee-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.493-500
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    • 2012
  • Background: This study investigated the clinical characteristics and risk factors of the severity of pandemic influenza A (H1N1) 2009 infection in pediatric patients in Busan and Gyeongsangnam-do. Methods: Cases of influenza A (H1N1) 2009 in patients under the age of 18 years, confirmed by reverse transcription polymerase chain reaction, at Pusan National University Hospital and Pusan National University Yangsan Hospital from the last week of August 2009 through the last week of February 2010 were retrospectively analyzed. Results: Of the 3,777 confirmed cases of influenza A (H1N1) 2009, 2,200 (58.2%) were male and 1,577 (41.8%) were female. The average age of the patients was $8.4{\pm}4.8$ years. The total cases peaked during 44th to 46th week. Most of the patients were in the 5- to 9-year-old age group. Oseltamivir was administered to 2,959 (78.3%) of the patients. 221 patients (5.9%) were hospitalized, age an average of $6.7{\pm}4.5$ years. The average duration of hospitalization was $7.4{\pm}5.6$ days. One hundred cases (45.2%) had pneumonia. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. Children with asthma were at very high risk of hospitalization, over 20 times the non-asthmatic children (odds ratio [OR], 21.684; confidence interval [CI], 13.295~39.791). Likewise the children with neurologic deficits faced a 16 times higher risk (OR, 15.738; CI, 7.961~31.111). Ten of the patients (4.5%) were admitted to the intensive care unit, and eight (3.6%) required mechanical ventilation. Conclusion: Of the pediatric patients with pandemic influenza A (H1N1) 2009, most of the patients were in the 5- to 9-year-old age group. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. The most common complication was pneumonia. The very high risk of severe morbidity in children with asthma or neurologic disease shows the critical importance of targeted vaccine coverage, special awareness and swift care by both guardians and primary care providers.

Changes in the Occurrence of Rotavirus Gastroenteritis before and after the Introduction of Rotavirus Vaccine among Hospitalized Pediatric Patients and Estimates of Rotavirus Vaccine Effectiveness (로타바이러스 백신 도입 후 소아 입원 환자에서의 로타바이러스 위장관염 발생 변화 및 로타바이러스 백신 효과 추정)

  • Yoon, Jung Min;Han, Tae Hwan;Yoon, So Won;Kim, Yong Joo;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.26-34
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    • 2018
  • Purpose: This study aimed to investigate the changes in the occurrence of rotavirus gastroenteritis (RGE) after the introduction of rotavirus vaccine and estimate rotavirus vaccine effectiveness in hospitalized children. Methods: We compared the retrospective data of 671 patients with acute gastroenteritis (AGE) admitted to the Department of Pediatrics, Hanyang University Seoul Hospital from January 1, 2014, to December 31, 2015, with retrospective data of 1,243 patients admitted to the same institution with AGE from January 1, 2004, to December 31, 2005. The vaccine effectiveness was estimated using a case-positive control test-negative study. Results: The proportion of RGE in AGE was significantly lower in 2014 to 2015 (9.0%, 48/531) than in 2004 to 2005 (22.7%, 282/1,243) (P<0.001). In particular, there was a significant decrease in the 6- to 11-, 12- to 23-, and 24- to 35-month-old groups (P<0.001), whose rotavirus vaccination rates were higher than the remaining age groups. The monthly distribution of patients with RGE in 2004 to 2005 was higher from November to May, peaked in January, followed by December and February. In 2014 to 2015, the monthly distribution of patients with RGE slightly peaked in January. In 2014 to 2015 study, the complete rotavirus vaccination rate was 66.0% (332/503) and incomplete vaccination rate was 6.2% (31/503). Presumed rotavirus vaccine effectiveness was 83.3% (95% confidence interval [CI], 60.5% to 92.9%) in the complete vaccination group and 27.4% (95% CI, -163.7% to 80.0%) in the incomplete group. Conclusions: The proportion of RGE in AGE has markedly decreased since the introduction of rotavirus vaccines, and improving vaccination coverage will further reduce the burden of RGE in Korea.

DENTAL TREATMENT OF A 11-YEAR-OLD MALE PATIENT WITH ADRENOLEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT (부신백질이영양증 환자의 전신마취 하 치과 치료 : 증례보고)

  • Jang, Jun-Hyuk;Shin, Teo-Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.107-110
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    • 2013
  • Adrenoleukodystrophy (ALD) is a rare, inherited disorder that leads to progressive brain damage and failure of the adrenal glands. It is passed down from parents to their children as an X-linked genetic trait. Therefore, it affects primarily males especially under the age of 10. People with ALD have excessive accumulation of very long chain fatty acids (VLCFAs) in their brain because they do not have the enzyme which break down these fatty acids. Special method for treatment of ALD is not available. Eating a diet low in VLCFAs and taking special oils, called Lorenzo's oil, can lower the blood levels of VLCFAs. But this oil cannot stop the destruction of nerve cell. This article presents a case report: Dental treatment of a 11-year-old male patient with ALD under general anesthesia. Careful management must be required during treatment procedure because of difficulty in cooperation, seizure disorders, gastroesophageal reflux, pulmonary aspiration and airway complications.

Meropenem Versus Piperacillin-Tazobactam as Empiric Therapy for Febrile Neutropenia in Pediatric Oncology Patients

  • Sezgin, Gulay;Acipayam, Can;Ozkan, Ayse;Bayram, Ibrahim;Tanyeli, Atila
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4549-4553
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    • 2014
  • Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.

Pediatric Cholecystectomy: Clinical Significance of Cases Unrelated to Hematologic Disorders

  • Kim, Hae-Young;Kim, Soo-Hong;Cho, Yong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.115-120
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    • 2015
  • Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group. Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was $21.7kg/m^2$, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy. Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.