• 제목/요약/키워드: Pediatric surgery

검색결과 1,537건 처리시간 0.027초

Analysis of behavioral management for dental treatment in patients with dementia using the Korean National Health Insurance data

  • Kim, Taeksu;Chi, Seong In;Kim, Hyuk;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.461-469
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    • 2021
  • Background: The global population is aging rapidly, and accordingly, the number of patients with dementia is increasing every year. Although the need for dental treatment increases for various reasons in patients with dementia, they cannot cooperate during dental treatment. Therefore, behavioral management, including sedation (SED) or general anesthesia (GA), is required for patients with dementia. Thus, this study aimed to investigate the trends and effects of SED or GA in patients with dementia undergoing dental treatment in South Korea based on the Korean National Health Insurance claims data. Methods: This study utilized customized health information data provided by the Health Insurance Review and Assessment Service. Among patients with records of using sedative drugs during dental treatment from January 2007 to September 2019, patients with the International Classification of Diseases-10 code for dementia (F00, F01, F02, F03, and G30) were selected. We then analyzed the full insurance claims data for dental care. Age, sex, sedative use, and dental treatment of patients were analyzed yearly. In addition, the number of cases of GA or SED per year was analyzed, and changes in behavioral management methods with increasing age were investigated. Results: Between January 2007 and September 2019, a total of 4,383 (male, 1,454; female, 2,929) patients with dementia received dental treatment under SED or GA. The total number of SED and GA cases were 1,515 (male, 528 ; female, 987 ) and 3,396 (male, 1,119 ; female, 2,277) cases, respectively. The total number of cases of dental treatment for 4,383 patients with dementia was 153,051 cases, of which 2.22% were under GA and 0.98% were under SED. Midazolam was the most commonly used drug for SED. Conclusion: Although gingivitis and pulpitis were the most common reasons for patients with dementia to visit the dentist, GA or SED for patients with dementia was frequently used in oral and maxillofacial or periodontal surgery.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center

  • Mehmood, Shahbaz;Alhazmi, Hamdan;Al-Shayie, Mohammed;Althobity, Ahmed;Alshammari, Ahmed;Altaweel, Waleed Mohamed;Almathami, Ahmed;Vallasciani, Santiago
    • International Neurourology Journal
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    • 제22권4호
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    • pp.287-294
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    • 2018
  • Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

Outcomes of transcatheter closure of ductus arteriosus in infants less than 6 months of age: a single-center experience

  • Choi, Gwang-Jun;Song, Jinyoung;Kim, Yi-Seul;Lee, Heirim;Huh, June;Kang, I-Seok
    • Clinical and Experimental Pediatrics
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    • 제61권12호
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    • pp.397-402
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    • 2018
  • Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

Changes of Bax, Bcl-2, CCR-2, MCP-1, and TGF-β1 genes in the left ventricle of spontaneously hypertensive rat after losartan treatment

  • Lee, Hyeryon;Kim, Kwan Chang;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.95-101
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    • 2019
  • Purpose: Increased apoptosis was recently found in the hypertrophied left ventricle of spontaneously hypertensive rats (SHRs). Although the available evidence suggests that apoptosis can be induced in cardiac cells by various insults including pressure overload, cardiac apoptosis appears to result from an exaggerated local production of angiotensin in adult SHRs. Altered expressions of Bcl associated X (Bax), Bcl-2, chemokine receptor (CCR)-2, monocyte chemoattractant protein (MCP)-1, transforming growth factor $(TGF)-{\beta}1$, phosphorylated extracellular signal-regulated kinases (PERK), and connexin 43 proteins, and kallikrein mRNA were investigated to explore the effects of losartan on the SHR model. Methods: Twelve-week-old male rats were grouped as follows: control (C), SHR (hypertension: H), and losartan (L; SHRs were treated with losartan [10 mg/kg/day] for 5 weeks). Western blot and reverse transcription polymerase chain reaction assays were performed. Results: Expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, PERK, and connexin 43 proteins, and kallikrein mRNA was significantly increased in the H group compared to that in the C group at weeks 3 and 5. Expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, and connexin 43 proteins and kallikrein mRNA was significantly decreased after losartan treatment at week 5. PERK protein expression was significantly decreased after losartan treatment at weeks 3 and 5. Bcl-2 protein expression was significantly decreased in the H group compared to that in the C group at weeks 3 and 5. Conclusion: Losartan treatment reduced expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, PERK, and connexin 43 proteins, and kallikrein mRNA in SHRs, along with decreased inflammation and apoptosis.

An ANKRD11 exonic deletion accompanied by a congenital megacolon in an infant with KBG syndrome

  • Seo, Go Hun;Oh, Arum;Kang, Minji;Kim, Eun Na;Jang, Ja-Hyun;Kim, Dae Yeon;Kim, Kyung Mo;Yoo, Han-Wook;Lee, Beom Hee
    • Journal of Genetic Medicine
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    • 제16권1호
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    • pp.39-42
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    • 2019
  • KBG syndrome is an autosomal dominant syndrome presenting with macrodontia, distinctive facial features, skeletal anomalies, and neurological problems caused by mutations in the ankyrin repeat domain 11 (ANKRD11) gene. The diagnosis of KBG is difficult in very young infants as the characteristic macrodontia and typical facial features are not obvious. The youngest patient diagnosed to date was almost one year of age. We here describe a 2-month-old Korean boy with distinctive craniofacial features but without any evidence of macrodontia due to his very early age. He also had a congenital megacolon without ganglion cells in the rectum. A de novo deletion of exons 5-9 of the ANKRD11 gene was identified in this patient by exome sequencing and real-time genomic polymerase chain reaction. As ANKRD11 is involved in the development of myenteric plexus, a bowel movement disorder including a congenital megacolon is not surprising in a patient with KBG syndrome and has possibly been overlooked in past cases.

Relationship between liver iron concentration determined by R2-MRI, serum ferritin, and liver enzymes in patients with thalassemia intermedia

  • Al-Momen, Hayder;Jasim, Shaymaa Kadhim;Hassan, Qays Ahmed;Ali, Hayder Hussein
    • BLOOD RESEARCH
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    • 제53권4호
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    • pp.314-319
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    • 2018
  • Background Iron overload is a risk factor affecting all patients with thalassemia intermedia (TI). We aimed to determine whether there is a relationship of serum ferritin (SF) and alanine aminotransferase (ALT) with liver iron concentration (LIC) determined by R2 magnetic resonance imaging (R2-MRI), to estimate the most relevant degree of iron overload and best time to chelate in patients with TI. Methods In this cross-sectional study, 119 patients with TI (mean age years) were randomly selected and compared with 120 patients who had a diagnosis of thalassemia major (TM). Correlations of LIC, as determined by R2-MRI, with SF and ALT levels, were assessed in all participants. A P-value <0.05 was considered statistically significant. Results SF and LIC levels were lower in patients with TI than in those with TM; only ferritin values were significant. We found a statistically significant relationship between SF and LIC, with cut-off estimates of SF in patients with TI who had splenectomy and those who entered puberty spontaneously (916 and 940 ng/mL, respectively) with LIC >5 mg Fe/g dry weight (P<0.0001). A significant relationship was also found for patients with TI who had elevated ALT level (63.5 U/L), of 3.15 times the upper normal laboratory limit, using a cut-off for LIC ${\geq}5mg\;Fe/g\;dry\;weight$. Conclusion We determined the cut-off values for ALT and SF indicating the best time to start iron chelation therapy in patients with TI, and found significant correlations among iron overload, SF, and ALT.

Risk factors and screening timing for developmental dysplasia of the hip in preterm infants

  • Jeon, Ga Won;Choo, Hye Jung;Kwon, Yong Uk
    • Clinical and Experimental Pediatrics
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    • 제65권5호
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    • pp.262-268
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    • 2022
  • Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis. Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants. Methods: A total of 155 preterm infants with a gestational age <32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review. Results: The incidence of DDH was 6.45% (10 of 155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n=10) and nontreated infants (n=145) (gestational age, 29.2±1.4 weeks vs. 29.6±2.0 weeks, P=0.583; birth weight, 1,240±237 g vs. 1,295±335 g, P=0.607; female sex, 7 of 10 (70.0%) vs. 77 of 145 (53.1%), P=0.346; and breech presentation, 5 of 10 (50.0%) vs. 43 of 145 (29.7%), P=0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus nonbreech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation. Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to nonbreech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.

Effects of Kinesio Taping on Edema Control in Patients With Musculoskeletal Injuries: A Literature Review

  • Yong, Joon-hyoung;Lim, Jin-seok;Moon, Il-young;Yi, Chung-hwi
    • 한국전문물리치료학회지
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    • 제29권3호
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    • pp.171-179
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    • 2022
  • Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders. Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: "Kinesio taping," "Kinesio tape," "swelling," and "edema," with different combinations and derivations. Only articles available in English were included in this study. Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint. Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

Meat Quality Changes in Aged Pork Loin using Jeju Volcanic Scoria Earthenware

  • DongGyun Kim;SangHoon Lee;GwangHeun Kim;KyoungBo Ko;YounChul Ryu
    • 한국축산식품학회지
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    • 제43권5호
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    • pp.901-913
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    • 2023
  • This study aimed to investigate changes in the quality of meat aged using Jeju scoria earthenware. Water-holding properties, pH, color, tenderization, fatty acid composition, and free amino acid characteristics of aged pork loin were evaluated to determine the effects of wet and dry (normal and Jeju Scoria) aging methods and aging time (0, 10, 20, 30, and 40 days) on meat quality. The aging methods altered pH and CIE L* after 10 days of aging. However, the aging method did not alter the pH and CIE L* of the aged pork loin after 10 days of aging. The shear force was significantly lower in the Scoria aging method than in the wet aging method after 10 and 20 days of aging. Both the normal and Scoria aging methods increased aging loss compared to the wet aging method, which could be attributed to longer air exposure times of the two non-packaged aging methods than in the packaged aging method. The scoria aging method had significantly higher contents and ratios of saturated (SFA) to mono-unsaturated fatty acids but lower ratios of poly-unsaturated fatty acids to SFA than the wet aging method. The content of most free amino acids significantly increased with aging time, especially those related to the sweet, and umami categories. In summary, this study suggests that the Scoria aging method provides positive aspects of eating quality, such as improvement of meat tenderness and taste, including umami, with minimum changes in the overall meat quality.

Estimation of genetic parameters for pork belly traits

  • Seung-Hoon Lee;Sang-Hoon Lee;Hee-Bok Park;Jun-Mo Kim
    • Animal Bioscience
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    • 제36권8호
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    • pp.1156-1166
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    • 2023
  • Objective: Pork belly is a cut of meat with high worldwide demand. However, although the belly is comprised of multiple muscles and fat, unlike the loin muscle, research on their genetic parameters has yet to focus on a representative cut. To use swine breeding, it is necessary to estimate heritability against pork belly traits. Moreover, estimating genetic correlations is needed to identify genetic relationship among the traditional carcass and meat quality traits. This study sought to estimate the heritability of the carcass, belly, and their component traits, as well as the genetic correlations among them, to confirm whether these traits can be improved. Methods: A total of 543 Yorkshire pigs (406 castrated males and 137 females) from 49 sires and 244 dam were used in this study. To estimate genetic parameters, a total of 12 traits such as lean meat production ability, meat quality and pork belly traits were chosen. The heritabilities were estimated by using genome-wide efficient mixed model association software. The statistical model was selected so that farm, carcass weight, sex, and slaughter season were fixed effects. In addition, its genetic parameters were calculated via MTG2 software. Results: The heritability estimates for the 7th belly slice along the whole plate and its components were low to moderate (0.07±0.07 to 0.33±0.07). Moreover, the genetic correlations among the carcass and belly traits were moderate to high (0.28±0.20 to 0.99±0.31). Particularly, the rectus abdominis muscle exhibited a high absolute genetic correlation with the belly and meat quality (0.73±52 to 0.93±0.43). Conclusion: A moderate to high correlation coefficient was obtained based on the genetic parameters. The belly could be genetically improved to contain a larger proportion of muscle regardless of lean meat production ability.