• Title/Summary/Keyword: Pediatric approach

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Surgical Management of Coronary Artery Fistulas in Children

  • Youngkwan Song;Eun Seok Choi;Dong-Hee Kim;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.79-86
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    • 2024
  • Background: This study investigated the surgical outcomes associated with coronary artery fistulas (CAFs) in children. Methods: We retrospectively reviewed the medical records of 23 pediatric patients who underwent surgical closure of CAFs between 1995 and 2021. At presentation, 7 patients (30.4%) exhibited symptoms. Associated cardiac anomalies were present in 8 patients. Fourteen fistulas originated from the right coronary artery and 9 from the left. The most common drainage site was the right ventricle, followed by the right atrium and the left ventricle. The median follow-up duration was 9.3 years (range, 0.1-25.6 years) Results: The median age and body weight at repair were 3.1 years (range, 0-13.4 years) and 14.4 kg (range, 3.1-42.2 kg), respectively. Cardiopulmonary bypass was used in 17 cases (73.9%), while cardioplegic arrest was employed in 14 (60.9%). Epicardial CAF ligation was utilized in 10 patients (43.5%), the transcoronary approach in 9 (39.1%), the endocardial approach in 2 (8.7%), and other methods in 2 patients (8.7%). The application of cardioplegic arrest during repair did not significantly impact the duration of postoperative intensive care unit stay or overall hospital stay. One in-hospital death and 1 late death were recorded. The overall survival rate was 95.7% at 10 years and 83.7% at 15 years. A residual fistula was detected in 1 patient. During the follow-up period, no surviving patient experienced cardiovascular symptoms or coronary events. Conclusion: Surgical repair of CAF can be performed safely with or without cardioplegic arrest, and it is associated with a favorable prognosis in children.

A Set of Monozygotic Female Twins With Anal Canal Duplication (일란성 쌍둥이에서 발생한 항문관 중복증)

  • Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.9 no.2
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    • pp.117-120
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    • 2003
  • Anal canal duplications occurring in a pair of 4 month-old healthy female twins are presented. The openings were located in the posterior midline of the anus since birth without a history of perianal abscess or swelling. Excision of the duplicated anal canals was performed using posterior sagittal approach. Although the anal canal duplication occurs predominantly in female, to our knowledge, this is the first case of anal duplication in a monozygotic female twins reported.

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Novel Non-Surgical Interventions for Benign Inflammatory Biliary Strictures in Infants: A Report of Two Cases and Review of Current Pediatric Literature

  • Reddy, Pooja;Rivas, Yolanda;Golowa, Yosef;KoganLiberman, Deborah;Ho, Sammy;Jan, Dominique;Ovchinsky, Nadia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.565-570
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    • 2019
  • Benign biliary strictures are uncommon in children. Classically, these cases are managed surgically, however less invasive approaches with interventional radiology and or endoscopy may have similar results and improved safety profiles While benign biliary strictures have been described in literature on several occasions in young children, (most older than 1 year and once in an infant 3 months of age), all reported cases were managed surgically. We present two cases of benign biliary strictures in infants less than 6 months of age that were managed successfully with novel non-invasive procedures and a review of all current pediatric cases reported in the literature. Furthermore, we describe the use of a Rendezvous procedure, which has not been reported as a treatment approach for benign biliary strictures.

Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience

  • Hyun, Myung Chul
    • Clinical and Experimental Pediatrics
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    • v.60 no.12
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    • pp.390-394
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    • 2017
  • Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

A CASE STUDY OF VARIOUS CLINICAL APPLICATION OF THE RUBBER DAM IN PEDIATRIC DENTISTRY (소아치과 영역에서 러버댐의 다양한 임상적 적용에 대한 증례보고)

  • Yi, Soung-Hyuck;Kim, Jong-Bum;Jang, Ki-Taeg;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.549-555
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    • 1997
  • Usage of the rubber dam has been advocated by countless number of dentists. The advantages of the rubber dam such as the following are well-known 1. Moisture control. 2. Improved field of vision. 3. Ease of approach. 4. Soft tissue retraction and Injury prevention. 5. Prevention of aspiration of materials or instruments. 6. Shortened chair time. 7. Induction of nasal breathing during administration of $N_2O-O_2$ sedation. Recent reports indicate the rubber dam can protect the dental staffs from the infection when treating HBV or HIV positive patients. Also, improved moisture control and freeing of both hands allowed by the rubber dam makes it very useful when bonding orthodontic brackets. This case study presents the various clinical application of the rubber dam on patients visiting SNUDH dept. of pediatric dentistry to emphasize the importance of its use in pediatric dentistry.

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The Survey of Nausea-vomiting and Diet Patterns among Pediatric Cancer Patient Received Chemotherapy (화학요법을 받고 있는 암환아의 구토 및 식이양상)

  • Park Sung Hee
    • Child Health Nursing Research
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    • v.3 no.1
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    • pp.62-70
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    • 1997
  • The incidence of chemothrapy related among pediatric cancer patient was 90.1%. Adequate oral intake and nutrition have been shown to be important. These consideration prompted the decision to survey by means of a questionaire. The questionaire were included nausea-vomiting peak time, causing factor, coping method, education need, diet pattern change and food preference. Results are fellow 1. Almost(90.1%) pediatric cancer patient experienced nausea-vomiting during chemotherapy and required coping method or reducing method. 2 . The food preference form were Identified. Those were fluid form, cold and small amout and frequentry eating form. The patients preferred noodles, chickens, soap, juice. The results of the survey indicate that nasea-vomiting relief nursing intervention are required pediatric cancer patient received chemotherapy. Health care personnels recognize the pediatric cancer patient's diet pattern and encourage the nutritional counselling. The care of patient should be multidisciplinary team approach and the nurse occupies a key position with in this team, which includes the pediatrician, nutrionist.

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Minimal Invasive Coronary Artery Fistula Ligation

  • Mitropoulos, Fotios A.;Kanakis, Meletios A.;Chatzis, Andrew;Contrafouris, Constantinos;Sofianidou, Ioanna A.;Lioulias, Achilleas G.
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.545-547
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    • 2014
  • A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

Pediatric Dysphagia (기질적 섭식장애)

  • Kim, Min-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.77-84
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    • 2009
  • Pediatric dysphagia comes from disturbances in swallowing process, which has 'preparatory phase', 'oral phase', 'pharyngeal phase', and 'esophageal phase', and mainly the causes are neuro-muscular discoor-dination. It is necessary to recognize clinical manifestation if they have accompanied organic disorder and diagnose accurately. Videofluoroscopic study evaluation is a valuable method to find out abnormal swallowing mechanism at each phases. Treatment should be diagnosis specific, and multidisciplinary team approach is desirable. We can use various behavioral techniques to facilitate normal swallowing mechanism including conditioning of oral and pharyngeal structures, bolus manipulation, postural compensation, and adaptive feeding utensils. Important point is that the diagnosis and treatment for pediatric dysphagia should not be delayed because children are under development.

Application of a Pediatric Advanced Life Support in the Situation of a Dental Treatment (치과진료 시 소아고급생명구조술의 적용)

  • Kim, Jongbin
    • The Journal of the Korean dental association
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    • v.53 no.8
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    • pp.538-544
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    • 2015
  • In a dental treatment, a dentist has to know the possibility to happen all kinds of the emergency and to prepare for managing that situation. Especially, the cardiac arrest is the most serious emergent problem. If the accident were happened, most dentists got embarrassed. The American Heart Association (AHA) is offering the Basic Life Support (BLS), Advanced Cardiopulmonary Life Support (ACLS) and Pediatric Advanced Life Support (PALS) programs for the healthcare who need to prepare the life threatening situation. The PALS is specialized to someone who participate in pediatric health-care field. This program is composed of three major emergency problems, such as respiratory emergencies, shock and cardiac arrests. The main concepts of the PALS are early recognition and systemic team approach. The purpose of this study was to introduce about PALS and to prepare response system for emergencies in the dental environment.

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

  • Pak, Seong Min;Lee, Yeoun Joo;Hwang, Jae Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.87-91
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    • 2022
  • Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.