• Title/Summary/Keyword: Pediatric surgery

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A Case of Intestinal Perforation in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 발생된 장천공 1례)

  • Kang, Won Sik;Oh, Chang Hwan;Kim, Jae Young;Lee, Young Taek;Lee, Hye Jin;Kim, Hee Jin;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.406-412
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    • 2002
  • Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is one of the most common vasculitic diseases of childhood, referred to as a leukocytoclastic vasculitis affecting small vessels. Although HSP related gastrointestinal symptoms are seen in up to 80% of patients during acute illness, these symptoms are usually transient. However, some patients with HSP have gastrointestinal major surgical complications such as intussusception, bowel infarction, necrosis, stricture, and perforation. We experienced a rare case of HSP-related ileal perforation developed after corticosteroid treatment. We report a case with HSP-related intestinal perforation and assess the effect of corticosteroid on the outcome of abdominal pain in children with HSP.

A Case of Repeated Ventricular Tachycardia Caused by Cardiac Rhabdomyomas in an Infant with Tuberous Sclerosis (반복되는 심실성 빈맥을 보인 대동맥판하 횡문근종을 동반한 결절성 경화증 1례)

  • Joo, Hee Jung;Song, Min Seob;Hwang, Tae Gyu;Kim, Chul Ho
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.913-917
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    • 2003
  • Cardiac rhabdomyomas are relatively uncommon and associated with tuberous sclerosis in 40-50% cases. We report a 10-month-old infant with tuberous sclerosis who presented with ventricular arrythmias and status epilepticus. There were hypopigmented macules on the body, periventricular calcifications, renal cyst and cardiac rabdomyomas just below the aortic valve. The patient required resection of left ventricular subaortic masses due to sustained arrythmia in spite of intravenous amiodarone therapy. The pathologic examination confirmed the diagnosis of rhabdomyoma. The patient had no more arrythmia during the 14 month follow up period. Although cardiac rhabdomyomas may spontaneously regress, surgery is often necessary and frequently resolves the underlying arrythmia.

A case of midgut volvulus due to mesenteric lymphangioma, not associated with malrotation in a 13-year-old boy (13세남아에서 발견된 창자 회전이상이 동반되지 않은 낭성 림프관종에 의한 창자꼬임 1례)

  • Lee, Jung Ho;Choi, Seok Ju;Kim, Tae Yoon;Kim, Young Tong;Cho, Hyun Deuk;Park, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.431-434
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    • 2008
  • A 13-year-old boy, complained of an intermittent suddenly aggravated severe abdominal pain and diarrhea, was diagnosed as a small bowel volvulus without an intestinal malrotation, due to mesenteric lymphangioma. He took abdominal ultrasonography, abdominal CT scanning, upper gastrointestinal study and got an operation. The small bowel volvulus with cystic lymphangioma was confirmed by gross and pathologic findings.

A Case of Primary Epiploic Appendagitis (원발성 복막수염 1례)

  • Ha, Tae Young;Kim, Chi Kwan;Jeong, Jin Young;Lee, Jong Hwa
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1024-1027
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    • 2002
  • Epiploic appendages are small, 0.5-5 cm long, peritoneal pouches containing small vessels and fat, located on the serous surface of the colon, from the cecum to the rectosigmoid junction. Pathologic states are rare in these appendages, the most frequent being is infarction either due to torsion or spontaneous. As a result of subsequent inflammatory reaction, the condition has been termed primary epiploic appendagitis. The condition is manifested by localized abdominal pain, which is often mistaken for appendicitis or diverticulitis and is usually diagnosed at surgery. With the aid of comtemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the clinician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy is no longer considered necessary. Conservative management has been shown to be safe. We report a 5-year-old male patient with epiploic appendagitis who presented with acute abdominal pain.

Treatment of obstructive sleep apnea in children

  • Ahn, Young-Min
    • Clinical and Experimental Pediatrics
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    • v.53 no.10
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    • pp.872-879
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    • 2010
  • Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.

Effects of a Multikinase Inhibitor Motesanib (AMG 706) Alone and Combined with the Selective DuP-697 COX-2 Inhibitor on Colorectal Cancer Cells

  • Kaya, Tijen Temiz;Altun, Ahmet;Turgut, Nergiz Hacer;Ataseven, Hilmi;Koyluoglu, Gokhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1103-1110
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    • 2016
  • In the present study, we investigated the effects of motesanib (AMG 706), a multikinase inhibitor alone and in combination with DuP-697, an irreversible selective inhibitor of COX-2, on cell proliferation, angiogenesis, and apoptosis induction in a human colorectal cancer cell line (HT29). Real time cell analysis (RTCA, Xcelligence system) was used to determine the effects on colorectal cancer cell proliferation. Apoptosis was assessed with annexin V staining and angiogenesis was determined with chorioallantoic membrane model. We found that motesanib alone exerted antiproliferative, antiangiogenic and apoptotic effects on HT29 colorectal cancer cells. Combination with DUP-697 increased the antiproliferative, antiangiogenic and apoptotic effects. Results of this study indicate that motesanib may be a good choice in treatment of colorectal tumors. In addition, the increased effects of combination of motesanib with DuP-697 raise the possibility of using lower doses of these drugs and therefore avoid/minimize the dose-dependent side effects generally observed.

A Study on the Effects of Percutaneous Transluminal Coronary Angioplasty and Pediatric Heart Surgery on the Differences of Risk-Adjusted Length of Stay and In-Hospital Death for Coronary Artery Bypass Graft Patients (관상동맥우회로술(CABG)환자의 재원일수와 병원 내 사망률 변이에 대한 경피적관상동맥성형술(PTCA)과 소아심장수술(PHS)의 영향분석)

  • Kim, Da-Yang;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.47-55
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    • 2014
  • The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

Considerations in dental management and medication for the medically compromised patients (임상가를 위한 특집 2 - 전신질환을 가진 환자의 치과처치 및 약물처방시 주의할점)

  • Nam, Jeong-Hun
    • The Journal of the Korean dental association
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    • v.48 no.1
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    • pp.27-37
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    • 2010
  • Current trend of aging society suggests that many patients are at risk for various preoperative preparations and postoperative complications during and following invasive dental procedures, due to an acquired medically compromised conditions from systemic disease and/or from medications. The medical history is critical for the identification of patients potentially at risk for medically compromised and old aged patients' factors from dental treatment. The proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and some standard laboratory tests. Polypharmacy in old age, besides representing a risk in and of itself, points to the potential risk the underlying diseases that necessitated the drugs can present in the dental office. These diseases and medications can also present a risk to oral health. A sequence for categorizing drugs in a medication list is presented here to aid in the identification of potential risks in the dental treatment and management of patients with complex medical histories and drug regimens. Specific patient populations, such as pediatric, may have specific drugs or additional criteria that need to be considered. Practitioners must use the health history and the medication list in concert, using one to make sense of the other and utilizing all the information available from reviewing each one carefully in order to manage their increasingly complex patients safely and effectively.

Bilateral iliac and popliteal arterial thrombosis in a child with focal segmental glomerulosclerosis

  • Han, Kyoung Hee;Park, Ji Youn;Min, Seung-Kee;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.59 no.5
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    • pp.242-245
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    • 2016
  • Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia. We report of a 33-month-old girl with bilateral iliac and popliteal arterial thrombosis associated with steroid-resistant NS due to focal segmental glomerulosclerosis. Her treatment involved thrombectomy and intravenous heparinization, followed by oral warfarin for 8 months. Herein, we report a rare case of spontaneous iliac and popliteal arterial thrombosis in a young child with NS.

A neonate with Joubert syndrome presenting with symptoms of Horner syndrome

  • Lee, Narae;Nam, Sang-Ook;Kim, Young Mi;Lee, Yun-Jin
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.32-36
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    • 2016
  • Joubert syndrome (JS) is characterized by the "molar tooth sign" (MTS) with cerebellar vermis agenesis, episodic hyperpnea, abnormal eye movements, and hypotonia. Ocular and oculomotor abnormalities have been observed; however, Horner syndrome (HS) has not been documented in children with JS. We present the case of a 2-month-old boy having ocular abnormalities with bilateral nystagmus, left-dominant bilateral ptosis, and unilateral miosis and enophthalmos of the left eye, which were compatible with HS. Brain magnetic resonance imaging (MRI) revealed the presence of the MTS. Neck MRI showed no definite lesion or mass around the cervical sympathetic chain. His global development was delayed. He underwent ophthalmologic surgery, and showed some improvement in his ptosis. To the best of our knowledge, the association of HS with JS has not yet been described. We suggest that early neuroimaging should be considered for neonates or young infants with diverse eye abnormalities to evaluate the underlying etiology.